We’ve said before that “genes predispose; they don’t predetermine”. It can be good to know one’s genes, of course, and we’ve written about this here:

Genetic Testing: Health Benefits & Methods

…which can include some quite contemporary risks, such as:

Genetic Risk Factors For Long COVID

And yet…

Nurture Over Nature

A very large (n=492,567) study looked into the impact of 25 lifestyle/environmental factors, of which 23 are considered modifiable, and found that lifestyle/environmental factors accounted for 17% of the variation in mortality risk, while genetic predisposition accounted for less than 2%.

Which is good news, because it means we can improve our lot.

But how?

The strongest negative factors (that increased mortality the most) were:

• Smoking
• Not owning your home (interestingly, “live in accommodation rent-free vs own” performed just as badly as various kinds of “renting home vs own”, while “own house with mortgage, vs own outright” had only a marginal negative effect)
• Sleeping more than 9 hours per day (performed even worse than sleeping under 7 hours per day, which also increased mortality risk, but not by as much as oversleeping)
• Financial difficulties in the past two years
• Homosexuality
• Unemployment
• Being an evening person
• Lonely lifestyle
• Frequent napping

We may hypothesize that homosexuality probably makes the list because of how it makes one more likely to have other items on the list, especially unemployment, and the various poverty-related indicators that come from unemployment.

Being an evening person, whatever its pathology, is a well-established risk factor that we’ve talked about before:

Early Bird Or Night Owl? Genes vs Environment ← this is also, by the way, an excellent example of how “genes predispose; they don’t predetermine”, because there is a genetic factor involved, and/but we absolutely can switch it up, if we go about it correctly, and become a morning person without trying to force it.

The strongest positive factors (that decreased mortality the most) were:

• The inverse of all of the various above things, e.g. never having smoked, owning your own home, etc
• Household income, specifically
• Living with a partner
• Having oil central heating
• Gym use
• Sun protection use
• Physical activity, especially if in leisure time rather than as part of one’s work
• Glucosamine supplements
• Family visit frequency
• Cereal fiber intake (i.e. whole grains)

We may hypothesize that having oil central heating is simply a more expensive option to install than many, and therefore likely one enjoyed by homeowners more often than renters.

We may hypothesize that glucosamine supplementation is an indication of the type of person who takes care of a specific condition (inflammation of the joints) without an existential threat; notably, multivitamin supplements don’t get the same benefit, probably because of their ubiquity.

We may hypothesize that “family visit frequency” is highly correlated to having a support network, being social (and thus not lonely), and likely is associated with household income too.

You can see the full list of factors and their impacts, here:

Environmental architecture of mortality in the UKB ← that’s the UK Biobank

You can read the paper in full, here:

Integrating the environmental and genetic architectures of aging and mortality

Practical takeaways

The priorities seem to be as follows:

Don’t smoke. Ideally you will never have smoked, but short of a time machine, you can’t change that now, so: what you can do is quit now if you haven’t already.

See also: Which Addiction-Quitting Methods Work Best?

Note that other factors often lumped in with such, for example daily alcohol consumption, red meat intake, processed meat intake, and salt intake, all significantly increased mortality risk, but none of them in the same league of badness as smoking.

See also: Is Sugar The New Smoking? ← simply put: no, it is not. Don’t get us wrong; added sugar is woeful for the health, but smoking is pretty much the worst thing you can do for your health, short of intentionally (and successfully) committing suicide.

Be financially secure, ideally owning your own home. For many (indeed, for most people in the world) this may be an “easier said than done” thing, but if you can make decisions that will improve your financial security, the mortality numbers are very clear on this matter.

Be social, as loneliness indeed kills, in numerous ways. Loneliness means a lack of a support network, and it means a lack of social contact (thus increased risk of cognitive decline), and likely decreased ikigai, unless your life’s purpose is something inherently linked to solitude (e.g. the “meditating on top of a mountain” archetype).

See also: What Loneliness Does To Your Brain And Body

And to fix it: How To Beat Loneliness & Isolation

Be active: especially in your leisure time; being active because you have to does convey benefits, but on the same level as physical activity because you want to.

See also: No-Exercise Exercises (That Won’t Feel Like “Having To Do” Exercise)

Use sunscreen: we’re surprised this one made the list; it’s important to avoid skin cancer of course, but we didn’t think it’d be quite such a driver of mortality risk mitigation as the numbers show it is, and we can’t think of a clear alternative explanation, as we could with some of the other “why did this make the list?” items. At worst, it could be a similar case to that of glucosamine use, and thus is a marker of a conscientious person making a regular sustained effort for their health. Either way, it seems like a good idea based on the numbers.

See also: Do We Need Sunscreen In Winter, Really?

Enjoy whole grains: fiber is super-important, and that mustn’t be underestimated!

See also: What Matters Most For Your Heart? ← hint: it isn’t about salt intake or fat

And, for that matter: The Best Kind Of Fiber For Overall Health?

Take care!

When it comes to painkilling medications, they can generally be categorized into two broad kinds:

• non-opioids (e.g. ibuprofen, paracetamol/acetaminophen, aspirin)
• ones that actually work for something more serious than a headache

That’s an oversimplification of course, but as a strong general rule, when there is serious painkilling to be done, that’s when doctors consider it’s time to break out the opioids.

Nor are all opioids created equal—there’s a noteworthy difference between codeine and morphine, for instance—but the problems of opioids are typically the same (tolerance, addiction, and eventual likelihood of overdose when one tries to take enough to make it work after developing a tolerance), and it becomes simply a matter of degree.

See also: I’ve been given opioids after surgery to take at home. What do I need to know?

But what if we’d like those benefits, without the tolerance, ease of addiction, and possibility of overdose?

The genetic advantage

Researchers (Dr. Corinna Oswell et al.) developed a targeted gene therapy that reduces pain by acting directly on specific brain circuits instead of broadly affecting the entire brain like opioids do.

In other words: this gene therapy reproduces pain relief without activating addiction-related brain pathways or dulling normal sensations.

Specifically, the therapy makes use of a brain-specific “off switch”, which dampens pain signals in the anterior cingulate cortex (a key brain area involved in the experience of pain). This way, it can target opioid-sensitive neurons and alter their activity, effectively recreating the beneficial effects of opioids at a circuit level, without having the usual adverse effects associated with opioids on the systemic level.

If you’re wondering how soon you can get it, that bad news is that the therapy is still in preclinical research, and further studies are needed before human clinical trials can confirm safety and effectiveness.

But it’s very promising so far; in animal models, the treatment provided sustained pain relief and reversed abnormal brain activity linked to chronic pain without impairing reflexes or sensory detection.

You can find the paper itself, here: Mimicking opioid analgesia in cortical pain circuits

So, how rapidly is science advancing? Well, this research comes a little more than a year after, a different team of scientists were pioneering a potential gene therapy for pain, with results that were very promising at the time, but not a patch on what we’ve been talking about today:

Structure-guided design of a peripherally restricted chemogenetic system

…which you can read about in pop-science terms (with diagrams!) here:

New gene therapy could alleviate chronic pain, researchers find

So… Pretty quickly, but we always love to see new advances!

Want to learn more?

If you’re looking for alternatives while you wait, we’ve written quite a bit about pain management, including:

• Before You Reach For That Tylenol…
• How To Stop Pain Spreading
• How To Dial Down Your Pain
• Managing Chronic Pain (Realistically!)
• Get The Right Help For Your Pain
• The 7 Approaches To Pain Management
• Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)

Take care!

It’s a surprising headline, because the primary function of an anti-allergy medication is generally to dial down the immune system.

Thus, if you want to defend against a virus, then one would expect that the last thing you’d want to squirt up your nose (aside, perhaps, from the virus itself) would be an anti-allergen.

And yet…

Azelastine’s antiviral powers

Researchers (Dr. Thorsten Lehr et al.) investigated the effects of a common anti-allergy nasal spray (azelastine) against various kinds of respiratory virus infection, including COVID.

What they did: 450 participants were split into two groups; 227 used azelastine nasal spray three times daily for 56 days, 223 used a placebo spray.

What they found: only 2.2% of the azelastine group got infected with SARS-CoV-2 versus 6.7% in the placebo group, a very statistically-significant threefold difference.

They further found: only 1.8% of the azelastine group got infected with rhinovirus versus 6.3% in the placebo group, reflecting the anti-COVID result.

But COVID and rhinovirus are both enteroviruses, and enterovirus can often be beaten with measures that don’t work on other viruses, because the chemical “envelope” that contains them can be disrupted—not something one can do vs an unenveloped virus (such as influenza) which doesn’t have an envelope to disrupt.

So, how does it perform vs flu? There’s good and bad news:

• Good news: azelastine does have anti-viral properties that work against flu also
• Bad news: or rather, good for the study participants but bad for science—the overall number of cases of flu in this study population was too low for statistical significance.

For azelastine’s antiviral-vs-flu properties, see this older, in vitro study:

Antiviral Potential of Azelastine against Major Respiratory Viruses

For the study we’ve been talking about today, you can find the paper itself here:

Azelastine Nasal Spray for Prevention of SARS-CoV-2 Infections

How useful is this?

The researchers emphasize (as researchers always do) the need for larger, multicentre studies to confirm results and test effectiveness against other respiratory pathogens, but as it stands, they are confident enough to say that this could serve as a cheap, accessible preventive option, particularly for vulnerable groups and/or during travel and high-risk periods (i.e. when there’s a local spike in cases, and/or you will be unavoidably in a high-risk situation, e.g. being in a closed environment with many people for a while).

If you’d like some, you can get it from your local pharmacy or online; we don’t sell it, but here’s an example product for your convenience.

There, of course, also other ways to improve the odds to keep yourself and your loved ones safe:

Vaccines are considered the “gold standard” against COVID and many other infectious diseases, for their very high rate of efficacy, clear science, and at least moderately lasting effects (i.e., it’s not something like handwashing*, which must be redone very frequently).

Since vaccines are not without their popular misunderstanders, we have written a little about that, here: Vaccine Mythbusting

*See also: The Truth About Handwashing ← for another mythbusting edition, covering what actually works against what, and what doesn’t—as well as the disparity between people’s self-reports of handwashing, and how often/well they actually wash their hands!

So, those are important ones, but still not the only things we can do; consider for example: Beyond Supplements: The Real Immune-Boosters! ← most people don’t know these things and the huge difference they make

And for that matter: Why Some People Get Sick More (And How To Not Be One Of Them) ← for a very prophylactic approach

Take care!