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Mexico obesity: Oaxaca bans sale of junk food to children
Mexico obesity: Oaxaca bans sale of junk food to children
Mexico obesity: Oaxaca bans sale of junk food to children
https://ift.tt/3a006kO August 06, 2020 at 06:37PM https://ift.tt/1R552o9
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Government notifies over 450 Fixed-Dose Combination drugs as 'rational'
Government notifies over 450 Fixed-Dose Combination drugs as 'rational' An FDC drug contains two or more active ingredients in a fixed dosage ratio. The drugs are deemed rational when claims for their benefits are supported by evidence-based data and well designed clinical studies. https://ift.tt/eA8V8J
A Sleep Storyteller Reveals Her Secrets For Drifting Off Naturally
It starts on a crisp winter night. Outside it’s dark and cold, the grass already coated with a thick, white layer of hoarfrost. Inside I sit–wrapped in a blanket, drinking my hot chocolate, surrounded by the orange glow of candlelight, with lavender incense diffusing into the air–slowly and purposefully crafting a tale. One designed to send millions of people, like you, drifting off to sleep.
It sounds like a peaceful scene. One so soporific I might send myself off to dreamland before I’ve finished my story. But it hasn’t always been this way.
Earlier in the day, everything was frantic. With deadlines looming, calls to make and emails to answer, it was like my phone was alive, lighting up with job after job, demanding my attention with high-pitched alerts and jarring beeps. It’s easy to let a smartphone’s incessant needs flood into our bedrooms too. And that, according to professor Orfeu Buxton, editor in chief of the journal Sleep Health, is why many of us are losing our ability to drift off naturally.
“When we sleep, things that keep us awake or disrupt our sleep are generally called threats,” he says. “We’re mammals, after all; we’re not computers. We don’t just shut off and sleep. These threats can be endogenous–internally generated, like if you have stressful thoughts–or they can be exogenous, such as the noise of an ambulance or pinging notifications on your phone overnight. All those engage the threat vigilance detection centers in our brain.”
Phones–and their alerts–have been designed to steal our attention. So about 10 years ago, desperate to sleep better, I fully removed myself from my phone’s reach. I took up wild camping–sleeping in remote and wild places around the country, away from campsites, people and, crucially, wi-fi. Sometimes I head off for a week with no contact with the modern world, other times for just a single night. No matter which way I choose, it always seems to reset my sleeping pattern effectively.
My quest for these sleeping adventures has led to some extreme bedtime scenarios. I’ve dangled off the edge of a sea cliff while seals frolicked below in the waves. I’ve bedded down inside caves where the only light comes from my own campfire. I’ve lain on mountaintops watching the stars and listening only to my breath as it clouds above me, then dissipates into the night sky.
And although, to some people, they may sound like scary places to take a pillow, I’ve found over the years that they often lead to the best night’s sleep. I am suddenly forced to see my concerns from a different perspective. How on earth can answering an email be anywhere near as important as sourcing clean water? How can posting on social media rank with staying warm, dry and safe? And why would answering a message be a worry when I need to navigate my way in the dark?
There’s another primal function I tap into by sleeping outdoors: resetting my circadian clock.
“We all have an internal clock in our brain that tells us what biological time of day it is,” says Ken Wright, a professor at the University of Colorado and director of a sleep lab. By sleeping in nature the way I do, I not only physically remove myself from exogenous threatening sounds and the demands of my smartphone, but also expose myself to natural light, which results in a better quality of sleep.
I realized a while ago that I could use my adventures to help others who also struggled to sleep. Words have the ability to soothe and calm. By writing about my wild sleeps, I could bring my fellow insomniacs with me. When we were kids, many of us were read to by a grownup–the bedtime story was (and still is) a classic way to get restless children to nod off. But many of us decided we were too old for this, that we had grown out of it. Which is why I began to write special nonfiction bedtime travel stories for adults–the aim being that they would never reach the end.
“When you try to sleep, your mind monitors your efforts, which actually keeps you awake,” says Dr. Steve Orma, a clinical psychologist specializing in insomnia. “Doing something calming before bed, that’s designed to help you let go and take you elsewhere, will prepare your body for sleep.”
In my Sleep Stories, each word is chosen carefully. Adjectives–which in literature are often removed or allowed only sparsely–are necessary in a bedtime tale to transport you to the place I’m in, so we can wander together through lavender fields in Provence, meander along the waterways in Oxfordshire, travel aboard South Africa’s slow and steady Blue Train, or listen to the wind in the leaves amid the giant cedar trees in Morocco’s hidden forest.
The sound of words is also key. I must choose them in such a way that they delicately inform what we can see, in a tender and comforting way. No loud sounds are found in these sentences, only peaceful, lulling prose. Then there are the other senses. Smells evoke images and sensations that relax and reassure. Sights must be captivating enough that you want more, yet magnificent enough that you are lost within them.
There was never a rule book for writing Sleep Stories–my techniques started with intuition and the drive to try to create something that I would like to have read to me when I was snuggled up in bed, surrounded by the warmth of my duvet. As time has moved on, as it always does, I listen to feedback I get from listeners, for places and themes that people tell me have made them feel most comforted, most relaxed, and then decide on my next destination and the journey I will take them on with another tale.
The process to write these stories can take many hours, but I always begin penning them in the same setting as I did the first time I wrote one on that winter’s night. Everything must be perfect: the lighting dim as though I were outside in my camp, the sounds soft, the phone off and out of reach, and my imagination allowed to feel as free as though it were on a mountaintop.
Only then can I begin to take you with me on a journey, one whose ending you may never even reach. But in which I know you will become immersed, snuggled into a world I’ve created for us both, where candlelight flickers, where all the world remains on the other side of the door. When my tale becomes your tale, we are both free to dream.
Smith is the sleep storyteller in residence for the app Calm and the author of Extreme Sleeps: Adventures of a Wild Camper
Individual Circadian Clocks Might Be the Next Frontier of Personalized Medicine
For as long as Seemay Chou can remember, she has gone to bed at midnight and woken around 4:30 a.m. Chou long assumed that meant she was a bad sleeper. Not that she felt bad. In fact, sleeping just four hours a night left her feeling full of energy and with free time to get more done at her job leading a research lab that studies bacteria. “It feels really good for me to sleep four hours,” she says. “When I’m in that rhythm, that’s when I feel my best.”
Still, in an effort to match the slumber schedules of the rest of the world, she would sometimes drug herself–with melatonin, alcohol or marijuana edibles–into getting more sleep. It backfired. “If I sleep seven or eight hours, I feel way worse,” she says. “Hung over, almost.”
Although the federal government recommends that Americans sleep seven or more hours per night for optimal health and functioning, new research is challenging the assumption that sleep is a one-size-fits-all phenomenon. Scientists have found that our internal body clocks vary so greatly that they could form the next frontiers of personalized medicine. By listening more closely to the ticking of our internal clocks, researchers expect to uncover novel ways to help everybody get more out of their sleeping and waking lives.
Human sleep is largely a mystery. We know it’s important; getting too little is linked to heightened risk for metabolic disorders, Type 2 diabetes, psychiatric disorders, autoimmune disease, neurodegeneration and many types of cancer. “It’s probably true that bad sleep leads to increased risks of virtually every disorder,” says Dr. Louis Ptacek, a neurology professor at the University of California, San Francisco (UCSF). But details about what’s actually going on during shut-eye are sparse. “We know almost nothing about sleep and how it’s regulated,” says Ptacek.
Some people are morning larks, rising early, and others are night owls, who like staying up late. Those patterns are regulated by the body’s circadian rhythm, a 24-hour internal clock. People can manipulate their circadian rhythm through all kinds of external factors, like setting an alarm clock or exposing themselves to light. But the ideal sleep duration has long been thought to be universal. “There are many people who think everyone needs eight to eight and a half hours of sleep per night and there will be health consequences if they don’t get it,” says Ptacek. “But that’s as crazy as saying everybody has to be 5 ft. 10 in. tall. It’s just not true.”
Ptacek and his wife Ying-Hui Fu, also a professor of neurology at UCSF, are pioneers in the relatively new field of sleep genetics. About a decade ago, Fu discovered the first human gene linked to natural short sleep; people who had a rare genetic mutation seemed to get the same benefits from six hours of sleep a night as those without the mutation got from eight hours. In 2019, Fu and Ptacek discovered two more genes connected to natural short sleep, and they’ll soon submit a paper describing a fourth, providing even more evidence that functioning well on less sleep is a genetic trait.
The researchers are now collecting data on short sleepers in order to figure out just how rare these mutations are. “If we can get a better understanding of why their sleep is more efficient, we can then come back and help everybody sleep more efficiently,” Fu says. Among the participants is Chou, who also happens to work at UCSF. One day at a faculty meeting, she and Ptacek chatted about his work. She immediately recognized herself when he described short sleepers. “I had never heard of this. But once I started reading about it, it was sort of an epiphany.”
Chou doesn’t know yet if she has the identified genetic variants. But after the researchers interviewed her about her family’s sleeping patterns, she realized her mom is also a short sleeper. “I have memories of when I was younger, and my dad being frustrated with her for staying up really late, but she always seemed fine,” she says. The researchers took blood samples from both women.
Doctors once dismissed short sleepers like Chou as depressed or suffering from insomnia. Yet short sleepers may actually have an edge over everyone else. Research is still early, but Fu has found that besides being more efficient at sleep, they tend to be more energetic and optimistic and have a higher tolerance for pain than people who need to spend more time in bed. They also tend to live longer. Chou says the first three hold true for her; by nature, she is sunny and positive, and though she often finds bruises on her body, she usually doesn’t remember getting them. “I find it annoying how much people complain about little physical pains,” she says.
So far, these are just intriguing observations. But by studying genetic short sleepers, Fu and Ptacek believe they’ll eventually learn lessons for the rest of us. “As we identify more and more genes and we think about the pathways in which they function, at some point, a picture is going to emerge, and we will begin to have an understanding of how sleep is regulated in greater detail,” Ptacek says. This, they hope, will lead to targeted treatments, like pills or vitamins, to improve sleep efficiency in everyone.
Researchers are also looking beyond sleep to other circadian bodily processes that might benefit from a personalized or targeted approach. While a master clock in the brain acts like a conductor, setting time for the whole body, the rest of the body is like orchestra players with clocks of their own. “All your organs have rhythms,” says Steven Lockley, an associate professor of medicine at Harvard Medical School who studies circadian rhythms and sleep. “There’s a clock in your heart, a clock in the lungs, a clock in the kidneys.” Just about everything in the body–metabolism, hormones, the immune system, reproductive function and the way DNA is translated–is influenced by a circadian rhythm, he says.
And not everybody’s is the same. People’s internal clocks are often hours off from one another, Lockley says. “The range of individual differences is much bigger than anyone really understands yet.”
The body’s complex clock system has implications for both healthy people and those with medical conditions, and scientists are already seeing glimpses of how they can time certain tests and treatments to get more accurate or potent results. A cholesterol reading, for example, might be affected by what time of day you go to the doctor’s office, because the liver (which makes cholesterol) has a circadian rhythm. “The time of day at which you measure something could make someone look clinically abnormal, even though they’re not,” Lockley says.
Medicine might also be more effective if taken at a certain time. Because they’re metabolized in the liver, “drugs change their effects throughout the day,” Lockley says. Other circadian bodily processes, like cell function, can also affect how medication acts. Early research suggests certain drugs–including some for colorectal cancer, pain and asthma–perform better or are less toxic when taken at different times of day.
Exercise, which can be as powerful as medicine for some conditions, is good for you whenever you do it. “But I do think that the time of day may have an influence, on top of the effects of exercise, on our metabolic health,” says Juleen Zierath, professor of physiology at Karolinska Institute in Sweden. In one small study published in 2018 in the journal Diabetologia, Zierath and her team started 11 men with Type 2 diabetes on a high-intensity interval training program. The men exercised either in the morning (around 8 a.m.) or the afternoon (4 p.m.) for two weeks, then switched schedules. The researchers expected that regardless of the time of day, men in both groups would see improvements in blood-sugar levels. But “when they exercised in the morning, they actually had slightly higher levels of blood sugar [than baseline], which we didn’t expect at all,” Zierath says. It’s not clear to what extent the type of exercise and other variables matter, but the study provides an intriguing hint that time of day might make a difference for exercise.
Scientific knowledge is nascent when it comes to optimizing testing and treatment by the clock. Our understanding of individual circadian time is even more primitive. But Lockley believes it’s the key to personalized medicine; he and others are exploring ways to measure a person’s internal circadian time through simple clinical tests. “Hopefully in the next five to 10 years, you’d go to the doctor, give a breath test or a pee sample, and the doctor would know your biological time,” he says. “Then all your test results and treatments could be based on your real internal time, which is going to be very different between you and me based on our internal clocks.”
For now, even the understanding that our bodies often operate according to different clocks is a big scientific advance. It’s already changed the way Chou sleeps, lives and works. “I’ve just become more comfortable with accepting my sleep,” she says. She now asks her employees about their sleep schedules to anticipate when each will be at their peak. She also informs everyone about her own abbreviated schedule, so they know she doesn’t expect an immediate response to an email she sends at 4:05 a.m. “That’s just when my brain is working,” she says.
‘A Rinsing of the Brain.’ New Research Shows How Sleep Could Ward Off Alzheimer’s Disease
Each of us carts around a 3-lb. universe that orchestrates everything we do: directing our conscious actions of moving, thinking and sensing, while also managing body functions we take for granted, like breathing, keeping our hearts beating and digesting our food. It makes sense that such a bustling world of activity would need rest. Which is what, for decades, doctors thought sleep was all about. Slumber was when all the intricate connections and signals involved in the business of shuttling critical brain chemicals around went off duty, taking time to recharge. We’re all familiar with this restorative role of sleep for the brain–pulling an all-nighter or staying awake during a red-eye flight can not only change our mood, but also affect our ability to think clearly until, at some point, it practically shuts down on its own. When we don’t get enough sleep, we’re simply not ourselves.
Yet exactly what goes on in the sleeping brain has been a biological black box. Do neurons stop functioning altogether, putting up the cellular equivalent of a Do Not Disturb sign? And what if a sleeping brain is not just taking some well-deserved time off but also using the downtime to make sense of the world, by storing away memories and captured emotions? And how, precisely, is it doing that?
In the past five years, brain researchers have begun to expose a hidden world of chemical reactions, fluids flowing into and out of the brain, and the busy work of neurons that reveal the sleeping brain is as industrious as the waking one. Without good-quality sleep, those critical activities don’t take place, and as a consequence, we don’t just feel tired and cranky, but the processes that lead to certain diseases may even get seeded. One of the reasons we sleep, it now seems, might be to keep a range of illnesses–including cognitive diseases like Alzheimer’s and other dementias–at bay. As Adam Spira, a professor in the department of mental health at the Johns Hopkins Bloomberg School of Public Health, puts it, “Sleep really should not be seen as a luxury or waste of time. People joke that they’ll sleep when they’re dead, but they might end up dead sooner if they don’t sleep.”
Blame Polymath Benjamin Franklin, who averred, “There will be sleeping enough in the grave”; ever since, a culture of industry has rooted itself in the human psyche–embedding the idea that activity, even well into the night, is valued far more than daily rest.
In part that’s because while medical experts have long recommended seven to eight hours of sleep a night–including some time spent in deep, or non-REM, sleep–exactly what our bodies are doing during that time is less clear. Now, thanks to newer technologies for measuring and tracking brain activity, scientists have defined the biological processes that occur during good-quality sleep. That they seem to be essential for lowering the risk of brain disorders, from the forgetfulness of senior moments to the more serious memory loss and cognitive decline of dementia and Alzheimer’s disease, may convince the Franklins of the world that sleep is not for the lazy.
Experts in the field of Alzheimer’s are especially excited, since there are currently no treatments for the neurodegenerative disease, and sleep-based strategies might open new ways to slow its progression in some and even prevent it in others.
“There has been a real renaissance in research around the connection between sleep, sleep quality, sleep disturbance and dementia, especially Alzheimer’s dementia,” says Dr. Kristine Yaffe, professor of psychiatry, neurology and epidemiology at the University of California, San Francisco. The National Institutes of Health is currently funding at least half a dozen new studies exploring how sleep may impact dementia, and the Alzheimer’s Association created a committee to promote more research in the area.
For decades, researchers thought sleep disturbances were a symptom or a consequence of Alzheimer’s. They assumed that as clumps of amyloid proteins built up, then started to strangle and kill nerve cells–particularly in the memory regions of the brain–changes in sleep followed. Even older people without Alzheimer’s can experience changes in their sleep patterns, sleeping less and more lightly as they age. So experts didn’t initially take these shorter and more fragmented sleep cycles seriously.
But in the 1980s and 1990s, scientists began studying whether there was any causal relationship between sleep patterns and cognitive-test performance among older people without Alzheimer’s by studying them over longer periods of time. Those studies suggested that people with poor sleep habits tended to perform worse on cognitive tests over time. “That got people thinking about the possibility that sleep could be a risk factor in dementia,” says Spira.
Yaffe’s recent research, which focused on a group of healthy older women, supported the idea that what seemed to matter, in terms of dementia risk, was the quality as opposed to the quantity of sleep. Those who reported spending less time in bed actually sleeping, and more time tossing and turning and waking up throughout the night, were more likely to develop any type of dementia five to 10 years later than those who got better-quality sleep.
Others focused on explaining the biology behind the sleep-dementia connection. At this point, Alzheimer’s researchers knew that a buildup in the brain of amyloid and another protein called tau were key features of the disease. At Washington University School of Medicine in St. Louis, David Holtzman, chair of the department of neurology, launched studies to track exactly where in the brain this amyloid originated. His search led him to nerve cells, which release fragments of the protein as they go about their normal business. Typically, these protein by-products (sometimes called amyloid beta) are released into the circulatory system, where they float around without causing problems, but in some cases they remain in the brain, where they morph into a sort of molecular Velcro, sticking together to form amyloid plaques, which in turn damage neurons.
But what controls the production of amyloid beta? In a 2009 study on mice, Holtzman found that while the animals were awake, levels of the protein fragments circulating in their brains surged. When the mice slept, the levels dropped dramatically–especially during the deeper stages of non-REM sleep. And when he and his team deprived the mice of non-REM sleep, more amyloid built up in their brains over time than in mice who got regular nightly rest. He saw similar changes when he compared amyloid in the spinal fluid of people who were well rested vs. sleep-deprived.
It was a revelation for Alzheimer’s experts. “That showed experimentally for the first time that there was an effect of sleep deprivation on Alzheimer’s disease pathology,” says Spira. “That’s what really flipped everything on its head.” In 2013, to test whether the same effect occurred in people, Spira studied brain scans of 70 healthy adults with an average age of 76. Indeed, the scans of those who reported less or compromised sleep showed higher levels of amyloid plaques than the scans of those who slept better.
A year later, a biological explanation for why poor sleep might be linked to Alzheimer’s emerged. Dr. Maiken Nedergaard, co-director of the Center for Translational Neuromedicine at the University of Rochester, identified a previously ignored army of cells that is called to duty during sleep in the brains of mice and acts as a massive pump for sloshing fluid into and out of the brain. This plumbing system, which she dubbed the “glymphatic system” (it works in parallel to the lymph system that drains fluid from other tissues in the body), seemed to perform a neural rinsing of the brain, swishing out the toxic proteins generated by active neurons (including those amyloid fragments) and clearing the way for another busy daily cycle of connecting and networking.
Taken together with Spira’s discovery that levels of amyloid spiked during the day and dropped during sleep, Nedergaard’s findings gave further credence to the theory that sleep might perform a housekeeping function critical for warding off diseases like Alzheimer’s. “These results very much support the notion that one of the roles of sleep is to actually accelerate the clearance of beta amyloid from the brain,” says Nora Volkow, director of the U.S. National Institute on Drug Abuse.
Late last year, Laura Lewis, assistant professor of biomedical engineering at Boston University, built on Nedergaard’s work by matching up the ebb and flow of cerebrospinal fluid in the brain with brain-wave activity, which indicates different stages of sleep. She showed that in healthy adults, during the day when the brain is active, there is less fluid bathing neurons and tissues in the organ. During sleep–and especially during deeper sleep–this solution saturates the brain in a cleansing flood. The finding reinforced Nedergaard’s theory that sleeping may help clear the brain of toxic proteins that can eventually cause disease.
Still, while all these discoveries are strongly suggestive, they are not what scientists would call definitive. For that, researchers need two additional pieces of evidence: first, a clear correlation between disrupted sleep patterns and a higher risk for Alzheimer’s; and second, evidence that if these high-risk people improve their sleep, that risk falls.
They are currently working to build those data sets, and already the results are promising. For example, Volkow measured baseline amyloid levels in the brains of 20 healthy people ages 22 to 72 years, then scanned their brains again after each had a good night’s sleep and yet again after each was kept awake for about 31 hours straight. After a loss of sleep, levels of amyloid were 5% more than after adequate sleep; the spikes were concentrated in parts of the brain involved in memory and higher thinking, which are typically affected in Alzheimer’s.
But seeing levels of amyloid change with more or less sleep doesn’t necessarily mean sleep habits are contributing to Alzheimer’s. To make that case, researchers are studying people with disorders like sleep apnea, or those who work night shifts or keep irregular working hours, such as first responders, pilots and flight attendants. Studies already suggest that all of these groups are more vulnerable to Alzheimer’s. The next step is to see if treatment, or changes in sleep habits, matters. For people with sleep apnea, for example, doctors can prescribe devices to wear during sleep to keep oxygen flowing more consistently to the brain so they don’t wake up. In shift workers, researchers want to test the impact of resetting their biological clocks to a standard day-night schedule. If these efforts lower their likelihood of developing Alzheimer’s, that would make a strong case for a connection between lifelong sleep patterns and risk of dementia.
Researchers also need to better understand how sleep medications and treatments like melatonin affect the dementia process. While some sleep aids promote the deeper sleep that seems to be protective against brain decline, it’s not clear yet whether long-term dependence on such medications can maintain the benefit.
Even while these studies are being done, many experts believe the data are already strong enough to start educating at least older people, especially those at higher risk of developing Alzheimer’s, about improving their sleep habits. Yaffe, for one, already does that with her patients. “Even practical sleep-hygiene tips, where we teach people best practices like avoiding caffeine in the evening and darkening their room and staying off their phones, could help them sleep better,” she says. “I would love to see whether this low-cost and pragmatic approach could improve cognition or prevent decline in Alzheimer’s patients.”
She and others don’t believe sleep alone can fully prevent Alzheimer’s or halt its progression. But together with other therapies that could emerge to treat the disease, sleep may be a powerful way to help people lower their risk even further. It’s even possible that sleep could play an important role in keeping our brains healthy in other ways: by controlling metabolism and other cellular functions behind diseases like diabetes, hypertension and even cancer. As the latest research shows, a good night’s sleep isn’t a luxury–it’s critical for keeping the brain healthy.
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