Cocoa may help treat common MS symptom

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ew research, which features in the Journal of Neurology, Neurosurgery & Psychiatry, finds that having a cocoa drink every day for 6 weeks helps combat fatigue in people living with multiple sclerosis.

Cocoa drinks are high in flavonoids, which may relieve fatigue in people living with MS.

Multiple sclerosis (MS) is an autoimmune disorder that affects about 400,000 people in the United States and approximately 2.5 million people worldwide.

MS affects the central nervous system. Symptoms often include muscle weakness, burning sensations, numbness, chronic pain, poor balance and coordination, fatigue, and difficulty concentrating.

In fact, as many as 9 out of 10 people with MS have fatigue, and the symptom is usually difficult to treat. Older research has suggested that a daily dose of 45 grams of dark chocolate may improve chronic fatigue syndrome. Dark chocolate contains 70–85 percent cocoa.

Based on these previous findings, Shelly Coe, who works in the Department of Sport, Health Sciences and Social Work at the Oxford Brookes Centre for Nutrition and Health in the United Kingdom, and a team of scientists set out to examine whether cocoa would have the same beneficial effects on fatigue in people with MS.

Studying the effect of flavonoids

Cocoa contains flavonoids, which are plant compounds that occur naturally in fruits, vegetables, wine, and tea. Multiple studies have suggested that flavonoids have anti-inflammatory, "antidiabetic, anticancer, and neuroprotective" benefits.

In the present study, Coe and colleagues randomly divided 40 adults with relapsing-remitting MS and fatigue into two groups. The first group received a cup of a flavonoid-rich drink consisting of rice milk and cocoa powder, while the other group drank a low-flavonoid version of this beverage.

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Each group consumed their beverage on a daily basis for 6 weeks. The researchers assessed the participants' fatigue as well as their "fatigability" — that is, how long a person can maintain cognitive and physical performance before fatigue sets in — at baseline, in the middle of the study period, and at the end.

This evaluation included subjective self-assessment and the use of a pedometer to monitor the participants' walking speed. The researchers carried out these assessments at three different points during the day.

A safe and easy way to relieve MS symptoms

The study found that drinking the high-flavonoid cocoa beverage had a "small effect on fatigue" and a "moderate effect on fatigability."

Specifically, those who drank the high-flavonoid version experienced a 45-percent improvement in fatigue and an 80-percent increase in walking speed.

Participants in the high-flavonoid group also reported feeling less pain, although the researchers did not objectively measure this symptom. Coe and colleagues conclude, "A flavonoid beverage demonstrates the potential to improve fatigue and fatigability in [relapsing-remitting MS].

"Our study establishes that the use of dietary interventions is feasible and may offer possible long-term benefits to support fatigue management by improving fatigue and walking endurance," continue the authors. Coe and her colleagues write:

"The use of dietary approaches to reduce fatigue and associated factors in people with MS may be an easy, safe, and cost-effective way to have an impact on quality of life and independence, allowing people to feel more in control of their condition."

However, the scientists also admit that there is a need for a "full evaluation, including wider geography, longer follow-up, and cost effectiveness."

Source: MedicalNewsToday

How does exercise impact cognitive function in Parkinson's?

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perts have already concluded that exercise can help people with Parkinson's disease improve their motor symptoms, but what is its effect on the cognitive symptoms of this condition?

Besides boosting motor function, exercise could improve memory in people with Parkinson's disease.

Parkinson's disease is a neurological condition that usually stands out for the motor symptoms that it causes, which include tremors, rigidity in the limbs, impaired balance, and a lack of control over movements.

However, this condition also has numerous other symptoms that can leave their mark on a person's quality of life.

Cognitive symptoms, in particular, have been worrying researchers interested in the pathology of Parkinson's disease.

People with this condition experience cognitive impairment, which can worsen in time and eventually evolve into Alzheimer's disease.

When it comes to managing Parkinson's, doctors often advise their patients to take up an exercise regime, since physical activity demonstrably helps improve motor symptoms.

The Parkinson's Foundation call exercise routines "a vital component" of efforts to maintain the quality of life following diagnosis.

But how does physical activity affect other symptoms of Parkinson's disease, particularly cognitive ones?

This is the question that a team of researchers from the German Sport University, in Cologne, the University Medical Center Mainz — both in Germany — and the University of the Sunshine Coast, in Australia, set out to answer by conducting a systematic review of the relevant literature published to date.

Based on the analyzed evidence, the review — which appears in the Journal of Parkinson's Disease— suggests that exercise may have a positive effect across different types of Parkinson's disease symptoms.

Can aerobic exercise really jog memory?

Lead researcher Tim Stuckenschneider notes that he and the team had anticipated these findings, based on the fact that physical activity is associated with cognitive improvements in older adults.

However, there had been no conclusions regarding the relationship between exercise and cognitive symptoms in Parkinson's.

"Physical exercise is generally associated with increased cognitive function in older adults, but the effects in individuals suffering from [Parkinson's disease] are not known," he says.

For the current review, the team searched for relevant randomized controlled trials that had investigated the relationship between Parkinson's, physical activity, and cognition and had been published before March 2018.

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All in all, the researchers analyzed data provided by 11 studies. Together, these included information on 508 participants with Parkinson's disease diagnoses and severity scores from one (the lowest) to four (the highest) on the Hoehn and Yahr scale, which measures the degree to which symptoms of the condition have progressed.

Five out of the 11 trials indicated that aerobic exercise, in particular, had a positive impact on memory and executive function, a term referring to the control of behavior, in Parkinson's.

The same studies suggested that combining resistance and coordination exercises also had a positive effect on cognitive function, overall.

Two other trials also found that coordination exercises could improve executive function in people with Parkinson's disease.

'Exercise is medicine'

While the review's results point to a generally positive impact of exercise on cognition in people with Parkinson's disease, the researchers warn that more in-depth studies will be necessary in order to better understand the specifics of this relationship.

Thus, while they were able to conclude that aerobic exercise can improve memory, it remains unclear how specific exercises — such as running versus stationary cycling — affect this cognitive aspect and which type of exercise is likely to bring about the best results.

Moreover, the team notes that the studies included in the present review were not of the best quality and that future research should aim for better-constructed approaches.

Still, Stuckenschneider maintains that "The potential of exercise to improve motor and non-motor symptoms is promising and may help to decelerate disease progression in individuals affected by [Parkinson's disease]."

"As part of a holistic therapy, the potential of exercise to maintain or improve non-motor symptoms such as cognitive function in individuals with [Parkinson's] needs to be acknowledged, and the most effective treatment options need to be defined," he adds.

"This will not only help practitioners to recommend specific exercise programs, but also ultimately improve the quality of life of the individual. Our work shows that 'exercise is medicine' and should routinely be recommended for people with [Parkinson's] to help combat both the physical and cognitive challenges of the disease."

Source: MedicalNewsToday

Pancreatic cancer: Two-hit treatment approach shows promise

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t may be feasible to treat pancreatic cancer by using one drug to get the cancer cells to depend on a single source of energy, and another drug to take it away from them.

Using two types of drugs at once may combat hard-to-treat pancreatic cancer.

The approach looks promising after a recent study successfully tested it on pancreatic cancercells and mice in the laboratory.

The researchers who led the study work at the Lineberger Comprehensive Cancer Center in the University of North Carolina (UNC) at Chapel Hill.

They hope that the findings will generate new options for treating pancreatic cancer, a disease that typically has a poor prognosis.

In the United States, only around 8.5 percent of people live more than 5 years after a diagnosis of pancreatic cancer.

The journal Nature Medicine has recently published a paper on the new findings.

First author Kirsten Bryant, Ph.D., who is a research assistant professor at UNC, says that it is early days and there is still a lot of work to do. There are questions to address and human clinical trials of drug safety and effectiveness to conduct.

However, she remains cautiously optimistic, especially as another team has recently come to a similar conclusion in a different study.

"This may not cure pancreatic cancer, but it's another step toward more treatment options," Bryant remarks.

Pancreatic cancer and autophagy

The pancreas is a large, flat organ that sits deep inside the abdomen behind the stomach. It produces enzymes and hormones that help to digest food and control blood sugar.

According to the Centers for Disease Control and Prevention (CDC), pancreatic cancer is one of the "10 most common cancers" that arise in both men and women in the U.S., and it is responsible for around 7 percent of all deaths to cancer.

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Pancreatic cancer is difficult to detect in its early stages. The deep location of the organ inside the body means that tumors and lumps are not easy to spot in routine exams. Often, by the time symptoms emerge, cancer has already spread, which makes it challenging to treat.

The new study focuses on autophagy, which is a term that literally means "self-eating." It is the process by which cells recycle spent materials, releasing energy as a result.

The researchers devised and tested a strategy whereby they got pancreatic cancer cells to rely on autophagy as their main fuel source and then blocked it.

They used one compound to stop the cancer cells from being able to use other sources of energy, making them rely heavily on autophagy, and then they used another compound that indirectly blocked that as well.

"What we found," says senior study author Channing J. Der, who is a professor of pharmacology at UNC, "is, if you cripple perhaps the most significant pathway for energy – glycolysis – the cancer cell really starts to suffer, and it ratchets up autophagy."

Increasing potency of autophagy inhibitors

In effect, the strategy that Prof. Der and his colleagues have developed could potentially increase the potency of autophagy inhibitors as a pancreatic cancer treatment.

Previous studies have revealed that a key driver of pancreatic cancer is a mutation in the KRASgene. However, when researchers have tried to develop treatments that target the mutation, they have not met with much success.

In the meantime, other studies have also found that autophagy is more active in pancreatic cancers with a mutated KRAS gene. But attempts to block autophagy indirectly with the inhibitor hydroxychloroquine also resulted in disappointment.

Prof. Der suggests that the reason that trials with hydroxychloroquine failed was that the cancer cells switched to another energy source.

"Cancer cells have many options for energy — we know of at least four or five," he explains.

Der and his colleagues tested some ideas on human pancreatic cells and in mice. They found that silencing KRAS made cells more dependent on autophagy; it effectively "crippled" their ability to use other energy sources. This was one way to weaken them.

The team then found that combining a compound that blocks signals "downstream" of KRAS with the autophagy inhibitor hydroxychloroquine worked even better. The two compounds helped each other.

"I'm going to keep improving this combination for future use and looking for other treatment strategies that could benefit pancreatic cancer patients

Source: MedicalNewsToday

What diet is best for older adults?

A new study has revealed that a diet rich in protein and low in calories can help older adults with obesity lose more weight while maintaining muscle mass and improving bone density.

Older adults often lose bone density and muscle mass when they concentrate on shedding weight.

This unwanted bone and muscle loss can result in mobility issues and can even increase a person's risk of injury.

A recent study, which Wake Forest University in Winston-Salem, NC, is the lead on, has shown that a high-protein, low-calorie diet can help adults avoid these problems.

Several peer-reviewed journals, which include Journals of Gerontology: Medical Sciences and American Journal of Clinical Nutrition have accepted four research papers from the study for publication.

The researchers randomly selected 96 adults over 65 years of age and assigned them to one of two groups.

They put the first group on a 6-month, low-calorie meal plan that was also high in protein — more than 1 gram (g) of protein per kilogram (kg) of body weight. They assigned the other group to a weight-maintenance plan that included 0.8 g of protein per kg of body weight.

High-protein, low-calorie

Those in the high-protein, low-calorie diet group experienced the most weight loss, but more revealing was that those in this group maintained their muscle mass. They also lost weight on the stomach, hips, thighs, and rear, which can decrease the risk of certain medical conditions, including diabetes and stroke.

Furthermore, the researchers found that the participants in the high-protein group improved their bone quality, and they gained 0.75 points on their Health Aging Index scores, involving longevity and mortality biomarkers.

Kristen Beavers, assistant professor of health and exercise science at Wake Forest and lead investigator of this study, led earlier, smaller studies where she scrutinized the planning and preparation of the participants' meals. For this study, though, with its greater number of participants, she wanted to find a more cost-effective method.

Consequently, the study asked those in the weight-loss group to use four meal replacements every day and to prepare two meals of lean protein and vegetables each day. The team allowed each participant one healthy snack per day to wrap up a low-calorie, high-protein meal plan. Those in the other group were instructed to maintain their regular diet and usual activities.

Older adults and nutrition

Older adults have unique nutritional needs and may need to make changes to their diets as the years go by. Muscle mass can decrease as a natural part of aging, and people do not burn caloriesat the same rate as they do during their younger years.

Targeting nutrient-dense foods is essential for older adults, and avoidance of high-calorie foods that lack vital nutrients is crucial.

Beneficial foods include fruits, vegetables, whole grains, lean meats, seafood, poultry, eggs, legumes, and low-fat dairy. Portion control may also be necessary — for older adults especially — as people may eat more food than they need.

It can be challenging to cook for a smaller family, so experts sometimes suggest cooking ahead and freezing portions to eat later when cooking is less appealing.

The particulars of this latest study seem to mirror the nutritional needs of older adults. However, the authors suggest that the addition of more protein may be the key to avoiding some of the unhealthful pitfalls that can take place when an older adult loses weight.

Source: Medical News Today

Being overweight or obese may improve stroke survival

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ew research reveals that being overweight, obese, or severely obese may improve a person's chances of surviving after a stroke.

Being obese or overweight may have its advantages, suggests one new study.

Obesity is a "serious medical condition" that can lead to various complications.

These might include atherosclerosis and heart disease, diabetes, cancer, and even sleep disorders.

Being overweight may also raise the risk of all-cause mortality and mental health conditions such as depression and anxiety.

Despite this, some researchers maintain that excessive body fat can have a protective cardiovascular effect.

In fact, the authors of a 2002 reference paper coined the phrase "obesity paradox" to describe the observation that people with a higher body mass index (BMI) are less likely to die from cardiovascular conditions than people with a normal weight.

Since then, the theory has been the subject of much controversy. However, new evidence appears to support it.

Dr. Zuolu Liu — from the University of California, Los Angeles — and her colleagues wanted to see how the obesity paradox applies to stroke. Previous research into the same issue, explain the researchers, yielded mixed results.

They will present their new findings at the American Academy of Neurology's 71st Annual Meeting, which this year takes place in Philadelphia, PA.

Up to 62 percent lower chance of death

Dr. Liu explains the motivation for their study, saying, "It was first noticed that carrying extra weight may play a role in survival for people who had suffered from kidney and heart disease, so we felt the need to investigate whether it also was tied to improved stroke survival."

To do so, the researchers examined 1,033 people who had experienced an ischemic stroke — that is, a condition wherein the arteries that pump blood to the brain are blocked.

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The participants were 71 years old, on average, and their average BMI was 27.5. People whose BMI is between 25 and 29.9 are considered overweight, while a BMI of over 29.9 indicates obesity.

Dr. Liu and team grouped the participants into five categories — "underweight, normal, overweight, obese, and severely obese" — according to their BMI. The researchers monitored the participants' survival and recovery for 3 months after their stroke.

Overall, people with severe obesity had a 62 percent lower chance of dying from a stroke than people with a normal BMI, people with obesity had a 46 percent lower chance of death, and those who were overweight had a 15 percent lower chance of dying.

However, those who were underweight had a 67 percent higher chance of dying following a stroke than people with a normal BMI. Dr. Liu and colleagues conclude:

"Outcome from acute ischemic stroke is characterized by an obesity paradox: elevated BMI is associated with reduced 3-month mortality over all, and reduced disability over most weight ranges."

The study was observational, so it cannot account for causality. However, a "possible explanation is that people who are overweight or obese may have a nutritional reserve that may help them survive during prolonged illness," says Dr. Liu.

The researchers also caution that their results may not be applicable to the general population, as the study sample was limited to people from southern California.

"More research is needed to investigate the relationship between [BMI] and stroke," says Dr. Liu.

Source: MedicalNewsToday

How language shapes our brains...and our lives

Language and communication are as vital as food and water. We communicate to exchange information, build relationships, and create art. In this Spotlight feature, we look at how language manifests in the brain, and how it shapes our daily lives.

We are all born within a language, so to speak, and that typically becomes our mother tongue.

Along the way, we may pick up one or more extra languages, which bring with them the potential to unlock different cultures and experiences.

Language is a complex topic, interwoven with issues of identity, rhetoric, and art.

As author Jhumpa Lahiri notes meditatively in the novel The Lowlands, "Language, identity, place, home: these are all of a piece — just different elements of belonging and not-belonging."

But when did our ancestors first develop spoken language, what are the brain's "language centers," and how does multilingualism impact our mental processes?

We will look at these questions, and more, in this Spotlight feature about language and the brain.

1. What makes human language special?

When did spoken language first emerge as a tool of communication, and how is it different from the way in which other animals communicate?

As Prof. Mark Pagel, at the School of Biological Sciences at the University of Reading in the United Kingdom, explains in a "question and answer" feature for BMC Biology, human language is quite a unique phenomenon in the animal kingdom.

While other animals do have their own codes for communication — to indicate, for instance, the presence of danger, a willingness to mate, or the presence of food — such communications are typically "repetitive instrumental acts" that lack a formal structure of the kind that humans use when they utter sentences.

By contrast, Prof. Pagel adds, human language has two distinctive characteristics. These are:

that it is "compositional," meaning that it "allows speakers to express thoughts in sentences comprising subjects, verbs, and objects"

that it is "referential," meaning that "speakers use it to exchange specific information with each other about people or objects and their locations or actions"

2. Origins and importance of language

As Homo sapiens, we have the necessary biological tools to utter the complex constructions that constitute language, the vocal apparatus, and a brain structure complex and well-developed enough to create a varied vocabulary and strict sets of rules on how to use it.

Though it remains unclear at what point the ancestors of modern humans first started to develop spoken language, we know that our Homo sapiens predecessors emerged around 150,000–200,000 years ago. So, Prof. Pagel explains, complex speech is likely at least as old as that.

It is also likely that possessing spoken language has helped our ancestors survive and thrive in the face of natural hardships.

Partly thanks to their ability to communicate complex ideas, Prof. Pagel says, "humans can adapt at the cultural level, acquiring the knowledge and producing the tools, shelters, clothing, and other artefacts necessary for survival in diverse habitats."

"Possessing language, humans have had a high-fidelity code for transmitting detailed information down the generations. Many [...] of the things we make use of in our everyday lives rely on specialized knowledge or skills to produce." Prof. Mark Pagel

3. Language in the brain

But where, exactly, is language located in the brain? Research has identified two primary "language centers," which are both located on the left side of the brain.

These are Broca's area, tasked with directing the processes that lead to speech utterance, and Wernicke's area, whose main role is to "decode" speech.

If a person experienced a brain injury resulting in damage to one of these areas, it would impair their ability to speak and comprehend what is said.

Source: Medical News Today

What to know about antibiotics

Antibiotics, also known as antibacterials, are medications that destroy or slow down the growth of bacteria.

They include a range of powerful drugs and are used to treat diseases caused by bacteria.

Antibiotics cannot treat viral infections, such as cold, flu, and most coughs.

This article will explain what antibiotics are, how they work, any potential side effects, and antibiotic resistance.

Fast facts on antibiotics

Alexander Fleming discovered penicillin, the first natural antibiotic, in 1928.

Antibiotics cannot fight viral infections.

Fleming predicted the rise of antibiotic resistance.

Antibiotics either kill or slow the growth of bacteria.

Side effects can include diarrhea, an upset stomach, and nausea.

What are antibiotics?

Antibiotics are powerful medicines that fight certain infections and can save lives when used properly. They either stop bacteria from reproducing or destroy them.

Before bacteria can multiply and cause symptoms, the immune system can typically kill them. White blood cells (WBCs) attack harmful bacteria and, even if symptoms do occur, the immune system can usually cope and fight off the infection.

Sometimes, however, the number of harmful bacteria is excessive, and the immune system cannot fight them all. Antibiotics are useful in this scenario.

The first antibiotic was penicillin. Penicillin-based antibiotics, such as ampicillin, amoxicillin, and penicillin G, are still available to treat a variety of infections and have been around for a long time.

Several types of modern antibiotics are available, and they are usually only available with a prescription in most countries. Topical antibiotics are available in over-the-counter (OTC) creams and ointments.

Resistance

Some medical professionals have concerns that people are overusing antibiotics. They also believe that this overuse contributes toward the growing number of bacterial infections that are becoming resistant to antibacterial medications.

According to the Centers for Disease Control (CDC), outpatient antibiotic overuse is a particular problem. Antibiotic use appears to be higher in some regions, such as the Southeast.

Use of carbapenems, a major class of last-line antibiotics, increased significantly from 2007 to 2010.

Alexander Fleming, speaking in his Nobel Prize acceptance speech in 1945, said:

"Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug, make them resistant."

As the man who discovered the first antibiotic almost 70 years ago predicted, drug resistance is starting to become commonplace.

How do antibiotics work?

There are different types of antibiotic, which work in one of two ways:

A bactericidal antibiotic, such as penicillin, kills the bacteria. These drugs usually interfere with either the formation of the bacterial cell wall or its cell contents.

A bacteriostatic stops bacteria from multiplying.

Source:Medical News Today