Obese teens' brains unusually susceptible to food commercials, study finds

TV food commercials disproportionately stimulate the brains of overweight teenagers, including the regions that control pleasure, taste and -- most surprisingly -- the mouth, suggesting they mentally simulate unhealthy eating habits that make it difficult to lose weight later in life.

The most surprising finding of a new Dartmouth College study was that TV food commercials activated overweight adolescents' brain region that controls their mouths, suggesting they mentally simulate unhealthy eating habits.

Credit: Kristina Rapuano

A Dartmouth study finds that TV food commercials disproportionately stimulate the brains of overweight teen-agers, including the regions that control pleasure, taste and -- most surprisingly -- the mouth, suggesting they mentally simulate unhealthy eating habits.

The findings suggest such habits may make it difficult to lose weight later in life, and that dieting efforts should not only target the initial desire to eat tempting food, but the subsequent thinking about actually tasting and eating it -- in other words, you should picture yourself munching a salad rather than a cheeseburger.

The study appears in the journal Cerebral Cortex. The study included researchers from Dartmouth College's Department of Psychological and Brain Sciences and the Norris Cotton Cancer Center at the Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth.

The prevalence of food advertising and adolescent obesity has increased dramatically over the past 30 years, and research has linked the number of television shows viewed during childhood with greater risk for obesity. In particular, considerable evidence suggests that exposure to food marketing promotes eating habits that contribute to obesity.

Using functional magnetic resonance imaging, the Dartmouth researchers examined brain responses to two dozen fast food commercials and non-food commercials in overweight and healthy-weight adolescents ages 12-16. The commercials were embedded within an age-appropriate show, "The Big Bang Theory," so the participants were unaware of the study's purpose.

The results show that in all the adolescents, the brain regions involved in attention and focus (occipital lobe, precuneus, superior temporal gyri and right insula) and in processing rewards (nucleus accumbens and orbitofrontal cortex) were more strongly active while viewing food commercials than non-food commercials. Also, adolescents with higher body fat showed greater reward-related activity than healthy weight teens in the orbitofrontal cortex and in regions associated with taste perception. The most surprising finding was that the food commercials also activated the overweight adolescents' brain region that controls their mouths. This region is part of the larger sensory system that is important for observational learning.

"This finding suggests the intriguing possibility that overweight adolescents mentally simulate eating while watching food commercials," says lead author Kristina Rapuano, a graduate student in Dartmouth's Brain Imaging Lab. "These brain responses may demonstrate one factor whereby unhealthy eating behaviors become reinforced and turned into habits that potentially hamper a person's ability lose weight later in life."

Although previous studies have shown heightened brain reward responses to viewing appetizing food in general, the Dartmouth study is one of the first to extend this relationship to real world food cues -- for example, TV commercials for McDonald's and Burger King -- that adolescents encounter regularly. The brain's reward circuitry involves the release of dopamine and other neurotransmitter chemicals that give pleasure and may lead to addictive behavior.

Children and adolescents see an average of 13 food commercials per day, so it isn't surprising they show a strong reward response to food commercials. But the new findings that these heightened reward responses are coupled with bodily movements that indicate simulated eating offer a clue into a potential mechanism on how unhealthy eating habits are developed.

"Unhealthy eating is thought to involve both an initial desire to eat a tempting food, such as a piece of cake, and a motor plan to enact the behavior, or eating it," Rapuano says. "Diet intervention strategies largely focus on minimizing or inhibiting the desire to eat the tempting food, with the logic being that if one does not desire, then one won't enact. Our findings suggest a second point of intervention may be the somatomotor simulation of eating behavior that follows from the desire to eat. Interventions that target this system, either to minimize the simulation of unhealthy eating or to promote the simulation of healthy eating, may ultimately prove to be more useful than trying to suppress the desire to eat."

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The above story is based on materials provided by Dartmouth College.

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Homely men who misbehave can't win for losing: Attractiveness influences online daters, jurors

Women tolerate an unattractive man up to a point, but beware if he misbehaves. Then they'll easily shun him, researchers report, after finding that a woman's view of a man is influenced by how handsome and law-abiding he is. Their study, they say, has significance for those using dating sites or doing jury duty.

Women tolerate an unattractive man up to a point, but beware if he misbehaves. Then they'll easily shun him. So say Jeremy Gibson and Jonathan Gore of the Eastern Kentucky University in the US, after finding that a woman's view of a man is influenced by how handsome and law-abiding he is. Their study in Springer's journal Gender Issues has significance for those using dating sites or doing jury duty.

Discovering how someone can make a positive first impression is an important field of study because of its role in forming relationships. It is often based on physical appearance and whether someone sticks to social norms or not. Such impressions are made in a flash, but are not always correct. In what is called the "halo effect," people warm up to others with positive characteristics, such as handsomeness. The "devil effect" or "negative halo effect" comes into play when people assume that others possess so-called "bad" characteristics, based on traits such as unattractiveness..

Gibson and Gore tested if and how levels of attractiveness and conforming to social norms combine to influence 170 college women's perceptions of men. Two male faces -- one attractive, the other not -- bearing similar features were paired in two written scenarios. In the one, the man committed a major social no-no, in the other not.

The researchers found that whether a man transgressed a social norm was a much greater put-off than whether he was unattractive. Normally women do not feel differently towards a homely man who toes the line. If that same ugly duckling, however, transgresses the boundaries of right or wrong, a magnified or "double" devil effect comes into play. He is then viewed in an extremely negative light, much more so than would have been the case if he were handsome.

"The unattractive male is tolerated up to a point; his unattractiveness is OK until he misbehaves," says Gibson.

The halo and devil effect often comes into play when people view others' profiles on online dating sites. Based on their results, Gibson and Gore believe that unattractive men who provide unusual or alarming information in their profiles may not receive a second glance from women. This will not be the case for an Adonis posting the same information, or unattractive ones who do not violate these norms. In the judicial system, unattractive defendants are also known to receive more severe penalties than more attractive ones, even if they committed the same crime.

"A man who stands trial has already shown himself to have violated social norms in one way or another. If he is also unattractive, the magnified devil effect may result in a larger fine or sentence, as it could influence how negatively jurors view him and, as a result, the degree to which they believe him guilty of the crime," explains Gore.

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The above story is based on materials provided by Springer Science+Business Media. Note: Materials may be edited for content and length.

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Journal Reference:

1. Jeremy L. Gibson, Jonathan S. Gore. You’re OK Until You Misbehave: How Norm Violations Magnify the Attractiveness Devil Effect.Gender Issues, 2015; DOI: 10.1007/s12147-015-9142-5

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Toothbrush contamination in communal bathrooms

Data confirms that there is transmission of fecal coliforms in communal bathrooms at a university, and that toothbrushes can serve as a vector for transmission of potentially pathogenic organisms.

Data confirms that there is transmission of fecal coliforms in communal bathrooms at Quinnipiac University and that toothbrushes can serve as a vector for transmission of potentially pathogenic organisms. This research is presented at the annual meeting of the American Society for Microbiology.

"The main concern is not with the presence of your own fecal matter on your toothbrush, but rather when a toothbrush is contaminated with fecal matter from someone else, which contains bacteria, viruses or parasites that are not part of your normal flora," said Lauren Aber, MHS (Graduate Student, Quinnipiac University). Potential microorganisms that can be introduced are enteric bacteria and pseudomonads. Enteric bacteria are a family of bacteria, Enterobacteriaceae, they are known to be normal flora found in the gut. They are also known to ferment glucose, fail to contain cytochrome in an oxidase test and many can reduce nitrates to nitrites. Pseudomonas group of bacteria are gram-negative aerobic rods commonly found in soil, water, plants and animals. They are part of the normal flora of the gut and also on the skin of humans.

All toothbrushes were collected from participants using communal bathrooms, with an average of 9.4 occupants per bathroom. Regardless of the storage method, at least 60% of the toothbrushes were contamination with fecal coliforms. There were no differences seen with the effectiveness of the decontamination methods between cold water, hot water or rinsing with mouthwash and 100% of toothbrushes regularly rinsed with mouthwash had growth on MacConkey agar indicating fecal contamination (n=2).

Fecal coliforms were seen on 54.85% of toothbrushes, which has been seen in previous studies. There is an 80% chance that the fecal coliforms seen on the toothbrushes came from another person using the same bathroom.

"Using a toothbrush cover doesn't protect a toothbrush from bacterial growth, but actually creates an environment where bacteria are better suited to grow by keeping the bristles moist and not allowing the head of the toothbrush to dry out between uses," said Aber.

"Better hygiene practices are recommended for students who share bathrooms both in the storage of their toothbrush but also in personal hygiene," said Aber. It is also recommended to follow the American Dental Association recommendations for toothbrush hygiene.

Toothbrushes are a known source of contamination. Since the 1920's scientists suspected that the re-use of toothbrushes could be a possible source of infection in the oral cavity. There are several potential sources of contamination of one's toothbrush; toothbrushes stored open in the bathroom are especially vulnerable to contamination with material from the toilet or contamination from other occupants. Sanitization and storage practices of a toothbrush are very important to the potential bacteria present on a toothbrush.

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Six-month-old conjoined twin sisters separated in Haiti

On Friday, May 22, physicians and nurses separated a pair of six-month-old conjoined Haitian twins, the first such operation ever performed on Haitian soil.

Henri Ford, Md, chief of Surgery, Children's Hospital Los Angeles, holds formerly conjoined twins Michelle and Marian three days after their separation surgery in Haiti.

Credit: Image courtesy of Childrens Hospital Los Angeles

On Friday, May 22, an 18-member team of physicians and nurses from Children's Hospital Los Angeles (CHLA) and Keck Medicine of the University of Southern California (USC) led an international collaboration to separate a pair of six-month-old conjoined Haitian twins, the first such operation ever performed on Haitian soil.

Marian Dave-Nouche Bernard and Michelle Dave-Nouche Bernard, born as one on Nov. 24, 2014, were separated after a seven-hour surgery at University Hospital of Mirebalais (HUM), in Mirebalais Haiti, a poor rural community in the country's Central Plateau, about 36 miles northeast of the capital city of Port-au-Prince.

"The girls are doing fantastic," said surgical team leader Henri Ford, MD, MHA, the Haitian-born surgeon in chief at Children's Hospital Los Angeles and vice dean for Medical Education, professor and vice chair for Clinical affairs, Department of Surgery, Keck School of Medicine of USC. "It was an extremely exhilarating day; not only did our preparations pay off and the surgery succeed in spectacular fashion, but this was also a time to put politics aside and celebrate our national pride."

Marian and Michelle -- "omphalopagus" twins since they are connected at the abdomen -- are actually triplets (sister Tamar is healthy and normal). The two sisters had faced each other since birth, but recuperated in separate beds in HUM's neonatal intensive care unit. They were ready to be discharged 12 days after surgery. "We anticipate Marian and Michelle will recover fully and go on to lead healthy and happy lives," Ford says.

Conjoined twins occur in roughly 1 in 200,000 births and omphalopagus twins represent about 30 percent of all conjoined twin births. As triplets, these girls are considered even rarer, occurring 1 in an estimated 1 million births. Fused together by the breastbone (or xiphoid bone) in the lower portion of the sternum, Marian and Michelle also had attached livers that would be separated during the procedure.

It took the international surgical team almost seven hours to separate the conjoined twins.

The mother, Manoucheca Ketan, 35, gave birth to all three of her daughters at HUM after carrying them for 36 weeks. The twins shared a crib until 10 a.m. on May 22, when Ketan and her husband, David Bernard, 31, watched as their infant daughters were wheeled into surgery as one. Ten hours later, after the surgery, the parents wept when they next saw the twins -- resting in separate cribs.

By then, the girls were already feeding on formula and breast milk. "It was an extraordinary moment," Ketan said, describing her reaction when she first laid eyes on her separated daughters. "When I first met Dr. Ford, he told me he was confident we could separate my children, but I didn't know how it would turn out when the day started. Now I am feeling a lot of joy and want to recognize and thank the hospital for everything."

The complex surgical procedure got underway within 24 hours of the arrival of the 18-member surgical team of surgeons, anesthesiologists and nurses from Children's Hospital Los Angeles. The Los Angeles team was joined by 12 medical staff from Centres GHESKIO, Hospital Bernard Mevs-Project Medishare and Hopital Universitaire de Mirebalais (HUM), led by Dr. Maclee Jean-Louis, director of Surgery at HUM. The group comprised what Ford described as an international medical "Dream Team."

The family received free treatment from HUM, which is supported by the Haitian Ministry of Health and Partners in Health, an international health organization. Keck Medicine and CHLA covered the travel expenses of the medical team and donated supplies to ensure the success of the operation.

Anticipating a six- to eight-hour procedure, doctors made the first incision along the abdominal wall that connected Marian and Michelle at 1:14 p.m. At 2:50 p.m., the girls were surgically separated to a burst of applause from the team and Marian was moved to an adjacent table. Donning red caps, Marian's team of six doctors and nurses hovered over her to close her incision, while Michelle's team worked in yellow caps -- ironically reflecting the colors of USC. "The mom gave them red and yellow bands months ago to identify them," Ford explains. "They were destined to be separated by Trojan surgeons."

Michelle was wheeled out of the surgery suite at 4:45 p.m., followed by Marian at 4:58 p.m.

"This surgery took less time than previous conjoined twin separations we have performed at CHLA, since there was no pelvic attachment," explains James Stein, lead surgeon during the separation and associate chief of surgery at Children's Hospital. Stein, an associate professor of surgery at Keck School of Medicine, has now separated six pairs of conjoined twins. "There are surgeries that require the expanded expertise of a place like CHLA, but the twins' anatomy and our team's expertise allowed us to undertake the surgery in Haiti, and compile the appropriate resources to do the surgery there safely."

Ford said that by doing the operation in Haiti, the children would benefit emotionally from the proximity of their parents and the surgery could be done more cost-effectively than if it were done in Los Angeles.

After completing the first ever surgery in Haiti to separate conjoined twins, part the international team takes a break in the surgery suite at University Hospital in Mirebalais.

During the seven-hour operation, the girls underwent 11 separate procedures, with only a few minor complications. Early on, surgeons and anesthesiologists encountered a "cross circulation" -- when fluids, blood and medication pass through one twin's liver to the other without benefiting the first.

Michelle's heart rate elevated, but the surgeons -- Stein, Ford and Aaron Jensen, MD, along with CHLA anesthesiologists Duc Nguyen, MD, and Joanna E. Green, MD -- remedied the situation by expeditiously separating the livers and individually hydrating the girls intravenously.

Doctors also removed an ovarian cyst in Michelle and surgically inserted patch material in both girls to reconstruct their abdominal walls after separation. They also formed new belly buttons for the twins, whose midline vertical scars should nearly disappear over time, Stein says.

One moment during the operation seemed to sum up the enormity of the procedure for Ford. "Their lower chests were connected so we had to remove a piece of the sternum, the breastbone, and then you could see their lungs and their hearts beating," he recalled.

Once the girls were moved to intensive care, a team of intensivists led by a graduate of CHLA's pediatric residency program, Peggy Han, MD, now an attending intensivist at Weill-Cornell, and neonatal intensive care unit nurses worked with HUM staff to oversee the twins' recovery. Volunteers from two other U.S. hospitals would fly in later to join the team and help oversee care after the CHLA team departed. Forty-eight hours after surgery, the girls were breathing independently, and after 72 hours they were being fed with a combination of breast milk and formula, Ford says.

Ford started recruiting his team back in September after his first conversation with the twins' doctors at HUM. Ford and team members would make almost monthly trips to Haiti between the November births and the May 22 surgery, checking up on the health of the girls and making sure that the proper human and material resources or equipment were available to safely do the surgery at HUM. By March, the team was set and the girls, strong and healthy, were scheduled for the May procedure.

Hours after the surgery, the Haitian media reported on the milestone operation and, three days postoperatively, the famous twins were paid a visit by Haitian First Lady Sophia Martelly and Minister of Health Florence Guillaume.

In the coming weeks, the girls will recover from their incisions and undergo physical therapy to help strengthen neck muscles weakened due to facing in a single direction for such a long time. "The girls look great; we don't expect any more surgeries," Stein says. "This was all about planning and organization. The amazing part for all of us is conducting seven hours of surgery, and then seeing two kids side by side, when they used to be just one. It's just awe-inspiring."

"I liken the entire international team of surgeons, anesthesiologists, intensivists, respiratory therapists and nurses to a symphony orchestra," says team leader Ford, who no doubt would make Gustavo Dudamel proud.

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The above story is based on materials provided by Childrens Hospital Los Angeles. Note: Materials may be edited for content and length.

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Missing link found between brain, immune system; major disease implications

In a stunning discovery that overturns decades of textbook teaching, researchers have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. The discovery could have profound implications for diseases from autism to Alzheimer's to multiple sclerosis.

Maps of the lymphatic system: old (left) and updated to reflect UVA's discovery.

Credit: University of Virginia Health System

In a stunning discovery that overturns decades of textbook teaching, researchers at the University of Virginia School of Medicine have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. That such vessels could have escaped detection when the lymphatic system has been so thoroughly mapped throughout the body is surprising on its own, but the true significance of the discovery lies in the effects it could have on the study and treatment of neurological diseases ranging from autism to Alzheimer's disease to multiple sclerosis.

"Instead of asking, 'How do we study the immune response of the brain?' 'Why do multiple sclerosis patients have the immune attacks?' now we can approach this mechanistically. Because the brain is like every other tissue connected to the peripheral immune system through meningeal lymphatic vessels," said Jonathan Kipnis, PhD, professor in the UVA Department of Neuroscience and director of UVA's Center for Brain Immunology and Glia (BIG). "It changes entirely the way we perceive the neuro-immune interaction. We always perceived it before as something esoteric that can't be studied. But now we can ask mechanistic questions."

"We believe that for every neurological disease that has an immune component to it, these vessels may play a major role," Kipnis said. "Hard to imagine that these vessels would not be involved in a [neurological] disease with an immune component."

New Discovery in Human Body

Kevin Lee, PhD, chairman of the UVA Department of Neuroscience, described his reaction to the discovery by Kipnis' lab: "The first time these guys showed me the basic result, I just said one sentence: 'They'll have to change the textbooks.' There has never been a lymphatic system for the central nervous system, and it was very clear from that first singular observation -- and they've done many studies since then to bolster the finding -- that it will fundamentally change the way people look at the central nervous system's relationship with the immune system."

Even Kipnis was skeptical initially. "I really did not believe there are structures in the body that we are not aware of. I thought the body was mapped," he said. "I thought that these discoveries ended somewhere around the middle of the last century. But apparently they have not."

'Very Well Hidden'

The discovery was made possible by the work of Antoine Louveau, PhD, a postdoctoral fellow in Kipnis' lab. The vessels were detected after Louveau developed a method to mount a mouse's meninges -- the membranes covering the brain -- on a single slide so that they could be examined as a whole. "It was fairly easy, actually," he said. "There was one trick: We fixed the meninges within the skullcap, so that the tissue is secured in its physiological condition, and then we dissected it. If we had done it the other way around, it wouldn't have worked."

After noticing vessel-like patterns in the distribution of immune cells on his slides, he tested for lymphatic vessels and there they were. The impossible existed. The soft-spoken Louveau recalled the moment: "I called Jony [Kipnis] to the microscope and I said, 'I think we have something.'"

As to how the brain's lymphatic vessels managed to escape notice all this time, Kipnis described them as "very well hidden" and noted that they follow a major blood vessel down into the sinuses, an area difficult to image. "It's so close to the blood vessel, you just miss it," he said. "If you don't know what you're after, you just miss it."

"Live imaging of these vessels was crucial to demonstrate their function, and it would not be possible without collaboration with Tajie Harris," Kipnis noted. Harris, a PhD, is an assistant professor of neuroscience and a member of the BIG center. Kipnis also saluted the "phenomenal" surgical skills of Igor Smirnov, a research associate in the Kipnis lab whose work was critical to the imaging success of the study.

Alzheimer's, Autism, MS and Beyond

The unexpected presence of the lymphatic vessels raises a tremendous number of questions that now need answers, both about the workings of the brain and the diseases that plague it. For example, take Alzheimer's disease. "In Alzheimer's, there are accumulations of big protein chunks in the brain," Kipnis said. "We think they may be accumulating in the brain because they're not being efficiently removed by these vessels." He noted that the vessels look different with age, so the role they play in aging is another avenue to explore. And there's an enormous array of other neurological diseases, from autism to multiple sclerosis, that must be reconsidered in light of the presence of something science insisted did not exist.

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Surgical anesthesia in young children linked to effects on IQ, brain structure

Children who received general anesthesia for surgery before age 4 had diminished language comprehension, lower IQ and decreased gray matter density in posterior regions of their brain, according to a new study. The authors of the study recommend additional studies to determine anesthesia's precise molecular effects on the brain and contribution to diminished brain function and composition.

Young children who received general anesthesia for surgery had diminished language comprehension, lower IQ and decreased gray matter density in posterior regions of their brain, according to a new study. (stock image)

Credit: © garagundi / Fotolia

Children who received general anesthesia for surgery before age 4 had diminished language comprehension, lower IQ and decreased gray matter density in posterior regions of their brain, according to a new study in the journal Pediatrics.

Researchers from Cincinnati Children's Hospital Medical Center report their findings in the journal's June 8 online edition. The authors recommend additional studies to determine anesthesia's precise molecular effects on the brain and contribution to diminished brain function and composition. Researchers say this knowledge could make it possible to develop mitigating strategies for what the authors describe as a potential dilemma for child health.

"The ultimate goal of our laboratory and clinical research is to improve safety and outcomes in young children who have no choice but to undergo surgery with anesthesia to treat their serious health concerns," said Andreas Loepke, MD, PhD, FAAP, lead study author and an anesthesiologist in the Department of Anesthesiology at Cincinnati Children's. "We also have to better understand to what extent anesthetics and other factors contribute to learning abnormalities in children before making drastic changes to our current practice, which by all measures has become very safe."

Loepke and his research colleagues have published previous studies showing widespread cell death, permanent deletion of neurons and neurocognitive impairment in laboratory rats and mice after exposure to general anesthesia. Those studies have raised concerns about similar effects in young children during a particularly sensitive neurodevelopmental period in early life, which researchers say could interfere with the refinement of neuronal networks and lead to long-term functional abnormalities.

For their current retrospective study, the authors compared the scores of 53 healthy participants of a language development study (ages 5 to 18 years with no history of surgery) with the scores of 53 children in the same age range who had undergone surgery before the age of 4.

The authors stress that average test scores for all 106 children in the study were within population norms, regardless of surgical history. Still, compared with children who had not undergone surgery, children exposed to anesthesia scored significantly lower in listening comprehension and performance IQ. Researchers also report that decreased language and IQ scores were associated with lower gray matter density in the occipital cortex and cerebellum of the brain.

Researchers, who used extensive analysis of surgical and other medical records, said the children were matched for age, gender, handedness and socioeconomic status -- all confounding factors of cognition and brain structure. The authors also factored into their calculations the types of surgeries and length of exposure to anesthetics. The anesthetics used during the surgeries included common agents such as sevoflurane, isoflurane or halothane (used alone or in combination) and nitrous oxide.

Children included in the study did not have a history of neurologic or psychological illness, head trauma or any other associated conditions. Neurocognitive assessments included the Oral and Written Language Scales and the Wechsler Intelligence Scale. Brain structural comparisons were conducted by MRI scans.

Estimated Social Cost

Extending their study a step beyond the medical data, the research team also considered the potential societal impact of their findings. Earlier research from 2008 had estimated the loss of 1 IQ point to decrease a person's lifetime earnings potential by $18,000. Factoring in the potential loss of 5 or 6 IQ points found in their current study, the researchers report that, based on the estimated 6 million children who undergo surgery in the United States each year the lifetime potential earnings loss could total $540 billion.

Emphasis on Safety

Although data in the current study highlight the need to look for improved methods of administering anesthesia, Loepke and his colleagues emphasize that current methods are very safe. Loepke advises parents who are concerned to discuss with their pediatrician and surgeon the risks of a surgical procedure -- and the potential risk of anesthetic exposure -- versus the risks of not having a surgery.

"It is important to note that no surgeries are truly elective in young children," Loepke said. "Many surgical procedures early in life treat life-threatening conditions, avert serious health complications, or improve quality of life. These cannot be easily postponed or avoided."

Loepke also stressed that researchers at Cincinnati Children's are actively looking for alternative anesthetic techniques in their ongoing laboratory studies. Drugs are being tested that show potential for lessening the harmful effects of anesthetics in laboratory rats and mice, and this research is ongoing. Additionally, the medical center is participating in an international clinical trial to test an alternative anesthetic regimen in young children undergoing urological procedures.

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Data scientists find connections between birth month and health

This data visualization maps the statistical relationship between birth month and disease incidence in the electronic records of 1.7 million New York City patients.

Credit: Dr. Nick Tatonetti

Columbia University scientists have developed a computational method to investigate the relationship between birth month and disease risk. The researchers used this algorithm to examine New York City medical databases and found 55 diseases that correlated with the season of birth. Overall, the study indicated people born in May had the lowest disease risk, and those born in October the highest. The study was published in the Journal of American Medical Informatics Association.

"This data could help scientists uncover new disease risk factors," said study senior author Nicholas Tatonetti, PhD, an assistant professor of biomedical informatics at Columbia University Medical Center (CUMC) and Columbia's Data Science Institute. The researchers plan to replicate their study with data from several other locations in the U.S. and abroad to see how results vary with the change of seasons and environmental factors in those places. By identifying what's causing disease disparities by birth month, the researchers hope to figure out how they might close the gap.

Earlier research on individual diseases such as ADHD and asthma suggested a connection between birth season and incidence, but no large-scale studies had been undertaken. This motivated Columbia's scientists to compare 1,688 diseases against the birth dates and medical histories of 1.7 million patients treated at NewYork-Presbyterian Hospital/CUMC between 1985 and 2013.

The study ruled out more than 1,600 associations and confirmed 39 links previously reported in the medical literature. The researchers also uncovered 16 new associations, including nine types of heart disease, the leading cause of death in the United States. The researchers performed statistical tests to check that the 55 diseases for which they found associations did not arise by chance.

"It's important not to get overly nervous about these results because even though we found significant associations the overall disease risk is not that great," notes Dr. Tatonetti. "The risk related to birth month is relatively minor when compared to more influential variables like diet and exercise."

The new data are consistent with previous research on individual diseases. For example, the study authors found that asthma risk is greatest for July and October babies. An earlier Danish study on the disease found that the peak risk was in the months (May and August) when Denmark's sunlight levels are similar to New York's in the July and October period.

For ADHD, the Columbia data suggest that around one in 675 occurrences could relate to being born in New York in November. This result matches a Swedish study showing peak rates of ADHD in November babies.

The researchers also found a relationship between birth month and nine types of heart disease, with people born in March facing the highest risk for atrial fibrillation, congestive heart failure, and mitral valve disorder. One in 40 atrial fibrillation cases may relate to seasonal effects for a March birth. A previous study using Austrian and Danish patient records found that those born in months with higher heart disease rates--March through June--had shorter life spans.

"Faster computers and electronic health records are accelerating the pace of discovery," said the study's lead author, Mary Regina Boland, a graduate student at Columbia. "We are working to help doctors solve important clinical problems using this new wealth of data."

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Toddler temperament could be influenced by different types of gut bacteria

The microbiome of a toddler's gut may influence their behavior, a new study suggests. Scientists found correlations between temperament and the presence of specific types of intestinal bacteria in both girls and boys. The researchers aren't looking for a way to help parents modify the 'terrible twos,' but for clues about how - and where - chronic illnesses like obesity, asthma, allergies and bowel diseases start.

The next time your toddler acts adventurous, shy, fidgety or cuddly, you might be able to blame the bacteria in his gut.

Researchers from The Ohio State University studied microbes from the gastrointestinal tracts of children between the age of 18 and 27 months, and found that the abundance and diversity of certain bacterial species appear to impact behavior, particularly among boys. The correlation exists even after the scientists factored in history of breastfeeding, diet and the method of childbirth -- all of which are known to influence the type of microbes that populate a child's gut.

Study authors say they aren't looking for a way to help parents modify the 'terrible twos,' but for clues about how -- and where -- chronic illnesses like obesity, asthma, allergies and bowel disease start.

"There is substantial evidence that intestinal bacteria interact with stress hormones- the same hormones that have been implicated in chronic illnesses like obesity and asthma," said Lisa Christian, PhD, a researcher with Ohio State's Institute for Behavioral Medicine Research. "A toddler's temperament gives us a good idea of how they react to stress. This information combined with an analysis of their gut microbiome could ultimately help us identify opportunities to prevent chronic health issues earlier."

Christian and study co-author, microbiologist Michael Bailey, PhD, studied stool samples from 77 girls and boys, and found that children with the most genetically diverse types of gut bacteria more frequently exhibited behaviors related with positive mood, curiosity, sociability and impulsivity. In boys only, researchers reported that extroverted personality traits were associated with the abundances of microbes from the Rikenellaceae and Ruminococcaceaefamilies and Dialister and Parabacteroides genera.

"There is definitely communication between bacteria in the gut and the brain, but we don't know which one starts the conversation," said Dr. Bailey, who is currently a researcher with Nationwide Children's Hospital and a member of Ohio State's Institute for Behavioral Medicine Research. "Maybe kids who are more outgoing have fewer stress hormones impacting their gut than shy kids. Or maybe the bacteria are helping mitigate the production of stress hormones when the child encounters something new. It could be a combination of both."

Overall, associations of temperament with the gut microbiome in girls were fewer and less consistent than boys. However, in girls, behaviors like self-restraint, cuddliness and focused attention were associated with a lower diversity of gut bacteria, while girls with an abundance of Rikenellaceae appeared to experience more fear than girls with a more balanced diversity of microbes.

To identify correlations between gut bacteria and temperament, researchers asked mothers to assess kid's behavior using a questionnaire which measures 18 different traits that feed into three composite scales of emotional reactivity: Negative Affect, Surgency/Extraversion and Effortful Control. Scientists looked at the different genetic types and relative quantity of bacteria found in the toddler's stool samples along with their diets.

The average gastrointestinal tract contains 400-500 different species of bacteria, and most of them belong to one of ten phyla of bacteria. Advancements in DNA-based methods have allowed scientists to identify bacteria in stool, along with the relative concentration of those bacteria -- giving them a much more accurate look at the diversity and composition of the microbial community.

"In the past, bacteria were cultured from samples in the lab, and scientists assumed that what grew was an accurate reflection of what was in the gut," said Dr. Bailey. "Now we can see that's not the case. All of the predominant bacteria that we found in our study have been previously linked to either changes in behavior or immune response, so I think we are definitely on the right track."

Similar to other child behavior studies, researchers separated their findings by gender to analyze temperament. Overall, the study found few differences in the abundance and types of gut microbiota between girls and boys.

While scientists believe that the microbiome is generally set by the age of two, there are dramatic changes in gut microbes that take place during and after birth, as babies pick up bacteria from their mothers during labor and through breastfeeding. Babies born via C-section will have different microbes than babies delivered vaginally.

However, the researchers found that gut bacterial composition wasn't impacted by delivery method, diet or length of breast feeding. The authors acknowledge that their study didn't delve deeply into individual diets, but looked generally at when food types were introduced and the types and frequency of food consumed daily.

"In this study, the associations between temperament and the gut microbiome that we saw weren't due to differences in the diets of children. However, it is possible that effects of diet would emerge if we used a more detailed assessment. It is certainly possible that the types or quantities of food that children with different temperaments choose to eat affect their microbiome. " said Dr. Christian, who also holds appointments in the departments of psychiatry, psychology and obstetrics/gynecology at Ohio State's College of Medicine.

Both researchers say that parents shouldn't try to change their child's gut microbiome just yet. Scientists still don't know what a healthy combination looks like, or what might influence its development.

"The bacterial community in my gut is going to look different than yours -- but we are both healthy. The perfect microbiome will probably vary from person to person," said Dr. Bailey.

Drs. Christian and Bailey are continuing to study how the gut microbiome impacts human health and behavior, recently publishing evidence that the babies of obese mothers have a different gut microbiome than babies of normal weight mothers. They are currently applying for an R01 grant to determine how this difference may predispose babies for developing obesity later in childhood.

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The above story is based on materials provided by Ohio State University Center for Clinical and Translational Science. Note: Materials may be edited for content and length.

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Schizophrenia, bipolar disorder may share genetic roots with creativity

Although creativity is difficult to define for scientific purposes, researchers consider a creative person to be someone who takes novel approaches requiring cognitive processes that are different from prevailing modes of thought or expression. Schizophrenia and bipolar disorder are disorders of thoughts and emotions, which means that those affected show alterations in cognitive and emotional processing.

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Genes linked to creativity could increase the risk of developing schizophrenia and bipolar disorder, according to new research carried out by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London.

Previous studies have identified a link between creativity and psychiatric disorders such as bipolar disorder, but it has remained unclear whether this association is due to common genes. Published in Nature Neuroscience, this new study lends support to the direct influence on creativity of genes found in people with schizophrenia and bipolar disorder.

Although creativity is difficult to define for scientific purposes, researchers consider a creative person to be someone who takes novel approaches requiring cognitive processes that are different from prevailing modes of thought or expression. Schizophrenia and bipolar disorder are disorders of thoughts and emotions, which means that those affected show alterations in cognitive and emotional processing.

It has long been suggested that creativity and psychosis show certain similarities, with notable examples of artists such as Vincent Van Gogh who themselves suffered from psychiatric illnesses. Previous studies have shown that psychiatric disorders, particularly bipolar disorder, tend to be found in the same families where creative professions are common. However, until now it had not been possible to pinpoint whether this was simply due to shared environmental factors or socioeconomic status.

Genetic risk scores were examined in a sample of 86,292 individuals from the general population of Iceland, in collaboration with researchers from deCODE Genetics, who provided the data. Creative individuals were defined as those belonging to the national artistic societies of actors, dancers, musicians, visual artists and writers.

Researchers found that genetic risk scores for both schizophrenia and bipolar disorder were significantly higher in those defined as creative individuals, with scores approximately halfway between the general population and those with the disorders themselves.

These findings lend support to the direct influence of genetic factors on creativity, as opposed to the effect of sharing an environment with individuals who have schizophrenia or bipolar disorder.

Robert Power, first author from the MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre at the IoPPN, said: 'For most psychiatric disorders little is known about the underlying biological pathways that lead to illness. An idea that has gained credibility is that these disorders reflect extremes of the normal spectrum of human behaviour, rather than a distinct psychiatric illness. By knowing which healthy behaviours, such as creativity, share their biology with psychiatric illnesses we gain a better understanding of the thought processes that lead a person to become ill and how the brain might be going wrong.'

'Our findings suggest that creative people may have a genetic predisposition towards thinking differently which, when combined with other harmful biological or environmental factors, could lead to mental illness.'

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The above story is based on materials provided by King's College London.Note: Materials may be edited for content and length.

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Over 95% of the world’s population has health problems, with over a third having more than five ailments

Just one in 20 people worldwide (4·3%) had no health problems in 2013, with a third of the world's population (2·3 billion individuals) experiencing more than five ailments, according to a major new analysis.

In 2013, low back pain and major depression ranked among the top ten greatest contributors to disability in every country, causing more health loss than diabetes, chronic obstructive pulmonary disease, and asthma combined.

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Just one in 20 people worldwide (4·3%) had no health problems in 2013, with a third of the world's population (2·3 billion individuals) experiencing more than five ailments, according to a major new analysis from the Global Burden of Disease Study (GBD) 2013, published in The Lancet.

Moreover, the research shows that, worldwide, the proportion of lost years of healthy life (disability-adjusted life years; DALYS [1]) due to illness (rather than death) rose from around a fifth (21%) in 1990 to almost a third (31%) in 2013.

As the world's population grows, and the proportion of elderly people increases, the number of people living in suboptimum health is set to rise rapidly over coming decades, warn the authors.

The findings come from the largest and most detailed analysis to quantify levels, patterns, and trends in ill health and disability around the world between 1990 and 2013.

In the past 23 years, the leading causes of health loss have hardly changed. Low back pain, depression, iron-deficiency anemia, neck pain, and age-related hearing loss resulted in the largest overall health loss worldwide (measured in terms of YLD -- Years Lived with Disability -- ie, time spent in less than optimum health [2]) in both 1990 and 2013.

In 2013, musculoskeletal disorders (ie, mainly low back pain, neck pain, and arthritis) and mental and substance abuse disorders (predominantly depression, anxiety, and drug and alcohol use disorders) accounted for almost half of all health loss worldwide.

Importantly, rates of disability are declining much more slowly than death rates. For example, while increases in rates of diabetes have been substantial, rising by around 43% over the past 23 years, death rates from diabetes increased by only 9%.

"The fact that mortality is declining faster than non-fatal disease and injury prevalence is further evidence of the importance of paying attention to the rising health loss from these leading causes of disability, and not simply focusing on reducing mortality," [3] says Theo Vos, lead author and Professor of Global Health at the Institute of Health Metrics and Evaluation, University of Washington, USA.

The GBD 2013 Disease and Injury Incidence and Prevalence Collaborators analysed 35,620 sources of information on disease and injury from 188 countries between 1990 and 2013 to reveal the substantial toll of disabling disorders and the overall burden on health systems from 301 acute and chronic diseases and injuries, as well as 2337 health consequences (sequelae) that result from one or more of these disorders.

Key findings include:

In 2013, low back pain and major depression ranked among the top ten greatest contributors to disability in every country, causing more health loss than diabetes, chronic obstructive pulmonary disease, and asthma combined.

Worldwide, the number of individuals with several illnesses rapidly increased both with age and in absolute terms between 1990 and 2013. In 2013, about a third (36%) of children aged 0-4 years in developed countries had no disorder compared with just 0·03% of adults older than 80 years. Furthermore, the number of individuals with more than ten disorders increased by 52% between 1990 and 2013.

Eight causes of chronic disorders -- mostly non-communicable diseases -- affected more than 10% of the world population in 2013: cavities in permanent teeth (2·4 billion), tension-type headaches (1·6 billion), iron-deficiency anemia (1·2 billion), glucose-6-phosphate dehydrogenase deficiency trait (1·18 billion), age-related hearing loss (1·23 billion), genital herpes (1·12 billion), migraine (850 million), and ascariasis (800 million; giant intestinal roundworm).

The number of years lived with disability increased over the last 23 years due to population growth and aging (537·6 million to 764·8 million), while the rate (age-standardised per 1000 population) barely declined between 1990 and 2013 (115 per 1000 people to 110 per 1000 people).

The main drivers of increases in the number of years lived with disability were musculoskeletal, mental, and substance abuse disorders, neurological disorders, and chronic respiratory conditions. HIV/AIDS was a key driver of rising numbers of years lived with disability in sub-Saharan Africa.

There has also been a startling increase in the health loss associated with diabetes (increase of 136%), Alzheimer's disease (92% increase), medication overuse headache (120% increase), and osteoarthritis (75% increase).

In central Europe, falls cause a disproportionate amount of disability and health burden, ranking as the second leading cause of disability in 11 of 13 countries. In many Caribbean nations anxiety disorders ranked more highly, and diabetes was the third greatest contributor to disability in Mexico, Nicaragua, Panama, and Venezuela. Disability from past war and conflict was the leading contributor to health loss in Cambodia, Nicaragua, Rwanda, and ranked second in Vietnam.

According to Professor Vos, "Large, preventable causes of health loss, particularly serious musculoskeletal disorders and mental and behavioural disorders, have not received the attention that they deserve. Addressing these issues will require a shift in health priorities around the world, not just to keep people alive into old age, but also to keep them healthy."

FOOTNOTES:

This study was funded by the Bill & Melinda Gates Foundation.

[1] Years of healthy life lost are measured in terms of disability adjusted life years (DALYS). These are worked out by combining the number of years of life lost as a result of early death and the number of years lived with disability.

[2] Years lived with disability (YLD) calculated by combining prevalence (proportion of the population with the disorder in any given year) and the general public's assessment of the severity of health loss (disability weight).

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The above story is based on materials provided by The Lancet. Note: Materials may be edited for content and length.

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