Science Says

We investigated the effect of snacking habits in childhood on changes in body mass index (BMI) and high BMI in adolescence and adulthood. In total, 2141 Japanese children from the Ibaraki Children’s Cohort Study were evaluated at age 6 years (baseline), then at ages 12 and 22 years. We examined associations between snacking (scheduled times, when children wanted, and freely) at age 6 years and changes in BMI over time and the proportion of high BMI at ages 12 and 22 years, using time-dependent mixed-effects and logistic regression models. Compared with children who snacked at scheduled times, those provided snacks when they wanted experienced larger increases in BMI over time between ages 6 and 22 years (multivariable time-dependent effect: 0.03 kg/m2 for boys, p = 0.047; 0.04 kg/m2 for girls, p = 0.019). No differences were observed in children who snacked freely. A higher proportion of high BMI was found in boys who were provided snacks when they wanted compared with those who snacked at scheduled times. The multivariable odds ratio (95% confidence interval) was 1.52 (1.04–2.23) at age 12 years and 2.23 (1.12–4.45) at age 22 years. No differences were observed for girls at either age. Children who were provided snacks when they wanted showed larger increases in BMI over time compared with those who snacked at scheduled times. Boys who were provided snacks when they wanted showed the higher proportion of high BMI at follow-up.

Sata M, Yamagishi K, Sairenchi T, et al. Long-term effect of feeding snacks at age 6 years on body mass index at ages 12 and 22 years. Sci Rep. 2019;9(1):8627. Published 2019 Jun 13. doi:10.1038/s41598-019-40730-3.

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Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565708/

Exposure to media coverage of mass violence has been shown to predict poorer mental health symptomology. However, it is unknown whether such media coverage can have ubiquitous effects on average community members, extending to biological and perceptual processes that underlie everyday decision making and behavior. Here, we used a repeated-measures design over the first anniversary of the Boston Marathon bombings to track participants’ self-reported distress, their eye blink startle reactivity while viewing images of the bombings, and their ability to perceptually distinguish armed from unarmed individuals in a behavioral shooting task. We leveraged a computational linguistics method in which we sampled news content from the sources our participants most commonly self-reported reading, and then quantified both the extent of news coverage about the marathon and the affective tone of that news coverage. Results revealed that participants experienced greater current distress, greater physiological reactivity to threats, and poorer perceptual sensitivity when recent news coverage of the marathon contained more affectively negative words. This is the first empirical work to examine relationships between the media’s affective tone in its coverage of mass violence and individuals’ threat perception and physiological threat reactivity.

Wormwood JB, Lin YR, Lynn SK, Barrett LF, Quigley KS. Psychological impact of mass violence depends on affective tone of media content. PLoS One. 2019;14(4):e0213891. Published 2019 Apr 1. doi:10.1371/journal.pone.0213891.

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443148/

Background: The NOVA food classification scheme divides foods into ultra-processed, processed, unprocessed, and culinary ingredients. Ultra-processed foods contribute >60% of energy to diets in the US.

Objective: To characterize ultra-processed foods by energy density, nutrient density, and monetary cost.

Methods: The 384 component foods of Fred Hutch (FHCRC) food frequency questionnaire (FFQ), were assigned to 4 NOVA categories and to 7 USDA MyPyramid food groups. Energy density was kcal/g. Nutrient density was measured using the Nutrient Rich Food index NRF9.3. Food prices were collected in local supermarkets from 2004 to 2016. Analyses examined time trends in food prices by NOVA category and by USDA food group.

Results: The ultra-processed classification captured mostly grains (91%), fats and sweets (73%), dairy (71%), and beans, nuts and seeds (70%), but only 36% of meat, poultry and fish, 26% of vegetables, and 20% of fruit. Compared to unprocessed foods, ultra-processed foods had lower nutrient density (NRF9.3 per 100 kcal: 21.2 vs. 108.5),higher energy density (mean (SD): 2.2 vs. 1.10 in kcal/g), and lower per calorie cost (0.55 vs. 1.45 in $/100 kcal). Ultra-processed foods did not increase in price as much as unprocessed foods over the 12 year period.

Conclusion: Ultra-processed foods tend to be energy-dense, low-cost, and nutrient-poor. Low energy cost could be one mechanism linking ultra-processed foods with negative health outcomes. Food-based Dietary Guidelines may need to address food processing in relation to economic aspects of food choice.

Gupta S, Hawk T, Aggarwal A and Drewnowski A (2019)Characterizing Ultra-Processed Foods by Energy Density, Nutrient Density, and Cost. Front. Nutr. 6:70. doi: 10.3389/fnut.2019.00070

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Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.frontiersin.org/articles/10.3389/fnut.2019.00070/full

Background: Life satisfaction is a cognitive and evaluative judgement of one’s outlook on life and an integral component of subjective wellbeing. There is a strong association between life satisfaction and mental and physical health, but it is currently unclear how environmental factors may influence life satisfaction. Our aim was to investigate the association between environmental factors and life satisfaction and to gain a better understanding of general life satisfaction statistics in the EU.

Methods: We used a three-level mixed effects logistic regression model to examine the effects of sociodemographic, macroeconomic and environmental factors on life satisfaction using a large sample size from Eurobarometer surveys (n = 268,696) representative of 27 EU countries. Data were collected through face-to-face interviews between May 2014 and June 2015.

Results: We found wide variation between countries, as well as between regions within the same country with regards to levels of life satisfaction. Having adjusted for individual sociodemographic factors, our analysis did not indicate statistically significant associations of mean temperature and precipitation with life satisfaction. However, there was a statistically significant association between environmental degradation and lower life satisfaction (OR = 0.98; 95% CI: 0.97–1.00). Consistent with existing literature, our results show statistically significant effects of sociodemographic factors such as sex, financial situation and employment on life satisfaction.

Conclusions: Future research should extend analyses to a wider range of sociodemographic, macroeconomic and geographical variables to gain insight on all possible factors affecting life satisfaction to inform policy makers and ensure higher quality of life, and in turn better mental and physical health.

Rajani NB, Skianis V, Filippidis FT. Association of environmental and sociodemographic factors with life satisfaction in 27 European countries. BMC Public Health. 2019;19(1):534. Published 2019 May 10. doi:10.1186/s12889-019-6886-y.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,unless otherwise stated.

Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509815/

Alzheimer’s disease is one of the most severe neurodegenerative diseases among elderly people. Different pathogenic factors for Alzheimer’s disease have been posited and studied in recent decades, but no effective treatment has been found, necessitating further studies. In this Viewpoint article, we assess studies on the mechanisms underlying the accumulation of amyloid (Aβ) peptide and the formation of Aβ oligomers because their accumulation in amyloid plaques in brain tissue has become a well-studied hallmark of Alzheimer’s disease. We focus on the production of Aβ and its impact on the function of synapses and neural circuits, and also discuss the clinical prospects for amyloid-targeted therapies.

Zhou Y, Sun Y, Ma QH, Liu Y. Alzheimer's disease: amyloid-based pathogenesis and potential therapies. Cell Stress. 2018;2(7):150–161. Published 2018 Jun 29. doi:10.15698/cst2018.07.143.

This is an open-access article released under the terms of the Creative Commons Attribution (CC BY) license, which allows the unrestricted use, distribution, and reproduction in any medium, provided the original author and source are acknowledged.

Sections of the Abstract, Introduction, The Amyloid Cascade Hypothesis and Subsequent Studies, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551797/

Demographic and income disparities may impact food accessibility. Research has not yet well documented the precise location of healthy and unhealthy food resources around children’s homes and schools. The objective of this study was to examine the food environment around homes and schools for all public school children, stratified by race/ethnicity and poverty status. This cross-sectional study linked data on the exact home and school addresses of a population-based sample of public school children in New York City from 2013 to all corner stores, supermarkets, fast-food restaurants, and wait-service restaurants. Two measures were created around these addresses for all children: 1) distance to the nearest outlet, and 2) count of outlets within 0.25 miles. The total analytic sample included 789,520 K-12 graders. The average age was 11.78 years (SD ± 4.0 years). Black, Hispanic, and Asian students live and attend schools closer to nearly all food outlet types than White students, regardless of poverty status. Among not low-income students, Black, Hispanic, and Asian students were closer from home and school to corner stores and supermarkets, and had more supermarkets around school than White students. The context in which children live matters, and more nuanced data is important for development of appropriate solutions for childhood obesity. Future research should examine disparities in the food environment in other geographies and by other demographic characteristics, and then link these differences to health outcomes like body mass index. These findings can be used to better understand disparities in food access and to help design policies intended to promote healthy eating among children.

Elbel B, Tamura K, McDermott ZT, et al. Disparities in food access around homes and schools for New York City children. PLoS One. 2019;14(6):e0217341. Published 2019 Jun 12. doi:10.1371/journal.pone.0217341.

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561543/

Objectives: While patients’ health priorities should inform healthcare, strategies for doing so are lacking for patients with multiple conditions. We describe challenges to, and strategies that support, patients’ priorities-aligned decision-making.

Design: Participant observation qualitative study.

Setting: Primary care and cardiology practices in Connecticut.

Participants: Ten primary care clinicians, five cardiologists, and the Patient Priorities implementation team (four geriatricians, physician expert in clinician training, behavioral medicine expert). The patients discussed were ≥ 66 years with >3 chronic conditions and ≥10 medications or saw ≥ two specialists.

Exposure: Following initial training and experience in providing Patient Priorities Care, the clinicians and Patient Priorities implementation team participated in 21 case-based, group discussions (10 face-to-face;11 telephonic). Using emergent learning (i.e. learning which arises from interactions among the participants), participants discussed challenges, posed solutions, and worked together to determine how to align care options with the health priorities of 35 patients participating in the Patient Priorities Care pilot.

Main outcomes: Challenges to, and strategies for, aligning decision-making with patient’s health priorities.

Results: Categories of challenges discussed among participants included uncertainty, complexity, and multiplicity of problems and treatments; difficulty switching to patients’ priorities as the focus of decision-making; and differing perspectives between patients and clinicians, and among clinicians. Strategies identified to support patient priorities-aligned decision-making included starting with one thing that matters most to each patient; conducting serial trials of starting, stopping, or continuing interventions; focusing on function (i.e. achieving patient’s desired activities) rather than eliminating symptoms; basing communications, decision-making, and effectiveness on patients’ priorities not solely on diseases; and negotiating shared decisions when there are differences in perspectives.

Conclusions: The discrete set of challenges encountered and the implementable strategies identified suggest that patient priorities-aligned decision-making in the care of patients with multiple chronic conditions is feasible, albeit complicated. Findings require replication in additional settings and determination of their effect on patient outcomes.

Tinetti M, Dindo L, Smith CD, et al. Challenges and strategies in patients' health priorities-aligned decision-making for older adults with multiple chronic conditions. PLoS One. 2019;14(6):e0218249. Published 2019 Jun 10. doi:10.1371/journal.pone.0218249.

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Sections of the Abstract and Introduction are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557523/

A substantial body of work has depicted a positive association between physical exercise and cognition, although the key factors driving that link are still a matter of scientific debate. Here, we aimed to contribute further to that topic by pooling the data from seven studies (N = 361) conducted by our research group to examine whether cardiovascular fitness (VO2), sport type participation (externally-paced (e.g., football or basketball) and self-paced (e.g., triathlon or track and field athletes) vs. sedentary), or both, are crucial factors to explain the association between the regular practice of exercise and vigilance capacity. We controlled for relevant variables such as age and the method of VO2 estimation. The Psychomotor Vigilance Task was used to measure vigilance performance by means of reaction time (RT). The results showed that externally-paced sport practice (e.g., football) resulted in significantly shorter RT compared to self-paced sport (e.g., triathlon) and sedentary condition, depicting larger effects in children and adolescents than in adults. Further analyses revealed no significant effect of cardiovascular fitness and self-paced sport practice, in comparison to the sedentary condition, on RT. Our data point to the relevance of considering the type of sport practice over and above the level of cardiovascular fitness as crucial factor to explain the positive association between the regular practice of exercise and vigilance capacity.

Sanabria D, Luque-Casado A, Perales JC, et al. The relationship between vigilance capacity and physical exercise: a mixed-effects multistudy analysis. PeerJ. 2019;7:e7118. Published 2019 Jun 6. doi:10.7717/peerj.7118

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

Sections of the Abstract, Introduction, Discussion,and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556370/

Fibromyalgia (FM) is one of the most frequent generalized pain disorders with poorly understood neurobiological mechanisms. This condition accounts for an enormous proportion of healthcare costs. Despite extensive research, the etiology of FM is unknown and thus, there is no disease modifying therapy available for this condition. We show that most (if not all) patients with FM belong to a distinct population that can be segregated from a control group by their glycated hemoglobin A1c (HbA1c) levels, a surrogate marker of insulin resistance (IR). This was demonstrated by analyzing the data after introducing an age stratification correction into a linear regression model. This strategy showed highly significant differences between FM patients and control subjects (p < 0.0001 and p = 0.0002, for two separate control populations, respectively). A subgroup of patients meeting criteria for pre-diabetes or diabetes (patients with HbA1c values of 5.7% or greater) who had undergone treatment with metformin showed dramatic improvements of their widespread myofascial pain, as shown by their scores using a pre and post-treatment numerical pain rating scale (NPRS) for evaluation. Although preliminary, these findings suggest a pathogenetic relationship between FM and IR, which may lead to a radical paradigm shift in the management of this disorder.

Pappolla MA, Manchikanti L, Andersen CR, et al. Is insulin resistance the cause of fibromyalgia? A preliminary report. PLoS One. 2019;14(5):e0216079. Published 2019 May 6. doi:10.1371/journal.pone.0216079.

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Sections of the Abstract, Introduction, Materials and Methods, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502334/

Objective: To investigate the incidence of trampoline park injuries (TPIs) at a local recreational facility and to quantify the burden on emergency and orthopaedic services at our institute.

Methods: All patients that presented to the Emergency Department (ED) from the trampoline park via ambulance from July 2014 to November 2015 were included in the study. Patients’ medical records were reviewed for clinical details including date, location and type of injury, treatment received, length of stay and outpatient follow-up. A cost analysis was performed to estimate the financial impact of each injury.

Results: A total of 71 patients were included in the study, with a mean age of 20 (7-48). Soft tissue sprains (n=29, 41%) and fractures (n=25, 35%) were the most common injuries, with the majority occurring in the lower limb. Two patients sustained open tibial fractures necessitating transfer to level 1 trauma centres. Fourteen patients (20%) underwent surgery, predominantly requiring open reduction and internal fixation. Overall, 18 patients (25%) required admission to hospital with mean length of stay of 2 days. The cost for pre-hospital, emergency and in-patient care amounted to over £80,000.

Conclusion: TPIs pose a significant financial cost for local orthopaedic and emergency services. Contrary to studies evaluating home trampoline injuries, the majority of fractures at trampoline parks occurred in the lower limbs. Improved injury prevention strategies are required to help reduce morbidity and lower the financial implications for local NHS trusts.

Jordan SJ, To CJ, Shafafy R, Davidson AE, Gill K, Solan MC. Trampoline Park Injuries and Their Burden on Local Orthopaedic and Emergency Services. Bull Emerg Trauma. 2019;7(2):162–168. doi:10.29252/beat-070212.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555216/