Health Topics – Johns Hopkins Medicine Podcasts

Anchor lead: Does limiting the duration of time during which you eat result in weight loss? Elizabeth Tracey reports

Consuming food for a limited amount of time earlier each day is advocated by some for weight loss. Now a study by Nisa Maruthur and colleagues at Johns Hopkins shows that if you eat the same amount of food each day, when you consume it really doesn’t matter.

Maruthur: In our study we provided all the food and randomized people to either the time restricted or their usual feeding pattern. The bottom line is that we found that eating earlier in the day didn’t seem to decrease weight more that eating later in the day if you keep your calories constant. We think now that eating earlier versus later should probably be based on individual preference more than anything else. If timing of feeding affects how many calories you eat then that’s a different story. If you find if you restrict your feeding you’re going to eat less than I think that will still serve you well but we worked to keep calories constant the whole twelve weeks of the study.  :30

This study had people eating most of their calories earlier during the day or following their usual custom. There was no difference in weight loss between the two groups after 12 weeks, Maruthur says. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: There are specific training strategies to help regain smell after Covid infection, Elizabeth Tracey reports

If you’ve lost your sense of smell due to Covid-19, you may have seen kits for sale that purport to help you regain it by regular sniffing of essential oils. Andrew Lane, an otolaryngologist at Johns Hopkins, says there are four scents that are typically utilized.

Lane: It’s rose, lemon, cloves, and eucalyptus. This was something that the group in Germany who originally came up with this, had picked them for a reason, that they had represented classes of odors in some scheme. Other people have said that it doesn’t have to be those, have even said how about smelling some household items might be just as good. Smelling coffee, vinegar, or smelling lemons. That’s better than nothing. We don’t really understand how this works so there’s probably nothing magical about those four.   :29

Lane says the strategy of regular retraining might make sense however, and it won’t cause any harms, so it is well worth attempting. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Both loss and altered sense of smell are features of Covid-19, Elizabeth Tracey reports

Smell and taste aren’t just senses that improve our lives, they also help keep us safe by alerting us to the smell of something burning or the taste of a food that may have spoiled. Andrew Lane, an otolaryngologist at Johns Hopkins, says that’s why persistent loss of these senses after Covid infection is so troubling.

Lane: There’s a very high rate of olfactory loss with Covid. Maybe 80%. Most people recover spontaneously. There’s some subset of people who have olfactory disturbances, either a change in their sense of smell where things don’t smell exactly right, or maybe they have higher thresholds where they can’t smell things until they become very intense. They may not know that they don’t have a sense of smell and they may say that generally it feels normal to them but if you test and look carefully you can see that there’s still some dysfunction that can persist for longer periods of time.  :29

Lane says anyone whose taste and smell are compromised for a prolonged period of time after Covid infection should likely be evaluated. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Can smell training help people who’ve lost their sense of smell due to Covid recover? Elizabeth Tracey reports

Not only is loss of smell and taste a prominent symptom of Covid-19, for a sizeable number of people that loss continues long after they’ve recovered otherwise. Andrew Lane, an otolaryngologist at Johns Hopkins, says there is one strategy that may help.

Lane: Olfactory loss has been around before there was Covid. People have lost their sense of smell due to viruses, that’s a well-known entity. More than 10 years ago there was a series of studies that were published about olfactory training, which is a couple times a day, sniffing a series of odors, essential oils. Over a period of months improvement was seen in a patient’s sense of smell. It isn’t necessarily that it brings your sense of smell back to being normal, it’s just there’s evidence that it improves from what it was before you started doing it.  :29

Lane says persistent loss of smell, and loss of taste that frequently accompanies it, can compromise someone’s quality of life over time, so attempting to retrain this ability is likely worth trying. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Could using mouthwash help prevent Covid-19? Elizabeth Tracey reports

Using mouthwash may help reduce the number of Sars-CoV2 viruses in the mouth and throat and may therefore reduce infections. That’s at least the hypothesis being tested by one mouthwash manufacturer. Andrew Lane, an otolaryngologist at Johns Hopkins, comments.

Lane: The gist of that one was that you might be able to kill virus with mouthwash. It’s the same idea we talk about for the nose. We know that on surfaces you can disrupt the virus with soaps and with Betadine and those kinds of things. Whether or not it makes sense to put it in your body or in your nose or in your mouth it needs to be researched. I’m thinking that all those things the virus is fairly fragile, many things can disrupt it. It’s just really in practical terms how much of the viral load are you removing and is this really going to change the course of the virus.  :29

Lane says he’s had many many patients ask him whether they should use mouthwash to help reduce their risk for Covid-19, and he’s largely adopted an ‘unlikely to cause harm,’ approach. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Protein based vaccines are also being studied for Covid-19, Elizabeth Tracey reports

Even as several vaccine types are being rolled out against Covid-19, additional types remain in clinical trials and seem poised for wider use. Andrew Pekosz, a vaccine expert at Johns Hopkins, says one of these types is often referred to as protein-based.

Pekosz: Protein based vaccines, sometimes they’re called subunit vaccine, inactivated vaccines, these are the more tried and true approach that has worked since the days of polio vaccines. This is where you take the whole virus and treat it with compounds that make it no longer infectious. Subunit vaccines express just one or two of the proteins and then purify them and then give those. Protein based vaccines make some antibody responses but it doesn’t induce as strong and probably not as long of an immune response.  :32

Pekosz notes that all vaccine types have both advantages and disadvantages, so having choices especially for different populations of people, will help control the infection. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: The Covid Astra Zeneca vaccine is being used in the UK and elsewhere, Elizabeth Tracey reports

Even as vaccines against Sars-CoV2 in the US use technology known as mRNA, elsewhere in the world another type of vaccine using a virus known as an adenovirus is also being used. Andrew Pekosz, a vaccine expert at Johns Hopkins, explains some differences.

Pekosz: Adenovaccines have a longer history of use. Adenovirus vaccines are almost on the complete other end of the spectrum when it comes to stability when you compare them to mRNA vaccines. They can be stored at room temperature. They can be stored in a fridge for extremely long periods of time without any kind of degradation. The advantage that they give now is especially important when it comes to places like Africa, various parts of southeast Asia, places where cold chains are virtually impossible to keep.  :29

This adenovirus vaccine was developed by Oxford University and the pharmaceutical company AstraZeneca, and has also been in clinical trials here in the US, where it’s makers will likely seek authorization or approval soon.[RC1]  At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Why do the Covid vaccines currently being used require two doses? Elizabeth Tracey reports

Most vaccines we’re accustomed to require a single injection, with a booster several years or even decades later. Why do the Covid vaccines currently in use require two doses? Andrew Pekosz, a vaccine expert at Johns Hopkins, explains.

Pekosz: With coronaviruses we have no immunity, so the first time your body sees this antigen, it recognizes it as foreign, but it doesn’t really go to the nth degree in terms of making antibody responses. It makes some, and actually this vaccine makes a significant amount, but it’s really the second time you see the antigen that your body now says, all right, this is foreign, and I’m seeing it again. Now this is really a threat so now I’m going to increase the amount of antibodies that I’m making and really generate a large strong amount of antibodies.  :30

Pekosz says most childhood vaccines do require a couple of doses, and the flu vaccine requires a single dose yearly because most of us have had some previous exposure to influenza. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: When you get the Sars-CoV2 vaccine, what should you expect? Elizabeth Tracey reports

Are the vaccines currently in use against Sars-CoV2 associated with more side effects than other types of vaccines? Andrew Pekosz, a vaccine expert at Johns Hopkins, explains.

Pekosz: If you compare it to the flu vaccine it seems to be a little bit more, we use the technical term ‘reactogenic.’ What that means is you’re a little bit more sore at the site of injection, a few hours later or a day later. You can get a little bit of redness and tenderness in that area, for a couple days. Some people have spiked a fever, but compared to the placebo group, those changes are significant but not to an overly concerning level. So it’s really just the symptoms that we often attribute to your immune system actually kicking in and doing its job.   :31

The most recent data from the federal Vaccine Adverse Events Reporting System or VAERS does not find a large number of severe reactions among the 3 million or so people who have received the vaccines in the US. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: mRNA technology has been under development for use in vaccines for quite some time now, Elizabeth Tracey reports

What makes an mRNA platform, currently in use in both Sars-CoV2 vaccines being administered in the US, so attractive? Andrew Pekosz, a vaccine expert at Johns Hopkins, says abundant research experience utilizing this technology for a variety of infectious diseases enabled researchers to move quickly.

Pekosz: People say that they’re a little bit concerned about this being a new platform but we should point out that there have been an awful lot of phase 1 clinical trials using mRNA vaccines for a host of different emerging infectious diseases. So there’s actually a good base of clinical studies that were used to guide everything that happened this year with the Covid-19 mRNA vaccines.  :23

Pekosz believes many types of vaccines, most especially the flu vaccine, will soon be made using this platform, which may enable the development of a flu vaccine that would only have to be administered once every few years rather than yearly as we do now. He is also confident that if a new strain of Sars-CoV2 emerges a vaccine can be developed fast using mRNA technology. At Johns Hopkins, I’m Elizabeth Tracey.