Friday, 21 November 2014

Forgetfulness could be a 12-year advance warning of dementia

REALISING you are becoming forgetful could be a 12-year advance warning of potential dementia.
health, news, britain, dementia, Alzheimer’s, elderly people, Research
Researchers have found that when people begin suffering memory problems they are three times more likely to develop dementia later in life, even if they have no clinical signs of diseases like Alzheimer’s.
The experts studied 531 people with an average age of 73 who were free of dementia.
They were asked yearly if they noticed any changes in their memory.
Of the one in six people investigated who developed dementia during the study, 80 per cent had first reported memory changes much earlier.
What’s notable about our study is the time it took for this transition to dementia or clinical impairment to occur – about 12 years
Dr Richard Kryscio, study author from Kentucky University
Study author Dr Richard Kryscio, of Kentucky University, said: “Our findings add strong evidence to the idea that memory complaints are sometimes indicators of future memory and thinking problems. Unfortunately, we do not yet have preventive therapies for Alzheimer’s.
“What’s notable about our study is the time it took for this transition to dementia or clinical impairment to occur – about 12 years.
“There may be a window for intervention.
The researchers, whose results are published online in the journal Neurology, found that 56 per cent of participants went on to report changes in their memory at an average age of 82.
Dr Simon Ridley, head of research at Alzheimer’s Research UK, said: “It is important to note that many people who report mild memory problems do not develop the condition. Anyone with concerns about their memory should speak to their doctor.”
By: Jo Willey, Published: Thu, September 25, 2014

Thursday, 13 November 2014

Diet and cancer - acrylamide, artificial sweeteners, green tea, soy, tomatoes and vitamin supplements

There are often stories in the media about certain foods or nutrients that are supposed to increase or decrease the risk of cancer. On the balance of evidence, it's unlikely that specific 'superfoods', on their own, could directly affect the risk of cancer, but some of the stories are still controversial.
Here, you can read about some of the stories you may have read or heard about, and find out our take on the evidence.
For information about other controversial topics, like mobile phones, power lines, stress and much more, go to our Cancer Controversies section.

Acrylamide

In 2002, Sweden’s National Food Agency reported that many foods contain high levels of a chemical called acrylamide. International public concern followed since acrylamide is known to cause cancer by damaging DNA. This substance is produced when starchy foods are heated to high temperatures, and is found in foods such as chips, crisps and some bread.
Later studies in people found that the levels of acrylamide in most food are far too low to cause cancer. Many studies found that acrylamide has no impact on the risk of several different cancers, including breast, bowel, lung, brain and testicular cancers. Even food industry workers, who are exposed to twice as much acrylamide as other people, do not have higher rates of cancer. There have been some indications that acrylamide could be linked to higher risks of ovarian and womb cancers, but the evidence for this is limited and inconsistent, so we can’t be sure if this link is real.
In 2014, a draft report was released by the European Food Safety Authority, which said that although there is not enough evidence to show acrylamide could cause cancer in people, the levels of acrylamide people may get from food could still be a cause for concern. They called for more research to better understand the levels of acrylamide in people’s foods and how this might affect health, and they will be finalising their recommendations in 2015. But at the moment, there is still little concrete evidence linking acrylamide and cancer in people.

Artificial sweeteners

Artificial sweeteners are used in a wide variety of foods and drinks. Almost everyone in developed countries consumes them, whether they know it or not. Because of this, any potential cancer risks would be very far-reaching. But overall, studies on artificial sweeteners have found that they do not increase the risk of cancer.
Saccharin is one of the best studied of the artificial sweeteners. Some studies in the 80s found that it could cause bladder cancer in rats. Because of this, the Canadian government banned saccharin, and the American government warned that it could cause cancer. We now know that these effects were specific to rats and not relevant to humans. Bladder cancer risks are the same even in diabetics, who use sweeteners more frequently, and in people who lived through WWII, when saccharin use was high.
Aspartame, another type of sweetener, was also the subject of a cancer scare. This was because of an article linking it to rising brain tumour rates. This article had very little scientific basis and many later studies showed that aspartame, like saccharin, was safe for humans.
Another study in rats raised the alarm again but the European Food Safety Authority (EFSA) found that the study had some major flaws. The EFSA’s report concluded that aspartame does not increase the risk of cancer below the daily recommended level. Even people who consume a lot of sweetened foods take in well below this amount.
Large studies looking at actual people have now provided strong evidence that artificial sweeteners are safe for humans. For example, one study looked at almost half a million people and found that aspartame does not increase the risk of leukaemia, lymphoma or brain tumours. New generation sweeteners seem t be safe, however we will continue to monitor studies.

Green tea

Some studies have found that green tea could reduce the risk of many cancers including cancers of the breastprostatemouthfoodpipestomach and bowel. The most promising studies were done in Asian countries. Studies in Western countries have mostly found no effect on cancer risk. These differences may be because Asians drink large amounts of green tea while people in Western countries drink mainly black tea.
Green tea contains high levels of a group of chemicals called catechins. Because of the way it is prepared, green tea contains 3-10 times more catechins than black tea. Laboratory studies on cells have shown that catechins could block the growth of cancers. They prevent DNA damage by mopping up free radicals, blocking the growth of tumour cells and stopping the activation of cancer-causing chemicals.
We still need more evidence from large-scale studies and clinical trials to prove that green tea could help to prevent some cancers.

Soy

The soybean is a staple part of East Asian diets and the evidence around the benefits or harms of soy is mixed. Some studies have linked eating soy products, such as tofu, soymilk or miso, to reduced risks of breastprostate and bowel cancer, while others show no reduction in risk. 
The studies that have shown a significant reduction in risk of cancer have looked at Asian populations, where the diet is high in soy. In 2014 a large study across Japan showed that soy didn't affect the risk of womb (endometrial) cancer. The much smaller amounts eaten by Western populations are unlikely to have any benefits.
Soy contains a group of chemicals called isoflavones. In our bodies, these act like mild versions of the hormone oestrogen. Many human cancers, such as breast cancer, are linked to high levels of this hormone. So some scientists believe that by taking the place of our own oestrogen, soy isoflavones can reduce the risk of hormonal cancers. Others are concerned that for the same reasons, isoflavones could actually increase the risk of some cancers.
Clinical trials are needed to say for sure if soy reduces or increases the risk of cancer.

Tomatoes

Tomatoes may reduce the risk of prostate cancer but we don't know for sure.
Tomatoes contain a chemical called lycopene. This is found in all forms of tomatoes and tomato products including fresh, tinned, paste, juice and ketchup. Lycopene is a powerful antioxidant and mops up free radicals that could damage DNA.

It is unclear if lycopene could actually reduce the risk of prostate cancer. A large study of 47,000 men found that eating 2-4 weekly servings of tomatoes reduced prostate cancer risk by a quarter. And the EPIC study found that people who have the highest levels of lycopene in their blood have lower risk of advanced types of prostate cancer, but no decreased risk of developing prostate cancer overall.
However, not all studies agree and there are questions still to answer. For example, we still don't know how large a dose of lycopene you would need to reduce the risk of cancer. Even so, eating lots of tomatoes can help you get your recommended five portions of fruit and vegetables a day. They are also an excellent source of vitamins A, C and E.

Vitamin and mineral supplements

Vitamin supplements do not substitute for a healthy diet.
Vitamin supplements do not have the same benefits as getting naturally-occurring vitamins in your food. It is thought that in fruit and vegetables, vitamins and nutrients interact with other chemicals to produce positive effects. On their own, they could be much less beneficial.

Several clinical trials have looked at the effects of vitamin supplements on cancer risk. Some of these have found that very high doses could actually increase the risk of cancer. An organisation called the Cochrane Collaboration first carried out a review of the evidence in 2008, which was updated in 2012 and now includes the results of 78 clinical trials of vitamin supplements. It found that these supplements, far from prolonging a person's life, either have neutral or harmful effects.
The best way to get your full range of vitamins and minerals is to eat a healthy, balanced diet, with a variety of fruit and vegetables. Supplements do not substitute for a healthy diet, although some people may be advised to take them at certain times in their lives. For example, doctors may advise women who are planning to have a baby to take a daily 400-microgram supplement of folic acid. And dark-skinned or elderly people may need to take vitamin D supplements since they need more sun exposure than other people to make enough vitamin D.

Sunday, 2 November 2014

How Much Sleep Do You Need?

Sleep Cycles & Stages, Lack of Sleep, and How to Get the Hours You Need

How Much Sleep Do You Need?
When you’re scrambling to meet the countless demands of your day, cutting back on sleep might seem like the only answer. Who can afford to spend so much time sleeping, anyway? The truth is you can’t afford not to. Even minimal sleep loss takes a toll on your mood, energy, and ability to handle stress. By understanding your nightly sleep needs and what you can do to bounce back from chronic sleep loss, you can finally get on a healthy sleep schedule.

The power of sleep

Many of us try to sleep as little as possible. There are so many things that seem more interesting or important than getting a few more hours of sleep, but just as exercise and nutrition are essential for optimal health and happiness, so is sleep. The quality of your sleep directly affects the quality of your waking life, including your mental sharpness, productivity, emotional balance, creativity, physical vitality, and even your weight. No other activity delivers so many benefits with so little effort!

Understanding sleep

Sleep isn’t exactly a time when your body and brain shut off. While you rest, your brain stays busy, overseeing a wide variety of biological maintenance that keeps your body running in top condition, preparing you for the day ahead. Without enough hours of restorative sleep, you won’t be able to work, learn, create, and communicate at a level even close to your true potential. Regularly skimp on “service” and you’re headed for a major mental and physical breakdown.
The good news is that you don't have to choose between health and productivity. As you start getting the sleep you need, your energy and efficiency will go up. In fact, you're likely to find that you actually get more done during the day than when you were skimping on shuteye.

Myths and Facts about Sleep

Myth 1: Getting just one hour less sleep per night won’t affect your daytime functioning. You may not be noticeably sleepy during the day, but losing even one hour of sleep can affect your ability to think properly and respond quickly. It also compromises your cardiovascular health, energy balance, and ability to fight infections.
Myth 2: Your body adjusts quickly to different sleep schedules. Most people can reset their biological clock, but only by appropriately timed cues—and even then, by one–two hours per day at best. Consequently, it can take more than a week to adjust after traveling across several time zones or switching to the night shift.
Myth 3: Extra sleep at night can cure you of problems with excessive daytime fatigue. The quantity of sleep you get is important, sure, but it's the quality of your sleep that you really have to pay attention to. Some people sleep eight or nine hours a night but don’t feel well rested when they wake up because the quality of their sleep is poor.
Myth 4: You can make up for lost sleep during the week by sleeping more on the weekends. Although this sleeping pattern will help relieve part of a sleep debt, it will not completely make up for the lack of sleep. Furthermore, sleeping later on the weekends can affect your sleep-wake cycle so that it is much harder to go to sleep at the right time on Sunday nights and get up early on Monday mornings.
Adapted from: Your Guide to Healthy Sleep (PDF) The National Institutes of Health

How many hours of sleep do you need?

According to the National Institutes of Health, the average adult sleeps less than seven hours per night. In today’s fast-paced society, six or seven hours of sleep may sound pretty good. In reality, though, it’s a recipe for chronic sleep deprivation.
There is a big difference between the amount of sleep you can get by on and the amount you need to function optimally. Just because you're able to operate on seven hours of sleep doesn't mean you wouldn't feel a lot better and get more done if you spent an extra hour or two in bed.
While sleep requirements vary slightly from person to person, most healthy adults need between seven and a half to nine hours of sleep per night to function at their best.Children and teens need even more ( see box at right ). And despite the notion that our sleep needs decrease with age, older people still need at least seven and a half to eight hours of sleep. Since older adultsnoften have trouble sleeping this long at night, daytime naps can help fill in the gap.
The best way to figure out if you're meeting your sleep needs is to evaluate how you feel as you go about your day. If you're logging enough hours, you'll feel energetic and alert all day long, from the moment you wake up until your regular bedtime.

Sleep needs and peak performance

There is a big difference between the amount of sleep you can get by on and the amount you need to function optimally. Just because you’re able to operate on seven hours of sleep doesn’t mean you wouldn’t feel a lot better and get more done if you spent an extra hour or two in bed. The best way to figure out if you’re meeting your sleep needs is to evaluate how you feel as you go about your day. If you’re logging enough hours, you’ll feel energetic and alert all day long, from the moment you wake up until your regular bedtime.

Think six hours of sleep is enough?

Think again. Researchers at the University of California, San Francisco discovered that some people have a gene that enables them to do well on six hours of sleep a night. This gene, however, is very rare, appearing in less than 3% of the population. For the other 97% of us, six hours doesn’t come close to cutting it.
Average Sleep Needs by Age
Newborn to 2 months old
12 - 18 hrs
3 months to 1 year old
14 - 15 hrs
1 to 3 years old
12 - 14 hrs
3 to 5 years old
11 - 13 hrs
5 to 12 years old
10 - 11 hrs
12 to 18 years old
8.5 - 10 hrs
Adults (18+)
7.5 - 9 hrs

Signs and symptoms of sleep deprivation and lack of sleep

If you’re getting less than eight hours of sleep each night, chances are you’re sleep deprived. What’s more, you probably have no idea just how much lack of sleep is affecting you.
How is it possible to be sleep deprived without knowing it? Most of the signs of sleep deprivation are much more subtle than falling face first into your dinner plate. Furthermore, if you’ve made a habit of skimping on sleep, you may not even remember what it feels like to be wide-awake, fully alert, and firing on all cylinders. Maybe it feels normal to get sleepy when you’re in a boring meeting, struggling through the afternoon slump, or dozing off after dinner, but the truth is that it’s only “normal” if you’re sleep deprived.

You may be sleep deprived if you...

  • Need an alarm clock in order to wake up on time
  • Rely on the snooze button
  • Have a hard time getting out of bed in the morning
  • Feel sluggish in the afternoon
  • Get sleepy in meetings, lectures, or warm rooms
  • Get drowsy after heavy meals or when driving
  • Need to nap to get through the day
  • Fall asleep while watching TV or relaxing in the evening
  • Feel the need to sleep in on weekends
  • Fall asleep within five minutes of going to bed

The effects of sleep deprivation and chronic lack of sleep

While it may seem like losing sleep isn't such a big deal, sleep deprivation has a wide range of negative effects that go way beyond daytime drowsiness. Lack of sleep affects your judgment, coordination, and reaction times. In fact, sleep deprivation can affect you just as much as being drunk.
The effects include:
  • Fatigue, lethargy, and lack of motivation
  • Moodiness and irritability
  • Reduced creativity and problem-solving skills
  • Inability to cope with stress
  • Reduced immunity; frequent colds and infections
  • Concentration and memory problems
  • Weight gain
  • Impaired motor skills and increased risk of accidents
  • Difficulty making decisions
  • Increased risk of diabetes, heart disease, and other health problems

How sleep deprivation can add to your waistline

Ever noticed how when you’re short on sleep you crave sugary foods that give you a quick energy boost? There’s a good reason for that. Sleep deprivation has a direct link to overeating and weight gain.
There are two hormones in your body that regulate normal feelings of hunger and fullness. Ghrelin stimulates appetite, while leptin sends signals to the brain when you are full. However, when don’t get the sleep you need, your ghrelin levels go up, stimulating your appetite so you want more food than normal, and your leptin levels go down, meaning you don’t feel satisfied and want to keep eating. So, the more sleep you lose, the more food your body will crave.

Stages of sleep: REM sleep and non-REM sleep stages

All sleep is not created equal. Sleep unfolds in a series of recurring sleep stages that are very different from one another in terms of what’s happening beneath the surface. From deep sleep to dreaming sleep, they are all vital for your body and mind. Each stage of sleep plays a different part in preparing you for the day ahead.

There are two main types of sleep:

  • Non-REM (NREM) sleep consists of three stages of sleep, each deeper than the last.
  • REM (Rapid Eye Movement) sleep is when you do most active dreaming. Your eyes actually move back and forth during this stage, which is why it is called Rapid Eye Movement sleep.
The Stages of Sleep
Non-REM sleep
Stage N1 (Transition to sleep) – This stage lasts about five minutes. Your eyes move slowly under the eyelids, muscle activity slows down, and you are easily awakened.
Stage N2 (Light sleep) – This is the first stage of true sleep, lasting from 10 to 25 minutes. Your eye movement stops, heart rate slows, and body temperature decreases.
Stage N3 (Deep sleep) – You’re difficult to awaken, and if you are awakened, you do not adjust immediately and often feel groggy and disoriented for several minutes. In this deepest stage of sleep, your brain waves are extremely slow. Blood flow is directed away from your brain and towards your muscles, restoring physical energy.
REM sleep
REM sleep (Dream sleep) – About 70 to 90 minutes after falling asleep, you enter REM sleep, where dreaming occurs. Your eyes move rapidly, your breathing shallows, and your heart rate and blood pressure increase. Also during this stage, your arm and leg muscles are paralyzed.

Understanding the Sleep Cycle

Quality sleep and your internal clock

Your internal 24-hour sleep-wake cycle, otherwise known as your biological clock or circadian rhythm, is regulated by processes in the brain that respond to how long you’ve been awake and the changes between light and dark. At night, your body responds to the loss of daylight by producing melatonin, a hormone that makes you sleepy. During the day, sunlight triggers the brain to inhibit melatonin production so you feel awake and alert.
Your internal clock can be disrupted by factors such as nightshift work, traveling across time zones, or irregular sleeping patterns—leaving you feeling groggy, disoriented, and sleepy at inconvenient times. The production of melatonin can also be thrown off when you're deprived of sunlight during the day or exposed to too much artificial light at night—especially the light from electronic devices, including TVs, computers, tables, and mobile phones.

The architecture of sleep

You may think that once you go to bed, you soon fall into a deep sleep that lasts for most of the night, progressing back into light sleep in the morning when it’s time to wake up. In reality, the sleep cycle is a lot more complicated.
Sleep Architecture
When you chart the sleep stages over the course of the night, the result looks like a city skyline—which is why it is called "sleep architecture"
During the night, your sleep follows a predictable pattern, moving back and forth between deep restorative sleep (deep sleep) and more alert stages and dreaming (REM sleep). Together, the stages of REM and non-REM sleep form a complete sleep cycle. Each cycle typically lasts about 90 minutes and repeats four to six times over the course of a night.
The amount of time you spend in each stage of sleep changes as the night progresses. For example, most deep sleep occurs in the first half of the night. Later in the night, your REM sleep stages become longer, alternating with light Stage N2 sleep. This is why if you are sensitive to waking up in the middle of the night, it is probably in the early morning hours, not immediately after going to bed.

Having a hard time getting up when your alarm goes off?

Even if you’ve enjoyed a full night’s sleep, getting out of bed can be difficult if your alarm goes off when you’re in the middle of deep sleep (Stage N3). If you want to make mornings less painful—or if you know you only have a limited time for sleep—try setting a wake-up time that’s a multiple of 90 minutes, the length of the average sleep cycle. For example, if you go to bed at 10 p.m., set your alarm for 5:30 (a total of 7 ½ hours of sleep) instead of 6:00 or 6:30. You may feel more refreshed at 5:30 than with another 30 to 60 minutes of sleep because you’re getting up at the end of a sleep cycle when your body and brain are already close to wakefulness.

The importance of deep sleep and REM sleep

It's not just the number of hours in bed that's important—it's the quality of those hours of sleep. If you're giving yourself plenty of time for sleep, but you're still having trouble waking up in the morning or staying alert all day, you may not be spending enough time in the different stages of sleep.
Each stage of sleep in the sleep cycle offers benefits to the sleeper. However, deep sleep (Stage N3) and REM sleep are particularly important. A normal adult spends approximately 50% of total sleep time in Stage 2 sleep, 20% in REM sleep, and 30% in the remaining stages, including deep sleep.

Deep sleep

The most damaging effects of sleep deprivation are from inadequate deep sleep. Deep sleep is a time when the body repairs itself and builds up energy for the day ahead. It plays a major role in maintaining your health, stimulating growth and development, repairing muscles and tissues, and boosting your immune system. In order to wake up energized and refreshed, getting quality deep sleep is essential. Factors that can lead to poor or inadequate deep sleep include:
  • Being woken during the night by outside noise, for example, or in order to care for a crying baby.
  • Working night shifts or swing shifts. Getting quality deep sleep during the day can be difficult, due to light and excess noise.
  • Smoking or drinking in the evening. Substances like alcohol and nicotine can disrupt deep sleep. It’s best to limit them before bed.

REM sleep

Just as deep sleep renews the body, REM sleep renews the mind by playing a key role in learning and memory. During REM sleep, your brain consolidates and processes the information you’ve learned during the day, forms neural connections that strengthen memory, and replenishes its supply of neurotransmitters, including feel-good chemicals like serotonin and dopamine that boost your mood during the day.
To get more mind and mood-boosting REM sleep, try sleeping an extra 30 minutes to an hour in the morning, when REM sleep stages are longer. Improving your overall sleep will also increase your REM sleep. If you aren’t getting enough deep sleep, your body will try to make that up first, at the expense of REM sleep.

Paying off your sleep debt

Sleep debt is the difference between the amount of sleep you need and the hours you actually get. Every time you sacrifice on sleep, you add to the debt. Eventually, the debt will have to be repaid; it won’t go away on its own. If you lose an hour of sleep, you must make up that extra hour somewhere down the line in order to bring your “account” back into balance.

Sleeping in on the weekends isn’t enough!

Many of us try to repay our sleep debt by sleeping in on the weekends, but as it turns out, bouncing back from chronic lack of sleep isn’t that easy. One or two solid nights of sleep aren’t enough to pay off a long-term debt. While extra sleep can give you a temporary boost (for example, you may feel great on Monday morning after a relaxing weekend), your performance and energy will drop back down as the day wears on.

Tips for getting and staying out of sleep debt

While you can’t pay off sleep debt in a night or even a weekend, with a little effort and planning, you can get back on track.
  • Aim for at least seven and a half hours of sleep every night. Make sure you don’t fall farther in debt by blocking off enough time for sleep each night. Consistency is the key.
  • Settle short-term sleep debt with an extra hour or two per night. If you lost 10 hours of sleep, pay the debt back in nightly one or two-hour installments.
  • Keep a sleep diary. Record when you go to bed, when you get up, your total hours of sleep, and how you feel during the day. As you keep track of your sleep, you’ll discover your natural patterns and get to know your sleep needs.
  • Take a sleep vacation to pay off a long-term sleep debt. Pick a two-week period when you have a flexible schedule. Go to bed at the same time every night and allow yourself to sleep until you wake up naturally. No alarm clocks! If you continue to keep the same bedtime and wake up naturally, you’ll eventually dig your way out of debt and arrive at the sleep schedule that’s ideal for you.
  • Make sleep a priority. Just as you schedule time for work and other commitments, you should schedule enough time for sleep. Instead of cutting back on sleep in order to tackle the rest of your daily tasks, put sleep at the top of your to-do list.(...)
Authors: Melinda Smith, M.A., Lawrence Robinson, and Robert Segal, M.A. Last updated: October 2014