The next therapeutic frontier may be in your gut

Scientists are trying to harness the microbiome for healing
— Read on massivesci.com/articles/microbiome-manipulation-prebiotics/

Tales from the Lab – Science Writing Prize 2018 – The human microbiome and cancer: friend or foe? – The Institute of Cancer Research, London

Tales from the Lab – Science Writing Prize 2018 – The human microbiome and cancer: friend or foe? – The Institute of Cancer Research, London
— Read on www.icr.ac.uk/blogs/tales-from-the-lab/page-details/science-writing-prize-2018-the-human-microbiome-and-cancer-friend-or-foe

Gut Feeling: the Microbiome and Mental Health | Mother Earth News

Your brain on bacteria: the link between the gut and the brain has long been studied and is finally being recognized as a major aspect of mental health.
— Read on www.motherearthnews.com/natural-health/gut-feeling-the-microbiome-and-mental-health-ze0z1808zpop

Here’s a mental health workout that’s as simple as ABC

People intuitively know what is best for their mental health. A new approach suggests enforcing this belief like regular exercise.
— Read on theconversation.com/heres-a-mental-health-workout-thats-as-simple-as-abc-98124

Treating Teen Depression Might Improve Mental Health Of Parents, Too

Evidence shows there’s a link between depressed parents and their offspring. But a new study suggests that when teens benefit from treatment for their depression, there’s a ripple effect on parents.
— Read on www.npr.org/2018/08/12/637886786/treating-teen-depression-might-improve-mental-health-of-parents-too

Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans.

Abstract
PURPOSE: Exercise is associated with altered gut microbial composition, but studies have not investigated whether the gut microbiota and associated metabolites are modulated by exercise training in humans. We explored the impact of 6 wk of endurance exercise on the composition, functional capacity, and metabolic output of the gut microbiota in lean and obese adults with multiple-day dietary controls before outcome variable collection.

METHODS: Thirty-two lean (n = 18 [9 female]) and obese (n = 14 [11 female]), previously sedentary subjects participated in 6 wk of supervised, endurance-based exercise training (3 d·wk) that progressed from 30 to 60 min·d and from moderate (60% of HR reserve) to vigorous intensity (75% HR reserve). Subsequently, participants returned to a sedentary lifestyle activity for a 6-wk washout period. Fecal samples were collected before and after 6 wk of exercise, as well as after the sedentary washout period, with 3-d dietary controls in place before each collection.

RESULTS: β-diversity analysis revealed that exercise-induced alterations of the gut microbiota were dependent on obesity status. Exercise increased fecal concentrations of short-chain fatty acids in lean, but not obese, participants. Exercise-induced shifts in metabolic output of the microbiota paralleled changes in bacterial genes and taxa capable of short-chain fatty acid production. Lastly, exercise-induced changes in the microbiota were largely reversed once exercise training ceased.

CONCLUSION: These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent of diet and contingent on the sustainment of exercise.
— Read on www.ncbi.nlm.nih.gov/m/pubmed/29166320/

An Underappreciated Key to College Success: Sleep – The New York Times

Many college-bound students start out with dreadful sleep habits that are likely to get worse once the rigorous demands of courses and competing social and athletic activities kick in.
— Read on www.nytimes.com/2018/08/13/well/an-underappreciated-key-to-college-success-sleep.html

How fiber and gut bacteria reverse stress damage

As gut bacteria digest fiber, they produce short-chain fatty acids. A new study finds that these molecules protect the gut against the ravages of stress.
— Read on www.medicalnewstoday.com/articles/amp/322636

Exercise Your Mental Wellness

The Sweet Spot:
  • 45 minutes of exercise (any type)
  • 3-5 times weekly
  • ~20% boost in Mental Wellness

Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study

Background

Exercise is known to be associated with reduced risk of all-cause mortality, cardiovascular disease, stroke, and diabetes, but its association with mental health remains unclear. We aimed to examine the association between exercise and mental health burden in a large sample, and to better understand the influence of exercise type, frequency, duration, and intensity.

Methods

In this cross-sectional study, we analysed data from 1 237 194 people aged 18 years or older in the USA from the 2011, 2013, and 2015 Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System survey. We compared the number of days of bad self-reported mental health between individuals who exercised and those who did not, using an exact non-parametric matching procedure to balance the two groups in terms of age, race, gender, marital status, income, education level, body-mass index category, self-reported physical health, and previous diagnosis of depression. We examined the effects of exercise type, duration, frequency, and intensity using regression methods adjusted for potential confounders, and did multiple sensitivity analyses.

Findings

Individuals who exercised had 1·49 (43·2%) fewer days of poor mental health in the past month than individuals who did not exercise but were otherwise matched for several physical and sociodemographic characteristics ( W=7·42 × 10 10, p<2·2 × 10 −16). All exercise types were associated with a lower mental health burden (minimum reduction of 11·8% and maximum reduction of 22·3%) than not exercising (p<2·2 × 10 −16 for all exercise types). The largest associations were seen for popular team sports (22·3% lower), cycling (21·6% lower), and aerobic and gym activities (20·1% lower), as well as durations of 45 min and frequencies of three to five times per week.

Interpretation

In a large US sample, physical exercise was significantly and meaningfully associated with self-reported mental health burden in the past month. More exercise was not always better. Differences as a function of exercise were large relative to other demographic variables such as education and income. Specific types, durations, and frequencies of exercise might be more effective clinical targets than others for reducing mental health burden, and merit interventional study.

Dangers of rising benzo prescriptions raise alarms of next drug crisis

If you think that the “opioid epidemic” is bad – the emerging epidemic of antidepressant and anti-anxiety drug addiction and withdrawal is just the tip of the iceberg because of the hundreds of millions of prescriptions written for these dangerous drugs…

— Read on www.nbcnews.com/health/health-news/dangers-rising-benzo-prescriptions-raise-alarms-next-drug-crisis-n895361

When Christy Huff developed a painful eye problem that led to insomnia, her doctor had a common solution— Xanax. She took the medication as directed.

One pill at night offered her some relief, but soon she began to experience anxiety, daytime terrors and tremors. Then, Huff had a startling realization. When she was off the Xanax she was going through withdrawal. And when she was on it “all of that just melted away,” she said.

In just three weeks, her body was dependent on Xanax.

“I don’t remember getting any warnings from doctors as far as addiction or dependence,” Huff, who is a cardiologist, told NBC News. “I was completely shocked at how sick I was.”

Xanax is part of a class of drugs called benzodiazepines, sometimes called “benzos” for short. Benzodiazepines are sedatives used primarily to treat anxiety and sleeplessness. The class of drugs also includes Valium, Ativan and Klonopin.

Dr. Anna Lembke, chief of addiction medicine at Stanford University Medical Center, said complications from benzos, such as dependency and addiction, are fueling a hidden epidemic akin to the opioid crisis.

“Medical students, residents and even doctors in practice don’t recognize the addictive potential of benzodiazepines,” she told NBC News. “There’s been all this awareness on opioids but very little focus on benzodiazepines and yet people are dying from them.”

According to data from the National Institute on Drug Abuse, there were 8,791 overdose deaths involving benzos in 2015, up from 1999 when there were 1,135 overdose deaths involving benzos. Between 1996 and 2013, the number of adults filling a benzodiazepine prescription increased by 67 percent, reaching 13.5 million in 2013, according to a study.

There is far less awareness of the dangers of benzos, perhaps because of attention over the opioid crisis. Opioids, including prescription opioids, heroin and fentanyl, killed more than 42,000 people in 2016, according to the Centers for Disease Control and Prevention.

The maker of Valium said it is commited to ensuring the drug is taken safely, and recommends it be prescribed carefully. The maker of Xanax said abuse of benzodiazepines has become a growing public health threat, and it will continue to educate consumers, patients and doctors about its proper use.

Lembke says more care should be taken when prescribing benzos.

“One of the silver linings of the opioid epidemic has been that the medical community has recognized that we have to educate doctors better about opioids and their risks,” Lembke said, “but we’re still not doing that for benzodiazepines.”

More Americans than ever are overdosing on anxiety drugs, and it’s not clear why

She explained that since benzos work so well for anxiety and sleeplessness and patients immediately respond to them, doctors are quick to prescribe them. But patients can quickly develop a tolerance, leading to higher and higher doses, and painful withdrawal symptoms between doses. Long-term use can even cause neurological damage, Lembke said.

Benzos are extremely difficult to kick, she said. For some of her patients, quitting opioids is easier. Benzos can be particularly dangerous when combined with opioids, which is not uncommon and can increase overdose risks nearly four-fold.

Huff has been working on kicking benzos for nearly three years.

When she first realized her dependency, her doctor didn’t take her seriously.

“She said, ‘This is all just anxiety,'” Huff said of her doctor. “‘You can taper it off in three weeks but honestly I think you can just cold turkey.'”

When she tried to stop taking Xanax, she developed severe symptoms. She couldn’t sleep more than three hours at night, she had difficulty eating and swallowing and lost almost 20 pounds. Lembke said that stopping benzos cold turkey can cause seizures and even death.

I have met online so many patients that have been harmed by these medications, just by taking them as prescribed by their doctor. They were never informed of the possible consequences they have suffered.

After some online research, Huff realized that she had to slowly taper off. Each time she lowers her dose, she goes through a period of intensifying symptoms, but is slowly making progress.

When Huff became dependent on benzos, she had already stopped practicing medicine to take care of her young daughter, Kathryn. The first year Huff was sick was her daughter’s last year of preschool. She had plans to enjoy time with her daughter before she started kindergarten, like go to the zoo and the park. Instead, she had to stay home and rest while a nanny took her daughter out.

“There’s a lot of anger,” Huff said. “It’s bad enough I’m suffering this way but not being able to participate fully in my daughter’s life, that’s just the ultimate insult.”

Huff is hoping that in another year, she’ll be off of benzos entirely, but what worries her is long-term damage. She struggles now with memory and fatigue — forgetting to do simple tasks, like put in her contact lenses in the morning.

Lembke points out that tapering off can take time. As the doses get smaller, the percentage of drug being taken away is greater, so the withdrawal symptoms can be more intense.

Today, Huff is trying to raise the alarm so others don’t wind up in the same situation. She directs a nonprofit, the Benzodiazepine Information Coalition. Its mission is to educate both doctors and patients about what it means to be prescribed benzodiazepines.

“I just really want the world to know that this is a huge problem,” Huff said. “I have met online so many patients that have been harmed by these medications, just by taking them as prescribed by their doctor. They were never informed of the possible consequences they have suffered.”

Lembke offered the following advice for patients:

• Before taking benzos, ask your doctor what the risks are. Ask if there are other treatment options like antidepressants or cognitive behavioral therapy.

• Benzos should be used as short-term and intermittent treatments. Avoid long-term use.

• Never stop taking benzos suddenly. Talk to a doctor about a plan to taper over time.

• Tell your doctor which other medications you’re taking, and ask about taking the drugs together.

• Parents should be aware that some benzos can be bought online so they should talk to their teens about the dangers and be on the lookout for mysterious packages and precision scales, which are used to measure doses. Even tiny dosages can be deadly.

Lembke hopes that eventually, doctors will be better informed, but for now, the onus is on patients to be aware of these concerns.