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Low fitness linked to higher depression and anxiety risk

People with low aerobic and muscular fitness are nearly twice as likely to experience depression, finds a new study led by UCL researchers.

Low fitness levels also predicted a 60% greater chance of anxiety, over a seven-year follow-up, according to the findings published in BMC Medicine.

Lead author, PhD student Aaron Kandola (UCL Psychiatry) said: “Here we have provided further evidence of a relationship between physical and mental health, and that structured exercise aimed at improving different types of fitness is not only good for your physical health, but may also have mental health benefits.”

The study involved 152,978 participants aged 40 to 69 of the UK Biobank study. Their baseline aerobic fitness at the start of the study period was tested by using a stationary bike with increasing resistance, while their muscular fitness was measured with a grip strength test. They also completed a questionnaire gauging depression and anxiety symptoms.

Seven years later they were tested again for depression and anxiety symptoms, and the researchers found that high aerobic and muscular fitness at the start of the study was associated with better mental health seven years later.

People with the lowest combined aerobic and muscular fitness had 98% higher odds of depression, 60% higher odds of anxiety, and 81% higher odds of having either one of the common mental health disorders, compared to those with high levels of overall fitness.

The researchers accounted for potentially confounding factors at baseline such as diet, socioeconomic status, chronic illness, and mental illness symptoms.

Previous studies have found that people who exercise more are less likely to experience mental illnesses, but most studies rely on people self-reporting their activity levels, which can be less reliable than the objective physical fitness measures used here.

Senior author Dr Joseph Hayes (UCL Psychiatry and Camden and Islington NHS Foundation Trust) said: “Our findings suggest that encouraging people to exercise more could have extensive public health benefits, improving not only our physical health but our mental health too. Improving fitness through a combination of cardio exercise and strength and resistance training appears to be more beneficial than just focusing on aerobic or muscular fitness.”

Aaron Kandola added: “Reports that people are not as active as they used to be are worrying, and even more so now that global lockdowns have closed gyms and limited how much time people are spending out of the house. Physical activity is an important part of our lives and can play a key role in preventing mental health disorders.

“Other studies have found that just a few weeks of regular intensive exercise can make substantial improvements to aerobic and muscular fitness, so we are hopeful that it may not take much time to make a big difference to your risk of mental illness.”

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The research involved academics at UCL, King’s College London and Harvard University, and was supported by Wellcome, the Medical Research Council, the UK Department of Health, the Scottish government, Northwest Regional Development Agency, Welsh Assembly government, the

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Higher fitness levels linked to lower AFib risk in male, African American veterans

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Credit: Unsplash/CC0 Public Domain

Higher fitness levels reduced the risk of developing an irregular heart rhythm, known as atrial fibrillation, by 30% to 50% in a study of male, African American veterans, according to preliminary research to be presented at the American Heart Association’s Scientific Sessions 2020.

Atrial fibrillation (also called AFib or AF) is an irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. According to the American Heart Association, at least 2.7 million Americans are living with AFib.

“Engaging in physical activity to increase fitness is an inexpensive and practical intervention that health care professionals can prescribe to patients to prevent and manage cardiovascular disease,” said lead researcher Apostolos Tsimploulis, M.D., a cardiology fellow at the State University of New York at Stony Brook. “All of our evidence suggests the health benefits associated with increased cardiorespiratory fitness and reduced risk of atrial fibrillation are the same for all adults regardless of race.”

To study the effects of exercise on the development of atrial fibrillation, researchers examined the medical records of more than 11,000 middle-aged, male African American veterans (average age 58) from 1985 to 2013. None exhibited evidence of heart disease during or prior to completing a symptom-limited treadmill stress test at two VA Medical Centers—in Washington, D.C., and Palo Alto, California.

Participants were categorized into four fitness groups based on their age-specific cardiorespiratory fitness (CRF). CRF was measured in metabolic equivalents, or METs, resting metabolic rate (1 MET=3.5 ml of O2/kg of body weight per minute). The groups were categorized as: least fit, moderately fit, fit and highly fit.

A search of medical records was conducted by two independent investigators to directly assess the association between CRF and atrial fibrillation. Models were adjusted for risk factors, including heart or blood pressure medications, age and body mass index.

During an average follow-up of 10.7 years, 1,423 veterans developed atrial fibrillation:

  • 421 (16.6%) in the least fit group;
  • 366(10.9%) in the moderately fit group;
  • 323 (11.9%) in the fit group; and
  • 313 (12%) in the high-fit group.

When compared to the least-fit group, the atrial fibrillation risk was:

  • 29% lower in the moderately fit group;
  • 37% lower in the fit group; and
  • 51% lower in the high fit group.

Researchers noted the study results are strong based on the number of participants, and atrial fibrillation incidence was established during a follow-up period spanning roughly 17 years (median 10.7 years). Access to adjusted, longitudinal data, including medications and heart risk factors, along with equal access to care (care from the VA regardless of a patient’s ability to pay) are significant factors. This permitted continuous follow-up and minimized the potential for disparities in medical care.

Tsimploulis noted the precise cause of atrial fibrillation was not determined. In addition, CRF was measured only once; the level or frequency of physical activity was not assessed; and follow-up data on changes in cardiorespiratory fitness or physical activity of the participants over time were not available.

“We cannot

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Warmer world linked to poor pregnancy results: study

Women exposed to high temperatures and heatwaves during pregnancy are more likely to have premature or stillborn babies, researchers said Wednesday.

Such outcomes — closely linked to poverty, especially in the tropics — will likely increase with global warming, especially during more frequent and intense heatwaves, they reported in BMJ, a medical journal.

Even small increases “could have a major impact on public health as exposure to high temperatures is common and escalating,” the study concluded.

Each year, 15 million babies are born premature, the leading cause of death among children under five, according to the World Health Organization (WHO). 

That mortality is concentrated in the developing world, especially Africa. 

To quantify the impact of higher heat on pregnancy outcomes, an international team of researchers led by Matthew Chersich from Wits Reproductive Health and HIV Institute in Johannesburg looked at 70 peer-reviewed studies of 27 rich, poor and middle-income nations.

Of the 47 studies that concerned preterm births, 40 reported they were more common at higher temperatures.

The odds of a preterm birth rose, on average, by five percent per one degree Celsius (1C) increase, and by 16 percent during heatwave days, according to the new findings.

Global warming has seen Earth’s average temperature rise by 1C over the last century, with greater increases over large land masses.

The number of exceptionally hot days are expected to increase most in the tropics, according to the UN’s climate science advisory panel, the IPCC.

– ‘High risk’ for heat –

Extreme heatwaves — made more dangerous by high humidity — are projected to emerge earliest in these regions as well.

Limiting global warming to 1.5C instead of 2C — goals consistent with the Paris Agreement — would mean around 420 million fewer people frequently exposed to extreme heatwaves, the IPCC said in a 2018 report.

The new study also found that stillbirths increased by five percent per 1C increase in temperature, with the link most pronounced in the last few weeks of pregnancy.

The impact of warmer days and heatwaves on low birth weight, which is associated with a host of health problems later in life, was smaller, but still significant, the researchers said.

As expected, adverse pregnancy outcomes associated with rising temperatures were strongest among poorer women.

Because other factors such as pollution might play a role in stillbirths and premature babies, the role of warmer temperatures is hard to pin down, the researchers acknowledged.

Nonetheless, the findings are strong enough to suggest that pregnant women “merit a place alongside the groups typically considered as at ‘high risk’ for heat-related conditions,” they concluded.

More research and targeted health policies should be a high priority, they added.

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Proinflammatory Dietary Pattern Linked to Higher CV Risk

Dietary patterns with higher inflammatory potential were significantly associated with a higher incidence of cardiovascular disease (CVD) and stroke in a new pooled analysis of three prospective cohort studies.

The analysis included 210,145 US women and men followed for up to 32 years in the Nurses’ Health Studies I and II and the Health Professionals Follow-up Study.

After adjustment for use of anti-inflammatory medications and CVD risk factors, those whose dietary pattern ranked in the highest quintile of inflammatory potential had a 38% higher risk of CVD (hazard ratio comparing highest to lowest quintiles, 1.38), a 46% higher risk of coronary heart disease (HR, 1.46), and a 28% higher risk of stroke (HR, 1.28), all P for trend < .001.

Jun Li, MD, PhD, and colleagues at Harvard T.H. Chan School of Public Health and Harvard Medical School Boston, Massachusetts, published the findings of their study in the November 10 issue of the Journal of the American College of Cardiology.

The inflammatory potential of a diet was assessed using a food-based, dietary index called the “empirical dietary inflammatory pattern” or EDIP.

In an interview, Li explained that the EDIP was developed 4 years ago by many of the same authors involved with this study, including nutrition heavyweights Walter C. Willett, MD, DrPH, and Frank B. Hu, MD, PhD, both from Harvard.

“We summarized all the foods people eat into 39 defined food groups and did a reduced-rank regression analysis that looked at these 39 food groups and three inflammatory markers — interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha receptor 2. We found 18 food groups that are most predictive of these biomarkers, and the EDIP was calculated as the weighted sum of these 18 food groups.”

Individuals who had higher intakes of green leafy vegetables (kale, spinach, arugula), dark yellow vegetables (pumpkin, yellow peppers, carrots), whole grains, fruits, tea, coffee and wine had lower long-term CVD risk than those with higher intakes of red meat, processed meat, organ meat, refined carbohydrates, and sweetened beverages. 

The associations were consistent across cohorts and between sexes and remained significant in multiple sensitivity analysis that adjusted for alcohol consumption, smoking pack-years, use of lipid-lowering and antihypertensive medications, sodium intake, and blood pressure.

In a secondary analysis, diets with higher inflammatory potential were also associated with significantly higher biomarker levels indicative of more systemic, vascular, and metabolic inflammation, as well as less favorable lipid profiles.

“We wanted to be able to provide guidance on dietary patterns and food combinations,” said Li. “If you tell people to eat more polyunsaturated fats instead of saturated fat or trans fat, most people don’t know what foods are higher and lower in those nutrients. Also, many foods have different nutrients — some of which are good and some of which are bad — so we wanted to help people find the foods with the higher proportion of healthy nutrients rather than point out specific nutrients to avoid.”

Researchers used prospectively gathered data from the Nurses’

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7-hour flight to Ireland linked to 59 covid-19 cases, researchers say

A seven-hour international flight to Ireland this summer has been linked to 59 coronavirus cases in the country, Irish researchers said in a report.

Thirteen of the 49 passengers onboard tested positive for the novel coronavirus, even though the flight was only 17 percent full, according to the report released last week by the Irish Department of Public Health. Those 13 passengers went on to infect 46 more people throughout Ireland, the report says, which “demonstrates the potential for spread of SARS-COV-2 linked to air travel.”

Researchers did not clarify where the flight originated but said the cases and their subsequent spread show that “restriction of movement on arrival and robust contact tracing” can limit travel-linked transmissions of the coronavirus.

Masks were utilized by nine of those 13 infected passengers, with one child not wearing a mask and three passengers’ mask use “unknown,” the report noted.

Out of the 13 who tested positive on the flight, 12 were symptomatic. The 13 ranged in age from 1 to 65. Four were hospitalized, with one ending up in intensive care.

The report showed the cases on an in-flight map of the aircraft, which had a three-by-three configuration.


A diagram shows passenger seating on flight to Ireland in summer 2020. (Health Service Executive)

“Four of the flight cases were not seated next to any other positive case, had no contact in the transit lounge, wore face masks in-flight and would not be deemed close contacts under current guidance from the European Centre for Disease Prevention and Control (ECDC),” the report states. Researchers defined “close contacts” on the flight as passengers within two seats of one another in every direction.

Symptoms began to appear in the earliest cases two days after the flight, and the latest case linked to the plane experienced symptoms 17 days after the flight. Researchers noted that the “source case is not known,” although one passenger reported that a family member that had tested positive three weeks before the flight.

“Air travel has accelerated the global pandemic, contributing to the spread of coronavirus disease (COVID-19) throughout the world,” the study said. Researchers say the flight-linked cases show “the nature of transmission on board, despite implementation of non-pharmaceutical interventions” such as masks.

In September, the Centers for Disease Control and Prevention estimated that nearly 11,000 people have been potentially exposed to the coronavirus on flights. A study released this month by the Defense Department that simulated in-flight transmission of the virus suggested that air passengers would need to be near an infectious person on a plane for 54 hours to receive a significant dose of the virus. The study has not yet been peer reviewed.

The report was published the same week that Ireland reimposed a stay-at-home order for six weeks in an effort to curb the spread of the virus. Daily new

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Deadly listeria outbreak possibly linked to deli meat

Oct. 24 (UPI) — The U.S. Centers for Disease Control and Prevention said it’s investigating an outbreak of listeria possibly linked to deli-style meats that has caused at least one death.

The outbreak has sickened 10 people, all of whom were hospitalized, in Florida, Massachusetts and New York. The death was reported in Florida.

The CDC said all those who were sick reported eating Italian-style meats, including salami, mortadella and prosciutto. The sick said they purchased both prepackaged meats and those sliced at a deli counter.

“The investigation is ongoing to determine if there is a specific type of deli meat or common supplier linked to illness,” the agency said.

The CDC advised those who are at a higher risk of becoming sick with listeriosis to avoid eating deli meats unless they’re cooked to an internal temperature of at least 165 degrees Fahrenheit.

Listeriosis can cause fever, muscle aches, headaches, stiff neck, confusion, loss of balance, convulsions, diarrhea and gastrointestinal symptoms. In pregnant women, the infection can cause early delivery or miscarriage.

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Coronavirus cases linked to live music event at Virginia restaurant, attendees asked to self-quarantine

A live music event at a restaurant in Henrico, Va., is linked to a “cluster” of cases of the novel coronavirus, local health officials said this week when encouraging residents who may have been exposed to self-quarantine and monitor themselves for symptoms of COVID-19 over the next 14 days. 

Anyone who attended the live music event on Oct. 9 at JJ’s Grille on Staples Mill Road may have been exposed to the coronavirus, said officials with the Henrico County Health Department (HCHD) in a news release posted to the Virginia Department of Health website. 

Dr. Danny Avula, the director of Richmond’s and Henrico’s health districts, told the Richmond Times-Dispatch that the restaurant voluntarily closed for a temporary period of time after the cases were identified. (iStock)

Dr. Danny Avula, the director of Richmond’s and Henrico’s health districts, told the Richmond Times-Dispatch that the restaurant voluntarily closed for a temporary period of time after the cases were identified. (iStock)

“While there have been no reported cases of exposure associated with live music or group events held on dates before October 9, HCHD is still evaluating the potential for further exposures and would recommend that individuals who have visited the establishment after October 9 monitor for symptoms and consider being tested for COVID-19 infection,” health officials said. 

Dr. Danny Avula, the director of Richmond’s and Henrico’s health districts, told the Richmond Times-Dispatch that the restaurant voluntarily closed for a temporary period of time after the cases were identified. 

CAN MOUTHWASH PROTECT AGAINST CORONAVIRUS? EXPERTS DISCUSS RESULTS OF VIRAL STUDY

“In an office setting, you know everybody who works in the office and spent 15 minutes within 6 feet of an affected individual, but at these types of settings, it’s harder to do that,” Avula said of why the health district publically announced the outbreak, as a “lack of cooperation with contact tracing efforts and delays in testing” impacted health official’s efforts to notify everyone who could have been exposed, the newspaper reported. 

CDC REDEFINES CORONAVIRUS ‘CLOSE CONTACT’ TO INCLUDE MULTIPLE BRIEF EXPOSURES TO VIRUS

Officials did not provide a number of people who have tested positive, but Avula said some 75 people, including staff and restaurant patrons, have been contacted. 

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New England ice rinks shut down after coronavirus case clusters emerge linked to hockey

Health officials are concerned that indoor ice hockey could result in the spread of coronavirus this winter in several New England states, according to The Washington Post.

Massachusetts ordered all indoor ice rinks and skating facilities to close on Thursday, citing the 108 probable or confirmed cases of COVID-19 have been found to be linked to hockey games and their practices, according to a press release.

“This pause will allow for the development of stronger COVID-19 protocols to further protect players, families, coaches, arena staff and other participants, as well as communities surrounding hockey rinks,” the release stated.

New Hampshire made a similar move earlier in October. Health officials identified nearly 158 cases connected to hockey over a two-month period within the state, according to a press briefing held by Gov. Chris Sununu (R).

The Centers for Disease Control and Prevention also released a study in October that revealed that 14 out of 22 Florida hockey players suffered COVID-19 symptoms following a game at an indoor arena in June. 

“The indoor space and close contact between players during a hockey game increase infection risk for players and creates potential for a superspreader event, especially with ongoing community COVID-19 transmission,” according to the study.

Youth hockey games in Maine were canceled after one referee contracted the virus and potentially exposed nearly 400 people over the course of one weekend, according to the Portland Press Herald.

Vermont Gov. Phil Scott (R) issued a ban this month to keep rinks from taking new reservations for two weeks and will potentially add more restrictions, according to a news release.

Other states across the U.S. are preparing to brace for the winter amid spikes in coronavirus cases. The country has seen a total of 71,671 new cases and 865 deaths since Thursday, according to Johns Hopkins University.

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Walmart sues US government in dispute linked to opioid crisis

Retail giant Walmart filed suit Thursday against the US Justice Department over what it said was an unfair attempt to hold it legally responsible for certain sales of opioid drugs.

The lawsuit is the latest legal battle linked to the opioid crisis in the United States, where widespread abuse has led to government efforts to address the problem and hold drugmakers accountable.

In its lawsuit brought before a federal court in Texas, the US retailer says its pharmacists and pharmacies were being put “in an untenable position” by the government.

The suit, which also names the US Drug Enforcement Administration (DEA), says Walmart was acting preemptively to head off a separate civil suit that the Justice Department has been preparing to file against it.

Walmart said the government’s rules were unclear and that pharmacists could not be expected to know when a prescription written by a licensed doctor should not be filled.

“Walmart and its pharmacists should not be held responsible for the government’s failures to address the opioid crisis,” the suit says.

With the help of aggressive marketing from pharmaceutical companies, particularly through doctors, prescriptions for highly addictive opiate painkillers that had previously been reserved for serious cases skyrocketed in the late 1990s.

According to the Centers for Disease Control and Prevention, more than 500,000 Americans have died of opioid overdoses — both prescription and non-prescription — since 1999.

Walmart accuses the DEA of seeking to pass blame for its failures.

It alleges the agency “authorized manufacturers to produce ever-increasing quantities of the drugs, and largely abandoned its most potent enforcement tools against bad actors.”

It also said that “nearly 70 percent of the doctors whose prescriptions” the government intends to challenge “maintain their DEA prescription privileges to this day.”

Walmart alleges the government has spent years and considerable amounts of money on a criminal investigation that has not produced an indictment and was now turning to a civil lawsuit instead.

It is calling on the court to state that the company and its pharmacists are not subject to the legal responsibility with which the government is seeking to brand it.

Other large companies, including drug distributors Cardinal Health and McKesson, have been targeted in lawsuits by local and state authorities that accuse them of turning a blind eye to millions of opioid prescriptions despite knowing their addictiveness.

A settlement was reached between three distributors and two Ohio counties in October 2019, raising the possibility of a larger settlement.

On Wednesday, the Justice Department announced that Purdue Pharma, manufacturer of the drug OxyContin, had agreed to plead guilty as part of a deal worth some $8.3 billion.

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EPA refuses to reduce particulate pollution, linked by scientists to coronavirus deaths | Environment

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In April, as coronavirus cases multiplied across the country, the head of the U.S. Environmental Protection Agency rejected scientists’ advice to tighten air pollution standards for particulate matter, or soot.

In the next few weeks, EPA Administrator Andrew Wheeler likely will reaffirm that decision with a final ruling, despite emerging evidence that links particulate pollution to COVID-19 deaths.

There was enough evidence to support a stricter standard before the pandemic, said Christopher Frey, an environmental engineering professor at North Carolina State University who studies air pollution. The added threat from the coronavirus is like “icing on the cake.”

Particulate matter kills people. “It is responsible for more deaths and sickness than any other air pollutant in the world,” said Gretchen Goldman, a research director at the Union of Concerned Scientists.

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Wheeler’s decision was specifically about fine particulate matter, or PM2.5, microscopic solid and liquid droplets less than one-thirtieth the width of a human hair. The pollution comes from cars, power plants, wildfires and anything that burns fossil fuels. It causes health complications that can lead people to die earlier than they would have, and it is linked to conditions such as COPD, asthma and diabetes.

Frey was part of a 26-member scientific panel that advised the EPA on particulate pollution until Wheeler disbanded the group in 2018. Twenty of the former members continued to review the science and provided unofficial advice to Wheeler as part of the public comment process. Their letter told Wheeler— a former coal lobbyist — that tightening the standard would avoid tens of thousands of premature deaths per year.

Firing the advisory panel and opting not to pursue a more stringent particulate standard were in keeping with the administration of President Donald Trump’s dim view of environmental regulation. By one tally compiled by The New York Times, 72 regulations on air, water and soil pollution, climate change and ecosystems have been canceled or weakened, with an additional 27 in progress. EPA leadership has sidelined or ignored research by agency scientists, and career staff are censoring their reports to avoid terms like “climate change” out of fear of repercussions from political staff.

The EPA has an “apparatus of particulate matter science denial” that rivals its attacks on climate science, Frey said. “If I wanted to get rid of [regulations on] particulate matter, I would do all the things Wheeler is doing.”

Wheeler made his decision “after carefully reviewing [the] scientific evidence and consulting with the agency’s independent science advisors,” an EPA spokesperson said in a statement. “The U.S. now has some of the lowest fine particulate matter levels in the world, five times below the global average, seven times below Chinese levels, and 20 percent lower than France, Germany and Great Britain.”

These

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