Dysphagia is a medical term that is used to refer to difficulties with swallowing. The level of dysphagia varies. Some people have problems swallowing certain foods or liquids, while others are completely unable to swallow. It takes more time and effort to move food or liquid from the mouth to the stomach. Difficulty swallowing may also be associated with pain. Persistent difficulty swallowing may indicate a serious medical condition requiring treatment.

The term “dysphagia” derives from the Greek root dys meaning “difficulty or disordered”, and phagia meaning “to eat”.

According to Medilexicon’s medical dictionary:

Dysphagia is “Difficulty in swallowing“.

Difficulty in swallowing can occur at any age, but is more common in older adults. The incidence of dysphagia is higher in the elderly, in patients who have had strokes, and in patients who are admitted to acute care hospitals or chronic care facilities. The causes of swallowing difficulties vary, and treatment depends on the cause. Dysphagia frequently arises as a complication of another health condition, such as a stroke, throat and mouth cancer or gastro-oesophageal reflux disease (GORD).

There are two types of dysphagia:

• Oropharyngeal or high dysphagia. Difficulties in swallowing are due to problems with the mouth or throat.
• Esophageal or low dysphagia. Difficulties in swallowing are due to problems with the esophagus.

Low dysphagia is often caused by a blockage in or irritation to the esophagus, and can often be treated using surgery.

High dysphagia is often caused by underlying problems with the nerves and muscles that help control the swallowing process.

Some degree of dysphagia is relatively common in elderly people staying in nursing homes.

Apart from the risk of malnutrition and dehydration, difficulties with the swallowing reflex mean that there is a chance that small particles of food can drop down into the lungs. That can trigger a serious and possibly fatal lung infection (aspiration pneumonia). Depending on the cause, possible treatments include physical therapy, diet modification, surgery, and the use of feeding tubes.

What are the signs and symptoms of dysphagia?

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

Signs and symptoms that can be associated with dysphagia:

• Bringing food back up (regurgitation)
• Choking when eating
• Coughing or gagging when swallowing
• Developing repeated and frequent lung infections (pneumonia)
• Drooling
• Food or stomach acid backing up into the throat
• Frequent heartburn
• Hoarseness
• Inability to swallow
• Pain while swallowing
• Sensation of food getting stuck in the throat or chest, or behind the breastbone
• Unexpected weight loss

Signs and symptoms of swallowing difficulties in infants and children:

• Breast-feeding problems
• Coughing or choking during feeding or meals
• Food or liquid leaking from the mouth
• Inability to coordinate breathing with eating and drinking
• Lack of attention during feeding or meals
• Lengthy and prolonged feeding or eating times
• Recurrent pneumonia
• Refusing to eat foods of different textures
• Spitting up or vomiting during feeding or meals
• Tensing of the body during feeding
• Weight loss or slow weight gain or growth

Seek medical attention if:

• In children. If a child has trouble swallowing, seek medical help.
• Constant problems. Slight or occasional difficulty swallowing usually is not cause for concern or action. But difficulty swallowing can indicate a serious medical problem, such as esophageal cancer. Seek medical advice if there is difficulty swallowing or if difficulty swallowing is accompanied by weight loss, regurgitation or vomiting.

• Obstructions. If an obstruction interferes with breathing, call for emergency help immediately. If unable to swallow due to an obstruction, go to the nearest emergency department.

What causes dysphagia?

How swallowing works

It takes about fifty pairs of muscles and nerves to accomplish the simple act of swallowing.

There are three stages to swallowing:

• Stage one. The tongue moves the food around the mouth so that it can be chewed. Chewing helps to break food down into smaller chunks. It mixes it with saliva. Saliva makes the food moist and easier to swallow.
• Stage two. The tongue pushes food or liquid to the back of the mouth in the pharynx. The nervous system triggers the swallowing reflex. It activates the muscles that push the food down the throat towards the esophagus which is a tube running from the throat to the stomach. During this phase, the larynx (voice box) closes in order to prevent any food or liquid from entering the lungs.
• Stage three. Food or liquid enters the esophagus. Muscles quickly move the food or liquid through the esophagus and into the stomach.

Dysphagia can affect any of the nerves, muscles or passageways that are used during the swallowing process.

Esophageal dysphagia refers to the sensation of food sticking or getting stuck in the base of the throat or chest.

In the case of Oropharyngeal dysphagia, certain problems related to the nerves and muscles can weaken the throat muscles. This makes it difficult to move food from the mouth into the throat and esophagus (pharyngeal paralysis). A person may choke, gag or cough when attempting to swallow, or have the sensation of food or fluids going down the windpipe (trachea) or up the nose. This may lead to pneumonia.

Neurological causes. Brain damage and damage to the nervous system can interfere with the nerves that are responsible for triggering and regulating the swallowing reflex. This can lead to dysphagia. Some neurological causes of dysphagia include: stroke, cerebral palsy, Parkinson’s disease, multiple sclerosis, and motor neurone disease.

Obstruction. An obstruction or a narrowing of the throat and esophagus can make swallowing difficult. Some causes of obstruction and narrowing include: mouth or lung cancer, cleft lip and palate, radiotherapy causing the development of scar tissue which can narrow the passageway in the throat and esophagus, gastro-esophageal reflux disease when stomach acid can cause scar tissue to develop, and infections, such as tuberculosis or herpes simplex, that lead to the inflammation of the esophagus.

Muscular conditions. Any health condition that affects the muscles that are used to push food down through the esophagus and into the stomach can cause dysphagia.

Scleroderma. The immune system attacks healthy tissue. This leads to a stiffening of the throat and esophagus muscles. Acid is allowed to reflux into the esophagus and causes symptoms and complications.

Achalasia. The muscles in the esophagus become too stiff to allow food or liquid to enter the stomach. This can cause regurgitation of food not yet mixed with stomach contents.

Aging. As a natural consequence of ageing, the muscles that are used in swallowing can become weaker. This may explain why dysphagia is a relatively widespread condition among elderly people. Any persistent trouble swallowing needs to be evaluated medically. This condition is not necessarily a normal part of aging.

Diffuse spasm. This condition produces multiple, high-pressure, and poorly coordinated contractions of the esophagus usually after swallowing. Diffuse spasm is a rare disorder. The contractions often occur occasionally, and may become more severe over time.

Esophageal stricture. Narrowing of the esophagus causes large chunks of food to get caught. Narrowing may result from the formation of scar tissue, often caused by gastroesophageal reflux disease or from tumors.

Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present.

Foreign bodies. Sometimes, food, such as a large piece of meat, or another object can become lodged in the throat or esophagus. Older adults with dentures and people who have difficulty chewing their food properly may be more likely to have an obstruction of the throat or esophagus. Children may swallow small objects that can become stuck.

Esophageal ring. This thin area of narrowing in the lower esophagus can occasionally cause difficulty swallowing solid foods.

Gastroesophageal reflux disease. Damage to esophageal tissues from stomach acid backing up into the esophagus can lead to spasm or scarring and narrowing of the lower esophagus.

Eosinophilic esophagitis. This condition is caused by an overpopulation of cells called eosinophils in the esophagus. It may be related to a food allergy, but often no cause is found.

Neurological disorders. Certain disorders, such as post-polio syndrome, multiple sclerosis, muscular dystrophy and Parkinson’s disease, may first be noticed because of oropharyngeal dysphagia.

Neurological damage. Sudden neurological damage (from a stroke or brain or spinal cord injury) can cause difficulty swallowing or an inability to swallow.

Pharyngeal diverticula. A small pouch forms and collects food particles in the throat. This leads to difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing.

Cancer. Certain cancers and some cancer treatments can cause difficulty swallowing.

Dysphagia in infants and children

Swallowing difficulties in infants and children are often caused by:

• Cleft lip or cleft palate
• Problems in development due to premature birth or low birth weight
• Nervous system disorders, such as cerebral palsy or meningitis

Unexplained dysphagia

Some people experience unexplained swallowing difficulties:

• Difficulty taking oral medications. Some people cannot swallow pills or tablets, even though they have no other difficulty swallowing.
• Feeling a lump in the throat. Some people feel the sensation of a foreign body or lump in their throats. But in reality no foreign body or lump exists. Stress or excitement may worsen this sensation.

What are the risk factors for dysphagia?

A risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2. The following are risk factors for difficulty swallowing:

• Aging. Due to natural aging and normal wear and tear on the esophagus, older adults are at higher risk of swallowing difficulties.
• Premature birth. Babies born prematurely are more prone to developmental problems. These include gastrointestinal disorders that may cause difficulty swallowing.
• Certain health conditions. People with neurological or nervous system disorders are more likely to experience difficulty swallowing.

What are the complications of dysphagia?

Difficulty in swallowing can lead to:

• Malnutrition and dehydration. Dysphagia can make it difficult to take in enough food and fluids to stay adequately nourished. People with difficulty swallowing are at risk of malnutrition and dehydration.
• Respiratory problems. If food or liquid enters the airway (aspiration) when swallowing, respiratory problems or infections can occur. This can lead to frequent pneumonia or upper respiratory infections. Aspiration pneumonia is a lung infection that is triggered when a small piece of food enters the lungs.

People with oropharyngeal or ‘high’ dysphagia are particularly vulnerable to aspiration pneumonia because their impaired swallowing reflexes mean that their larynx does not close during swallowing, so their lungs are not protected.

The symptoms of aspiration pneumonia include:

• blue skin (cyanosis) due to a lack of oxygen
• chest pain
• fatigue
• fever
• shortness of breath
• wheezing
• coughing that sometimes produces foul-smelling phlegm and may contain traces of blood and pus

The symptoms of aspiration pneumonia can range from mild to severe. Severe cases require admission to hospital and treatment with intravenous antibiotics.

In the case of particularly vulnerable or frail people, there is a chance that the infection could cause their lungs to become filled with fluid, preventing them from working properly. This is known as acute respiratory distress syndrome (ARDS).

How is dysphagia diagnosed?

A physical examination is performed as well as a variety of tests to determine the cause of the swallowing problem. The aim is to determine the exact location of the swallowing problem (‘high’ or ‘low’ dysphagia) and to assess how the ability to swallow has been affected.

Recent medical history

The patient will be asked about the dysphagia symptoms: for how long the symptoms have been experienced, whether dysphagia has affected the ability to swallow solids, liquids or both, and whether there has been any weight loss.

Water-swallow test

This test can provide a good initial assessment of the patient´s swallowing abilities. The patient is given a glass of water and asked to swallow it as quickly as possible. The time it takes to drink all the water and the number of swallows that were required are recorded.

Barium Swallow Test or Videofluoroscopic Swallow Study (Fluoroscopy)

It is one of the most effective ways of assessing a person’s swallowing, and locating exactly where the problems are occurring. The test can often identify blockages or problems with the muscles that are used during swallowing.

The patient is asked to drink some barium solution. Barium is a non-toxic chemical that is widely used for testing purposes because it shows up on an X-ray. The barium coats the inside of the esophagus, allowing it to show up better on X-ray. It allows assessing of the muscular activity.

Endoscopy

A thin, flexible, lighted instrument (endoscope) is passed down the throat to view the esophagus. A test called a fiber-optic endoscopic evaluation of swallowing (FEES) can also be carried out. It uses a small lighted tube (flexible laryngoscope) placed in the nose. This allows the mechanisms during swallowing to be seen.

Esophageal muscle test. In this test, a small tube is inserted into the esophagus and connected to a pressure recorder. This allows measurement of the muscle contractions of the esophagus during swallowing.

What is the treatment for dysphagia?

Treatment depends on the particular type or cause of the swallowing disorder:

Oropharyngeal dysphagia or ‘high’ dysphagia

The patient will most likely be referred to a throat specialist or neurologist for further diagnostic testing and to a speech or swallowing specialist for therapy. Therapy may include:

• Exercises. Certain exercises may help coordinate the swallowing muscles or stimulate the nerves that trigger the swallowing reflex.
• Learning swallowing techniques. Learning simple ways to place food in the mouth or to position the body and head to help swallow successfully. There are also a number of physical techniques that can be used to make swallowing easier. For example, some people find that ducking their chin forward when swallowing helps to prevent any food from entering their airways.
• Dietary changes. A nutritionist can advise the patient about making changes to their diet, such as incorporating food and liquids that are easier to swallow while ensuring that they receive a healthy, balanced diet.
• Feeding tubes. They may be required in severe cases of dysphagia that put the patient a risk of malnutrition and dehydration.

There are two types of feeding tubes:

• Nasogastric tube, a tube that is passed down the nose and into the stomach.
• Percutaneous endoscopic gastrostomy (PEG) tube, a tube that is surgically implanted directly into the stomach. It passes through a small incision on the surface of the stomach, or abdomen.

Nasogastric tubes are designed for short-term use and last for 10 to 28 days before they need to be replaced. PEG tubes are designed for long-term use and last for up to six months before they need to be replaced.

Most people with dysphagia prefer to use a PEG tube because the equipment can be easily hidden under clothing. However, PEG tubes do carry a greater risk of complications than nasogastric tubes (tube displacement, skin infection, tube blockage, and tube leakage). Major complications of PEG tubes include internal bleeding, and infection.

There is an indication that people who use PEG tubes find it more difficult to resume normal feeding compared with those who use nasogastric tubes.

In the case of dysphagia caused by Parkinson’s disease medication is useful. While Parkinson’s disease cannot be cured, the symptoms of dysphagia can be controlled using medication.

Esophageal dysphagia or ‘low’ dysphagia

Treatment approaches for esophageal dysphagia may include:

• Esophageal dilation. In the case of a tight esophageal sphincter (achalasia) or an esophageal stricture, an endoscope with a special balloon attached may be used to gently stretch and expand the width of the esophagus or pass a flexible tube or tubes to stretch the esophagus (dilatation).
• Surgery. For an esophageal tumor or pharyngeal diverticula, surgery may be recommended to clear the esophageal path.
• Medications. Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid after a stricture is dilated. These medications may need to be taken for an extended period of time.In the case of esophageal spasm but with normal esophagus and without GERD, patients may be treated with medications to relax the esophagus and reduce discomfort.
• Botulinum toxin. It can be used to treat achalasia which is a type of dysphagia where the muscles in the oesophagus become too stiff to allow food and liquid to enter the stomach. The toxin can be used to paralyze the stiff muscles that are preventing food from reaching the stomach.

Coping with the condition

Living with swallowing difficulties can be challenging. Dysphagia may affect interaction with friends and family, productivity at work, and overall quality of life.

Patients may find that talking to a counselor or therapist can help them cope with the effects of swallowing difficulties. They may find encouragement and understanding in a support group.

Support groups can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences.

When the cause is neurological damage or disorders, swallowing difficulties cannot be prevented. The risk of occasional swallowing difficulty can be reduced by eating slowly and chewing food well.

Early detection and effective treatment of GERD can lower the risk of developing dysphagia associated with an esophageal stricture.

Written by Stephanie Brunner (B.A.)

“This is the first time cortisol reactivity has been identified as a mediator between depressed mood and obesity in girls,” said Elizabeth J. Susman, the Jean Phillips Shibley professor of biobehavioral health at Penn State. “We really haven’t seen this connection in kids before, but it tells us that there are biological risk factors that are similar for obesity and depression.”

Cortisol, a hormone, regulates various metabolic functions in the body and is released as a reaction to stress. Researchers have long known that depression and cortisol are related to obesity, but they had not figured out the exact biological mechanism.

Although it is not clear why high cortisol reactions translate into obesity only for girls, scientists believe it may be due to physiological and behavioral differences — estrogen release and stress eating in girls — in the way the two genders cope with anxiety.

“The implications are to start treating depression early because we know that depression, cortisol and obesity are related in adults,” said Susman.

If depression were to be treated earlier, she noted, it could help reduce the level of cortisol, and thereby help reduce obesity.

“We know stress is a critical factor in many mental and physical health problems,” said Susman. “We are putting together the biology of stress, emotions and a clinical disorder to better understand a major public health problem.”

Susman and her colleagues Lorah D. Dorn, professor of pediatrics, Cincinnati Children’s Hospital Medical Center, and Samantha Dockray, postdoctoral fellow, University College London, used a child behavior checklist to assess 111 boys and girls ages 8 to 13 for symptoms of depression. Next they measured the children’s obesity and the level of cortisol in their saliva before and after various stress tests.

“We had the children tell a story, make up a story, and do a mental arithmetic test,” said Susman. “The children were also told that judges would evaluate the test results with those of other children.”

Statistical analyses of the data suggest that depression is associated with spikes in cortisol levels for boys and girls after the stress tests, but higher cortisol reactions to stress are associated with obesity only in girls. The team reported its findings in a recent issue of the Journal of Adolescent Health.

“In these children, it was mainly the peak in cortisol that was related to obesity,” Susman explained. “It was how they reacted to an immediate stress.”

The National Institutes of Health supported this work.

Source:
Amitabh Avasthi
Penn State

But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program – compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.

“It is unusual to find a program like this that works well, and also saves the patient money. It’s a win-win for everyone,” said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. “This type of program is something that all health care systems should consider implementing.”

“People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the healthcare system millions of extra dollars,” said the study’s principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. “Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that’s great news for patients and their providers.”

Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.

This randomized controlled trial, conducted in 2004-2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.

Half of the participants were enrolled in the intervention and asked to read the book “Overcoming Binge Eating” by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20-25 minutes. The average cost of the intervention was $167 per patient.

All participants were mailed fliers detailing the health plan’s offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.

By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.

Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.

The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.

As expected, participants in the intervention group spent less on weight loss programs and over-the-counter medications and supplements.

“While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them,” said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.

Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.

Source:
Emily Schwartz
GolinHarris International

Scientists at the University of Leeds are planning to extract chemical compounds from different species of seaweed and use them to develop a new range of hair dyes. The naturally sourced compounds will be used by scientists as substitutes for synthetic ingredients that can be found in most hair dyes currently on the market.

Many compounds in existing products are allergens and certain chemicals, notably p-phenylenediamine (PPD), have been linked to more serious long-term health effects.

The project also hopes to develop other safer and more environmentally friendly cosmetics, including hair treatments and skin care, from the compounds extracted from the Shetland seaweed.

“We are hoping to be able to offer people a real alternative to current hair dyes that contain chemicals which are known to be very bad for you,” explains project leader Dr Richard Blackburn, a natural products researcher at The University of Leeds.

The good news is that the new hair dyes won’t be green – scientists are confident that a range of colours including blonde, brown and red, and even black, can be made using the seaweed extracts.

“We can make a range of colours using these natural compounds because the variety of British seaweed species is so diverse,” explains Professor Christopher Rayner, also at the University of Leeds, who is working alongside Dr Blackburn on the project.

“Seaweed is especially suited to being used in cosmetics because it has evolved very clever techniques to protect itself from weathering. And cosmetics are all about protection from ageing and the elements,” says Dr Blackburn.

Laboratory work at the University of Leeds will focus on developing ways of isolating and extracting individual compounds found in seaweed that have these special properties in order to understand them better and explore their potential uses in other products.

The 2-year project is worth just over £500,000, including an investment of nearly £300,000 from the Technology Strategy Board plus from projects partners, including The Body Shop and Böd Ayre, Shetland seaweed farmers and processors based in Lunnaness.

“This could bring commercial and job opportunities to Shetland for a new high-value farming industry. It would be much better to extract the seaweed on Shetland rather than shipping elsewhere for processing,” said Margaret Blance from Böd Ayre.

Source:
Clare Ryan
University of Leeds

It was among more than 12,000 scientific reports scheduled for presentation at the meeting, one of the largest scientific gatherings of 2010.

Joseph Laszlo, Ph.D., who headed the research, pointed out that sales of sunscreens and other skin-care products that protect against the damaging effects of ultraviolet (UV) light have been booming. Driving the multi-billion-dollar-per-year market are consumers who are better informed about the link between overexposure to the sun and skin cancer and sunlight’s effects in giving skin an aged appearance. At the same time, however, concerns have arisen over certain ingredients in today’s mainstay sunscreens. “One, for instance, is a substance known as oxybenzone that is a suspected hormone disruptor that could contribute to the disruption of aquatic species reproduction.”

“We’re trying to provide nature-inspired skin-care materials that avoid such health concerns and at the same time have fewer adverse environmental impacts,” Laszlo said. He is with the U.S. Department of Agriculture’s Agricultural Research Service in Peoria, Ill. Sunscreens are among the substances, termed “pharmaceuticals and personal care products (PPCPs),” that constitute a relatively new family of water contaminants with potential adverse health effects on wildlife and people.

Sunscreens protect against skin cancer by shielding the body from two types of UV light. One is UV-A, which absorbs deep in the skin and is linked to reactive oxygen species (ROS) formation. The other is UV-B, which causes sunburn. Some sunscreen ingredients generate ROS when exposed to UV-A, which can damage DNA.

For years, the sunscreen industry focused on offering UV-B protection to prevent sunburn. Laszlo and colleagues have developed technology for converting soybean oil into a biobased active ingredient for sunscreen products. It involves incorporating ferulic acid, found naturally in hundreds of plants, into soybean oil.

The use of ferulic acid along with vegetable oil produces a water-resistant material capable of absorbing both UV- A and UVB light. In addition, it can be used as an anti-aging and anti-wrinkle product, Laszlo said. Called feruloyl soy glycerides (FSG), the material is produced commercially by iSoy Technologies Corporation and used in several cosmetic products in the U.S. and Asia.

“The skin ages not just from exposure to the sun but also from air pollutants and other environmental effects,” Laszlo said. “We believe that this molecule (ferulic acid) could prevent some of the damage caused by the free-radical processes involved in those environmental exposures.That’s particularly important for preserving the integrity and health of skin tissue. The approach builds on knowledge that antioxidants consumed in the diet or applied topically can prevent some of that damage.”

In his ACS presentation, Laszlo reported on various aspects of FSG production, clinical safety and efficacy test results and his group’s recent discoveries on the antioxidant effects of one major component of FSG.

“Our findings support the hypothesis that FSG can protect sensitive cellular components and reduce the impacts of skin sun exposure,” he said. “Our work also demonstrates how agricultural materials can be used to craft safe and useful consumer products.”

Source:
Michael Bernstein
American Chemical Society

They are examining whether the Goby fish can help researchers locate genes linked to high blood pressure. This is because a protein called Urotensin II, first identified in the fish, is important for regulating blood pressure in all vertebrates- from fish to humans.

The study is being carried out in the University’s Department of Cardiovascular Sciences. Researcher Dr Radoslaw Debiec said: “The protein found in the fish has remained almost unaltered during evolution”.

“This indicates that the protein might be of critical importance in regulation of blood pressure and understanding the genetic background of high blood pressure.

“Uncovering the genetic causes of high blood pressure may help in its better prediction and early prevention of its complications. My research at the University of Leicester has shown how variation in the gene encoding the protein may influence risk of hypertension.”

Dr Debiec will be presenting his research at the Festival of Postgraduate Research which is taking place on Thursday 25th June in the Belvoir Suite, Charles Wilson Building at the University of Leicester between 11.30am and 1pm.

He added: “Drugs affecting the protein might be a novel alternative to the available therapies in particular in those patients who have chronic kidney disease coexisting with high blood pressure.

“Analysis of large cohort of families has provided us with evidence that genetic information encrypted in the protein travels together with the risk of high blood pressure across generations. Furthermore, the same genetic variant responsible for elevated blood pressure is responsible for the development of chronic kidney disease in this group of patients.

“The present findings may have an impact on the development of new blood pressure-lowering medications.”

Dr Debiec’s study was supervised Dr. M. Tomaszewski (Department of Cardiovascular Sciences, Cardiology Group,) and Professor D.G. Lambert (Department of Cardiovascular Sciences; Pharmacology and Therapeutics Group).

Source: Leicester University

“People don’t necessarily think of influenza when you include the symptoms of nausea or vomiting, but our study showed that they are common with influenza in pregnancy,” said Dr. Vanessa Rogers, assistant professor of obstetrics and gynecology and lead author of the study, which appears in the May edition of Obstetrics and Gynecology.

“Both physicians and patients should be aware of these findings so treatment is not delayed,” she said. “I think our findings should encourage people to be vigilant and to take symptoms seriously.”

Adults with flu tend not to have nausea or vomiting, according to the Centers for Disease Control and Prevention. These symptoms are more typical in children.

The researchers studied the cases of pregnant women during the 2003-2004 flu season, when the most common strain of influenza caused more severe symptoms than usual. There also were more cases of flu than expected, because the vaccine given that year didn’t match the strain that was predominant.

During that period, 107 pregnant women were diagnosed with flu at Parkland Memorial Hospital in Dallas. Ninety-three percent of the women had a cough, and 89 percent had fever common signs of flu the researchers found. Eighty-five percent had a “profound” elevated heart rate, and 60 percent had nausea and/or vomiting. Although “morning sickness” and nausea are common during pregnancies, the researchers said that reporting any unusual additional symptoms (fever, coughing, elevated heart rate) could help diagnose the disease earlier in these patients.

Nearly two-thirds of the expectant women treated at Parkland were sick enough to require hospitalization. The most common complication was pneumonia, which occurred in 12 percent of the cases.

Despite the illness, there was no significant difference in complications between women with flu and women without flu who gave birth at the hospital during flu season. After birth, the babies also showed no significant difference in complications.

“Early diagnosis and treatment might be the reason our patients did so well,” Dr. Rogers said.

Other UT Southwestern researchers involved in the study were Dr. Jeanne Sheffield, associate professor of obstetrics and gynecology; Dr. Scott Roberts, professor of obstetrics and gynecology; Dr. Donald McIntire, professor of obstetrics and gynecology; Dr. James Luby, professor of internal medicine; Sylvia Trevino, infection preventionist in internal medicine; and Dr. George Wendel, professor of obstetrics and gynecology.

Source: UT Southwestern Medical Center

The above statements are taken from some of the results from an extensive soccer research project involving more than 50 researchers from seven countries. The researchers studied physiological, psychological and sociological aspects of recreational soccer and compared it with running. Led by Professors Peter Krustrup and Jens Bangsbo from the Department of Exercise and Sports Sciences, University of Copenhagen, the 3-year project covered several intervention studies involving both men, women and children, who were divided into soccer, running and control groups. The results from the studies are so remarkable that the Scandinavian Journal of Medicine and Science in Sports are publishing a special edition issue entitled Football for Health containing 14 scientific articles from the soccer project on Tuesday 6 April 2010.

Soccer for Health

The researchers studied the physical effects of soccer training for untrained subjects aged 9 to 77 years. The conclusion was clear. Soccer provides broad-spectred health and fitness effects that are at least as pronounced as for running, and in some cases even better.

Study leader Peter Krustrup concludes “Soccer is a very popular team sport that contains positive motivational and social factors that may facilitate compliance and contribute to the maintenance of a physically active lifestyle. The studies presented have demonstrated that soccer training for two-three hours per week causes significant cardiovascular, metabolic and musculoskeletal adaptations, independent on gender, age or lack of experience with soccer”.

Professor Jens Bangsbo continues: “The effects can be maintained for a long period even with a reduced frequency of training to one to two times one hour a week. Recreational soccer, therefore, appears to be an effective type of training leading to performance improvements and significant beneficial effects to health, including a reduction in the risk of cardiovascular diseases, falls and fractures. In a number of aspects, soccer training appears to be superior to running training. Soccer training can also be used to treat hypertension and it was clearly superior to a standard treatment strategy of physician-guided traditional recommendations”.

The two researchers foresee a great perspective in using soccer as a health promoting activity: “The studies have convincingly shown that soccer training is effective to enhance fitness and the health profile for the general population. Future studies are needed to understand what is causing the beneficial effects of football, how well football can be used to improve heart health in early childhood and how other patient groups such as those with type II diabetes or cancer can benefit from playing soccer”.

Soccer creates we-stories and helps women stay active

One of the many aspects of the study was to examine the level of social capital for women gained from running and soccer. Even though both the soccer players and the runners trained in groups, there were significant differences in the way they interacted and what they considered the most important aspects of the sport they were engaging in. The runners were more focused on themselves as individuals, whereas the soccer players developed “we”-stories as they began to see themselves as a team. From the beginning, most of the women, both soccer players and runners, thought running would be an easier form of exercise to stick to after the intervention programme was over. That turned out not to be the case:

“The most important finding was the difference in social interaction and creation of we-stories between the groups, which may impact the possibilities of long-term compliance. A year after the study, many of the soccer players continue to play soccer, some have even joined an organised soccer club. Not many from the running group have continued their training. This can very well be due to the fact that the runners focussed on their health and on getting in shape, whereas the soccer players were more committed to the activity itself, including the fun and not letting down team mates”, says Associate Professor Laila Ottesen. Men worry less when playing soccer than when running. Another study examined the exertion experienced during training for untrained adults and their experience of “worries” and “flow”. This study, based on 6 groups of untrained men and women, showed that all groups experienced an overall high level of flow during the intervention, which underlines that the participants felt motivated, happy and involved to the point where they forgot time and fatigue. There was no difference in the level of worry for the female soccer players and runners, but the running men seemed to worry quite a lot more than their soccer playing counterparts.

“The men that played soccer elicited lower levels of worry than during running, 2.8 vs 4.0 on a 0-6 scale, and although they are training at the same average heart rate they do not feel the exertion as strongly as during running” says Associate Professor Anne-Marie Elbe and adds: “Further research is needed to examine why men and women experience playing soccer differently but it could be that the men just have had more experience with football in earlier years than the women”.

Documentation for FIFA, Michelle Obama and others

F-MARC, the research unit of FIFA, is a central partner in the project and the research provides scientific documentation for initiatives such as FIFA’s newly launched “The 11 for Health” campaign that uses soccer as an educational health tool for children in order to raise awareness and improve health in African and South American communities. Also Michelle Obama’s “Let’s Move” project aiming at eliminating obesity in American children through diet and sports have recently promoted soccer as a favourable activity. The research results are also used in Europe, where the research group is directly involved in implementing the results through projects focusing on adults and children, such as “The Open Soccer Club project”, “The Soccer at Work project” and the “Intensity in Pupil School Sport project”. Sports Confederations, Football Associations, Ministries of Culture and Health and researchers from Universities, Hospitals and Centres for Working Environment are cooperating about the implementation and scientific evaluation of those projects.

About the project:

The project has received funding from, among others, FIFA – Medical Assessment and Research Centre (F-MARC), The Danish Ministry of Culture’s Sports Research Committee, United Federation of Danish Workers, TrygFonden, The Danish Football Association, Team Denmark and The Danish Sports Confederation.

Source:
Jes Andersen
University of Copenhagen

Successful weight loss in obese individuals is defined as a reduction of 10 percent or more of initial body weight maintained for at least a year. The jury is still out, however, as to whether fast or slow initial weight loss is the best approach for long-term weight control in obese patients. On the one hand, there is evidence that losing weight slowly initially results in continued weight loss, reduced risk of weight regain, and successful long-term weight loss maintenance. On the other hand, it has also been shown that the greater the initial weight loss in obese patients, the larger the total weight loss observed longer term.

Nackers and team’s study examines the association between rate of initial weight loss and long-term maintenance of lost weight, by looking specifically at whether losing weight at a slow initial rate results in larger long-term weight reduction and less weight regain than losing weight at a fast initial rate.

The authors analyzed data for 262 middle-aged obese women who took part in the Treatment of Obesity in Underserved Rural Settings (TOURS) trial. These women followed a six-month lifestyle program encouraging them to reduce their calorie intake and increase their moderate intensity physical activity to achieve an average weight loss of 0.45kg per week. They were then supported for a further year with an extended care program involving contact twice a month in the form of group sessions, telephone contact or newsletters.

Nackers and team split the women into three groups according to how much weight they lost in the first month of the intervention. Women in the FAST group lost over 0.68kg per week; those in the MODERATE group lost between 0.23 and 0.68kg per week; women in the SLOW group lost less than 0.23kg per week in that first month. The authors then looked at the womens’ weight loss at 6 and 18 months, as well as any weight regain.

They found that there were long-term advantages to fast initial weight loss. Fast weight losers lost more weight overall, maintained their weight loss for longer and were not more likely to put weight back on than the more gradual weight losers. In particular, women in the FAST group were five times more likely to achieve the clinically significant 10 percent weight loss at 18 months than those in the SLOW group and those in the MODERATE group were nearly three times more likely to achieve this milestone than women in the SLOW group.

The authors conclude: “Our study provides further evidence that, within the context of lifestyle treatment, losing weight at a fast initial rate leads to greater short-term weight reductions, does not result in increased susceptibility to weight regain, and is associated with larger weight losses and overall long-term success in weight management. We suggest that, within lifestyle weight control programs, substantial efforts should be focused on promoting large rather than small behavioral changes during the initial weeks of treatment.”

Reference:
1. Nackers LM et al (2010). The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race? International Journal of Behavioral Medicine, DOI 10.1007/s12529-010-9092-y

The results, based on a 10-week study of 72 healthy volunteers with mildly elevated cholesterol levels, are published in the March 8 issue of the American Heart Association’s journal Arteriosclerosis, Thrombosis and Vascular Biology (available online at http://www.atvbaha.org).

‘Lowering LDL cholesterol is a well-accepted means of reducing the likelihood of heart disease,’ said Sridevi Devaraj, an assistant professor of pathology and investigator in the Laboratory for Atherosclerosis and Metabolic Research at UC Davis Medical Center who led the sterol study.

‘Fortifying orange juice with plant sterols is an easy and effective way to boost a diet’s LDL-fighting power in individuals with mildly elevated cholesterol levels.

‘Fifty percent of Americans have mildly elevated cholesterol levels, defined as having a total cholesterol reading of more than 200 mg/dL. The inclusion of sterols in orange juice offers an important treatment option without increasing saturated fat and at the same time providing vitamin C, flavonoids and other essential nutrients.’

The American Heart Association and National Cholesterol Education Program recommend a diet that is low in saturated fat and cholesterol and rich in soluble fiber and plant sterols to help individuals reduce their risk of heart disease.

Sterols are present in small quantities in a variety of foods, including fruits, vegetables, nuts, seeds, cereals and legumes. Chemically similar to cholesterol, sterols are thought to lower LDL levels in the body by limiting absorption of cholesterol in the intestine.

The UC Davis study is the first to show the cholesterol-reducing effects of plant sterols in a nonfat beverage.

For the study, the UC Davis researchers enrolled healthy volunteers ages 20 to 73 with mildly elevated cholesterol levels. The volunteers were asked to eat their normal diet but to drink a cup of juice along with whatever they had for breakfast and dinner.

Half of the group had the sterol-fortified orange juice while the others drank regular orange juice by the same manufacturer. Fasting blood tests were taken before and after the study to determine total cholesterol, total triglyceride, LDL cholesterol, high-density lipoprotein cholesterol and apolipoprotein B levels.

‘Volunteers who drank the sterol-fortified orange juice had a 7.2-percent decrease in total cholesterol, 12.4-percent decrease in LDL cholesterol, and 7.8-percent decrease in non-high-density lipoprotein levels compared to baseline and to the group that received the non-sterol orange juice group,’ she said.

‘Orange juice has wide appeal since it is consumed by individuals of all ages, from early childhood to old age. And for individuals who do not want to take a drug for mildly elevated cholesterol, this may provide a healthy and attractive alternative.’

Previous studies at other institutions have evaluated plant sterols in yogurt and other low-fat and non-fat foods, with variable results. The UC Davis study may be unique in that it did not place volunteers on a special diet and only asked that they drink the juice with their normal meals.

‘The fat in the meals may have helped to emulsify the sterols, but further research will need to be done to determine the meal’s relevance,’ said Ishwarlal Jialal, professor of pathology and internal medicine and director of the Laboratory for Atherosclerosis and Metabolic Research at UC Davis Medical Center.

‘We also would like to investigate whether sterols can add to the LDL-reducing effects of statin drugs in higher-risk individuals. Sterol-fortified orange juice could potentially enable more patients to meet cholesterol level goals as outlined by the National Cholesterol Education Program.’

This study was supported with grants from National Institutes of Health and Minute Maid –The Coca Cola Company.

Contact: Carole Gan
carole.gan@ucdmc.ucdavis.edu
916-734-9047
University of California, Davis – Medical Center