Archive for month: February, 2024

The Lancet Child & Adolescent HealthAn enthusiastic response to food in early childhood may be linked to a higher likelihood of experiencing eating disorder symptoms in adolescence, according to a new study led by researchers at UCL and Erasmus University Rotterdam.

The study, published in The Lancet Child & Adolescent Health, looked at survey data from 3,670 young people in the UK and the Netherlands to investigate how appetite traits in early childhood might relate to the likelihood of developing eating disorder symptoms up to 10 years later.

The researchers found that a particularly high food responsiveness, defined as the urge to eat when you see, smell or taste palatable food, at the ages of four and five was linked to a higher likelihood of reporting a range of eating disorder symptoms at ages 12 to 14.

The team also found that a slower pace of eating and feeling full more quickly (high sensitivity to satiety) in early childhood may be protective against developing some eating disorder symptoms later.

Co-lead author Dr Ivonne Derks (UCL Institute of Epidemiology & Health Care) said: “Although our study cannot prove causality, our findings suggest food cue responsiveness may be one predisposing risk factor for the onset of eating disorder symptoms in adolescence.

“However, high responsiveness to food is also a normal and very common behaviour and should be seen as just one potential risk factor among many rather than something to cause parents worry.”

Higher food responsiveness was linked to a 16% to 47% increase in the odds of reporting eating disorder symptoms, including binge eating symptoms, uncontrolled eating, emotional eating, restrained eating and compensatory behaviours.

The 47% increase was found for binge eating symptoms (eating a very large amount of food and/or experiencing the feeling of loss of control over eating), meaning that adolescents whose parents rated them highest on food responsiveness were almost three times more likely to report binge eating symptoms compared to adolescents whose parents scored them lowest.

A 16% increase in odds was found for restrained eating, whereby a person restricts their intake of food to lose weight or avoid weight gain.

Just like food responsiveness, emotional overeating in early childhood was also linked with higher odds of engaging in compensatory behaviours, which are intended to avoid weight gain, such as skipping meals, fasting and excessive exercise.

In turn, some appetite traits seemed to be protective against developing eating disorder symptoms later. Higher satiety responsiveness – that is, feeling full more quickly after eating, and feeling full for longer – was linked to lower odds of uncontrolled eating (defined as the extent to which someone feels out of control and eats more than usual) and compensatory behaviours.

A slower pace of eating, meanwhile, was linked to lower odds of compensatory behaviours and restrained eating.

The researchers also found that appetite traits such as food fussiness, emotional undereating (eating less due to low mood), and enjoyment of food in early childhood were not linked to later eating disorder symptoms in adolescence.

For the study, the researchers looked at data from two separate longitudinal studies: Generation R, following children born in Rotterdam, the Netherlands, between 2002 and 2006, and Gemini, which follows twins born in England and Wales in 2007.

Appetite traits were assessed based on parents’ questionnaire responses when the children were aged four or five. Eating disorder symptoms were self-reported by the then adolescents themselves at ages 12 to 14, when eating disorder symptoms typically start to emerge.

About 10% of the adolescents reported binge eating symptoms, where people eat an unusual amount of food and/or experience the feeling of loss of control over eating. Next to that, 50% reported at least one behaviour to compensate their food intake or to avoid gaining weight, such as skipping a meal.

Co-senior author Dr Clare Llewellyn (UCL Institute of Epidemiology & Health Care) said: “While the role of appetite in the development of obesity has been studied for many decades, this is the first study to comprehensively examine the role of appetite traits in the development of eating disorder symptoms.

“Eating disorders can be harder to treat effectively once they develop and so it would be better to prevent them from occurring in the first place. Our work in identifying risk factors in early life aims to support the development of possible prevention strategies. These could, for instance, involve providing extra support to children at higher risk.”

Appetite traits indicate how we respond to food and the opportunity to eat, and the extent to which we want to eat more or less when experiencing negative emotions. They are divided into food approach appetitive traits (e.g. food responsiveness, enjoyment of food, emotional overeating) and food avoidance traits (e.g. satiety responsiveness, food fussiness, slowness in eating, emotional undereating).

Co-senior author Professor Pauline Jansen of Erasmus University Rotterdam said: “Overall, our findings suggest that developing and testing prevention strategies may be a worthwhile effort. Although appetite has a substantial genetic component, we also know that there are environmental influences that offer opportunities for behaviour change.”

The researchers indicate that a healthy food environment and responsive parental feeding strategies may help to lower the risk of developing eating disorders.

Co-lead author Dr Zeynep Nas (UCL Institute of Epidemiology & Health Care) explained: “A healthy food environment is an environment in which healthy foods are available and more prominent, salient and affordable than less healthy options. This also includes wider access to food such as what types of food outlets are available in our neighbourhood and what food we see on TV.

“Responsive feeding is about providing nutritious food at set mealtimes and snack times, and then allowing the child to decide what to eat and how much to eat (if anything at all) without pressuring them.”

In a separate paper, accepted for publication in the International Journal of Eating Disorders, a similar research team looked at the same two cohorts, Generation R and Gemini, to investigate how parental feeding practices in early childhood might affect likelihood of eating disorder symptoms in adolescence.

The researchers found that non-responsive feeding practices, such as putting pressure on children to eat or using food as a reward or to soothe emotions, were linked to a higher likelihood of specific eating disorder symptoms later. However, the associations were small and varied between the two cohorts, and the researchers said further replication studies were needed.

Reference:

vonne P M Derks, Zeynep Nas, Holly A Harris, Alice R Kininmonth, Prof Janet Treasure, Prof Pauline W Jansen, Early childhood appetitive traits and eating disorder symptoms in adolescence: a 10-year longitudinal follow-up study in the Netherlands and the UK, The Lancet Child & Adolescent Health, DOI:https://doi.org/10.1016/S2352-4642(23)00342-5.

In the groundbreaking INBUILD trial, researchers discovered that nintedanib
can significantly improve the lives of patients suffering from progressive
pulmonary fibrosis (PPF). Nintedanib
holds promise not only in reducing the progression of dyspnea, fatigue, and
cough but also in mitigating the overall impact of ILD over 52 weeks in
patients grappling with PPF.

The trial results were published in the journal European Respiratory Journal. 

Pulmonary fibrosis, a
condition characterized by scarring of the lungs, often leads to symptoms such
as dyspnea (shortness of breath) and cough, profoundly impacting patients’
daily lives. Hence, researchers conducted a trial, that focused on the effects
of nintedanib on PPF symptoms using the Living with Pulmonary Fibrosis (L-PF)
questionnaire to assess changes in patients’ conditions.

The trial included 663 patients with fibrosing interstitial lung
disease (ILD), excluding idiopathic pulmonary fibrosis, but with more than 10%
lung involvement on high-resolution computed tomography (HRCT) scans and
evidence of ILD progression within the past 24 months. Patients were randomly
assigned to receive either nintedanib or a placebo, with researchers analyzing
L-PF questionnaire scores from baseline to week 52 using mixed models for
repeated measures.

Findings:         

• The results revealed a significant positive
  impact of nintedanib on patients’ lives compared to the placebo group.
• Those receiving nintedanib experienced smaller
  increases (worsenings) in adjusted mean L-PF questionnaire total scores (0.5
  versus 5.1) at week 52.         
• This trend was also observed in symptom scores
  (1.3 versus 5.3), dyspnea (4.3 versus 7.8), and fatigue (0.7 versus 4.0).          
• One notable finding was the decrease in L-PF
  questionnaire cough score in the nintedanib group, in stark contrast to the
  placebo group where cough scores increased (-1.8 versus 4.3).          
• Additionally, the impacts of ILD, as assessed
  by the L-PF questionnaire impact score, decreased slightly in the nintedanib
  group while increasing in the placebo group (-0.2 versus 4.6).       
• These positive outcomes were consistent across
  different patient subgroups, including those with a usual interstitial
  pneumonia-like fibrotic pattern on HRCT and those with other fibrotic patterns
  on HRCT.
  

The findings suggest that nintedanib has the potential to not only
reduce the worsening of dyspnea, fatigue, and cough but also mitigate the
overall impact of ILD over 52 weeks in patients with progressive pulmonary
fibrosis.

This breakthrough offers hope to individuals grappling with the
debilitating effects of pulmonary fibrosis, as it paves the way for improved
treatment strategies and enhanced quality of life for those affected by this
challenging respiratory condition. As researchers continue to unravel the
complexities of pulmonary fibrosis, advancements like these represent a
significant step forward in the pursuit of better therapeutic options and
increased well-being for patients.

Further reading: Effects of nintedanib on symptoms in patients with progressive pulmonary fibrosis. DOI: 10.1183/13993003.00752-2023

Adopting a healthy lifestyle is strongly linked to a lower risk of irritable bowel syndrome or IBS for short, finds research published online in the journal Gut.

Of the big 5 healthy behaviours, not smoking, a high level of vigorous physical activity, and getting enough sleep were independently associated with keeping the condition at bay.

Characterised by abdominal pain, bloating, and abnormal bowel habit, IBS is thought to affect up to 1 in 10 people worldwide. Exactly what causes IBS isn’t fully understood, but disordered functioning of the gut–brain axis has a key role in the symptoms, explain the researchers.

Previously published research has linked individual lifestyle factors with a heightened risk of IBS, and the researchers wanted to find out if a combination of these factors might ward off the condition.

They therefore looked at the big 5 healthy behaviours-never smoking; at least 7 hours of sleep every night; a high level of vigorous physical activity every week; a high quality balanced diet every day; and moderate alcohol intake-among middle aged participants (average age 55) of the UK Biobank.

The final analysis included 64,286 people, just over half of whom (55%) were women, and who had completed at least two 24-hour dietary recall questionnaires.

During an average monitoring period of just over 12.5 years, 961 (1.5%) cases of IBS were recorded.

Of the total sample, 7604 (12%) said they didn’t do any of the 5 healthy lifestyle behaviours, while 20,662 (32%) reported one; 21,901 (34%) reported two; and 14,101 (22%) reported 3 to 5 behaviours at the start of the monitoring period.

After accounting for potentially influential factors, the higher the number of healthy behaviours, the lower was the risk of IBS.

One behaviour was associated with a 21% lower risk, while 2 were associated with a 36% lower risk; and 3 to 5 were associated with a 42% lower risk.

Although of a smaller size than when combined, 3 healthy behaviours were independently associated with a lower risk of IBS: never smoking (14% lower); high level of physical activity (17% lower); and a good night’s sleep (27% lower).

Further in depth analysis showed that these associations were independent of age, sex, employment status, residential area, gut infection, family history of IBS or other lifestyle choices.

This is an observational study, and as such, can’t establish cause, added to which it relied on self-report, which may not always be accurate and older people, so may not be applicable to younger age groups. Nor was it possible to account for any lifestyle changes over time during the monitoring period.

Nevertheless, the researchers point out: “Although lifestyle modification is recommended as a means of managing IBS symptoms, its potential role in preventing the onset of the condition has not been given due attention.”

And they conclude: “IBS has a complex aetiology, involving biological, genetic, psychosocial and environmental factors. Our findings underscore the value of lifestyle modification in the primary prevention of IBS and suggest that healthy lifestyle choices could significantly attenuate the effects of aetiological factors on the incidence of IBS.”

Reference:

Ho FF, Sun H, Zheng H, et alAssociation of healthy lifestyle behaviours with incident irritable bowel syndrome: a large population-based prospective cohort studyGut Published Online First: 20 February 2024. doi: 10.1136/gutjnl-2023-331254.

In a case of suspected food poisoning, over 300 people including children reportedly received medical treatment while lying on the ground outside a hospital in Bibi village, Maharashtra.

The incident occurred on Tuesday night during a religious event in Buldhana district’s Lonar area. The people complained of food poisoning after consuming ‘prasad’ and were administered saline bottles fitted on the trees outside the hospital.

For the full story, check out the link given below:

Viral Video Shows Saline Bottles Hanging On Ropes Outside Hospital, Over 300 Patients Getting Treatment On Road

Around 8,000 resident doctors across the State of Maharashtra have commenced their pan-Maharashtra indefinite strike, as their demands regarding hostel accommodation and stipend hike have not been fulfilled despite written assurance from the Government authorities.

For the full story, check out the link given below:

Mass Hadtaal: 8000 Plus Maha Resident Doctors On Strike Demanding Stipend Hike, Hostel Accommodation