Wood Street Clinic Blog

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What are the consequences of a sedentary lifestyle?

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2008 physical activity guidelines for Americans. (2008, October). Retrieved from https://health.gov/paguidelines/pdf/paguide.pdf

Chekroud, S. R., Gueorguieva, R., Zheutlin, A. B., Paulus, M., Krumholz, H. M., Krystal, J. H., & Chekroud, A. M. (2018, August 8). Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: A cross-sectional study. The Lancet Psychiatry, 5(9), 739–746. Retrieved from https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30227-X/fulltext

Dunstan, D. W., Howard, B., Healy, G. N., & Owen, N. (2012, September). Too much sitting — a health hazard. Diabetes Research and Clinical Practice, 97(3), 368–376. Retrieved from https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(12)00208-2/fulltext 

Facts about physical activity. (2014, May 23). Retrieved from https://www.cdc.gov/physicalactivity/data/facts.htm

Facts & statistics: Physical activity. (2017, January 26). Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html

Matthews, C. E., Chen, K. Y., Freedson, P. S., Buchowski, M. S., Beech, B. M., Pate, R. R., & Troiano, R. P. (2008, April 1). Amount of time spent in sedentary behaviors in the United States, 2003–2004. American Journal of Epidemiology, 167(7), 875–881. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527832/

Physical inactivity. (2017, September 15). Retrieved from https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/PhysicalInactivity.html

Sanchez-Villegas, A., Ara, I., Guillén-Grima, F., Bes-Rastrollo, M., Varo-Cenarruzabeitia, J. J., & Martínez-González, M.-A. (2008, May). Physical activity, sedentary index, and mental disorders in the SUN cohort study. Medicine and Science in Sports and Exercise, 40(5), 827–834. Retrieved from https://pdfs.semanticscholar.org/b086/9f0e2b071fe8063a180edcbd2decec7bdbae.pdf

Thorp, A. A., Owen, N., Neuhaus, M., & Dunstan, D. W. (2011, August). Sedentary behaviors and subsequent health outcomes in adults: A systematic review of longitudinal studies, 1996–2011. American Journal of Preventive Medicine, 41(2), 207–215. Retrieved from http://getamericastanding.org/pdfs/research/77.pdf

Tremblay, M. S., Aubert, S., Barnes, J. D., Saunders, T. J., Carson, V., Latimer-Cheung, A. E., ... & Chinapaw, M. J. M. (2017, June 10). Sedentary behavior research network (SBRN) —terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity, 14, 75. Retrieved from https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0525-8

Warren, T. Y., Barry, V., Hooker, S. P., Sui, X., Church, T. S., & Blair, S. N. (2010, May). Sedentary behaviors increase risk of cardiovascular disease mortality in men. Medicine & Science in Sports and Exercise, 42(5), 879–885. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857522/

Zhai, L., Zhang, Y., & Zhang, D (2014, September 2). Sedentary behavior and the risk of depression: A meta-analysis. British Journal of Sports Medicine, 49(11), 705–709. Retrieved from https://bjsm.bmj.com/content/49/11/705.info

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How exercise affects metabolic hormones

Researchers from Denmark have found that cardio or endurance exercise impacts metabolic hormones differently to strength or resistance training with weights.
sweaty woman at the gym
Cardio exercise and strength training impact our metabolic hormones in different ways.

The research has deepened our understanding of how different forms of exercise affect the body.

A significant finding is that endurance exercise increases a metabolic hormone called fibroblast growth factor 21 (FGF21), whereas strength training decreases another called fibroblast growth factor 19 (FGF19).

The effects of various forms of exercise on better-known hormones such as insulin and adrenalin are already well-understood, says senior study author Christoffer Clemmensen, who is working as an associate professor in the Novo Nordisk Foundation Center for Basic Metabolic Research in Copenhagen.

The new insight from their findings, he explains, is "that strength training and cardio exercise affect FGF hormones differently."

The study — which features in the Journal of Clinical Investigation: Insight — also confirmed some known effects of other metabolic substances.

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Metabolism and exercise

The word metabolism comes from the Greek phrase for "to change," but we use it to refer to all the processes that extract and use energy to sustain life.

These range from breathing, digestion, and temperature regulation to muscle contraction, keeping the brain and nerves working, and getting rid of waste through feces and urine.

Metabolism changes over the lifespan. As we get older, we burn fewer calories and our digestion alters. We also lose lean muscle and — unless we take care of our diet and exercise regularly — gain weight.

Eating too much and having a lifestyle that is mostly sedentary can hasten these age-related changes.

To protect against this, experts advise us to follow guidelines on how to eat a healthful diet and remain physically active.

In the United States, the physical activity guidelines for adults advise a combination of muscle-strengthening and aerobic, or endurance, exercise.

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Exercise and metabolic hormones

However, while there is a lot of evidence outlining the various benefits of exercise on health, "the underlying mechanisms remain incompletely understood," Clemmensen and his colleagues note in their study paper.

So, they investigated this further by examining the impact of two forms of exercise on metabolic hormones, which are the chemical messengers that regulate the processes of metabolism.

They recruited 10 healthy young men and randomly split them into two groups. In one group, the men did cardio training first, and then strength training about a week later. In the other group, the men did the strength training first and then the cardio.

All the exercise sessions lasted for about an hour and were intensive. In the cardio session, the men cycled at 70 percent maximum intake of oxygen. In the strength training session, they put all major muscle groups through a regime comprising five different exercises repeated between five and 10 times.

During the 3-hour recovery period following each exercise session, the researchers took blood samples from each man immediately after exercise and then at intervals thereafter.

They used the blood samples to measure changes in levels of: blood sugar, lactic acid, several hormones, and bile acid.

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Different effects on metabolic hormones

The results showed that blood levels of FGF21 rose significantly during the cardio or endurance sessions, but not in the strength training sessions.

The effect of cardio on FGF21 was so marked that the researchers believe that it warrants further investigation. Of particular interest is whether the hormone is directly involved in the health-promoting effects of cardio exercise.

The results also showed that levels of FGF19 fell slightly after strength training. This was a surprise to the researchers who were expecting it to rise, since animal studies suggest that the metabolic hormone helps with muscle growth.

FGFs are active in many different biological processes, in addition to helping regulate metabolism. These include, for example, cell growth, embryonic development, tissue repair, and tumor formation.

FGF21 is produced in several organs and is active in weight loss, glucose control, and reducing inflammation.

In fact, researchers have proposed that FGF21 has potential as a drug for treating "metabolic complications such as diabetes and fatty liver disease."

FGF19, which is produced in the gut, is described as an "atypical" member of the FGF family. As a hormone, it helps regulate bile acid production and metabolism of glucose and lipids.

Animal studies have shown that, as well as helping with muscle growth, FGF19 can aid weight loss, reduce fats and glucose levels in the liver, and improve use of insulin.

The team now plans to further investigate the links between metabolic hormones and exercise. One limitation of the new study was that it only looked at changes in the 3 hours following the exercise session. It is still not clear what happens in the longer-term.

"FGF21's potential as a drug against diabetes, obesity, and similar metabolic disorders is currently being tested, so the fact that we are able to increase the production ourselves through training is interesting."

Christoffer Clemmensen

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Dairy and meat 'beneficial for heart health and longevity'

New research suggests that current dietary guidelines should be revised to account for the dietary habits of modern populations from across the globe. Unprocessed red meat and dairy, for instance, should be included as part of a heart-healthy diet.
dairy and meat
Dairy products, such as cheese and milk, and unprocessed meat may actually benefit heart health.

Many studies suggest that a diet that avoids red meat and dairy but is rich in fruit, vegetables, nuts, and whole grains is the best for heart health.

However, new research suggests that we should amend these guidelines.

The Prospective Urban Rural Epidemiological (PURE) study — which was led by Prof. Salim Yusuf, the director of the Population Health Research Institute (PHRI) at McMaster University in Hamilton, Canada — suggests that the results of these traditional studies may be biased and outdated.

Specifically, explain the researchers, such studies are based on the dietary habits of high-income countries and rely on data from decades ago. For these reasons, the new study aimed to make a more comprehensive analysis of people's dietary patterns across the world.

Its findings were presented at the 2018 annual conference of the European Society of Cardiology, held in Munich, Germany.

The researchers have also published their results in the journal The Lancet.

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Diet quality and cardiovascular health

For the PURE study, Prof. Yusuf and colleagues examined the link between diet and heart health in almost 140,000 healthy people, aged 35–70, who were clinically followed for over 9 years.

During this period, 6,821 people died of a cardiovascular disease and 5,466 experienced major cardiovascular events such as heart attack, stroke, and heart failure.

The quality of the participants' diets was assessed using a food score. To develop the score, the researchers included foods that previous studies suggested might lower the risk of premature death, such as: fruit, vegetables, nuts, legumes, fish, dairy products, and meat.

PHRI's Andrew Mente, the study's co-principal investigator, summarizes the findings. "People who consumed a diet emphasizing fruit, vegetables, nuts, legumes, fish, dairy products, and meat had the lowest risks of cardiovascular disease and early death," he says.

"Regarding meat, we found that unprocessed meat is associated with benefit."

Andrew Mente

Specifically, compared with people who scored the lowest on the quality of their diet, those with the highest quality score were 11 percent less likely to experience a major cardiovascular event, 17 percent less likely to have a stroke, and 25 percent less likely to die of any cause.

Additionally, the findings suggest that the intake of refined carbs should be limited, but that dairy and unprocessed red meat may be healthful.

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'Dairy products and meat are beneficial'

The researchers replicated their findings in four further studies. Overall, the results were confirmed in a total sample of more than 218,000 people from over 50 countries spread across the globe.

"Our results appeared to apply to people from different parts of the world and so the findings are globally applicable," explains Mahshid Dehghan, who is also a co-principal investigator affiliated with PHRI.

Prof. Yusuf explains that, while these findings may go against traditional beliefs, they are a better reflection of our modern, international dietary habits.

"Thinking on what constitutes a high-quality diet for a global population needs to be reconsidered. For example, our results show that dairy products and meat are beneficial for heart health and longevity. This differs from current dietary advice."

Prof. Salim Yusuf

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Newly discovered skull channels play role in immunity

Researchers have now discovered "tiny channels" that allow the injured brain to communicate with bone marrow in the process of inflammation. These "tunnels" are key to ensuring a quick immune response.
blue and fuchsia brain concept
'Tiny channels' in the skull allow injured brain tissue to recruit help fast.

Inflammation occurs as an immune response to instances of infection or injury within the body.

The immune response is subject to a complex process of coordination that involves a type of spongy tissue known as bone marrow.

Bone marrow can be found inside a number of bones, including the skull, the vertebrae of the vertebral column, and leg bones, such as the tibia.

This tissue produces both red blood cells and some types of immune cells, all of which are involved in inflammation, responding to injuries or infections.

Now, a study conducted by researchers from the Harvard Medical School in Boston, MA, and partly funded by the National Institutes of Health (NIH), has discovered how the brain and bone marrow coordinate to ensure a quick, targeted immune response.

The answer, the specialists explain in a paper featured in the journal Nature Neuroscience, lies in previously unknown channels that allow the two to communicate.

"We always thought that immune cells from our arms and legs traveled via blood to damaged brain tissue. These findings suggest that immune cells may instead be taking a shortcut to rapidly arrive at areas of inflammation," explains Francesca Bosetti, program director at the NIH's National Institute of Neurological Disorders and Stroke.

"Inflammation plays a critical role in many brain disorders and it is possible that the newly described channels may be important in a number of conditions. The discovery of these channels opens up many new avenues of research."

Francesca Bosetti

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The injured brain recruits help from the skull

The researchers first conducted their study in a mouse model, and once they knew what to search for, they were also able to replicate their findings in humans.

Using advanced optical imaging techniques, they tracked the movements of neutrophils, a type of immune cell typically first to migrate to places in the body that have sustained an injury.

Specifically, the researchers could find out whether neutrophils that reached brain tissue damaged as the result of a stroke or meningitis were released from bone marrow found in the skull or from marrow found in the tibia.

Looking at brains of mice, the scientists saw that during a stroke, injured brain tissue receives neutrophils from the skull, rather than the tibia, in most cases.

During a heart attack, however, the researchers revealed that the heart is likely to receive a similar number of neutrophils from both skull and tibia marrow, seeing as the heart is situated farther from both of those bone structures.

Also, they noted that 6 hours after a stroke occurs, there are fewer neutrophils in the marrow of the skull than in that of the tibia.

What this suggests is that the injured brain tissue and the marrow found in the skull have a direct means of "communication," which allows for a quick and targeted immune response from the closest "respondent."

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An 'unexpected' discovery

How does this all happen? The first clue about the mechanisms involved came from a bone marrow protein known as stromal cell-derived factor-1 (SDF-1), whose role is to regulate when immune cells are stored in the bone marrow and when they are released.

When SDF-1 levels drop, the bone marrow releases neutrophils, so they can attend to the injured tissue.

The team noted that SDF-1 levels decrease 6 hours after a stroke only in the marrow found in skull bones, which indicates that the bone marrow found in the skull is in direct communication with the brain, which "alerts" it of the damage, "recruiting" the closest source of help.

"We [then] started examining the skull very carefully, looking at it from all angles, trying to figure out how neutrophils are getting to the brain," explains study co-author Dr. Matthias Nahrendorf.

"Unexpectedly, we discovered tiny channels that connected the marrow directly with the outer lining of the brain," he adds.

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Dr. Nahrendorf and his team identified such "tiny channels" of communications not just all over the skull, but also in the tibia.

Following these findings in mice, the researchers then searched for the same structures in humans and found them; the channels they observed in human skulls were five times larger than the ones seen in mice, they report.

Moreover, in mice as well as in humans, the channels appear both in the inner and outer layers of the skull.

In the future, the scientists are eager to see what other types of cells may move through these newly discovered channels and to uncover more information about how these tiny passages mediate the immune response.

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Dairy consumption guidelines 'should be revised'

Guidelines that advise people to limit how much dairy food — particularly yogurt and cheese — they eat should be revised, according to new research.
milk, cheese and yogurt
Researchers believe that dairy consumption guidelines should now be revised.

It found that higher overall consumption of dairy products is linked to a lower risk of premature death from all causes and "cerebrovascular causes" such as stroke.

Drinking milk, on the other hand, was found to be associated with a higher risk of coronary heart disease.

However, the researchers also say that this needs further investigation.

Meanwhile, they recommend that the guideline for milk consumption should be to drink fat-free or low-fat milk, especially for those who drink a lot of milk.

Maciej Banach, who is a professor in the Department of Hypertension at Medical University of Lodz in Poland, and his colleagues analyzed national survey data from the United States and confirmed their results in a further analysis of pooled data from several other studies.

Their findings feature at the 2018 annual congress of the European Society of Cardiology, held in Munich, Germany.

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Conflicting evidence on dairy foods

Cerebrovascular diseases, such as stroke, affect the blood vessels in the brain. Stroke accounts for high rates of disability and death. In the U.S., it is the "fifth leading cause of death."

For a long time, it was thought that eating dairy foods — because they contain more saturated fat — raised people's risk of premature death, especially from cancer, cerebrovascular diseases, and coronary heart disease.

However, the researchers say that the evidence to support this idea, especially that which applies to U.S. adults, is conflicting.

Prof. Banach notes, for example, that an analysis of pooled data from 29 studies that was published in 2017 "found no association between the consumption of dairy products and either cardiovascular disease [...] or all-cause mortality."

That being said, another study of adults in Sweden that was published in the same year found that drinking more milk was linked to double the risk of premature death — including death from cardiovascular disease — in women.

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Lower risk of death

For the new analysis, the researchers used data from the 1999–2010 National Health and Nutrition Examination Surveys (NHANES) covering 24,474 adults — aged 47.6 years, on average — of whom 51.4 percent were female.

The Centers for Disease Control and Prevention (CDC) carry out a NHANES survey every year with a nationally representative sample of 5,000 U.S. residents. It includes physical examinations and interviews.

Over an average follow-up period of 76.4 months, there were 3,520 deaths. Of these, 827 were from cancer, 709 were due to heart-related causes, and 228 were due to cerebrovascular diseases.

The researchers found that overall consumption of dairy foods was linked to a 2 percent lower risk of death from all causes, while cheese consumption in particular was tied to an 8 percent lower risk.

Focusing on cerebrovascular disease deaths, the researchers found that overall dairy food intake was tied to a 4 percent lower risk, while milk consumption was linked to a 7 percent lower risk.

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Results confirmed — except for milk

The team then sought to confirm these findings by analyzing pooled data from 12 other studies that followed groups of people over time. Overall, the data covered a total of 636,726 individuals with a follow-up of around 15 years.

The analysis confirmed the earlier results, with the exception of milk consumption. Here, much like in the Swedish study that Prof. Banach mentioned, milk intake was linked to a 4 percent higher risk of death from coronary heart disease.

Consumption of yogurt and other fermented dairy foods, on the other hand, was tied to a 3 percent lower risk of death from all causes. Further adjustment, however, showed that the results on yogurt were not statistically significant and could just as likely have occurred by chance.

The researchers note that the links found between milk and coronary heart disease warrant further investigation. Because many people who drink milk also consume other dairy products, it is not easy to untangle the effect of milk from the rest.

In the meantime, they advise milk drinkers to confine their intake to the fat-free and low-fat varieties.

"In light of the protective effects of dairy products, public health officials should revise the guidelines on dairy consumption."

Prof. Maciej Banach

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Distress boosts heart attack and stroke risk

A new study confirms that having high or very high psychological distress due to depression or anxiety impacts a person's risk of experiencing cardiovascular health problems such as heart attack and stroke.
pensive woman
We should pay more attention to the risks that psychological distress poses to cardiovascular health.

Researchers from the University of Edinburgh in the United Kingdom and the University of Queensland in Brisbane, Australia have conducted a large study investigating the association between measures of psychological distress and cardiovascular risk.

The idea that mental health status can influence a person's risk of having a cardiovascular health event is not a new one.

In fact, an increasing number of studies have been examining it in an effort to gain a better understanding of how much of a bearing psychological factors actually have on physical health.

In the new study, the team assessed a cohort of 221,677 participants aged 45 and over, focusing on their individual levels of distress and following the evolution of their cardiovascular health over the years.

The investigators' analysis led them to conclude that psychological distress influences the risk of events such as heart attack and stroke independently of other factors.

For this reason, in the paper they recently published in Circulation: Cardiovascular Quality and Outcomes, they advise that people already at risk of cardiovascular health problems should take instances of psychological distress as a serious influencing factor.

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Distress and cardiovascular health

The researchers worked with participants recruited via the 45 and Up Study. The volunteers joined the study in 2006–2009, and none of them had experienced a heart attack or a stroke at the time of recruitment.

Of the total number of participants, 119,638 were women (aged 60, on average), and 102,039 were men (aged 62, on average).

After accounting for the impact of other relevant factors — including smoking, diet, regular alcohol intake, and medical history — the research team was able to confirm that the link between high or very high psychological distress and a boosted cardiovascular risk remained in place.

"While these factors might explain some of the observed increased risk, they do not appear to account for all of it, indicating that other mechanisms are likely to be important," explains senior study author Caroline Jackson.

Specifically, the researchers found that women experiencing high or very high psychological distress had a 44 percent higher risk of stroke. As for men, those aged 45–79 who reported high or very high distress had a 30 percent higher risk of heart attacks.

For men, the association appears to become weaker with age, with those aged 80 or over experiencing a lower increase in risk, even with high measures of distress.

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Higher distress, higher cardiovascular risk

In order to determine the participants' levels of psychological distress, the researchers used a self-assessment questionnaire, featuring questions such as "How often do you feel tired out for no good reason?" and "How often do you feel so sad that nothing could cheer you up?"

According to the results, 16.2 percent of the participants experienced moderate levels of psychological distress, while 7.3 percent reported high or very high distress levels.

The participants' health developments were followed up for a period of over 4 years, during which time the researchers recorded 4,573 heart attacks and 2,421 strokes.

Importantly, the investigators note that a person's overall risk of heart attack and stroke increased with each measure of psychological distress.

The researchers explain that the results of their study consolidate the notion that severe distress — perhaps tied to conditions such as depression and anxiety — can boost the risk of cardiovascular disease.

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'We encourage more proactive screening'

At the same time, the researchers stress the need to conduct further studies addressing the underlying mechanisms that may be at play. They also add that we need to gain a better understanding of the potential differences in risk between women and men.

Jackson further emphasizes that individuals experiencing psychological distress should receive more focused attention and assistance for symptom management, as their mental health status may actually harm their physical health, as well.

"We encourage more proactive screening for symptoms of psychological distress. Clinicians should actively screen for cardiovascular risk factors in people with these mental health symptoms."

Caroline Jackson

In fact, the researchers explain, due to the methodological approach — which required analyzing all modifying factors at the same point in time — they were unable to assess the potential association between measures of psychological distress and other variables, such as dietary habits or smoking.

This, they warn, may mean that the impact of psychological distress on cardiovascular risk may be even greater than they estimated.

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Forehead wrinkles — an early sign of cardiovascular disease?

New research suggests that deep forehead wrinkles might be a quick and easy way to spot individuals at risk of atherosclerosis, a cardiovascular condition that can lead to more serious issues such as a heart attack or stroke.
close up of wrinkles on man's forehead
Numerous deep wrinkles on someone's forehead may be an early sign of atherosclerosis, suggests a new study.

In atherosclerosis, plaque builds up inside the arteries, making them less elastic and narrowing them down over time.

This limits the supply of oxygen-rich blood to the body's major organs, which, in turn, may lead to a range of diseases — depending on which organ is affected.

When plaque accumulates inside the coronary arteries, coronary heart disease and even heart attacks may ensue.

Some of the main risk factors for atherosclerosis include smoking, high cholesterol levels, insulin resistance, high blood pressure, physical inactivity, age, and a family history of heart disease.

New research adds another risk factor to the list — and one that may be more easy to detect than high blood pressure or insulin resistance. Deep forehead wrinkles, say the authors of the new study, may signal atherosclerosis.

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The new research was presented at the 2018 annual conference of the European Society of Cardiology, held in Munich, Germany.

Study author Yolande Esquirol, who is an associate professor of occupational health at the Centre Hospitalier Universitaire de Toulouse in France, shares what motivated the research. "You can't see or feel risk factors like high cholesterol or hypertension," she says.

"We explored forehead wrinkles as a marker because it's so simple and visual. Just looking at a person's face could sound an alarm, then we could give advice to lower risk."

This is not the first time that facial features are explored as a potential marker of cardiovascular health. For example, male pattern baldness and prematurely gray hair have been found to raise heart disease risk by fivefold in previous studies.

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Cardiovascular death risk 10 times higher

Esquirol and colleagues examined forehead wrinkles in 3,200 healthy adults, aged 32–62 at baseline. The researchers assessed the participants' wrinkles by applying a score ranging from 0 ("no wrinkles") to 3 ("numerous deep wrinkles").

The scientists clinically followed the participants for 2 decades. During this time, 233 participants died of various conditions.

Overall, the research revealed a directly proportional link between wrinkle score and risk of dying from a cardiovascular problem.

While a wrinkle score of 1 elevated cardiovascular death risk only slightly, people with a wrinkle score of 2 and 3 were almost 10 times more likely to die a cardiovascular death than people with wrinkle scores of 0.

These results were obtained after the scientists accounted for age and job strain in their analysis.

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Why wrinkles may signal atherosclerosis

While the prospective research was observational, the researchers speculate that the missing link between wrinkle scores and the probability of cardiovascular death may be atherosclerosis.

They base this theory on the fact that both wrinkles and atherosclerosis are subject to oxidative stress and changes in collagen protein levels.

Also, the researchers explain, blood vessels in the forehead are particularly fine, which could mean they are more sensitive to the buildup of plaque that is a hallmark of atherosclerosis.

Finally, the authors suggest that forehead wrinkles could be an easier and much less costly way of determining whether someone has the condition than lipid tests and blood pressure measurements.

"Forehead wrinkles may be a marker of atherosclerosis," says Esquirol. "This is the first time a link has been established between cardiovascular risk and forehead wrinkles, so the findings do need to be confirmed in future studies," she adds.

"[B]ut the practice could be used now in physicians' offices and clinics," she explains, referring to the use of wrinkle scores as a way to detect signs of cardiovascular conditions. "It doesn't cost anything, and there is no risk."

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High blood pressure? Turn up your thermostat

According to a recently published study, living in a cooler house might be a risk factor for hypertension. The authors believe that the temperature of the home should be discussed with people who are at risk.
Cold man
Ambient temperature may play a significant role in hypertension.

High blood pressure, or hypertension, affects more than 100 million adults in the United States.

Though hypertension rarely produces significant symptoms, it increases the risk that other more serious problems may develop, such as stroke and heart attack.

High blood pressure is increasingly prevalent and lays the groundwork for significant and potentially life-changing health outcomes.

For these reasons, it is important to understand why it occurs and how it can be managed. Many risk factors — such as older age, a family history of hypertension, an unhealthful diet, being overweight, smoking tobacco, and drinking too much alcohol — are already known.

A recent study, conducted at University College London (UCL) in the United Kingdom, adds a new risk factor to the list: the temperature of your home.

The research paper — titled 'My blood pressure is low today, do you have the heating on?' The association between indoor temperature and blood pressure — now appears in the Journal of Hypertension.

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Temperature and blood pressure

Earlier research has tentatively linked colder living conditions to an increased risk of hypertension; however, these studies did not have access to nationally representative data, making their results less solid.

The most recent study, which was carried out in a large number of participants, makes much more robust conclusions about the relationship between home temperature and blood pressure.

To investigate, the researchers took data from the Health Survey for England 2014, which included information from 4,659 individuals aged 16 or over. Initially, each participant completed questionnaires on lifestyle factors.

Next, they were visited by a nurse who measured the ambient temperature in their living room and assessed their systolic and diastolic blood pressure, or measures of the force of the heart's contraction and the resistance in blood vessels, respectively.

A healthy blood pressure is considered to be between 90/60 millimeters of mercury (mmHg) and 120/80 mmHg.

They found that for every 1°C decrease in temperature, there was an increase of 0.48 mmHg in systolic blood pressure and 0.45 mmHg in diastolic blood pressure.

For individuals in the coolest homes, the average systolic blood pressure was 126.64 mmHg and diastolic was 74.52 mmHg. Those in the warmest homes were 121.12 mmHg and 70.51 mmHg, respectively.

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Should doctors consider indoor temperature?

These findings were significant even after the data had been adjusted to account for potentially confounding variables, such as socioeconomic demographics and outdoor temperature.

The relationship between indoor temperature and blood pressure was most pronounced in the participants who did not exercise regularly. Therefore, increased levels of exercise might help reverse the potential negative effects of living in cooler temperatures.

Senior study author Dr. Stephen Jivraj, from UCL's Institute of Epidemiology & Health Care, explains.

"Our research," he says, "has helped to explain the higher rates of hypertension, as well as potential increases in deaths from stroke and heart disease, in the winter months, suggesting indoor temperatures should be taken more seriously in diagnosis and treatment decisions, and in public health messages."

The researchers believe that the new study provides strong enough evidence to be used to advise certain patients with hypertension.

"We would suggest that clinicians take indoor temperature into consideration, as it could affect a diagnosis if someone has borderline hypertension, and people with cooler homes may also need higher doses of medications."

Study co-author Hongde Zhao

From the data collected, the scientists could not ascertain the perfect temperature to keep one's home. However, the authors suggest that 21°C, as a minimum, would be advisable.

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'Good' cholesterol: How much is too much?

New research challenges the popular belief that high-density lipoprotein cholesterol, also known as the "good" kind, is beneficial to one's health, regardless of its levels.
lipid profile test
If your tests reveal very high levels of the 'good' kind of cholesterol, you may still be at risk of cardiovascular disease.

Physicians typically advise that people maintain high levels of high-density lipoprotein (HDL) cholesterol on the basis of the assumption that it prevents heart disease and stroke.

This protective effect is thought to be due to the HDL molecules, which "flush" cholesterol from the blood into the liver and out of the body.

However, little is known about people with very high levels of this type of cholesterol.

In fact, some recent research has suggested that high levels of it may actually raise the risk of premature mortality.

A new study reinforces this idea. It was presented by Dr. Marc Allard-Ratick, of the Emory University School of Medicine in Atlanta, GA, at the European Society of Cardiology Congress, held in Munich, Germany.

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Dr. Allard-Ratick and colleagues examined the link between "good" cholesterol levels and the risk of heart attack and cardiovascular death in almost 6,000 individuals aged 63 years, on average.

Most had heart disease; the researchers followed them up over the course of 4 years, grouping them according to their levels of HDL cholesterol, measured in milligrams per deciliter (mg/dL).

During the follow-up period, 13 percent of the participants experienced a heart attack or died from cardiovascular disease.

Participants whose HDL cholesterol levels were 41–60 mg/dL were the least likely to experience a heart attack or die from a cardiovascular event.

However, for people with very low HDL cholesterol levels (less than 41 mg/dL) and those with very high levels (higher than 60 mg/dL), the risk of adverse cardiovascular events and death increased.

Specifically, people with cholesterol levels higher than 60 mg/dL were almost 50 percent more likely to have a heart attack or die from cardiovascular disease than those with levels at 41–60 mg/dL.

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Dr. Allard-Ratick comments on these findings. "Our results," he explains, "are important because they contribute to a steadily growing body of evidence that very high HDL cholesterol levels may not be protective, and because unlike much of the other data available at this time, this study was conducted primarily in patients with established heart disease."

"It may be time to change the way we view HDL cholesterol. Traditionally, physicians have told their patients that the higher your 'good' cholesterol, the better. However, the results from this study and others suggest that this may no longer be the case."

Dr. Marc Allard-Ratick

He cautions that the reasons for the associations revealed remain unclear; but, he speculates, "one possible explanation is that extremely elevated HDL cholesterol may represent 'dysfunctional HDL' which may promote rather than protect against cardiovascular disease."

"One thing is certain," concludes Dr. Allard-Ratick: "the mantra of HDL cholesterol as the 'good' cholesterol may no longer be the case for everyone."

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Which foods lower blood sugar?

When a person has diabetes, either their body does not produce enough insulin, or it cannot use the insulin correctly, so glucose accumulates in the blood. High levels of blood glucose can cause a range of symptoms, from exhaustion to heart disease.

One way to control blood sugar is to eat a healthful diet. Generally, foods and drinks that the body absorbs slowly are best because they do not cause spikes and dips in blood sugar.

The glycemic index (GI) measures the effects of specific foods on blood sugar levels. People looking to control their levels should pick foods with low or medium GI scores.

A person can also pair foods with low and high GI scores to ensure that a meal is balanced.

Below are some of the best foods for people looking to maintain healthy blood sugar levels.

1. Whole wheat or pumpernickel bread foods that lower blood sugar pumpernickel bread
Pumpernickel has a low GI score and fewer carbs than other breads.

Many kinds of bread are high in carbohydrates and quickly raise blood sugar levels. As a result many breads should be avoided.

However, pumpernickel bread and 100 percent stone-ground whole wheat bread have low GI scores, at 55 or less on the GI scale.

Pumpernickel and stone-ground whole wheat breads have lower GI scores than regular whole wheat bread because the ingredients go through less processing.

Processing removes the fibrous outer shells of grains and cereals. Fiber slows digestion and helps to stabilize blood sugar levels.

In a 2014 study, researchers reported that spelt and rye both caused low initial glycemic responses in rats. They also found that these ancient wheat types, as well as emmer and einkorn, suppressed genes that promote glucose metabolism.

2. Most fruits Except for pineapples and melons, most fruits have low GI scores of 55 or less. This is because most fruits contain lots of water and fiber to balance out their naturally occurring sugar, which is called fructose. However, as fruits ripen, their GI scores increase. Fruit juices also have very high GI scores because juicing removes the fibrous skins and seeds. A large 2013 study found that people who consumed whole fruits, especially blueberries, grapes, and apples, had significantly lower risks of developing type 2 diabetes. The researchers also reported that drinking fruit juice increased the risk of developing the condition. 3. Sweet potatoes and yams Regular potatoes have a high GI score, but sweet potatoes and yams have low scores and are very nutritious. Some research indicates that the flesh of the sweet potato contains more fiber than the skin, indicating that the whole vegetable could be beneficial for those with diabetes. Reporting the findings of an animal study, the researchers also noted that sweet potato consumption may lower some markers of diabetes. While there is still no conclusive evidence that sweet potatoes can help to stabilize or lower blood sugar levels in humans, they are undoubtedly a healthful, nutritious food with a low GI score. People can substitute sweet potatoes or yams for potatoes in a variety of dishes, from fries to casseroles. Thank you for supporting Medical News Today 4. Oatmeal and oat bran foods that lower blood sugar oatmeal
Oats contain B-glucans, which help maintain glycemic control. Oats have a GI score of 55 or lower, making them less likely to cause spikes and dips in blood sugar levels. Oats also contain B-glucans, which can do the following: reduce glucose and insulin responses after meals improve insulin sensitivity help maintain glycemic control reduce blood lipids (fats) A 2015 review of 16 studies concluded that oats have a beneficial effect on glucose control and lipid profiles in people with type 2 diabetes. Determining the impact of oat consumption on type 1 diabetes requires more research. Doctors still recommend that people with diabetes limit their consumption of oatmeal because 1 cup contains roughly 28 grams of carbohydrates. 5. Most nuts Nuts are very rich in dietary fiber and have GI scores of 55 or less. Nuts also contain high levels of plant proteins, unsaturated fatty acids, and other nutrients, including: A 2014 systemic review concluded that eating nuts could benefit people with diabetes. As with other foods in this article, it is best to eat nuts that are as whole and unprocessed as possible. Nuts with coatings or flavorings have higher GI scores than plain nuts. 6. Legumes Legumes, such as beans, peas, chickpeas, and lentils, have very low GI scores. They are also a good source of nutrients that can help maintain healthy blood sugar levels. These nutrients include: fiber complex carbohydrates protein A 2012 study found that incorporating legumes into the diet improved glycemic control and lowered the risk of coronary heart disease in people with type 2 diabetes. Avoid legume products that contain added sugars and simple starches, such as those in syrups, sauces, or marinades. These additions can significantly increase a product's GI score. 7. Garlic Garlic is a popular ingredient in traditional medicines for diabetes and a wide variety of other conditions. The compounds in garlic may help reduce blood sugar by improving insulin sensitivity and secretion. In a 2013 study, 60 people with type 2 diabetes and obesity took either metformin alone or a combination of metformin and garlic twice daily after meals for 12 weeks. People who took metformin and garlic saw a more significant reduction in their fasting and post-meal blood sugar levels. People can eat garlic raw, add it to salads, or use it in cooked meals. Thank you for supporting Medical News Today 8. Cold-water fish foods that lower blood sugar cod
Cod does not contain carbohydrates and may reduce the risk of developing type 2 diabetes. Fish and other meats do not have GI scores because they do not contain carbohydrates. However, cold-water fish may help manage or prevent diabetes better than other types of meat. A 2014 study included data taken from 33,704 Norwegian women over a 5-year period. The researchers found that eating 75–100 milligrams of cod, saithe, haddock, or pollock daily reduced the risk of developing type 2 diabetes. However, the researchers were uncertain whether the reduction in risk was a direct result of eating the fish or whether other healthful lifestyle factors, such as exercise, could have influenced the findings. 9. Yogurt Eating plain yogurt daily may reduce the risk of type 2 diabetes. Authors of a large 2014 meta-analysis concluded that yogurt may be the only dairy product that lowers the risk of developing the condition. They also noted that other dairy products do not seem to increase a person's risk. Researchers are still unsure why yogurt helps lower the risk of type 2 diabetes. However, plain yogurt is generally a low-GI food. Most unsweetened yogurts have a GI score of 50 or less. It is best to avoid sweetened or flavored yogurts, which often contain too much sugar for a person looking to lower their blood sugar levels. Greek-style yogurt can be a healthful alternative. Other ways to lower blood sugar levels Eating a healthful, well-balanced diet is key. Additional strategies to help lower or manage blood sugar levels include: staying hydrated by drinking plenty of clear liquids exercising regularly eating small portions more frequently not skipping meals managing or reducing stress maintaining a healthy body weight or losing weight, if necessary People with diabetes may also need to take medications and measure their blood sugar regularly to reduce the risk of potentially dangerous symptoms and complications. Speak with a doctor about how to incorporate a healthful diet into a diabetes care plan.
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Better heart health may mean lower dementia risk in older people

Older adults with more ideal measures of cardiovascular health were less likely to develop dementia and experience cognitive decline.
healthy greens and running shoes
Better measures of heart health protect older people from dementia.

This was the main finding of a recent study now published in JAMA that followed 6,626 people aged 65 and over in France for an average of 8.5 years.

It based the cardiovascular health measures on the American Heart Association (AHA) "Simple 7" guide.

The guide recommends: giving up smoking; being physically active; having a diet rich in vegetables, fruit, and fish; having a healthy weight; and managing blood pressure, cholesterol, and blood sugar.

Lead study author Dr. Cecilia Samieri, from the Université de Bordeaux in France, and colleagues explain in their study paper that few researchers have "investigated the combined effect of these risk factors on the risk of dementia and cognitive aging."

Those that have, they observe, have tended to concentrate on the first four "lifestyle" factors — namely, smoking status, physical activity, diet, and weight.

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'Optimal levels' of cardiovascular health

The people examined in the research lived in Bordeaux, Dijon, and Montpellier, all in France. None had dementia or a history of cardiovascular disease when they joined the study, which began recruiting in 1999. Their average age was 73.7 years and 4,200 were women.

All of the participants took repeated tests of cognitive ability during the follow-up. In addition, they underwent screening for dementia, and an independent panel of neurologists confirmed any diagnoses.

At the start of the study, the scientists also assessed each individual according to how well they matched the "optimal level" of each of the seven cardiovascular health measures.

They defined the optimal levels of these measures as:

never having smoked or having quit for at least 12 months regular physical activity, such as walking at least 8 hours per week or 4 hours per week or more of moderate-intensity sport or leisure activity at least one daily portion of raw vegetables, fresh fruits, and cooked fruits or vegetables and two or more servings per week of fish a body mass index (BMI) under 25 total cholesterol under 200 milligrams per deciliter, untreated blood pressure below 120/80 millimeters of mercury, untreated fasting blood glucose under 100 milligrams per deciliter, untreated

At the start of the study, 36.5 percent of people were in the optimal level in 0–2 of the measures, while 57.1 percent achieved optimal levels in 3–4 measures and 6.5 percent achieved 5–7.

Over the follow-up, the panel diagnosed and confirmed 745 cases of dementia.

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Brain and heart share risk factors

When they analyzed the results at the end of the study, the researchers revealed that having more optimal levels of cardiovascular health measures was tied to a lower dementia risk and cognitive decline rate.

They conclude that:

"These findings may support the promotion of cardiovascular health to prevent risk factors associated with cognitive decline and dementia."

In discussing the study's limitations, the authors note that because it included mainly white people living in urban settings, the results may not be typical of other groups.

Another limitation that they highlight is the fact that they did not consider changes to individuals' cardiovascular measures over the period of the study.

In a linked editorial, Drs. Jeffrey L. Saver and Mary Cushman comment on these results and those of another investigation, led by the University of Oxford in the United Kingdom, published in the same issue of the journal.

The other study examined healthy young adults for any links between cardiovascular health and measures of brain structure and function that were assessed using state-of-the-art imaging technology.

Those results showed that good cardiovascular health — "already at this early age" — was tied to signs of "more robust" blood circulation and less damage of white matter in the brain.

"Failure to attain optimal cardiovascular health," note Drs. Saver and Cushman, "appears to subtly compromise the fundamental anatomic structure of the brain vascular system in addition to its functional physiology and the integrity of the brain tissue it nourishes."

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Alcohol and heart health: Consistency may be key

The latest study to peer at the relationship between heart health and alcohol concludes that shifting drinking patterns across the years might increase the risk of cardiovascular disease.
Selection of alcoholic drinks
Alcohol and heart health are examined once more in a new study.

Alcohol has been addling minds since it was first brewed millennia ago.

Consumed in virtually every country on earth, understanding its health implications is important.

Already, scientists have tied plenty of health hazards to alcohol. Among other conditions, it increases the risk of certain cancers, stroke, and liver disease.

Heavy drinking has conclusively been shown to harm health, but there is still discussion surrounding the fine print.

For instance, although light drinking has been shown to increase cancer risk, there is also evidence that light drinking could protect the heart.

A recent study found that people who drank one or fewer drinks per day had lower cardiovascular risk than people who drank more, as well as people who abstained completely. Could a small amount of alcohol be heart protective?

However, the increased cardiovascular risk seen in people who do not drink at all may not be what it seems. Some have made the point that individuals who do not drink now might still have been drinkers in the past.

In other words, someone who hasn't touched a drop for months may have still been a heavy drinker for many years in the past.

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Alcohol and the heart revisited

The latest study, which is published in the journal BMC Medicine, set out to clear up this query by comparing rates of coronary heart disease (CHD) in individuals who have never drunk and those who used to drink but quit.

As corresponding author Dr. Dara O'Neill, who works at University College London in the United Kingdom, says, "This study uses long-term data to distinguish between persistent non-drinkers and former drinkers, allowing us to test the established theory that only the latter have an elevated risk of CHD."

To investigate whether the theory held true, they examined data from 35,132 people taken from six earlier studies in the U.K. and France. The data included self-reported weekly alcohol intake across a period of 10 years. Of the 35,132 people, 1,718 (4.9 percent) developed CHD. In 325 of the cases (0.9 percent), the person died.

Did persistent non-drinkers have a lower cardiovascular risk than former drinkers, as hypothesized? Dr. O'Neill says, "We did not find this to be the case, but we did observe a sex-related difference. Amongst consistent non-drinkers, women showed higher risk of developing CHD compared to consistently moderate drinkers, but their male counterparts did not."

CHD incidence was highest for former drinkers (6.1 percent had a CHD event), while incidence was lowest in consistently heavy drinkers (3.8 percent experienced a CHD event).

However, the scientists make it clear that because there were so few people who drink heavily in the dataset, the apparent reduction in risk should not be taken as fact.

As Dr. O'Neill points out, "Given that heavy drinkers are known to be undersampled in population-level surveys, interpretation of the absence of effect amongst heavy drinkers in the current study should be done very cautiously, particularly in light of the known wider health impact of heavy alcohol intake levels."

They showed that individuals who drank sensibly and in line with U.K. guidelines over a 10-year period had a lower risk than those who never drank, those who inconsistently drank in moderation, and those who had stopped drinking.

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Consistency and fluctuation

According to the authors, these findings suggest that fluctuations in drinking patterns over time are associated with an increase in CHD risk. It is probable that changes in drinking patterns mirror life events, such as long periods of ill health or other life stresses, including divorce, bereavement, or unemployment.

This complex interaction makes studies such as this difficult to draw meaning from. We all have long, complicated lives, wherein a myriad of influences increase or decrease health risks. To investigate these relationships further, the researchers split the data into age groups.

"When we split the sample by age," explains Dr. O'Neill, "we found that the elevated risk of incident CHD amongst inconsistently moderate drinkers was observed in participants aged over 55, but not those aged below," adding:

"It may be that the older group experienced lifestyle changes, such as retirement, which are known to co-occur with increases in alcohol intake and that these could have played a role in the differing risk."

As with any study that looks at alcohol intake and health, there are unavoidable gaps and plenty of room for future improvements. For instance, heavy drinkers who had fallen ill early on in the study may have dropped out, skewing the data.

Also, as ever, this is an observational study, meaning that cause and effect can not be proven. In the long line of studies investigating long-term alcohol intake and heart health, this study adds another slice of information but still leaves plenty of questions unanswered.

Thanks to humanity's fascination with alcohol, studies unpicking its potential benefits and pitfalls are sure to continue.

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How to tell if it is a bruise or a blood clot

Blood clots and bruises both affect the blood vessels, but they have some significant differences. A bruise is a noticeable mark on the skin that generally resolves over time. A blood clot is a clump of blood that has formed in deeper tissue or within a blood vessel and is rarely visible.

A bruise often forms while the outer layer of skin is still intact and it changes the color of the visible layers of skin. This change in appearance is due to tiny blood vessels called capillaries bursting in the area. The skin may continue to change color as the bruise begins to heal.

Blood clots can also result from damage to a blood vessel. When an injury occurs to a blood vessel, such as damage from a cut or impact from a blunt object, blood leaks out of the blood vessel and into the tissue around it. It forms a collection of blood that often clots, which is called a hematoma.

A blood clot can also occur inside a blood vessel, in which case doctors will call it a thrombus. A blood clotting problem in the body can sometimes be the cause. In other cases, high blood pressure, diabetes, and other conditions can damage the lining of the blood vessel, resulting in a thrombus forming.

Differences in bruise and blood clot causes Bruises and blood clots can both be the result of damage to blood vessels. However, the causes and symptoms can vary. Causes of bruises Bruise on person's knee.
A bruise can form after a hard impact.

Bruises typically occur after an injury, such as hard contact with an object, falling down, or breaking a bone. These types of injury can cause the blood vessels in the skin to burst. Bruises can occur anywhere on the skin.

The burst blood vessels leak blood, which becomes trapped and discolored beneath the surface of the skin, forming a bruise. The black and blue appearance of a bruise comes from the lack of oxygen in the trapped blood.

Causes of blood clots

Blood clots are part of the natural process of healing after an injury.

Damage to an area causes coagulants in the blood called platelets to collect and clump together near the injury, which helps stop the bleeding.

Small clots are normal and disappear on their own. However, some blood clots become larger than necessary or form in places where there is no injury. Blood clots can form on their own within a blood vessel due to hypercoagulation, which requires medical treatment.

Symptoms Many of the symptoms of bruises and blood clots can be quite similar, but certain types of clot can cause much more severe effects. Symptoms of bruises Most bruises tend to create similar symptoms. The site of the bruise will appear reddish at first, then turn to a dark blue, purple, or blackish color over the first few hours to days. A bruise will change color as it heals, typically getting lighter and more yellow until it fades completely. Bruises may be sore or painful to the touch as they heal. As the marks of the bruise fade, the pain tends to lessen as well. Symptoms of blood clots Deep tissue blood clots, or hematomas, do not follow an exact pattern as they heal but may cause different symptoms depending on where they are in the body and which tissues they affect. Large hematomas that occur within muscles or organs often require medical treatment. Blood clots within blood vessels can block the flow of blood and oxygen to parts of the tissue. This obstruction can be life-threatening as it can cause severe damage or death to cells. Some examples of severe conditions that a thrombus can cause include: Stroke: A blood clot in any of the arteries going to the brain or within the brain itself. Heart attack: A blood clot in an artery of the heart. Pulmonary embolism: A blood clot in an artery of the lung. Mesenteric ischemia: A blood clot in an artery to the intestines. Deep vein thrombosis (DVT): A blood clot in any deep vein, most commonly in the leg. The symptoms of a thrombus vary according to the organ and tissue that it affects and can include: slurred speech and numbness or weakness on one side of the body, which are signs of a stroke chest pain and shortness of breath, which can signify a heart attack or a pulmonary embolism abdominal pain, fever, and blood in the stool, which are signs of mesenteric ischemia leg pain and swelling, which are signs of DVT Anyone who thinks that they are experiencing the symptoms of a thrombus should seek immediate medical care. Thank you for supporting Medical News Today Risk factors There are many risk factors for blood clots and bruises, some of which people can manage by making lifestyle changes. Risk factors for bruises Bruises are a relatively common occurrence. Bumping into a hard surface is usually enough to cause a bruise. It may not take a significant impact, so sometimes the individual will not remember how they got the bruise. Although most people will get a bruise at some point, specific factors may increase the likelihood. Some drugs, including blood thinners, may lead to increased bleeding from blood vessels after an injury and, therefore, more bruising. This can occur with both prescription blood thinners, such as warfarin, and over-the-counter (OTC) drugs, such as aspirin and fish-oil supplements. Some vitamin deficiencies or bleeding disorders may also make a person more prone to bruising and bleeding, while aging tends to make the skin and blood vessels more fragile. There are also certain medical conditions that can lead to abnormally low platelets or low clotting factors, which can result in unexplained bruising or bleeding. Risk factors for blood clots Office workers sitting at desks in front of computers
Sitting for prolonged periods may increase the risk of blood clots. Normal wound healing can involve blood clot formation. However, there are a large number of risk factors for other blood clots forming within blood vessels. Genetic predisposition is a risk factor for abnormal blood clotting. People may be more likely to experience excessive blood clotting if they have a family history of dangerous blood clots or have previously had them themselves. According to the American Society of Hematology, other factors that may increase the risk include: smoking being pregnant being over the age of 60 being overweight or obese sitting or resting for extended periods having hormone therapy having had recent surgeries Other disorders may also make blood clots more likely. Among others, these include chronic inflammatory diseases, heart failure, high blood pressure, and diabetes. People who have experienced recent trauma, such as a fall or another accident, may also be at higher risk. When to see a doctor Anyone with severe pain at the site of an injury should see a doctor for a full diagnosis. Normal bruising is rarely a cause for concern, but any unexplained bruising requires a visit to the doctor. Certain severe medical conditions and illnesses can cause unexplained bruising, bleeding, and blood clots. These conditions require proper diagnosis and treatment. People should speak to a doctor about any bruises that last longer than 2 weeks or appear alongside other symptoms, such as pain or swelling. Anyone who suspects that they are experiencing symptoms of a thrombus should seek immediate medical attention. It is also advisable for people who have a higher risk of developing a thrombus to see a doctor as a precaution. Anyone who experiences the following should also visit a doctor: a deep bruise after an injury a lump that is firm to the touch below the skin deep aching after a significant injury, such as a bicycle or car accident, sports injury, or fall How are bruises and blood clots diagnosed? Many doctors will use imaging tests to help diagnose a thrombus or hematoma after they have carried out a physical examination and a review of the person's medical history. Imaging tests for blood clots may include an ultrasound, CT, or MRI scan. These tests can help doctors look for blood clots both in blood vessels and within tissues and organs. Doctors can generally diagnose superficial bruises by sight , taking into account any skin discoloration, tissue swelling, and other injuries. This is also the case for small blood clots under the fingernails or toenails, known as subungual hematomas. Thank you for supporting Medical News Today Treatment man pouring pills into palm of hand from prescription pot
A doctor can prescribe medication to prevent blood clots. Bruises do not usually require any treatment. However, doctors may recommend using home remedies to alleviate symptoms, for example, applying ice packs to the bruise for the first 24–48 hours and then using heat packs after that. If a bruise is particularly painful or extensive, doctors may recommend OTC pain relievers. Doctors who suspect that an underlying condition is causing the bruising may run additional tests or recommend treatments for the condition. Depending on its cause and the organs and tissues that it affects, a hematoma may or may not require treatment. Sometimes, these blood clots may need medical treatment or surgical procedures, particularly if they occur without injury. To treat a thrombus, doctors will use medications to help prevent ongoing clotting or future blood clots. This treatment will usually require a hospital stay. Injectable blood-thinning drugs, such as heparin, can help prevent new clots from forming. In cases of stroke, heart attack, or pulmonary embolism, a person may receive clot-dissolving medications called thrombolytics. Doctors may also recommend that the individual uses blood thinners going forward as a way to prevent their blood from clotting unnecessarily in the future. Takeaway Both bruises and blood clots often result from damage to blood vessels. Bruises generally heal on their own, while the formation of small blood clots due to cuts or injury is a normal part of the body's healing process. However, blood clots in deep tissues may require further evaluation and treatment, depending on their location. Blood clots within blood vessels are always a medical emergency and can become life-threatening due to their effects on blood and oxygen flow. Anyone who suspects that they have a thrombus should seek immediate medical attention.
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High cholesterol early in life boosts heart disease risk

High levels of low-density lipoprotein cholesterol can increase a person's risk of cardiovascular disease. People may worry more about their cholesterol levels when they age, but new research suggests that they should take preventive action much earlier.
ldl cholesterol chart
You may need to start monitoring your cholesterol levels earlier in life to avoid cardiovascular disease, a new study suggests.

A new study — the findings of which appear in the journal Circulation — suggests that people with high levels of low-density lipoprotein (LDL) cholesterol early in life may experience an increased lifetime risk of death related to cardiovascular disease (CVD).

LDL cholesterol can increase cardiovascular risk at high levels because it leads to lipid buildup in the arteries, which can affect the blood flow to and from the heart.

In the new study, which was of an observational nature, the scientists considered the links between LDL cholesterol levels, high-density lipoprotein (HDL) cholesterol levels, and the risk of premature death related to CVD and coronary heart disease (CHD).

Specifically, the researchers wanted to find out whether individuals currently considered at low risk of CVD or CHD for the coming 10 years may benefit from learning about their cholesterol levels earlier in life and keeping them in check so as to prevent the development of complications.

"High cholesterol at younger ages means there will be a greater burden of cardiovascular disease as these individuals age. This research highlights the need to educate Americans of any age on the risks of elevated cholesterol, and ways to keep cholesterol at a healthy level throughout life."

Dr. Robert Eckel, the former president of the American Heart Association (AHA)

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While usually, studies about cholesterol levels and cardiovascular risk recruit participants who are at moderate to high risk of developing cardiovascular conditions, the new research focused on younger and mostly healthy individuals.

For this study, the researchers recruited 36,375 participants — of which 72 percent were men — aged 42, on average, via the Cooper Center Longitudinal Study. All the participants were free of both diabetes and CVD at baseline, and the investigators followed their health progression for a period of 27 years.

The researchers revealed that, for people who were otherwise at low risk of CVD, high LDL levels were independently associated with a heightened risk of CVD-related death.

Specifically, when compared with participants with normal LDL levels (under 100 milligrams per deciliter), those with high LDL levels (between 100–159 milligrams per deciliter) had a 30–40 percent higher likelihood of experiencing premature death due to CVD.

Also, compared with participants who displayed normal LDL readings, those with LDL cholesterol levels of 160 milligrams per deciliter or higher had a 70–90 percent higher risk of CVD-related death.

In total, within the study cohort, there were 1,086 CVD-related deaths and 598 deaths related to CHD.

"Our study demonstrates that having a low 10-year estimated cardiovascular disease risk does not eliminate the risk posed by elevated LDL over the course of a lifetime," says lead study author Dr. Shuaib Abdullah, from the University of Texas Southwestern Medical Center in Dallas.

"Those with low risk should pursue lifestyle interventions, such as diet and exercise, to achieve LDLs levels as low as possible, preferably under 100 [milligrams per deciliter]," Dr. Abdullah advises, adding, "Limiting saturated fat intake, maintaining a healthy weight, discontinuing tobacco use, and increasing aerobic exercise should apply to everyone."

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New 'triple pill' could eliminate high blood pressure

A new combination drug may have the potential to revolutionize hypertension treatment worldwide, after a clinical trial has declared it safe to use and very effective.
concept photo of heart pills and pulse
A recent clinical trial has confirmed that a new pill can treat hypertension more effectively than traditional therapy.

In a recent clinical trial led by researchers from the George Institute for Global Health — with branches in the United Kingdom, Australia, and India — they tested the effectiveness and safety of using an innovative drug for the treatment of high blood pressure, or hypertension.

This drug, nicknamed the "triple pill" by the investigators, combines low doses of three existing drugs for blood pressure.

Namely, these are: telmisartan (20 milligrams), amlodipine (2.5 milligrams), and chlorthalidone (12.5 milligrams).

According to World Health Organization (WHO) data from 2008, about 40 perecent of adults aged over 25 had raised blood pressure worldwide. The WHO also estimate that hypertension is responsible for 7.5 million of all deaths across the globe.

That is because this condition is a major risk factor for both heart disease and stroke, making it a priority to have effective treatments in place for the regulation of blood pressure.

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Normally, people with hypertension start taking one blood pressure drug at low doses, only to have to return to their doctors time and again. They then get prescriptions for increasingly higher doses and more hypertension drugs.

According to study co-author Dr. Ruth Webster, "Patients are brought back [to the doctor's office] at frequent intervals to see if they are meeting their targets with multiple visits required to tailor their treatments and dosage."

"The problem with this approach," she adds, is that it "is not only time inefficient, it's costly. We also know that many doctors and patients find it too complicated and often don't stick to the process."

So, Dr. Webster and colleagues tested a method that, they hoped, would be more efficient, would not have additional side effects, and would remove some of the inconveniences related to a traditional treatment.

This is how they came up with the "triple pill," which combines fixed low doses of three already existent drugs commonly used to treat hypertension.

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'Triple pill' vs. traditional therapy

The clinical trial testing the efficacy and safety of the new combination pill took place in Sri Lanka. It involved 700 participants — aged 56, on average — whose average blood pressure amounted to 154/90 millimeters of mercury (mm Hg), which is a typical sign of hypertension.

Of all the participants, some took the combination pill, while others continued to follow their usual blood pressure-lowering therapy, as per their doctors' advice.

In contrast to those following traditional therapy for hypertension, a larger number of those taking the combination pill were able to lower their blood pressure effectively, reaching their target pressure of 140/90 mm Hg or under.

The target for individuals with diabetes or kidney disease was 130/80 mm Hg, which many people taking the "triple pill" were able to reach.

More specifically, 70 percent of the people taking the "triple pill" achieved their target blood pressure, compared with a little over 50 percent of the participants who continued on traditional hypertension therapy.

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In the study paper they published in JAMA, the authors explain that after 6 months from the start of the trial, 83 percent of the people who had started on the "triple pill" were still following this same treatment.

To the contrary, most of the participants following a traditional treatment had added medication or increased drug quantities by the 6-month mark.

"The World Heart Federation [have] set an ambitious goal that by 2025 there will be a 25 percent reduction in blood pressure levels globally," says study co-author Prof. Anushka Patel.

"The triple pill," she continues, "could be a low-cost way of helping countries around the world to meet this target."

'This study has global relevance'

Researchers at the George Institute believe that their "triple pill" could really make a difference to current therapy for hypertension.

Right now, the team is looking into the combination drug's cost effectiveness for various countries and putting into place strategies to make the drug accessible across the world. "This study has global relevance," says Prof. Patel.

"While the most pressing need, from the perspective of the global burden of disease, is low- and middle-income countries, it's equally relevant in a country like Australia where we're still achieving only [40–50 percent] control rates for high blood pressure."

Prof. Anushka Patel

In the video below, you can listen to Prof. Patel as she explains exactly how the "triple pill" works.

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Foods to eat for better sex

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Barassi, A., Corsi Romanelli, M. M., Pezzilli, R., Damele, C. A. L., Vaccalluzzo, L., Goi, G., . . . Melzi d'Eril, G. V. (2017, February 8). Levels of L-arginine and L-citrulline in patients with erectile dysfunction of different etiology. Andrology, 5(2), 256–261. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/andr.12293/full

Cassidy, A., Franz, M., & Rimm, E. B. (2016, February 1). Dietary flavonoid intake and incidence of erectile dysfunction. The American Journal of Clinical Nutrition, 103(2), 534–541. Retrieved from https://academic.oup.com/ajcn/article/103/2/534/4564750

Davis, S. R., Worsley, R., Miller, K. K., Parish, S. J., & Santoro, N. (2016, February). Androgens and female sexual function and dysfunction – Findings from the Fourth International Consultation of Sexual Medicine [Abstract]. Journal of Sexual Medicine, 13(2), 168–178. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26953831

English, J. (2013, April 19). A natural approach to enhancing sexual libido and performance. Retrieved from https://nutritionreview.org/2013/04/arginine-select-phytonutrients-enhance-libido/

Fallah, A., Mohammad-Hasani, A., & Colagar, A. H. (2018, April–June). Zinc is an essential element for male fertility: A review of Zn roles in men's health, germination, sperm quality, and fertilization. Journal of Reproduction & Infertility, 19(2), 69–81. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/

Fulgoni III, V. L., Dreher, M., & Davenport, A. J. (2013, January 2). Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: Results from the National Health and Nutrition Examination Survey (NHANES) 2001–2008. Nutrition Journal, 12(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545982/

Higdon, J. (2016, February). Flavonoids. Retrieved from https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/flavonoids

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How much salt does it really take to harm your heart?

Too much salt is bad for you, particulary because it is associated with an increased risk of heart problems — but how much is too much? A new study suggests that we may not have to worry so much about how salty we like our food to be.
salt shaker
A new international study suggests that we may want to rethink how much salt is actually harmful.

Table salt, which we commonly use to season our food, contains sodium.

Sodium, if often ingested in large quantities, can lead to a range of cardiovascular problems, including hypertension.

The World Health Organization (WHO) say that a person should not consume more than 2 grams of sodium per day, which is about 5 grams of salt per day.

The American Heart Association (AHA) recommend no more than 2.5 grams of sodium per day, though they state that the ideal intake is of no more than 1.5 grams per day for an adult.

However, researchers from a range of international institutions — including McMaster University and Hamilton Health Sciences, both in Hamilton, Canada, as well institutions from 21 other countries — suggest that these limits are unnecessarily low.

Researcher Andrew Mente and colleagues conducted a study of 94,000 people aged 35–70, aiming to establish how much sodium really is too much for heart health.

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Current guidelines, the team notes, push for standards that are unrealistic for many, seeing as salt is often an almost invisible ingredient contained by numerous packaged foods.

"The [WHO recommend] consumption of less than 2 grams of sodium — that's one teaspoon of salt — a day as a preventative measure against cardiovascular disease," says Mente.

He also adds, however, that "there is little evidence in terms of improved health outcomes that individuals ever achieve at such a low level."

The new study, whose results are now featured in The Lancet, now suggests that we can be more lenient about our salt consumption without fearing that it will harm our cardiovascular health.

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Slightly higher sodium intake is safe

The study followed the participants — who were based in communities across 18 different countries — for an average period of 8 years.

Mente and his colleagues revealed that a high intake of sodium did lead to an increased risk of cardiovascular disease and stroke — but only in communities where the average intake for an adult was greater than 5 grams per day.

This amounts to about 2.5 teaspoons of table salt, the researchers explain.

Encouragingly, the researchers also noticed that under 5 percent of the participants coming from developed countries exceeded the 5-gram cutoff point for sodium intake.

In most of the countries, the majority of the communities that the researchers observed had an average sodium intake of 3–5 grams of sodium — or 1.5 to 2.5 teaspoons of salt — per day.

In fact, of all the populations in the study, only those from China showed a consistently high intake of sodium. Specifically, 80 percent of the communities from China had a sodium intake that was higher than 5 grams per day.

"Only in the communities with the most sodium intake — those over 5 grams [per] day of sodium — which is mainly in China, did we find a direct link between sodium intake and major cardiovascular events like heart attack and stroke," Mente explains.

On the other hand, he adds, "In communities that consumed less than 5 grams of sodium a day, the opposite was the case. Sodium consumption was inversely associated with myocardial infarction or heart attacks and total mortality, and [there was] no increase in stroke."

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Community interventions can help

Even in the case of individuals who do consume too much table salt, however, the situation is not unsalvageable, the researchers say.

Mente notes that people can easily redress the balance and protect their heart health by making a few simple adjustments to their diets, such as adding more fruits, vegetables, and foods naturally rich in potassium.

"We found all major cardiovascular problems, including death, decreased in communities and countries where there is an increased consumption of potassium which is found in foods such as fruits, vegetables, dairy foods, potatoes, and nuts and beans," says the study author.

Another one of the researches involved with the current study, Martin O'Donnell, notes that most of the studies looking at the relationship between sodium intake and cardiovascular risk so far have focused on individual data, rather than information collected from larger cohorts.

This, he suggests, may have skewed the best practice guidelines into a direction that is both unrealistic and perhaps too cautious.

"Public health strategies should be based on best evidence. Our findings demonstrate that community-level interventions to reduce sodium intake should target communities with high sodium consumption, and should be embedded within approaches to improve overall dietary quality."

Martin O'Donnell

"There is no convincing evidence that people with moderate or average sodium intake need to reduce their sodium intake for prevention of heart disease and stroke," O'Donnell adds.

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'Monster' radish might help fight heart disease

Discovering ways of reducing cardiovascular risk is an ongoing challenge for medical science. A recent study asks whether "monster" radishes might provide some assistance.
Radish heart shape
The Sakurajima radish dwarfs the regular radishes pictured here.

The official name for the so-called monster radish is the Sakurajima daikon.

Originally cultivated on the island of Sakurajima, Japan, centuries ago, it is an impressive beast.

The largest Sakurajima on record weighed almost 69 pounds, measuring well over 1 meter in circumference.

Radishes in general are known to contain high levels of antioxidants. Also, according to earlier studies, they may influence factors associated with heart attack and stroke — namely, increased blood pressure and the risk of blood clots.

Roughly 1 in 4 deaths are due to cardiovascular diseases, such as heart attack and stroke, so discovering a natural chemical that can reduce the risks would be a big win.

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Dissecting the monster radish

To date, no studies have investigated the potential cardiovascular benefits of the monster radish. So, recently, researchers from Kagoshima University in Japan set up a trial to see whether the radishes' health benefits are as sizable as its girth. The results were published recently in the Journal of Agricultural and Food Chemistry.

The team of scientists, led by Katsuko Kajiya, was particularly interested in the Sakurajima's influence over nitric oxide production, an important regulator of blood vessel function.

The cells that line blood vessels — vascular endothelial cells — produce nitric oxide; when this gas is released into the bloodstream, it causes blood vessels to relax, which reduces blood pressure.

Nitric oxide helps reduce cardiovascular risk in more than one way: white and red blood cells sometimes attach to blood vessel walls, which increases the risk of clots forming. Nitric oxide release prevents this from happening so freely.

Antioxidants are thought to damage endothelial cells, which reduces their ability to produce nitric oxide and therefore increases the risk of cardiovascular disease.

Uncovering interventions that can induce nitric oxide release from these cells would, therefore, have a protective effect on vascular health.

The team used vascular endothelial cells from both humans and pigs to pit Sakurajima daikon against other, less impressive types of radish. Using a range of tests, including fluorescence microscopy, the scientists demonstrated that the monster radish "induced more nitric oxide production" than its diminutive cousins.

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Radish compound identified

Kajiya also wanted to understand exactly how the Sakurajima daikon influences nitric oxide. After ruling out other potential compounds, including the neurotransmitter GABA, the team concluded that a plant hormone called trigonelline could be the main player.

Trigonelline seems to trigger a molecular cascade that boosts nitric oxide production. Interestingly, trigonelline is not a stranger to medical research, as the authors explain:

"The compound is found in coffee and some agricultural and marine products. [...] Trigonelline has been reported to reduce brain aging and Alzheimer-type dementias, and it has inhibitory effects on the invasion of cancer cells."

The compound may also be useful in the prevention of diabetes. It is present in a number of plants, including garden peas, hemp seed, oats, and potatoes. It might be that, over the coming years, we hear more about the potential uses of this chemical.

The authors of the new study hope that their results will be useful to scientists looking for active components in other vegetables.

Once the mechanism is understood in more detail, it could lead to much improved pharmaceutical interventions that slow the progression of cardiovascular disease or prevent it from developing in the first place.

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Can you have hypoglycemia without diabetes?

Hypoglycemia occurs when blood sugar levels fall dangerously low. It is more common in people with diabetes, but it can affect others.

In this article, we explore the health conditions beyond diabetes that can cause hypoglycemia. We also look at treatment options and the dietary changes that can help prevent low blood sugar.

What is hypoglycemia? Blood sugar
Hypoglycemia is when blood sugar levels are very low.

Hypoglycemia occurs when blood sugar levels drop below 70 milligrams per deciliter (mg/dl). Severe hypoglycemia can be life-threatening if a person does not receive treatment. Treatments focus on returning blood sugar to safe levels.

Blood sugar, or glucose, is the body's primary source of energy. When levels fall too low, the body does not have enough energy to function fully. This is called hypoglycemia.

Insulin helps the body's cells to absorb sugar from the bloodstream. A person with diabetes may take insulin shots because their body is resistant to insulin or because it does not produce enough.

In people with diabetes, taking too much insulin can cause blood sugar levels to drop too low. Not eating enough or exercising too much after taking insulin can have the same effect.

However, people who do not have diabetes can also experience hypoglycemia.

Thank you for supporting Medical News Today Causes of hypoglycemia without diabetes In people without diabetes, hypoglycemia can result from the body producing too much insulin after a meal, causing blood sugar levels to drop. This is called reactive hypoglycemia. Reactive hypoglycemia can be an early sign of diabetes. Other health issues can also cause hypoglycemia, including: Drinking too much alcohol When a person's blood sugar levels are low, the pancreas releases a hormone called glucagon. Glucagon tells the liver to break down stored energy. The liver then releases glucose back into the bloodstream to normalize blood sugar levels. Drinking too much alcohol can make it difficult for the liver to function. It may no longer be able to release glucose back into the bloodstream, which can cause temporary hypoglycemia. Medication Taking another person's diabetes medication can cause hypoglycemia. Hypoglycemia can also be a side effect of: Some groups have an increased risk of medication-induced hypoglycemia, including children and people with kidney failure. Anorexia A person with the eating disorder anorexia may not be consuming enough food for their body to produce sufficient glucose. Hepatitis Hepatitis is an inflammatory condition that affects the liver. Having hepatitis can prevent the liver from working properly. If the liver cannot produce or release enough glucose, this can cause problems with blood sugar levels and lead to hypoglycemia. Adrenal or pituitary gland disorders Problems with the pituitary gland or adrenal glands can cause hypoglycemia because these parts of the body affect the hormones that control glucose production. Kidney problems The kidneys help the body process medication and excrete waste. If a person has a problem with their kidneys, medication can build up in their bloodstream. This type of buildup can change blood sugar levels and lead to hypoglycemia. Pancreatic tumor Pancreatic tumors are rare, but having one can lead to hypoglycemia. Tumors in the pancreas can cause the organ to produce too much insulin. If insulin levels are too high, blood sugar levels will drop. Symptoms Dizzy and confused senior woman outdoors.
Dizziness and confusion can be symptoms of hypoglycemia. When a person has hypoglycemia, they may feel: shaky dizzy unable to concentrate unable to focus their eyes confused moody hungry A person with hypoglycemia may develop a headache or pass out (lose consciousness). If a person has hypoglycemia often, they may stop experiencing symptoms. This is called hypoglycemia unawareness. Thank you for supporting Medical News Today Diagnosis To diagnose hypoglycemia, a doctor first asks a person about their symptoms. If the doctor suspects hypoglycemia, they may perform a blood test. Blood sugar levels below 70 mg/dl can indicate hypoglycemia. However, everyone has a different base blood sugar level, and the measurement that determines hypoglycemia can vary. The doctor may use other tests to determine the underlying cause of low blood sugar. Treatment Pink round tablet supplements
Glucose tablets can help to raise blood sugar levels. Treating the underlying cause is the best way to prevent hypoglycemia in the long term. In the short term, receiving glucose helps blood sugar levels return to normal. According to research from 2014, the best way to treat mild hypoglycemia is to: take 15 grams of glucose wait for 15 minutes measure blood glucose levels again repeat this treatment if hypoglycemia persists There are many ways to receive glucose, including: taking a glucose tablet injecting glucose drinking fruit juice eating carbohydrates Eating slow-release carbohydrates may help sustain blood sugar levels. Thank you for supporting Medical News Today Non-diabetic hypoglycemia diet A non-diabetic hypoglycemia diet can help keep blood sugar levels balanced. The following tips can help to prevent hypoglycemia: eating small meals regularly, rather than three large meals eating every 3 hours eating a variety of foods, including protein, healthful fats, and fiber avoiding sugary foods Carrying a snack to eat at the first sign of hypoglycemia can prevent blood sugar levels from dipping too low. Ultimately, the best way to prevent hypoglycemia is to identify and treat the underlying cause.
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What is the difference between heartburn and acid reflux?

Understanding the differences between heartburn, acid reflux, and gastroesophageal reflux disease involves understanding the links between them.

According to the American College of Gastroenterology, heartburn is a common digestive complaint in the United States, affecting more than 60 million Americans each month.

Heartburn is not a condition on its own, and it has nothing to do with the heart. Instead, it is a symptom of acid reflux.

If symptoms of acid reflux occur frequently, it can indicate that a person has gastroesophageal reflux disease (GERD).

Distinguishing between heartburn, acid reflux, and GERD may be hard, because they may all feel the same in the moment. However, understanding the differences can help a person find the right treatment.

Symptoms The following symptoms can help a person to tell the difference between acid reflux, heartburn, and GERD: Symptoms of acid reflux Heartburn vs. acid reflux
Acid reflux causes stomach acid to travel up the food pipe into the mouth.

Acid reflux is sometimes called gastroesophageal reflux or GER. It occurs when stomach acid travels up the food pipe to the mouth.

This can happen when the muscle at the bottom of the food pipe, which acts as a gateway to the stomach, becomes weak or loose.

Heartburn is a burning sensation in the chest or abdomen, and it has nothing to do with the heart. People often feel heartburn behind the breastbone and after eating. It can get worse when sitting or lying down.

Heartburn is the most common symptom of acid reflux, though it does not appear in every case.

Acid reflux also causes the following symptoms:

bad breath nausea or vomiting difficulty or pain when swallowing breathing problems

Symptoms of GERD

GERD is the term for chronic acid reflux. The symptoms are the same, but they happen more frequently with GERD.

If a person experiences symptoms of acid reflux more than twice a week for a few weeks, they may have GERD. The disease affects about 20 percent of the U.S. population.

Causes The stomach is built to withstand acid. The food pipe is not, and when acid rises into it, a person experiences burning pain. The muscle at the end of the food pipe is called the lower esophageal sphincter. It can weaken or relax, and potentially cause acid reflux, for several reasons. For example, high amounts of pressure on the abdomen can cause the sphincter to grow slack. For this reason, acid reflux is common in people who are overweight, obese, or pregnant. Other causes of acid reflux involve: smoking or regular exposure to secondhand smoke alcohol consumption a type of hernia called a hiatal hernia eating large meals eating late at night or just before bed consuming high-fat or fried foods acidic drinks, such as fruit juice Various medications can also trigger acid reflux, including: Thank you for supporting Medical News Today Heartburn vs. heart attack Heartburn vs. acid reflux chest pain
Seek medical care immediately if chest pain accompanies shortness of breath and a squeezing feeling. Chest pain and related symptoms are among the top reasons for visits to emergency departments in the U.S. Acid reflux is a common cause of chest pain, and it can be easy to confuse this pain with that of a heart attack. Because heartburn can spread to the neck, throat, and jaw, it may feel like the radiating chest pain of a heart attack. There are a few ways to tell the difference between heartburn and a heart attack. If the pain improves after a quick antacid or a belch, or if there is a sour taste in the mouth, a person most likely has heartburn. A person having a heart attack often experiences a feeling of squeezing or pressure and shortness of breath. Due to the seriousness of a heart attack, The American Heart Association recommend that anyone who believes they may be having a heart attack should seek medical care as soon as possible. This includes people who are unsure whether their chest pain results from a heart. Diagnosis A doctor is a good place to start for an acid reflux or GERD diagnosis. Assessments typically begin with a few questions and a review of the person's medical history. The doctor may suggest changes to the diet or medications because these can influence symptoms. If the symptoms persist, especially any related to swallowing, the doctor may work with a gastroenterologist, surgeon, or another healthcare professional to confirm a diagnosis. Tests that can help diagnose GERD include: Upper gastrointestinal (GI) endoscopy and biopsy. A doctor inserts a thin, tube-like camera down the food pipe to look inside the stomach and perhaps take a tissue sample. Upper GI series. A doctor checks X-rays to see whether something inside the body, such as a hernia, is causing the acid reflux. Esophageal pH and impedance monitoring. The doctor places a thin tube inside the food pipe for about 1 day to measure acid levels. Bravo wireless esophageal pH monitoring. The doctor monitors acid levels using a small capsule inside the food pipe and a receiver outside the body. Esophageal manometry. This allows the doctor to measure muscle contractions in the food pipe. Complications If a person does not receive treatment for GERD, it can lead to more severe complications, including: esophagitis, or inflammation of the food pipe narrowing of the food pipe that causes trouble swallowing respiratory problems, such as pneumonia or laryngitis Barrett's esophagus, a condition that causes cells in the food pipe to change. Without treatment, this can potentially lead to cancer. Thank you for supporting Medical News Today Treatment and prevention Heartburn vs. acid reflux antacids
Antacids neutralize stomach acid and may reduce the symptoms of acid reflux. Acid reflux and GERD are treatable with medications, lifestyle changes, or both. Some medications for acid reflux include: Antacids, which neutralize stomach acid. Options include Tums, Rolaids, Pepto-Bismol, and Mylanta. Many brands can be purchased online. H2 blockers, which reduce acid production. Options include Pepcid, Zantac, Axid, and Tagamet. Proton pump inhibitors, a group of longer-term prescription medications that can reduce stomach acid. Options include Nexium, Prevacid, and Prilosec. Prokinetics, a type of prescription drug that helps to empty the stomach more quickly. Options include Reglan and Urecholine. People with acid reflux or GERD can manage symptoms by taking steps to avoid triggers. Start by avoiding some or all of the following: fried and fatty foods large meals smoking alcohol coffee tomatoes and tomato products spicy food peppermint citrus fruits and juices Weight loss can also help to reduce symptoms, as it decreases pressure on the food pipe. People should also try not to eat late at night or lie down soon after eating. In serious cases of GERD, surgery may help to strengthen the muscles in the gut. Children and pregnancy Children, adolescents, and pregnant women often experience acid reflux. Heartburn may occur with 17 to 45 percent of pregnancies. Fortunately, over-the-counter heartburn and acid reflux treatments tend to be safe to use during pregnancy. About 10 percent of teenagers and pre-teens experience GERD, according to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. The symptoms, diagnosis, and treatments for children with GERD are similar to those for adults. Check with a pediatrician to learn more. When to see a doctor If acid reflux occurs on a regular basis, use an antacid, and try different brands if the first is ineffective. Also, try making lifestyle changes, such as eliminating certain foods or drinks from the diet. If the acid reflux still recurs after making these changes, it may be time to call the doctor. Although chest pain is often a symptom of acid reflux or GERD, do not hesitate to visit the doctor or the emergency room if it seems more serious. Sometimes GERD symptoms warrant urgent attention. A person experiencing any of the following should seek immediate medical care: regular, forceful vomiting persistent upper body pain difficulty breathing difficulty swallowing Outlook The relationship between heartburn and acid reflux is that of a symptom and its cause. Heartburn is a painful, common problem that can affect a person's quality of life. To eliminate it, a person needs to treat the underlying cause, which is acid reflux. Manage symptoms of acid reflux by avoiding the many potential triggers. If acid reflux goes unchecked or untreated, it may develop into GERD.
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