Could yogurt help lower high blood pressure?

Yogurt may have a beneficial effect on women's blood pressure, especially when part of a healthy diet.

The study shows that women who consumed five or more servings of yogurt a week - especially as part of a healthy diet - had a lower risk of developing high blood pressure.

This was the conclusion of a study recently presented at the American Heart Association's (AHA's) Epidemiology/Lifestyle 2016 Scientific Sessions in Phoenix, AZ.

The researchers found that women who consumed five or more servings of yogurt a week had a lower risk of developing high blood pressure than similar women who hardly ever ate yogurt.

According to the AHA, high blood pressure - defined as higher than 140/90 mm/Hg - is potentially dangerous because it strains the heart, hardens arteries and raises the risk of brain hemorrhage and kidney problems.

If not controlled, high blood pressure can result in heart and kidney disease, stroke and blindness.

Previous studies have already shown that dairy products can reduce the risk of high blood pressure in at-risk adults, say the researchers, but few long-term studies have looked at the independent effect of yogurt alone.

"I believe that this is the largest study of its kind to date to evaluate the specific effects of yogurt on blood pressure," says lead author Justin Buendia, a PhD candidate at Boston University School of Medicine, MA.

For the study - which was funded by the National Dairy Council - Buendia and his colleagues used data from the first and second cohorts (NHS and NHS II) of the Nurses' Health Study, where the participants were mainly women aged 25-55, and also from the Health Professionals Follow-up Study (HPFS), where the participants were mostly men.

Over 18-30 years of follow-up, 75,609 of the participants developed high blood pressure.

20% lower risk of high blood pressure with higher yogurt intake

After adjusting for other factors that might influence the link to high blood pressure, such as age, race, family history of high blood pressure, physical activity and diet, the researchers examined the link between yogurt and the development of high blood pressure in the three groups.

They found that compared with women who ate fewer than one serving per month, women who ate five or more yogurt servings per week had a statistically significant 20% lower risk of developing high blood pressure.

A serving of yogurt is a cup, or around a scoop the size of a baseball.

There was a much weaker link between regular yogurt consumption and high blood pressure in men, but this could be because the men in the groups they examined consumed far lower amounts of yogurt than the women, say the researchers. It does not necessarily mean that yogurt has no beneficial effect on men's blood pressure.

The team then looked at the women's data again and focused on diet. They assigned a score to each participant, depending on how closely her diet matched one designed to lower blood pressure, called Dietary Approaches to Stop Hypertension (DASH).

Yogurt's strongest effect is as part of healthy diet

The DASH diet is rich in fruits, vegetables, fat-free or low-fat milk and milk products, whole grains, fish, poultry, beans, seeds and nuts.

The results showed that women whose diets most closely matched DASH and who ate five or more servings of yogurt a week had a 31% lower risk of developing high blood pressure. This was compared with women with the lowest DASH scores and who had the lowest yogurt intakes (one serving or less per week).

The team also looked at the links between other dairy foods and high blood pressure. They found a positive link between daily servings of milk and cheese and lower risk of high blood pressure, but according to Buendia, this was not as strong as the effect of yogurt.

The researchers suggest the beneficial effect of yogurt on lowering risk of high blood pressure, especially when consumed as part of a healthy diet, could be by lowering body mass index (BMI - a measure of obesity); the links were weaker when they adjusted for BMI.

This reinforces the idea that you are unlikely to reduce your risk of high blood pressure just by adding yogurt to your diet. It is when yogurt is part of a diet plan designed to reduce high blood pressure, which also has a positive effect on helping you reach a healthy weight, that it appears to have the most benefit. As Buendia concludes:

"No one food is a magic bullet but adding yogurt to an otherwise healthy diet seems to help reduce the long-term risk of high blood pressure in women."

Meanwhile, from another study presented at the same meeting, Medical News Today learned that cutting the price of fruits, vegetables and grains by 10%, and marking up sugary drink prices by the same amount, could prevent more than half a million Americans dying prematurely of cardiovascular disease between now and 2035.

Written by Catharine Paddock PhD

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Stomach acid drugs linked to chronic kidney disease

Taking a class of drugs commonly used to reduce acid in the stomach is linked to a higher risk of developing chronic kidney disease, compared with not taking them.

Over 15 million Americans used prescription PPIs - drugs that reduce stomach acid - in 2013, at a cost of over $10 billion.

This was the finding of a new study led by the Johns Hopkins University in Baltimore, MD, and published in JAMA Internal Medicine.

However, the authors also point out that finding a link between use of proton pump inhibitors (PPIs) and chronic kidney disease does not prove the drugs actually cause the disease - that is for further studies to establish.

It could be, they suggest, that the participants who were prescribed PPIs may have been at higher risk of chronic kidney disease for reasons unrelated to their PPI use.

However, the researchers also note that previous studies have linked use of PPIs to a form of kidney inflammation called acute interstitial nephritis.

PPIs are among the most commonly used drugs worldwide. They are used to relieve symptoms of acid reflux and gastroesophageal reflux disease (GERD). They are also prescribed for treating peptic or stomach ulcers and damage to the lower esophagus caused by acid reflux.

PPIs work by reducing the amount of stomach acid made by cells in the lining of the stomach. They are not the same as antacids, which work by neutralizing excess acid after it has entered the stomach.

There are many types and brands of PPI; examples include omeprazole (brand name Prilosec, also available without a prescription), esomeprazole (Nexium) and lansoprazole (Prevacid). The side effects vary from drug to drug.

In an accompanying editorial article - where they summarize recent evidence on the adverse effects of taking PPIs - Drs. Adam Jacob Schoenfeld and Deborah Grad, of the University of California-San Francisco, note that:

"A large number of patients are taking PPIs for no clear reason - often remote symptoms of dyspepsia or 'heartburn' that have since resolved."

10-year risk of kidney disease higher for PPI users

For their study, the Johns Hopkins researchers and their colleagues first analyzed data on 10,482 participants followed up for a median of nearly 14 years in the Atherosclerosis Risk in Communities (ARIC) study.

Fast facts about acid reflux

• Acid reflux, or gastroesophageal reflux (GER), happens when stomach contents come back up into the esophagus
• It is felt as heartburn when stomach acid touches the lining of the esophagus
• A more serious, persistent form - gastroesophageal reflux disease (GERD) - affects about 20% of the US population.

Learn more about acid reflux

They then replicated the results in a bigger cohort of 248,751 participants followed up for a median of 6 years - these participants were members of the Geisinger Health System in Pennsylvania.

They found that at the beginning of the monitoring period, PPI users in both groups were more likely to have a higher body mass index (BMI) and to be taking aspirin, statins or drugs to control high blood pressure.

In the ARIC group, 56 of 332 participants using PPIs developed chronic kidney disease, compared with 1,382 of 10,160 non-users. These figures translate to 14.2 and 10.7 per 1,000-person years, respectively. Participants were classed as a PPI user if they were taking the drugs at the start of the follow-up.

Further analysis of these ARIC figures revealed that the 10-year absolute risk of developing chronic kidney disease in the PPI users was 11.8%, compared with 8.5% if they had not used PPIs.

When they repeated this same analysis in the Geisinger cohort, the researchers found 1,921 of 16,900 PPI users and 28,226 of 231,851 of non-users developed chronic kidney disease, which translates to 20.1 and 18.3 per 1,000 person-years, respectively.

Again, further analysis of the larger cohort showed PPI use was associated with higher risk of disease. The 10-year absolute risk of developing chronic kidney disease among the PPI users was 15.6%, compared with 13.9% had they not used the drugs.

Commenting on their own findings, the authors emphasize the point that their study "is observational and does not provide evidence of causality," but should the link between PPI use and chronic kidney disease prove to be causal, then it could have important implications for public health, given the widespread use of the drugs.

Over 15 million Americans used prescription PPIs in 2013 at a cost of over $10 billion, they note, and conclude:

"Study findings suggest that up to 70% of these prescriptions are without indication and that 25% of long-term PPI users could discontinue therapy without developing symptoms. Indeed, there are already calls for the reduction of unnecessary use of PPIs."

In 2010, Medical News Today reported how a study by researchers from Seoul National University Hospital in South Korea, published in the Canadian Medical Association Journal, also found that use of PPIs and another class of acid reflux drug called histamine2 receptor antagonists may be linked to higher risk of pneumonia.

Written by Catharine Paddock PhD

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Cancer breakthrough? Drug combo eradicated breast cancer tumors in 11 days

A cancer drug duo could one day eliminate the need for chemotherapy for women with HER2-positive breast cancer; in a new study, a combination of two drugs was found to completely eradicate or significantly shrink breast cancer tumors within 11 days of diagnosis.

Women with HER2-positive breast cancer saw a complete eradication or significant reduction in tumors when treated with both trastuzumab and lapatinib.

Lead researcher Prof. Judith Bliss, of the Institute of Cancer Research (ICR) in the UK, and colleagues recently presented the results of their EPHOS B Trial at 10th European Breast Cancer Conference (EBCC-10) in Amsterdam, the Netherlands.

After skin cancer, breast cancer is the most common cancer among women in the US. It is estimated that 1 in 8 American women will be diagnosed with an invasive form of the disease at some point in their lives.

According to the American Cancer Society, around 1 in 5 breast cancers are human epidermal growth factor receptor 2-positive, or HER2-positive. This means the cancer tumors have too many copies of the HER2 gene, resulting in excess production of the HER2 protein.

Compared with other breast cancers, HER2-positive breast cancers tend to spread faster and more aggressively, and patients with this type of cancer are more likely to experience recurrence following treatment.

Current treatments for HER2-positive breast cancer include surgery, chemotherapy and hormone therapy. There are also drugs available that target and block the HER2 receptors on breast cancer cells, such as trastuzumab (brand name Herceptin), which is the most common medication for HER2-positive breast cancer.

In recent years, new anti-HER2 drugs have entered the market, including lapatinib (brand name Tyverb or Tykerb), though this drug is currently only used to treat advanced HER2-positive breast cancer.

11% of women treated with drug combo saw tumors disappear

For their study, Prof. Bliss and colleagues set out to investigate how trastuzumab and lapatinib affected HER2-positive breast cancer tumors in the short window between diagnosis and surgery.

Fast facts about breast cancer

• This year, around 246,660 women in the US will be diagnosed with invasive breast cancer
• Around 40,450 women will die from breast cancer in 2016
• There are more than 2.8 million breast cancer survivors in the US.

Learn more about breast cancer

The team enrolled 257 women who had been diagnosed with HER2-positive breast cancer and allocated them to one of three treatment groups for the 11 days between diagnosis and surgery; one group received trastuzumab, one group received lapatinib and the final group received no treatment, representing the control group.

However, previous research has suggested that a combination of trastuzumab and lapatinib may be effective against HER2-positive breast cancer. As such, the team amended the trial halfway through, so that women in the lapatinib group also received trastuzumab.

Before and after the 11-day treatment period, the researchers measured biological markers of cellular proliferation in the women's breast cancer tumors, including levels of the ki67 protein and apoptosis - programmed cell death.

However, they found that for around a quarter of the 66 women who received both trastuzumab and lapatinib, their tumors were too small to measure cellular proliferation.

The team found that 17% of women treated with the drug combination had minimal residual disease - defined as a tumor that is smaller than 5 mm in diameter - while for a further 11%, the drugs had eradicated their tumors, representing a complete pathological response.

In comparison, minimal residual disease or a complete pathological response was identified in just 3% of women treated with trastuzumab only, while neither response was identified among women in the control group.

The team notes that many of the women who responded to the combination therapy had stage 2 breast cancer, where the cancer has spread to the lymph nodes.

Findings have 'groundbreaking potential'

Based on their findings, the researchers suggest that therapy involving a combination of trastuzumab and lapatinib prior to surgery could be an effective treatment option for women with HER2-positive breast cancer, potentially eliminating the need for chemotherapy.

Commenting on the results, study coauthor Prof. Nigel Bundred, of the UK's University of Manchester and the University Hospital of South Manchester National Health Service (NHS) Trust, says:

"This has groundbreaking potential because it allows us to identify a group of patients who, within 11 days, have had their tumors disappear with anti-HER2 therapy alone and who potentially may not require subsequent chemotherapy. This offers the opportunity to tailor treatment for each individual woman."

Writing about their findings in The Telegraph, Prof. Bliss says the possibility that they can eradicate a tumor in just 11 days is "remarkable."

"It suggests that in future - if the findings are replicated in larger trials which also assess the effects of these responses on long-term disease outcomes - some women might be able to be spared chemotherapy, and the side effects it can bring," she adds.

Earlier this month, Medical News Today reported on another potentially groundbreaking cancer discovery, in which researchers claim they have found a way to encourage the immune system to target and destroy cancer cells, bringing us closer to a personalized cancer vaccine.

Written by Honor Whiteman

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Coffee may protect against liver cirrhosis

Drinking coffee every day is linked to a reduced risk of liver cirrhosis, according to a new review of published evidence that also suggests drinking two extra cups a day may nearly halve the risk of dying from the disease.

The researchers say the link between coffee and lower risk of liver cirrhosis is larger than that between many medications and the diseases they prevent.

The systematic review and meta-analysis is published in the journal Alimentary Pharmacology & Therapeutics.

The researchers - from the University of Southampton in the UK - pooled and analyzed data from nine long-term studies covering nearly half a million men and women from six countries.

They found that increasing coffee consumption may substantially reduce the risk of liver cirrhosis.

The analysis shows a dose-response relationship between coffee consumption and liver cirrhosis - with more cups per day linked to lower risk.

Two extra cups of coffee per day were linked to a 44% lower risk of developing liver cirrhosis and a nearly 50% lower risk of death to the disease.

Liver cirrhosis can be fatal because it raises the risk of liver failure and cancer.

The condition develops when healthy tissue in the liver is replaced by scarred tissue, often as a result of long-term and persistent injury from viruses like hepatitis C and toxins like alcohol.

Liver cirrhosis is an important public health concern and a significant cause of disease and death in the US. The prevalence is likely to be higher than official figures suggest because many cases are undiagnosed.

A recent estimate suggests around 0.27% of Americans - some 633,323 adults - have liver cirrhosis, with 69% unaware of the fact they have the disease.

Effect is 'larger than that of statins on reducing cardiovascular risk'

In their paper, where they discuss the results, the authors explain that coffee has many biologically active ingredients, in addition to caffeine. These include "oxidative and anti-inflammatory agents, such as chlorogenic acid, kahweol and cafestol," and there is evidence, they note, that these may "confer protection against liver fibrosis."

In addition to a direct biochemical effect, there could also be an indirect effect of coffee protecting against cirrhosis, suggest the researchers. For example, they cite lab studies that show various compounds found in coffee block hepatitis B and C viruses and studies that show links between increased coffee consumption and reduction in type 2 diabetes.

The paper concludes that the analysis shows the link between increased daily coffee consumption and reduction in risk of liver cirrhosis is large - larger than that of many medications used for the prevention of disease.

"For example," note the authors, "statin therapy reduces the risk of cardiovascular disease by 25%."

They also point out that "unlike many medications, coffee is generally well tolerated and has an excellent safety profile."

Lead and corresponding author Dr. O. J. Kennedy, of Southampton's Faculty of Medicine, concludes:

"Coffee appeared to protect against cirrhosis. This could be an important finding for patients at risk of cirrhosis to help to improve their health outcomes. However, we now need robust clinical trials to investigate the wider benefits and harms of coffee so that doctors can make specific recommendations to patients."

In November 2015, Medical News Today learned how chronic liver disease and cirrhosis are among the reasons death rates are increasing among middle-aged white Americans.

Our Knowledge Center article - "Coffee: health benefits, nutritional information" - looks at some of the other ways the popular beverage may benefit our health, as well as the risks associated with it.

Written by Catharine Paddock PhD

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Cervical cancer: the importance of regular screening

The American Cancer Society state that cervical cancer used to be the leading cause of cancer death for women in the US. But because more women are undergoing screening for the disease, the number of deaths from the condition have decreased significantly over the past 40 years.

Cervical cancer is most common in women between the ages of 21-50.

However, it is estimated that 12,900 new cases of cervical cancer were diagnosed in the US last year, and 4,100 deaths occurred as a result of the disease, suggesting that there is still more that can be done to combat the cancer.

In line with Cervical Health Awareness Month, we highlight the signs and symptoms women need to look out for when it comes to cervical cancer, the importance of screening and what more can be done to increase awareness of the disease.

Cervical cancer forms in the tissues of the cervix - the organ that connects the uterus and the vagina.

There are two forms of cervical cancer. The first is squamous cell cervical cancer. This is cancer on the outer surface of the ectocervix - the area of the cervix that projects into the vagina.

The other form of cervical cancer is called adenocarcinoma of the cervix. This is cancer of the endocervix - the inner area of the cervix.

According to the American Cancer Society, cervical cancer is most common in women under the age of 50, and it rarely occurs in women under the age of 20.

The risks for cervical cancer

The National Institutes of Health state that almost all cases of cervical cancer are caused by certain types of human papillomavirus (HPV).

There are over 100 types of HPV, and around 40 of these can be sexually transmitted. Of these, approximately 15 are thought to be cancer-causing viruses, with two types - HPV-16 and HPV-18 - being responsible for around 70% of cervical cancer cases globally.

Studies have shown that other risk factors for cervical cancer include a family history of the disease, smoking, a weakened immune system and long-term mental stress.

Research has also shown that taking contraceptive pills can increase a woman's risk of cervical cancer.

Ignoring the signs of cervical cancer

In the past, health professionals have referred to cervical cancer as the "silent killer." Spotting cervical cancer in its early stages can prove difficult, as early forms of the disease do not usually present symptoms.

It is not until the cancer becomes invasive that symptoms occur, such as abnormal bleeding after sexual intercourse, during menopause or between periods, heavy or prolonged periods, unusual discharge and/or pain during sex.

Given the absence or subtleness of early symptoms of the disease, it is a concern that some women may not realize they have it, and some may even ignore the signs or confuse them with symptoms of other conditions.

Debbie Saslow, director of breast and cervical cancer at the American Cancer Society, told Medical News Today:

"Bleeding and pain are symptoms that women sometimes do ignore, but women also identified abnormal bleeding as the most likely symptom to be associated with cancer.
There are also a range of reasons that people ignore symptoms - one major explanation is denial. Other reasons can be related to culture. For example, some cultures are very fatalistic and believe that if you have cancer, there is nothing you can do about it so there's no reason to see a doctor."

The importance of cervical cancer screening

The fact that cervical cancer rarely presents any symptoms in its early stages highlights the importance of regular screening for the disease.

There are two main screening methods for cervical cancer. The first is liquid-based cytology (LBC).

This involves the doctor or nurse scraping the cervix with a small brush to collect cells. The head of this brush is then detached and preserved in liquid, before being sent to a laboratory to be analyzed for cell abnormalities.

During a Pap test, cells are collected from a patient's cervix and sent to a lab to be tested for abnormalities, from which cancerous cells (pictured) may be detected.

The second screening method is the Papanicolaou (Pap) test, also referred to as a cervical smear test.

This involves a doctor or nurse scraping the outer opening of the patient's cervix in order to collect a sample of cells. These cells are then analyzed under a microscope for any abnormalities.

In 2014, the Food and Drug Administration (FDA) approved the first HPV test for primary screening of cervical cancer, called the cobas HPV test. This test simultaneously detects 14 HPV types - including HPV-16 and HPV-18 - from DNA.

Current recommendations from the US Preventive Services Task Force (UPSTF), which were updated in March 2012, state that women aged between 21-65 years should undergo a Pap test every 3 years.

Women aged between 30-65 years can choose to have the Pap test every 3 years, or the Pap test and an HPV test (carried out the same way as a Pap test) every 5 years.

Due to increased usage of the Pap test, the American Cancer Society state that between 1955-1992, the death rate as a result of cervical cancer reduced by almost 70% - meaning the screening may have saved hundreds of thousands of lives.

Saslow explained that in most areas of the US, cervical cancer screening rates are very high - at over 80%. But she notes that in some places, screening rates are very low, and so there should be focus on increasing awareness in these areas.

She told MNT:

"Awareness efforts should include education about what the Pap test and HPV test is. While many women get screened regularly, a good many of these women do not know what the test is for.
Women often do not know the difference between a pelvic exam and a Pap test, and often think that Pap tests look for sexually transmitted diseases and/or ovarian cancer. Awareness about HPV tests is much lower than for Pap tests, since the latter have been in use for many more decades."

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On the next page, we discuss the negative implications of cervical cancer screening and the possibility of new screening tests for the disease.

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Drinking more water reduces sugar, sodium and saturated fat intake

Based on the fact that about two thirds of our bodies are comprised of water, it may seem obvious that consuming water is important for our health. But a new study finds that by increasing plain water consumption, we can control our weight and reduce intakes of sugar, sodium and saturated fat.

Drinking more water is associated with reduced intakes of sugar, sodium and saturated fat, researchers say.

The study, published in the Journal of Human Nutrition and Dietetics, is led by Prof. Ruopeng An, from the University of Illinois.

Though most people meet their body's fluid requirements by drinking plain water and other beverages, we also get some fluids through certain foods, such as soup broths, celery, tomatoes and melons.

To further investigate how increasing water intake can affect parameters of health, the researchers used a nationally representative sample of more than 18,300 adults in the US from the National Health and Nutrition Examination Survey (NHANES) 2005-2012.

The researchers asked participants to recall all foods and drinks they consumed on 2 days that were between 3-10 days apart.

Prof. An then calculated the amount of plain water that each participant consumed as a percentage of daily dietary water intake from both foods and drinks.

Although drinks such as black tea, herbal tea and coffee were not assessed as sources of plain water, Prof. An did include their water content in the calculations of total water consumption.

Promoting water consumption: a public health strategy

On a daily basis, the participants consumed an average of about 4.2 cups of plain water, which accounts for just over 30% of their total water consumption.

The average calorie intake for each participant was 2,157 calories, which included 125 calories from sugar-sweetened beverages and 432 calories from "discretionary foods" - desserts, pastries, snack mixes and other foods that are not essential.

The results of the study revealed that people who increased their consumption of plain water by one to three cups daily lowered total energy intake by 68-205 calories each day and their sodium intake by 78-235 g each day.

Fast facts about water's benefits

• Water keeps the body temperature normal and lubricates and cushions joints
• It protects the spinal cord
• Water also gets rid of waste through urination, perspiration and bowel movements.

Learn more about water

For purposes of the study, "plain water" was defined as water from a tap, cooler, drinking fountain or bottle.

Further results showed that the people who increased their water consumption also consumed 5-18 g less sugar, as well as 7-21 g less cholesterol.

"This finding indicates that it might be sufficient to design and deliver universal nutrition interventions and education campaigns that promote plain water consumption in replacement of beverages with calories in diverse population subgroups without profound concerns about message and strategy customization," says Prof. An.

He and his team add that these effects were similar across race, ethnicity, education attainment, income level and body weight status, however, they were larger among males than females, and among young or middle-aged adults than older adults.

Prof. An suggests these differences could have been linked with the higher daily calorie intakes associated with men and young or middle-aged adults.

The researchers conclude their study by noting that "promoting plain water intake could be a useful public health strategy for reducing energy and targeted nutrient consumption in US adults, which warrants confirmation in future controlled interventions."

Medical News Today previously reported on a study that suggested placing water dispensers in schools lowers obesity in students.

Written by Marie Ellis

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How healthy foods could lead to overeating

Is your New Year's resolution to eat more healthily? If so, watch out: foods portrayed as healthy may lead to overeating and contribute to weight gain, according to new research.

Researchers say foods portrayed as healthy are often viewed as being less filling, causing us to eat more.

In the Journal of the Association for Consumer Research, investigators found that if we perceive a certain food to be healthy, we are likely to consume more of it.

According to study coauthor Jacob Suher and colleagues, from the University of Texas-Austin, their findings support the "healthy equals less filling" theory - the idea that we consume healthy foods in larger amounts because we consider them less filling than unhealthy foods.

The researchers conducted three experiments on three groups of participants to reach their findings.

Firstly, the team enrolled 50 undergraduate students to complete the Implicit Association Test, which was used to assess whether they believed healthy foods to be less filling than unhealthy foods.

Next, the researchers asked 40 graduate students to consume a cookie; one cookie was presented to them in packaging with nutritional information that represented it as unhealthy, while the other cookie was portrayed as healthy.

After consuming the cookie, participants were asked to report their hunger levels.

In a third "real world" experiment involving 72 undergraduate students, the team assessed how health portrayals of food affected the amount of food participants ordered prior to watching a short film, and how such portrayals impacted the amount of food consumed during the film.

Healthy food labels may be contributing to obesity epidemic

In the cookie experiment, researchers found that participants who consumed the "healthy" cookie reported greater hunger after eating than those who consumed the cookie portrayed as unhealthy.

What is more, in the real world experiment, the team found that participants ordered larger portion sizes before watching the film and ate more food during the film when food was portrayed as healthy, compared with when food was portrayed as unhealthy.

Interestingly, even individuals who did not believe in the theory that unhealthy foods are less filling - as determined by the Implicit Association Test - reported greater hunger after consuming the "healthy" cookie and ordered and consumed more food when it was portrayed as healthy.

The team says their findings suggest an irony when it comes to healthy eating; rather than helping to combat obesity, healthy food labels may be contributing to the obesity epidemic by causing us to overeat.

The researchers recommend that consumers opt for foods that are portrayed as nourishing rather than healthy in order to feel full without overeating.

Medical News Today recently reported on a study published in the journal BMC Nutrition, in which researchers found consumers who paid a lower price for an all-you-can-eat buffet reported greater feelings of guilt and fullness after eating than those who paid a higher price.

And last month, we reported on a study that suggested the price we pay for foods influences how we judge food quality.

Written by Honor Whiteman

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Could stem cell transplantation yield a cure for MS?

More than 2.3 million people across the globe are living with multiple sclerosis. At present, there is no cure for the condition. However, researchers believe they are close to uncovering one: a stem cell treatment already used for some cancers has enabled wheelchair-bound patients with multiple sclerosis to walk again.

Worldwide, more than 2.3 million people have MS.

Multiple sclerosis (MS) is a debilitating disease of the central nervous system (CNS). It is believed to be an autoimmune disease, in which the immune system mistakenly attacks the brain, spinal cord and optic nerves.

In detail, the immune system attacks myelin - the protective coating surrounding nerve fibers - as well as the nerve fibers themselves. Such damage impairs communication between the brain and spinal cord, producing a variety of symptoms.

Common symptoms of MS include numbness or tingling of the face and body, walking and balance difficulties, involuntary muscle spasms, pain, weakness, fatigue, dizziness and cognitive impairment. Some people with MS may also experience seizures, speech problems or tremors.

Relapsing-remitting MS (RRMS) is the most common form of the disease, accounting for around 85% of all cases. In RRMS, people experience flare-ups of symptoms, followed by periods of partial or complete recovery.

Primary-progressive MS (PPMS) accounts for around 10-15% of all cases. Rather than experiencing flare-ups of symptoms, people with PPMS experience steady worsening of symptoms.

Secondary-progressive MS (SPMS) normally follows RRMS. This occurs when symptom flare-ups cease and the disease starts to progress more steadily.

MS: a debilitating disease with no cure

According to the National Multiple Sclerosis Society, around two thirds of people with MS retain their ability to walk, though many individuals may require the assistance of a cane or crutches to get around. In severe cases, some patients may become wheelchair-bound.

One such patient was 25-year-old Holly Drewry from Sheffield, UK, who was diagnosed with RRMS at the age of 21. Following the birth of her daughter Isla, her condition worsened, confining her to a wheelchair.

"Within a couple of months I got worse and worse. I couldn't dress or wash myself; I didn't even have the strength to carry my daughter," she told BBC News.

At present, the outcome is bleak for MS patients who find themselves in Holly's position. There is currently no cure for MS, only treatments that may help modify the course of the disease or help manage symptoms.

But according to preliminary trial results, a cure for MS could be on the horizon; the treatment in question has already enabled some patients with MS - including Holly - to walk again.

Utilizing a cancer treatment for MS

The groundbreaking treatment being trialed is called autologous hematopoietic stem cell transplantation (AHSCT) - a procedure that is currently used to treat cancers of the bone and blood, such as leukemia and multiple myeloma.

AHSCT aims to "reboot" the immune system, preventing it from attacking the myelin and nerve fibers.

AHSCT "reboots" the immune system by re-infusing patients' own HSCs (pictured) into their blood.

Firstly, hematopoietic stem cells (HSCs), or hemocytoblasts, are collected from the patient's bone marrow or blood and are frozen until they are needed.

HSCs are adult stem cells that are made in bone marrow. They have the ability to renew themselves and make different cells found in the blood.

Next, the patient will undergo high-dose chemotherapy in order to destroy and clear all the harmful immune cells that are attacking the brain and spinal cord.

The patient's frozen HSCs are then thawed and re-infused into their blood, where they begin to make new red and white blood cells within 2 weeks. Because the harvested HSCs have not developed the abnormalities that damage the CNS, re-introducing them into the patient's blood effectively restarts the immune system.

"The immune system is being reset or rebooted back to a time point before it caused MS," explains Prof. John Snowden, consultant hematologist at the UK's Royal Hallamshire Hospital, where 20 clinical trial patients have received the treatment so far.

After transplantation, patients are monitored for about 3-4 weeks, during which time they receive antibiotics and transfusions to aid recovery. The immune system should be fully rebuilt within 1 month.

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On the next page, we look at the amazing results AHSCT has produced so far for MS patients, as well as the risks associated with the treatment.

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E-cigarettes 'poison the airways and weaken the immune system'

Electronic cigarettes expose the lungs to toxicity, reduce the effectiveness of the immune system and encourage bacterial activity, potentially making superbugs more deadly, according to research published in the Journal of Molecular Medicine.

E-cigarettes are shown to promote bacterial virulence and inflammation in the latest study.

In the US, the use of e-cigarettes tripled from 4.5% in 2013 to 13.4% in 2014 among high school students, and from 1.1% in 2013 to 3.9% in 2014 among middle school students, surpassing rates of youth cigarette smoking. In the 25-44-year age group, 20% of Americans smoke e-cigarettes.

While teens smoke them because they are trendy, older smokers are turning to them in an attempt to give up smoking. Interestingly, many teens who smoke e-cigarettes then move on to conventional cigarettes just 1 year later, as reported recently by Medical News Today.

In using the device, smokers are risking their airways and immune systems. They are also enhancing the conditions for colonizing bacteria, including some deadly strains.

Researchers at the University of California-San Diego (UCSD) carried out mouse studies to examine the effects of e-liquids from seven different manufacturers.

Superbug MRSA more deadly after smoking e-cigarettes

The scientists exposed mice to e-cigarette vapors for 1 hour a day, 5 days a week over 4 weeks.

Results showed that inflammatory markers in the airways and blood of mice after inhaling e-vapors were 10% higher than those in unexposed mice. Bacteria that had been exposed to e-cigarette vapor were more virulent in mice infected with pneumonia.

When mice were infected with normal methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant "superbug," they survived; but 25% of mice that were infected with MRSA after being exposed to e-cigarette vapor died. In other words, S. aureus becomes more virulent when exposed to e-cigarette vapor.

The researchers observed that exposing bacterial pathogens to e-cigarette vapor caused them to thrive. The vapor helped S. aureus bacteria to form biofilms, to adhere to and invade airway cells and to resist the defenses of the human immune system.

Some of the changes observed in mice are common to those seen in the airways and blood of conventional cigarette smokers. Others are characteristic of human cancers or inflammatory lung disease.

The results were the same regardless of the brand of vapor used.

Dr. Laura E. Crotty Alexander, of the UCSD School of Medicine, says:

"This study shows that e-cigarette vapor is not benign; at high doses, it can directly kill lung cells, which is frightening. We already knew that inhaling heated chemicals, including the e-liquid ingredients nicotine and propylene glycol, couldn't possibly be good for you. This work confirms that inhalation of e-cigarette vapor daily leads to changes in the inflammatory milieu inside the airways."

Dr. Crotty Alexander says it is not yet clear which lung and systemic diseases will be caused by inhaling e-cigarette vapor, but data suggest that acute toxicities will result from the inflammatory changes involved.
The team recently reported that MRSA bacteria exposed to conventional cigarette smoke are less likely to be killed by the immune system than unexposed bacteria.
Meanwhile, a news outlet recently revealed that a 20-year-old German man's teeth were blown out when an e-cigarette that he was trying in a store exploded in his mouth. He suffered severe facial injuries.
Findings reported in MNT also associate e-cigarettes with the development of cancer cells.

Written by Yvette Brazier

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Delivery method, infant diet could impact long-term health

The gut microbiome of 6-week-old infants appears to be affected by both delivery method at birth and the way they are fed afterward, says research published online in JAMA Pediatrics.

Babies fed only with breast milk have different gut microbiota than those whose diet includes formula milk.

"Gut microbiome" refers to the diversity of bacterial life that colonizes the human gastrointestinal tract. It develops after birth and after the start of feeding, and it has been increasingly linked with health outcomes in adults.

Meanwhile, cesarean delivery has been linked with obesity, asthma, celiac disease and type 1 diabetes later in life, and breastfeeding has been related to a lower risk of asthma, obesity, infection, metabolic syndrome, and diabetes, compared with formula feeding.

It is thought that exposure to microflora present during vaginal delivery could be related to the microbiome patterns in infants, but how this happens is unclear.

Previous small studies have indicated a link between the intestinal microbiome of infants, delivery mode and whether or not they were breastfed. Less is known, however, about how early life exposures shape the gut microbiome and its long-term effects on health.

In addition, there is evidence that human milk primes and matures the infant gastrointestinal system, potentially promoting a unique microbial colonization profile that could lead to healthy outcomes.

Vaginal delivery and breastfeeding may promote distinct microbiota

In the current study, researchers hypothesized that exposure to maternal vaginal microflora and/or to breast milk could cause specific microbes to be acquired in a particular order during the establishment of the core microbiome. This could represent a key mechanism underlying differences in immune development that influence lifelong disease risk.

Anne G. Hoen, PhD, of the Geisel School of Medicine at Dartmouth, Lebanon, NH, and coauthors examined associations between delivery mode and feeding method with the composition of the gut microbiomes of 102 infants.

The team collected information about the delivery mode from medical records, details on feeding from questionnaires and data about microbiome composition from stool samples.

The infants were born at an average gestational age of nearly 40 weeks; 70 were delivered vaginally and 32 by cesarean section (C-section).

In the first 6 weeks of life, 70 were breastfed, 26 received a combination of breast milk and formula, and six of them consumed only formula.

Results showed a link between the composition of the gut microbiome and the delivery mode. Differences in microbiome composition between infants delivered vaginally and infants delivered by C-section were equivalent or greater than the differences in composition by feeding method.
The microbiome of infants who were breastfed exclusively was different from those who consumed formula milk or a combination.

Those who were exclusively fed formula and those who were fed the combination shared a similar microbiome composition.

There have been no long-term longitudinal studies of the effects of early feeding method on the microbiome, but it appears that early feeding methods could have lasting effects on microbial community structure. These findings could provide one explanation for how breastfeeding benefits health both in childhood and in the long term.

The authors conclude:

"Understanding the patterns of microbial colonization of the intestinal tract of healthy infants is critical for determining the health effects of specific alterable early-life risk factors and exposures.
To this end, we have identified measurable differences in microbial communities in the intestinal tracts of infants according to their delivery mode and diet, with possible consequences for both short- and long-term health."

Limitations of the study include its small sample size and the population being from a single group in the US. Future studies could also take into account the exact proportion of the infants' diets and timing.

Medical News Today recently reported on research suggesting that people with anorexia have a unique gut microbiota composition.

Written by Yvette Brazier

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Eating chocolate during pregnancy may benefit fetal growth, development

Good news for all you expectant mothers out there: eating 30 g of chocolate every day during pregnancy may benefit fetal growth and development. This is the conclusion of a new study recently presented at the 2016 Pregnancy Meeting of the Society for Maternal-Fetal Medicine in Atlanta, GA.

Eating 30 g of chocolate daily during pregnancy was linked to benefits for fetal growth and development in the new study.

The study results are likely to be warmly welcomed by moms-to-be, given the lengthy list of foods women are told to avoid during pregnancy.

While chocolate itself is - thankfully - absent from this no-go list, expectant mothers are recommended against overindulging in the tasty treat due to its fat, sugar and caffeine content.

There are many benefits that may come with moderate chocolate consumption, however. Chocolate contains flavanols - a type of flavonoid - that have been linked to reduced risk of cardiovascular problems and lower cholesterol; the darker the chocolate, the more flavanols it contains.

Previous studies have also suggested that moderate chocolate consumption during pregnancy may lower the risk of preeclampsia - where the blood supply to the fetus is reduced due to the mother's high blood pressure.

However, Dr. Emmanuel Bujold, of the Université Laval Québec City, Canada, notes that the results of research assessing the link between chocolate intake during pregnancy and preeclampsia have been conflicting, spurring him and his colleagues to find out more.

Both low- and high-flavanol chocolate may have fetal benefits

The researchers enrolled 129 expectant mothers with a singleton pregnancy who were between 11-14 weeks' gestation.

All women had double notching on the uterine artery Doppler pulsatility index at study baseline. The uterine artery Doppler pulsatility index is a test that measures uterine, placental and fetal blood flow, and notches are an indicator of the risk of preeclampsia, hypertension and other possible pregnancy outcomes.

The expectant mothers were randomized to consume 30 g of either low- or high-flavanol chocolate daily for 12 weeks. Uterine artery Doppler pulsatility was measured again at the end of the 12 weeks, and the women were followed-up until they gave birth.

The team found that there were no differences in preeclampsia, gestational hypertension, placental weight and birthweight between the low- and high-flavanol chocolate groups.

However, the researchers identified a significant improvement in uterine artery Doppler pulsatility among both chocolate groups, suggesting that both low- and high-flavonol chocolate may benefit fetal growth and development.

This improvement was much greater than what is normally expected among the general population, the team notes.

"This study indicates that chocolate could have a positive impact on placenta and fetal growth and development and that chocolate's effects are not solely and directly due to flavanol content," says Dr. Bujold.

Medical News Today asked Dr. Bujold whether they recommend that expectant mothers indulge in a daily dose of chocolate to improve fetal outcome. He replied:

"We cannot speculate on the overall effect of chocolate on the risk of preeclampsia from our study results because we did not have a group of women who were not taking chocolate.
However, previous epidemiological studies along with our results suggest that consumption of dark chocolate during pregnancy could help in the improvement of placental function and the reduction of preeclampsia."

He added that the next step for the team is to conduct a large randomized control trial in order to better determine whether chocolate intake among expectant mothers can lower the risk of preeclampsia and other pregnancy-related hypertensive disorders.

Our Knowledge Center article - "Chocolate: health benefits, facts, research" - provides more information on how chocolate may be good for us, as well as the risks associated with its consumption.

Last November, MNT reported on another study that is likely to have been welcomed by expectant mothers. Published in the American Journal of Epidemiology, the study suggests that consuming moderate amounts of caffeine during pregnancy does not impact offspring's intelligence.

Written by Honor Whiteman

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How safe is the Paleo diet?

Scientists have warned against following celebrities into "fad" diets that are not supported by scientific evidence, as findings published in the journal Nutrition and Diabetes reveal that just 8 weeks on the "Paleo" diet can pile on the pounds and raise the risk of health problems.

The researchers say on a 'Paleo' diet gained 15% of their body weight in less than 2 months.

Image credit: University of Melbourne

Supporters of the low-carbohydrate, high-fat (LCHF) "Paleo," "stone-age" or "caveman" diet recommend consuming only foods that were available to our hunter-gatherer ancestors.

Mass media hype, including celebrity chefs, the tabloids and reality TV shows, are encouraging growing numbers of people to try this and other diets, despite the lack of evidence regarding health benefits. In 2014, the Paleo diet was the most searched-for diet on the Internet.

Adherents of the LCHF diet consume more protein, fiber and fat than the average Western diet and less sugar and starchy carbohydrates.

Suggested "dos" include grass-produced meats, fish or seafood, fresh fruits and vegetables, eggs, nuts and seeds, and healthful oils such as olive, walnut, flaxseed, macadamia, avocado and coconut.

Foods to avoid include cereal grains, legumes - including peanuts - dairy products, refined sugar, potatoes, processed foods, salt and refined vegetable oils.

Risks of weight gain and diabetes with LCHF diet

Switching from processed foods and refined sugars to more fruit and vegetables can help achieve weight loss, and a lower carbohydrate intake also means less chance of blood glucose levels rising after a meal.

However, the pounds will not automatically fall off with an LCHF diet. Moreover, high dietary fat, regardless of body weight, can cause lipids to accumulate in the liver, limiting the ability of insulin to deal with hepatic glucose production.

Researchers at the University of Melbourne were concerned about the hazards of a paleo diet, especially for those who are already overweight and living a sedentary lifestyle and for individuals with pre-diabetes or diabetes.

To investigate, they took two groups of overweight mice with symptoms of pre-diabetes.

The mice in one group consumed an LCHF diet for 8 weeks, 60% of which was fat, compared with their usual 3% fat intake. Carbohydrates made up 20%. The mice in the control group ate their usual food.

The report states that after 8 weeks, the Paleo diet group had increased in weight, glucose intolerance and insulin. The mice had gained 15% of their body weight, and their fat mass had doubled from 2% to almost 4%.

This "extreme weight gain" is equivalent to a person who weighs 200 pounds gaining 30 pounds in 2 months.

It increases the risk of high blood pressure, bone problems, arthritis, anxiety and depression, and potentially high blood sugar, elevated insulin levels and ultimately diabetes.

The bottom line, says lead author Assoc. Prof. Sof Andrikopoulos, is that eating too much fat is not good.

Assoc. Prof. Andrikopoulos, who is also president of the Australian Diabetes Society, concludes:

"There is a very important public health message here. You need to be very careful with fad diets, always seek professional advice for weight management and always aim for diets backed by evidence."

Instead, he recommends the Mediterranean diet for people with pre-diabetes or diabetes, because, he says, "It is backed by evidence and is a low-refined sugar diet with healthy oils and fats from fish and extra virgin olive oil, legumes and protein."

Medical News Today recently reported on research that asks what ancient people really did eat.

Written by Yvette Brazier

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Should we soften our approach to female genital mutilation?

A paper published this week in the Journal of Medical Ethics asks whether some forms of female genital mutilation should be legalized in America. They argue that not allowing minor versions of the operation is a form of cultural prejudice.

Somalia has one of the highest rates of female genital mutilation.

Female genital mutilation (FGM) is a hot topic and a subject that insights anger, confusion and distress.

In many countries, the practice is extremely prevalent and shows little sign of slowing. In Egypt, for instance, between 2006-2011, the percentage of girls undergoing FGM only dropped from 77.8% to 71.6%.

In one study conducted in Somalia, 81% of subjects underwent infibulation (complete excision of the clitoris, labia minora, and most of the labia majora) and only 3% did not have any form of FGM.

A recent paper - written by Dr. Kavita Shah Arora, from the Department of Obstetrics and Gynaecology at the MetroHealth Medical Center, Cleveland, OH, and Allen J. Jacobs, from the Department of Obstetrics and Gynecology, Stony Brook University, NY - puts a new slant on the difficult topic.

The paper, published alongside a series of responses from other experts, is likely to spark impassioned discourse. The main thrust of Dr. Arora's argument is that banning the most minor of FGM procedures is:

"Culturally insensitive and supremacist and discriminatory towards women."

An estimated 200 million girls and women alive today have been subjected to some form of FGM. Many nations in the Middle East, Asia and Africa carry out the procedure as a matter of course.

FGM is, to a certain extent, routed in religion, but it also has cultural significance. The practice, many would argue, is anti-female and misogynistic.

The current state of affairs

In most Western countries, including the US and UK, FGM is banned in all of its forms, but this does not necessarily prevent individuals from countries where FGM is practiced from having their children altered.

Some families take their daughters back to their country of origin to carry out the procedure; others find someone in their local community who will undertake the procedure illegally. Either of these outcomes can be risky at best.

To combat this, Dr. Arora and her colleagues believe that more time and thought needs to be devoted to finding some middle ground.

They argue that some FGM procedures are little more than a nick in the vulvar skin and cause no long-term changes in the form or function of the genitalia.

The authors consider that by categorizing the procedures along a scale of severity and renaming them as "female genital alterations (FGAs)," some of the stigma might be dropped. The authors are careful to make it clear that they "are not arguing that any procedure on the female genitalia is desirable. [...] we only argue that certain procedures ought to be tolerated by liberal societies."

By legalizing only the least intrusive FGM procedures, they believe that some young girls might be saved from the most serious procedures that include clitoral removal and vaginal cauterization. These most disruptive interventions would be classed as "Category 5" and would remain outlawed. On the other hand, so-called "nick" procedures, classed as "Category 1," would become permissible.

According to the authors, Category 1 FGM would be no more invasive - in fact, slightly less invasive - than circumcision, which is widespread in the US. The medical benefits of circumcision are tenuous, and the authors consider that the practice, in many cases, is a religious, cultural intervention with parallels to Category 1 FGM.

Both practices are carried out without the consent of the minor at the sharp end of the scalpel.

'Not all cultural symbols deserve respect'

Dr. Arora's paper is accompanied by a number of commentaries on the topic that argue against many of the points that she makes.

The circumcision argument is rebuffed by Ruth Macklin, of the Albert Einstein College of Medicine, NY, in her commentary entitled "Not all cultural symbols deserve respect." She argues that symbolically, FGM is about subjugation. In its worst form, it seeks to prevent women from having intercourse or, at the very least, prevent them from deriving pleasure from it.

Additionally, in many cultures, FGM is necessary to make your daughter marriageable. Macklin says:

"As a cultural rite, it signifies a means of making girls and women physically, aesthetically or socially acceptable to men."

Macklin also wonders whether a genital nick would suffice for Somalians, whose culture permits and encourages the most extreme versions of FGM. If a father has his sights on a culturally necessary Category 5 operation, Macklin asks whether he would settle for a Category 1 nick.

If Category 1 truly leaves no mark in later life, would this be sufficient to make his daughter marriageable in his eyes?

'In defence of genital autonomy for children'

In another commentary on the controversial subject, entitled "In defence of genital autonomy for children," Brian D. Earp, of The Hastings Center Bioethics Research Institute, NY, makes his stance clear early on in the text:

"Ultimately, I suggest that children of whatever sex or gender should be free from having healthy parts of their most intimate sexual organs either damaged or removed before they can understand what is at stake in such an intervention and agree to it themselves."

Earp goes on to explain the legal issues that would surround making Category 1 FGM permissible. He states "cutting into a child's genitals without a medical diagnosis, and without its informed consent, meets the formal definition of criminal assault under the legal codes of most of these societies."

He also raises concerns about regulating the procedures; he worries that it might "open the door" for more invasive procedures. Earp's commentary goes on to discuss medical, sexual, cultural and political issues that would go hand in hand with weakening laws surrounding FGM.

Cutting slack and cutting corners

Arianne Shahvisi, of the Department of Ethics, Brighton & Sussex Medical School, UK, also submitted a commentary regarding a legislative easing around FGM. Her paper is entitled "Cutting slack and cutting corners: an ethical and pragmatic response to Dr. Arora and Jacobs' "Female genital alteration: a compromise solution."

She also argues that Category 1 FGM would not be adequate to bring about the desired effect.

Shahvisi explains that "in Somalia, FGA ensures religious adherence; in Nigeria, the clitoris is believed to pose a threat in childbirth. Satisfying these reasons often requires complete clitoral excision or infibulation. Since obtaining these changes is the very reason for performing the practice, Dr. Arora and Jacobs' suggested replacement procedure would miss the mark."

For the majority of people in the West, there is no level of FGM that should be deemed acceptable. However, opening debates on this issue, whether accepted or rejected can still be a useful undertaking. Hiding from, avoiding or ignoring these topics would be the greatest mistake.

In 2014, Medical News Today wrote an article asking how society should address the issue of FGM.

Written by Tim Newman

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The impact of shift work on health

When Dolly Parton sang of working 9 to 5, she expressed concern for people barely getting by with a hard life of routine that only seems to benefit the boss. But what about all those people working less conventional hours, including night shifts? Shouldn't Ms. Parton be just as concerned about their welfare?

Shift workers, such as doctors, flight attendants, bartenders and police officers, have been found to be at a greater risk of certain chronic diseases.

Shift work has its own demands that set it apart from jobs with traditional working hours. Shift work has its benefits; it can be more convenient from a child care perspective, is sometimes better paid and can allow workers time for other activities, such as study.

However, the medical and scientific communities are continually reporting that shift work can increase the risk of certain disorders and have a negative impact on the overall well-being of employees.

In this article, we take a look at what has been reported recently about the effects of shift work, what reasons could possibly be behind these findings and what people working shifts can potentially do to lower their risks of various health problems.

Shift work in the US

Shift work tends to be classified as any work schedule that involves hours that are irregular or unusual in comparison with the traditional daytime work schedule that usually occurs between 6 am and 6 pm.

The term shift work can, for this reason, refer to working evenings, overnight, rotating shifts or irregular employer-arranged shift patterns.

According to an article published in 2000 by the Bureau of Labor Statistics (BLS), over 15 million (16.8 %) full-time wage and salary workers are employed working alternative shifts. Of these, the most common alternative shifts are evening shifts, with working hours usually between 2 pm and midnight, and irregular shifts with a constantly changing schedule.

In contrast, the University of California-Los Angeles (UCLA) Sleep Disorders Center reports more than 22 million Americans work evening, rotating or on-call shifts.

Recently, the BLS reported that the proportion of full-time wage and salary workers employed working alternative shifts now sits at 14.8%. This figure is supported by a poll conducted by the National Sleep Foundation (NSF) in 2005, which found 14% of Americans work shifts.

While there has been a slight drop in the number of white Americans working these hours - from 16.2% in 1997 to 13.7% in 2004 - the proportion of black, Asian and Latino Americans working alternative shifts has remained largely the same. In May 2004, the percentages for these groups were 20.8%, 15.7% and 16%, respectively.

Shift work is most commonly found within industries that provide services around the clock, such as food services, transportation, health services and protective services like the police force.

At first glance, it appears as though the main factor connecting shift workers is that they work different hours to the typical "9-to-5" routine. However, multiple studies report that there is something else that connects bar staff, long-distance truck drivers, nurses and police officers - an increased risk for certain diseases.

Previous studies reported by MNT

Medical News Today have reported on various studies associating shift work with an increased risk of certain health problems. These associations have ranged from the somewhat predictable to the surprising.

In July 2014, a meta-analysis published in Occupational and Environmental Medicine suggested that shift workers face an increased risk of type 2 diabetes. In particular, people working rotating shifts face an increased risk of 42%.

A 2014 study suggested shift work may raise the risk of type 2 diabetes.

The authors theorized that rotating shifts made it more difficult for workers to maintain a regular sleep-wake cycle, negatively affecting sleep quality and potentially weakening insulin resistance.

Then, in November 2014, another study published in the same journal suggested that shift work could impair the functioning of the brain.

Study participants who were currently working or had previously worked shifts scored lower in tests assessing memory, processing speed and overall brain power than participants working traditional daytime hours.

"The cognitive impairment observed in the present study may have important safety consequences not only for the individuals concerned, but also for society as a whole," wrote the study authors, "given the increasing number of jobs in high hazard situations that are performed at night."

More recently, a study published in the American Journal of Preventive Medicine reported that female nurses working rotating night shifts for 5 or more years could be at an increased risk of all-cause and cardiovascular disease mortality.

In addition, working rotating night shifts for 15 years or more was found to potentially raise the risk of lung cancer mortality.

A quick perusal of these studies indicates another factor that shift workers are likely to have in common - disruptions to the sleep-wake cycle. Shift work can lead to workers sleeping at strange or varying times of day, potentially resulting in reduced amounts of sleep.

But how much of an impact can sleep disruption have on an individual's health?

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On the next page, we look at what circadian rhythms are and what can be done to protect the health of shift workers.

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