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Food Addiction Tied to Type 2 Diabetes, Even Beyond BMI

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A “strong, positive association” exists between food addiction and type 2 diabetes that is only partially explained by body weight, new data suggest.

In a large Danish population-based study, people who scored positively on the Yale Food Addiction Scale 2.0 had more than a fivefold increased risk for type 2 diabetes, even after adjusting for age and body mass index (BMI). The increased risk was attenuated, but still present, among individuals with mental disorders.

The study is the first to demonstrate a positive association between food addiction and type 2 diabetes, say Christina Horsager, MD, PhD, of the department of psychiatry at Aalborg University Hospital, Denmark, and colleagues in their article published in the May issue of Clinical Nutrition.

“The findings add to our current understanding of potential risk factors for type 2 diabetes and, by extension, possible targets for interventions aimed at risk reduction,” Horsager told Medscape Medical News.

It might be expected that “food addiction” would lead to overeating and weight gain, which in turn, raises the risk for type 2 diabetes. “However, the results from our study suggest that BMI is not the only mediator in this context, which is not that surprising given the complex etiology of type 2 diabetes,” she said.

However, she also cautioned, “the interpretation of these findings is complicated by the fact that BMI was calculated using self-reported weight and height, making it susceptible to response bias.” In addition, “the cross-sectional design of the study precludes causal interpretation of the findings.”

Food Addiction, Type 2 Diabetes Strongly Linked

The study, from the Food Addiction Denmark Project, involved 1699 adults from the general population and 1394 adults from a population with clinically verified mental disorders including substance abuse, affective disorders, stress/anxiety-related disorders, and autism spectrum disorders.

Food addiction was assessed using the self-reported 11-point Yale Food Addiction Scale 2.0. The categories of mild, moderate, and severe food addiction were combined into one group, and discrete scale scores were also assessed.

Among the general population sample, 9.0% met the criteria for food addiction and 3.1% had type 2 diabetes. The odds ratio was 6.7 for the association between food addiction and type 2 diabetes, after adjustment for sex and age (P < .001), dropping just slightly to 5.6 after additional adjustment for BMI but remaining significant (P < .001).

In a dose–response model, the odds ratios per point on the addiction scale were 1.3 after age and sex adjustment (P < .001) and 1.3 with the addition of BMI adjustment (P < .001).

Association Among Those With Mental Disorders

Among those with mental disorders, 26.5% had a food addiction and 4.1% had type 2 diabetes. Here, the age- and sex-adjusted odds ratio for the association between food addiction and type 2 diabetes was 2.4 (P = .002). With BMI factored in, there was still an association, with an odds ratio of 1.8, which just missed statistical significance (P = .061).

The dose–response relationship, on the other hand, remained significant even in the group with mental disorders, with odds ratios of 1.1 (P < .001) and 1.1 (P = .034) per point on the Yale Food Addiction 2.0 scale, respectively.

An analysis of individual mental disorders showed that all associations were positive, but because of the small sample sizes, only the age- and sex-adjusted odds ratio for anxiety remained significant (4.9; P = .041).

It’s likely that the weaker association among those with mental disorders is “a consequence of a ceiling effect, as food addiction “competes” with other risk factors for type 2 diabetes that are common among individuals with mental disorders, such as sedentary lifestyle and use of psychotropic medication, making food addiction a relatively weaker risk factor for type 2 diabetes in this specific population when compared with the general population,” Horsager and colleagues write.

The higher prevalence of type 2 diabetes in the population with mental disorders, despite that group being nearly 10 years younger (mean age, 33.5 vs 43.4 years), lends support to that explanation, they note.

The group is continuing this work, Horsager told Medscape Medical News. “There is a paucity of studies assessing the longitudinal course and correlates of food addiction. We will aim to bridge this gap with the upcoming Food Addiction, Obesity, and Type 2 Diabetes in Denmark (FAT2DK) cohort study,” she said.

The study was supported by grants from the Beckett Foundation, the A.P. Møller Foundation, the Lundbeck Foundation, and the Heinrich Kopps Grant. Horsager has reported no relevant financial relationships.

 

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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