Honoring the Health Sacrifices of Our Veterans

“On Veterans Day, America pauses to honor every service member who has ever worn one of our Nation’s uniforms. Each time our country has come under attack, they have risen in her defense. Each time our freedoms have come under assault, they have responded with resolve. Through the generations, their courage and sacrifice have allowed our Republic to flourish. And today, a Nation acknowledges its profound debt of gratitude to the patriots who have kept it whole.

As we pay tribute to our veterans, we are mindful that no ceremony or parade can fully repay that debt. We remember that our obligations endure long after the battle ends, and we make it our mission to give them the respect and care they have earned. “

These two paragraphs are taken directly from the 2013 Veterans Day Presidential Proclamation.

But getting Veterans the care they deserve is not always easy.  The wounds of war can go far beyond what meets the eye. From mental health issues to pain and illness that persist long after they’ve left the battlefield, veterans face a multitude of health troubles either unique to their service or more frequent among them than the general population.

“Folks returning from combat have a constellation of health concerns, including physical issues, psychological issues and psychosocial issues concerning things like work and family,” said Dr. Stephen Hunt, national director of the U.S. Department of Veterans Affairs Post Deployment Integrative Care Initiative.

Some of the most common physical complaints of returning soldiers cannot be classified into a single disorder. They include nonspecific symptoms such as fatigue, pain and cognitive disturbances such as memory and concentration problems.

Here are seven of the most commonly seen health conditions confronting veterans:

Musculoskeletal injuries and pain

Just over half of all veterans’ post-deployment health visits address lingering pain in their backs, necks, knees or shoulders.  According to a study in the Journal of Pain, about 100,000 veterans of the Gulf War nearly 20 years ago have reported chronic muscle pain.

Mental health issues

While post-traumatic stress disorder (PTSD) among soldiers has been well publicized, other mental woes can also result from the trauma of war. A study in the journal Archives of General Psychiatry [now JAMA Psychiatry] found that one in 10 Iraq war vets develop serious mental problems, including violent behavior, depression and alcohol abuse. The study found that PTSD or depression seriously impaired daily functioning in 8.5 – 14% of these vets.  Disabling on its own, PTSD is also linked to the development of physical illnesses for veterans as years pass. Researchers from Walter Reed Army Medical Center reported that 54% of veterans with PTSD also had sleep apnea, compared with 20%of PTSD patients in the general population. PTSD in vets is also associated with a greater risk of developing dementia.

Chemical exposure

Research by the American Heart Association found that exposure to nerve agents such as sarin – which can trigger convulsions and death on the battlefield – may cause long-term heart damage in Gulf War veterans. The damage can include an enlarged left ventricle, heart rhythm abnormalities or a reduction in the pumping strength of the heart.

Infectious diseases

Although all military personnel are given routine vaccinations before deployment, veterans suffer disproportionately from certain infections that civilians almost never experience.  They include bacterial infections such as brucellosis, which may persist for years; campylobacter jejuni, which causes abdominal pain, fever and diarrhea; and Coxiella burnetii, which in chronic cases can inflame the heart.

Leishmaniasis, a parasitic disease caused by the bite of a sand fly native to the Middle East, is a particularly brutal condition veterans experience. Those infected suffer weight loss, fevers, headaches, muscle pain and weakness, anemia, and enlargement of the spleen and liver. It can be fatal if untreated, according to the VA..

Traumatic Brain Injury (TBI)

TBI, often brought on by a blow or jolt to the head, disrupts brain function and has been called the signature wound of the fighting in Iraq and Afghanistan, according to the National Academy of Sciences. Blast exposures and other combat-related activities put service members at greater risk for sustaining a TBI compared to their civilian counterparts, according to the Defense and Veterans Brain Injury Center.

Common effects of TBIs include cognitive issues such as shorter attention span, language disabilities, and an inability to process information. Vets can also suffer from lack of motivation, irritability, anxiety and depression, headaches, memory loss and PTSD.

However, you choose to mark Veteran’s Day 2013, please remember the sacrifices made by all of our vets and be mindful of the long-term health problems they face. Ladies and Gentleman of the military, we thank you for your service.

Working Out to Ward Off Depression

Physical activity is being increasingly recognized as an effective tool to treat depression. But now researchers have taken the connection one step further.  In a review published in the October issue of the American Journal of Preventive Medicine, George Mammen has demonstrated that moderate exercise can actually prevent episodes of depression.

This is the first longitudinal review to focus exclusively on the role that exercise plays in maintaining good mental health and preventing the onset of depression later in life.

Mammen analyzed over 26 years’ worth of research findings to discover that even low levels of physical activity (walking and gardening for 20-30 minutes a day) can ward off depression in people of all age groups.

Mammen’s findings come at a time when mental health experts want to expand their approach beyond treating depression with costly prescription medication. “We need a prevention strategy now more than ever,” he says. “Our health system is taxed. We need to shift focus and look for ways to fend off depression from the start.”

Mammen acknowledges that other factors influence a person’s likelihood of experiencing depression, including their genetic makeup. But he says that the scope of research he assessed demonstrates that regardless of individual predispositions, there’s a clear take-away for everyone. “It’s definitely worth taking note that if you’re currently active, you should sustain it. If you’re not physically active, you should initiate the habit. This review shows promising evidence that the impact of being active goes far beyond the physical.”

Let’s hope so.  Now that I’m back in the gym six days a week maybe all the push-ups and perspiration will keep the Prozac at bay!

 

10 Brain Damaging Habits

According to the World Health Organization here’s 10 habits that can severely damage your brain:

1.  No Breakfast – Skipping breakfast in order to lose weight or save time is totally wrong and directly affects our brain. Those who don’t take breakfast or take unhealthy breakfast having lower blood sugar level and sometime it may cause overweight.

2. Overreacting – causes hardening of the brain arteries, leading to a decrease in mental power.

3. High Sugar consumption – Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development by reducing the production of Brain Derived Neutrotrophic Factor, without which the brain cannot learn.

4. Smoking – causes brain shrinkage, damages memory, judgment, learning and thinking powers and may even lead to dementia and Alzheimer’s disease.

5. Air Pollution – The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation – Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping – Sleeping with the head covered decreases available air space and forces you to start breathing carbon dioxide instead of oxygen. This leads to a rise in intracranial pressure and results in brain hypoxia which may lead to brain damaging effects.

8. Working your brain during illness – Working hard or studying with sickness may lead to a decrease in effectiveness of the brain. When we are sick the brain is at its weakest and becomes more easily stressed. This stress can also affect memory.

9. Drinking too little water – Water is the main source of energy and is essential for brain function and activity of neurotransmitters. Dehydration can lead to anger, stress, exhaustion, depression and lack of mental clarity.

10. Rarely Talking – Intellectual conversations help to train and promote efficiency of the brain. Conversely, lack of stimulating thoughts may cause brain shrinkage. Reading SRxA’s Word on Health and discussing the content with friends is an excellent way to avoid this!  So grab a glass of water and subscribe today. Consider it free brain fuel!

Drinking our way to brain fitness

As we reported last week, drinking the occasional glass of wine might help to stave off depression. This week we learned how to better protect ourselves from that wine we’ve been drinking!

Previous studies have shown that long-term alcohol abuse increases the risk of dementia. But according to new research from Loyola University Chicago Stritch School of Medicine, omega-3 fish oil might help protect against alcohol-related dementia.

The Loyola study found that in the brain cells of rats exposed to high levels of alcohol, a fish oil compound protected against inflammation and cell death.

The study by Michael Collins, PhD, and colleagues was reported Sept. 8 at the 14th Congress of the European Society for Biomedical Research on Alcoholism.  An earlier analysis by Collins and Loyola colleague Edward Neafsey, PhD, which pooled the results of 143 studies, found that moderate social drinking may reduce the risk of dementia and cognitive impairment.

It appears that small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate amounts stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.

However, as always, moderation is the key! Too much alcohol overwhelms the cells, leading to inflammation and cell death. The study authors defined moderate as one drink per day for women and two for men.

In the new study, Collins and colleagues exposed cultures of adult rat brain cells to amounts of alcohol equivalent to more than four times the legal limit for driving. These cell cultures were compared with cultures of brain cells exposed to the same high levels of alcohol, plus a compound found in fish oil called omega-3 docosahexaenoic acid (DHA).  Researchers found there was about 90% less neuroinflammation and neuronal death in the brain cells exposed to DHA and alcohol than in the cells exposed to alcohol alone.

Of course, being a health blog we should point out that the best way for an alcohol abuser to protect their brain is to quit drinking or to cut back to moderate amounts.  But as Collins says: “Fish oil has the potential of helping preserve brain integrity in abusers. At the very least, it wouldn’t hurt them.”

In Vino Veritas?

Happy Hump Day!

While we may not be able to make you laugh quite as much as the GEICO camel, we do bring you news that should at least make you smile.

A new Spanish study suggests that drinking wine might help you avoid depression.

Although drinking a lot of wine or other alcohol may be a sign of depression or other mental health problems, alcohol in moderation may benefit mental health according to the study authors.

“One drink a day, preferentially wine, may help prevent depression,” said lead researcher Dr. Miguel Martinez-Gonzalez, chair of the department of preventive medicine and public health at the University of Navarra, in Pamplona.

Researchers followed more than 5,500 light-to-moderate drinkers, aged between 55 and 80 for up to seven years.  None of the individuals had suffered from depression or had alcohol-related problems at the start of the study. Over seven years, with medical exams, interviews with dietitians and questionnaires, the researchers kept tabs on participants’ mental health and lifestyle.  Wine was the most popular drink and participants who drank two to seven glasses a week were the least likely to suffer from depression, compared to nondrinkers. These findings remained significant even after the researchers took factors such as smoking, diet and marriage into account.

But before you start reaching for the corkscrew, we need to warn you that not all experts agree with the findings and even the research team, only saw benefit in moderate drinkers.

Martinez-Gonzalez thinks the apparent benefit of wine in preventing depression may work the same way that moderate drinking helps prevent heart disease.

“Depression and heart disease seem to share some common mechanisms because they share many similar protective factors and risk factors,” he said. However, he added that depression prevention is not a reason to start drinking.

“If you are not a drinker, please don’t start drinking,” he said. “If you drink alcohol, please keep it in the range of one or less drinks a day and consider drinking wine instead of other alcoholic beverages.”

Tony Tang, an adjunct psychology professor at Northwestern University, in Evanston, Ill., said the new research “is consistent with other studies suggesting modest health benefits of very modest drinking.”

But, Tang said other factors may be at work in the potential connection between wine and depression. He noted that compared to nondrinkers, those in the Spanish study who drank a moderate amount of wine were more likely to be married men who were also physically active.  Being single or divorced, living alone and being sedentary are well-established risk factors of depression. Thus, he suggests, the correlation between modest drinking and depression is a coincidence caused by these other known factors.

“An adequate social life is the most important factor we know that protects people from depression,” Tang said. “Perhaps not drinking is a sign of serious social isolation in Spain while drinking a glass of wine a day is simply a sign of having a normal social life.”

Wine with friends anyone?

Cheers!

Stress and Distress at Work

Here’s a classic Catch-22 conundrum for co-workers to consider. Psychological distress, such as feelings of  worthlessness, hopelessness, nervousness, and/or restlessness)  can be predictors  of early stage anxiety and depression. It can also lead to decreased job productivity and absenteeism. But, it may actually be the job that’s creating the mental distress in the first place. Norwegian researchers have identified that perceived role conflicts and emotional demands are the most important and most consistent risk factors for psychological distress. While other psychosocial working conditions have been linked to distress, this study is the first to highlight the importance of these two issues. Håkon A. Johannessen, PhD, and colleagues from the Norwegian National Institute of Occupational Health, looked at how the work environment affected employees’ levels of psychological distress. Sixteen percent of workers said they were at least slightly bothered by psychological distress over the past month. The study focused on two main risk factors: role conflict, such as being given work tasks without enough resources to complete them and receiving contradictory requests from different people; and emotional demands, defined as “dealing with strong feelings such as sorrow, anger, desperation and frustration” at work. Problematic levels of distress were 53% more likely for workers reporting role conflict and 38% more likely for those facing high emotional demands. Other risk factors were low job control, bullying/harassment, and job insecurity. The researchers conclude that employers should focus on the identified risk factors to improve the psychosocial work environment and thus promote good mental health and productivity among employees. Is your job getting you down? Have you any tips for beating work-related stress?  We’d love to hear from you.

Feeling Good about Memorial Day?

We’d like to start this post by wishing all of our US readers a wonderful Memorial Day. And for those elsewhere, Happy Monday!

For some of us, Memorial Day signifies a welcome day off from work and the unofficial start of summer. For others, the day is all about trips to memorials or cemeteries with family. And for a few it may be a day in private introspection and remembrance.

If you’re one of the latter, or tend to keep to yourself on this day, you might want to re-consider this year.  According to research, getting together with friends and family for a grill out or participating in a parade can have positive health benefits.

Holidays offer the opportunity to gather with others to laugh and bond. Social activities have been shown to reduce stress, and satisfying social relationships have been shown to result in fewer health problems and longer, happier lives. In contrast, an isolated, less social life has been linked to depression and cognitive decline, according to reports in the Harvard Women’s Health Watch.

One study of almost 5,000 adults in Alameda County, Calif. showed that individuals who maintained strong social connections live longer than those who lived more isolated lives. Subjects were rated using a social network index, which translated their answers into a number. A high number indicated a strong amount of social contacts while a low number represented social isolation.

Over the following nine years, researchers tracked the subjects’ health. They found that people who placed lower on the social network showed an increased risk of death, implicating social isolation as a major risk factor for poor health.

So why are social connections so healthy? It appears that both biological and behavioral factors are at play. Some research points to stress reduction when we’re happily supported and surrounded by a social circle. Conversely stress, wreaks havoc on our immune system which in turn negatively affect coronary arteries and heart health.

Of course, holidays such as Memorial Day, can also bring out the worst in us.  Excessive drinking, eating and sun-tanning are not good for our health. And sadly, bingeing on beer with a buddy or piling your plate with potato salad in the company of others doesn’t make it any healthier!

Born to have Baby Blues?

It’ s not clear what causes postpartum depression.  The condition, which is marked by persistent feelings of sadness, hopelessness, exhaustion and anxiety, usually begins within four weeks of giving birth and can persist for weeks, months or even up to a year. An estimated 10 to 18% of all new mothers develop the condition, and the rate rises to 30 to 35% among women with previously diagnosed mood disorders.

Scientists have long believed the symptoms were related to the large drop-off in the mother’s estrogen levels following childbirth, however studies have shown that both depressed and non-depressed women have similar estrogen levels.

Now researchers from Johns Hopkins say they have discovered alterations in two genes that, can reliably predict whether a woman will develop postpartum depression.

The genetic modifications, which alter the way genes function without changing the underlying DNA sequence, can apparently be detected in the blood of pregnant women during any trimester, potentially providing a simple way to foretell depression in the weeks after giving birth, and an opportunity to intervene before symptoms become debilitating.

By studying mice, the researchers suspected that estrogen induced genetic changes in cells of the hippocampus – the part of the brain that governs mood.  They  then created a complicated statistical model to find the candidate which could be potential predictors for postpartum depression. That process resulted in the identification of two genes, known as TTC9B and HP1BP3.

Little is known about these genes except for their involvement in hippocampal activity. However the team suspects that they may have something to do with the creation of new cells in the hippocampus and the ability of the brain to reorganize and adapt in the face of new environments. Both of these elements are known to be important in mood.

Furthermore, estrogen can behave like an antidepressant, so when it is inhibited, it adversely affects mood.

“Postpartum depression can be harmful to both mother and child,” says Zachary Kaminsky, Ph.D., an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “But we don’t have a reliable way to screen for the condition before it causes harm, and a test like this could be that way.”

The findings of the small study involving 52 pregnant women are described online in the journal Molecular Psychiatry.

The study involved looking for epigenetic changes tin the thousands of genes present in blood samples from 52 pregnant women with mood disorders. The women were followed both during and after pregnancy to see who developed postpartum depression.

The researchers noticed that women who developed postpartum depression exhibited stronger changes in those genes that are most responsive to estrogen, suggesting that these women are more sensitive to the hormone’s effects. Specifically, changes to the two genes – TTC9B and predicted with 85% certainty which women became ill.

“We were pretty surprised by how well the genes were correlated with postpartum depression,” Kaminsky says. “With more research, this could prove to be a powerful tool.”

Evidence suggests that early identification and treatment of postpartum depression can limit or prevent debilitating effects. Alerting women to the condition’s risk factors — as well as determining whether they have a previous history of the disorder, other mental illness and unusual stress — is key to preventing long-term problems.

Research also shows that postpartum depression not only affects the health and safety of the mother, but also her child’s mental, physical and behavioral health.

If the results of this preliminary work pan out then a blood test for the biomarkers could be added to the battery of tests women already undergo during pregnancy.  More importantly, the results could help to inform decisions about the use of antidepressants. While there are concerns about the effects of these drugs on the fetus and their use should be weighed against the potentially debilitating consequences to both the mother and child of forgoing them.

As Kaminsky says “If you knew you were likely to develop postpartum depression, your decisions about managing your care could be made more clearly.”

Beans, Broccoli and Bluefin could help new moms beat the “Baby Blues”

According to an article published last week in the Canadian Journal of Psychiatry, postpartum depression may be caused by low levels of omega-3 fatty acids.

For the 70-80% of all new mothers who experience some negative feelings or mood swings after the birth of their child could the answer lie with legumes?

Women are at the highest risk of depression during their childbearing years, and the birth of a child may trigger a depressive episode in vulnerable women. Postpartum depression is associated with diminished maternal health as well as developmental and health problems for her child.

Symptoms of “baby blues” include:

• Weepiness or crying for no apparent reason
• Impatience
• Irritability
• Restlessness
• Anxiety
• Fatigue
• Insomnia
• Sadness
• Mood changes
• Poor concentration

Gabriel Shapiro of the University of Montreal and the Research Centre at the Sainte-Justine Mother and Child Hospital says “The literature shows that there could be a link between pregnancy, omega-3 and the chemical reaction that enables serotonin, a mood regulator, to be released into our brains.”

Because omega-3 is transferred from the mother to her fetus and later to her breastfeeding infant, maternal omega-3 levels decrease during pregnancy, and remain lowered for at least six-weeks following the birth.

Furthermore, in addition to the specific circumstances of pregnant women, it has been found that most people in the US do not consume sufficient amounts of omega-3. “These findings suggest that new screening strategies and prevention practices may be useful,” said Shapiro.

And while there are plenty of commercial omega-3 supplements, don’t forget that these clever little fatty acids are also present in seafood, (especially salmon, anchovies, tuna and sardines) as well as in oils, beans, nuts and seeds, winter squash, broccoli and my personal favorite – cauliflower.

Although Shapiro’s study was preliminary and the further research is needed to clarify the link, new moms could do worse than use salmon to stave off sadness or anchovies as the answer to anxiety!

The Peak Time for Everything

Not enough hours in your day?  So much to do…so little time?  If you’re anything like me, these will be familiar expressions.

And in which case, you should be interested to learn that maybe, just maybe, you could pack more into each day if you did everything at the optimal time?

A growing body of research suggests that paying attention to your body clock, and its effects on energy and alertness, can help pinpoint the different times of day when it’s best to perform at specific tasks.

Most people organize their time around everything but the body’s natural rhythms.

But workday demands such as commuting, social events and kids’ schedules inevitably end up clashing with the body’s natural circadian rhythms of waking and sleeping.

And as difficult as it may be to align your schedule with your body clock, it may be worth a try, because there are significant potential health benefits.

Disruption of circadian rhythms has been linked to problems such as diabetes, depression, dementia and obesity.

When it comes to doing cognitive work, for example, most adults perform best in the late morning, says Dr. Steve Kay, a professor of molecular and computational biology at the University of Southern California.  As body temperature starts to rise just before awakening in the morning and continues to increase through midday, working memory, alertness and concentration gradually improve. Taking a warm morning shower can jump-start the process.

The ability to focus and concentrate typically starts to slide soon thereafter. Most people are more easily distracted from noon to 4 p.m.

Alertness tends to slump after eating a meal, and sleepiness tends to peak around 2 p.m.  But you may want to rethink taking a nap at your desk.  It turns out, somewhat surprisingly, that fatigue may boost creative powers.

For most adults, problems that require open-ended thinking are often best tackled in the evening when they are tired. According to a 2011 study when students were asked to solve a series of two types of problems, requiring either analytical or novel thinking, their performance on the second type was best when they were tired.

Mareike Wieth, an assistant professor of psychological sciences at Albion College in Michigan who led the study says, “Fatigue may allow the mind to wander more freely to explore alternative solutions.”

Of course, not everyone’s body clock is the same. Morning people tend to wake up and go to sleep earlier and to be most productive early in the day. Evening people tend to wake up later, start more slowly and peak in the evening.

Communicating with friends and colleagues online has its own optimal cycles, research shows. Sending emails early in the day helps beat the inbox rush.  6 a.m. messages are most likely to be read.

Reading Twitter at 8 a.m. or 9 a.m. can start your day on a cheery note. That’s when users are most likely to tweet upbeat, enthusiastic messages, and least likely to send downbeat tweets steeped in fear, distress, anger or guilt.

Other social networking is better done later in the day. If you want your tweets to be re-tweeted, post them between 3 p.m. and 6 p.m., when many people lack energy to share their own tweets and turn to relaying others’ instead. And posts to Facebook  at about 8 p.m. tend to get the most “likes,” after people get home from work or finish dinner.

When choosing a time of day to exercise, paying attention to your body clock can also improve results. Physical performance is usually best, and the risk of injury least, from about 3 p.m. to 6 p.m.

Muscle strength tends to peak between 2 p.m. and 6 p.m. as does lung function which is almost 18% more efficient at 5 p.m. than at midday.

Is there a best time to eat? Experts suggest limiting food consumption to hours of peak activity to keep from packing on pounds.  Perhaps we are not only what we eat, we are when we eat!