Sugary drinks and type 2 diabetes

 

Strong evidence indicates that sugar-sweetened soft drinks contribute to the development of type 2 diabetes.

The Nurses’ Health Study explored this connection by following the health of more than 90,000 women for eight years.

Results published in the Journal of the American Medical Association indicate that the nurses who said they had one or more servings a day of a sugar-sweetened soft drink or fruit punch were nearly twice as likely to have developed type 2 diabetes during the study than those who rarely had these beverages.

 

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Fish oils and psychosis

Recent evidence published in Archives of General Psychiatry suggests that fish oil supplementation may reduce the risk of transition to psychotic illness in people at very high risk of these disorders.

The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain omega-3 polyunsaturated fatty acids may be beneficial in a range of psychiatric conditions, including schizophrenia. Given that omega-3 polyunsaturated fatty acids are generally beneficial to health and without clinically relevant adverse effects, their preventive use in psychosis is of considerable interest.

Previous studies have found low levels of omega-3 and omega-6 polyunsaturated fatty acids in people with schizophrenia, and some scientists have suggested that problems with fatty acid metabolism could play a role in the development of the disorder. However, studies looking at the effects of omega-3 polyunsaturated fatty acid supplementation in people with schizophrenia have so far been inconclusive. Types of omega-3 fatty acids are found in oily fish, certain vegetable oils and in fish oil capsules.

A randomized, double-blind, placebo-controlled trial was conducted between 2004 and 2007 in the psychosis detection unit of a large public hospital in Vienna, Austria.

The aim was to determine whether omega-3 polyunsaturated fatty acids reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis.

Eighty-one individuals at ultra-high risk of psychotic disorder participated in the trial. These participants had at least one of the following risk factors for psychosis:

• low levels of psychotic symptoms (delusions, hallucinations, suspiciousness, or conceptual disorganisation measured on a standard scale),

• transient psychosis, i.e. lasted less than a week and resolved without antipsychotic medication, or

• having either a schizotypal personality disorder or a first-degree relative (such as a mother, father, sister or brother) who had psychosis, plus the participant experienced a significant reduction in ability to function in the last year.

A 12-week intervention period of 1.2 g per day omega-3 polyunsaturated fatty acids or placebo was followed by a 40-week monitoring period; the total study period was 12 months.

Researchers monitored how much of their supplements the participants took by monitoring the number of pills they had left and by taking blood samples. The placebo pill contained coconut oil (which does not contain omega-3 polyunsaturated fatty acids) and an equivalent amount of vitamin E to the fish oil capsules, plus 1% fish oil to make the taste of the capsules similar.

Seventy-six of 81 participants (93.8%) completed the intervention. By the end of the study (12 months), 2 of 41 individuals (4.9%) in the omega-3 group and 11 of 40 (27.5%) in the placebo group had transitioned to psychotic disorder (P = .007). The difference between the groups in the cumulative risk of progression to full-threshold psychosis was 22.6% (95% confidence interval, 4.8-40.4).

Omega-3 polyunsaturated fatty acids also significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01) and improved functioning (P = .002) compared with placebo.

The incidence of adverse effects did not differ between the treatment groups.

The researchers concluded that:

a 12-week intervention with omega-3 significantly reduced the transition rate to psychosis and led to significant symptomatic and functional improvements during the entire follow-up period (12 months)

This small study does seem to suggest that, at least in the short term, fish oil supplementation could prevent young people at high risk from progressing to psychotic illness. However, while the study was robust in its design it was too short to say whether the illnesses were prevented completely or just delayed.

Psychotic illnesses are serious conditions and if fish oils can be confirmed to prevent or delay their development in susceptible individuals this would be a very important finding. However, it will require larger, long-term studies to know if this is the case.

To learn more about the effects of what we eat on our mental health, why not come along to a Cooking for Health course on “Food and Emotions“, taught by nutrition consultant Dr Jane Philpott.

Life expectancy continues to increase

Harry Patch lived to 111 years old

A recent paper by Professor David Leon, an epidemiologist at the London School of Hygiene and Tropical Medicine, in the International Journal of Epidemiology reports that Western Europeans are living longer than ever before despite concerns about obesity and health problems.  Average life expectancy in Western Europe is now six to eight years higher than in the 1970s.

The report used mortality data from the WHO Health for All Database and the Human Mortality Database, and its findings are likely to be reliable.

Data from 2007 indicate that average life expectancy for the UK was 80 years (for males 77.9 and women, 82), compared with 78 in the US.

The report also discusses life expectancy in Eastern Europe.  Between 1970 and the end of the 1980s, life expectancy in eastern European countries stagnated or declined, but after the fall of the Berlin Wall in 1989, life expectancy started to rapidly rise in the countries of the CEE (Czech Republic, Hungary, Poland and Slovakia).  This rise is still continuing but on a “parallel trajectory to Western Europe” that makes it difficult to close the gap between east and west.

Russia and the Baltic states have seen a decline in life expectancy that is only recently being reversed.  Russia in particular has had some dramatic fluctuations in recent years – its life expectancy in 2008 was just 68 years (men 61.8 and women 74.2) – the same age as 40 years previously.  Prior to this, Russia also saw a sharp decline in life expectancy between 1990 and 1994, when male life expectancy fell by six years to a low of 57 years.

The report discusses the possible causes of the trends in different countries.

The decline in cardiovascular disease is seen as an important contributor to the rise in life expectancy in Western Europe. According to the author,

Deaths from cardiovascular disease in the UK have seen some of the largest and most rapid falls of any Western European country, partly due to improvements in treatment as well as reductions in smoking and other risk factors.

The fact that US life expectancy lags behind the UK, he says, underlines that

GDP and health care expenditure per capita are not good predictors of population health within high income countries.

The rises in life expectancy seen in central Europe since the collapse of the Berlin Wall in 1989 reportedly illustrate that mortality can fluctuate rapidly in response to social, political and economic change.

The study’s author believes that the dramatic fluctuations in life expectancy in Russia are associated with the “stress and chaos” after the collapse of communism, as well as high rates of alcoholism. The recent upward trend in life expectancy in Russia and the Baltic states is probably due to recent reductions in alcohol-related deaths, rather than overall health improvements.

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