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The Emperor Has No Crown
Abstract
The fundamental crux of disease is weakness.
The solution is strength - in mind and in body.
The solution has always been strength, and it has stared the medical profession in the eye for decades.
It is only a rigid traditionalism and the unexpressed fear of leaving the beaten path and forging a new way ahead that has maintained the status quo for such a long time.
If there was ever an opportunity to take decisive action it is now.
We face an unknown enemy which preferentially preys on the weak and debilitated.
There might be a learning curve to getting to know this enemy and taking the battle to him.
No such learning curve is staring us down when it comes to strengthening the weak.
The research has been done and the methods are available and ready to implement.
The situation we face compels us to look to a functional approach in healthcare and focus on resolving chronic disease for the long-term, as opposed to short-term damage control and a resignation to a lifetime of medication punctuated with the occasional surgical intervention.
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Background Vitamin D is a micronutrient which is essential to help maintain bone and musculoskeletal health 1. However, recent research has highlighted a crucial supportive role for vitamin D in immune cell function, particularly in modulating the inflammatory response to viral infection 2,3. At a cellular level, vitamin D modulates both the adaptive and innate immune system through cytokines and regulation of cell signalling pathways 4. Vitamin D receptor (VDR) is present on both T and B immune cells; Vitamin D modulates the proliferation, inhibition and differentiation of these cells 5. In experimental models of lipopolysaccharide-induced inflammation, vitamin D is associated with lower concentrations of the pro-inflammatory cytokine Interleukin-6 (IL-6) 6 , which plays a significant role in Covid-19 induced acute respiratory distress syndrome (ARDS) 7. Vitamin D also reduces lipolysaccharide-induced lung injury in mice by blocking Abstract Background Recent research has indicated that vitamin D may have immune supporting properties through modulation of both the adaptive and innate immune system through cytokines and regulation of cell signalling pathways. We hypothesize that vitamin D status may influence the severity of responses to Covid-19 and that the prevalence of vitamin D deficiency in Europe will be closely aligned to Covid-19 mortality.
Background:
Until recently, the World Health Organization (WHO) estimated the annual mortality burden of influenza to be 250 000 to 500 000 all-cause deaths globally; however, a 2017 study indicated a substantially higher mortality burden, at 290 000-650 000 influenza-associated deaths from respiratory causes alone, and a 2019 study estimated 99 000-200 000 deaths from lower respiratory tract infections directly caused by influenza. Here we revisit global and regional estimates of influenza mortality burden and explore mortality trends over time and geography.
Methods:
We compiled influenza-associated excess respiratory mortality estimates for 31 countries representing 5 WHO regions during 2002-2011. From these we extrapolated the influenza burden for all 193 countries of the world using a multiple imputation approach. We then used mixed linear regression models to identify factors associated with high seasonal influenza mortality burden, including influenza types and subtypes, health care and socio-demographic development indicators, and baseline mortality levels.
Results:
We estimated an average of 389 000 (uncertainty range 294 000-518 000) respiratory deaths were associated with influenza globally each year during the study period, corresponding to ~ 2% of all annual respiratory deaths. Of these, 67% were among people 65 years and older. Global burden estimates were robust to the choice of countries included in the extrapolation model. For people <65 years, higher baseline respiratory mortality, lower level of access to health care and seasons dominated by the A(H1N1)pdm09 subtype were associated with higher influenza-associated mortality, while lower level of socio-demographic development and A(H3N2) dominance was associated with higher influenza mortality in adults ≥65 years.
Conclusions:
Our global estimate of influenza-associated excess respiratory mortality is consistent with the 2017 estimate, despite a different modelling strategy, and the lower 2019 estimate which only captured deaths directly caused by influenza. Our finding that baseline respiratory mortality and access to health care are associated with influenza-related mortality in persons <65 years suggests that health care improvements in low and middle-income countries might substantially reduce seasonal influenza mortality. Our estimates add to the body of evidence on the variation in influenza burden over time and geography, and begin to address the relationship between influenza-associated mortality, health and development.
This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators: (1) acute and chronic effects of exercise on the immune system, (2) clinical benefits of the exercise–immune relationship, (3) nutritional influences on the immune response to exercise, and (4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900–1980, which focused on exercise-induced changes in basic immune cell counts and function; 1980–1990, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers, and increased risk of upper respiratory tract infections; 1990–2010, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches (i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise immunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the personalized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases.
We described the contribution of ultra-processed foods in the U.K. diet and its association with the overall dietary content of nutrients known to affect the risk of chronic non-communicable diseases (NCDs). Cross-sectional data from the U.K. National Diet and Nutrition Survey (2008–2014) were analysed. Food items collected using a four-day food diary were classified according to the NOVA system. The average energy intake was 1764 kcal/day, with 30.1% of calories coming from unprocessed or minimally processed foods, 4.2% from culinary ingredients, 8.8% from processed foods, and 56.8% from ultra-processed foods. As the ultra-processed food consumption increased, the dietary content of carbohydrates, free sugars, total fats, saturated fats, and sodium increased significantly while the content of protein, fibre, and potassium decreased. Increased ultra-processed food consumption had a remarkable effect on average content of free sugars, which increased from 9.9% to 15.4% of total energy from the first to the last quintile. The prevalence of people exceeding the upper limits recommended for free sugars and sodium increased by 85% and 55%, respectively, from the lowest to the highest ultra-processed food quintile. Decreasing the dietary share of ultra-processed foods may substantially improve the nutritional quality of diets and contribute to the prevention of diet-related NCDs.
The purpose of this study was to investigate the effectiveness of strength training, performed against a different resistance from body weight, in improving motor and nonmotor symptoms in patients with Parkinson’s disease (PD). The following electronic databases were searched: PubMed, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science. The review was conducted and reported in accordance with the PRISMA statement. Thirteen high-quality randomized controlled trials were included. Strength training performed against external resistance is well tolerated and appears to be a suitable physical activity to improve both physical parameters and quality of life parameters of PD subjects. However, although the study intervention included strength training, only a few selected studies assessed the improvement of muscle strength. Despite the encouraging results, it is difficult to establish a correlation between strength training and the improvements made. Our review highlights the lack of common intent in terms of study design and the presence of different primary and secondary outcomes. Accordingly, further studies are needed to support the beneficial effects of different types of strength training in PD subjects and to underline the superiority of strength training in PD patients with respect to other training.
Background:
The proper nutrition in diabetes is one of the crucial elements of therapy, but in practice, diet of diabetic individuals is commonly improperly balanced, that is associated with lack of nutritional knowledge. The nurses are also often characterized by insufficient knowledge about diabetes diet therapy and poor nutritional behaviors.
Objective:
The aim of the study was to analyze of the declared nutritional behaviors in a group of diabetology nurses and to compare it with declared nutritional behaviors of the control group.
Material and methods:
The group of 52 nurses recruited from all the regions of Poland working with diabetic patients was analysed and compared with control group of 63 individuals - random non-diabetic patients from all the regions of Poland. They were asked about accomplishing practical recommended nutritional goals for adults in Poland and were able to indicate if they follow detailed recommended nutritional goals "always" (3 points), "sometimes" (1 point) or "never" (0 points).
Results:
The diabetology nurses rarely declared fish and legumes intake (never or sometimes accomplishing goal: 87%), milk and dairy products intake (75%), as well as moderate sugar and sweets intake (69%). Nurses significantly rarer than control group declared regularity of meals (p=0.0000) and diversion of meals (p=0.0000). The lack of correlation between number of years of working with diabetic individuals and number of obtained points during assessment of nutritional behaviors was observed.
Conclusions:
The nutritional behaviors of diabetology nurses are not good, even if they educate diabetic patients on daily basis. Nutritional education should be conducted not only in groups of diabetic patients, but also, in groups of diabetology nurses. KEY WORDS: nutritional behaviors, diabetology nurses, diabetes, nutritional education.
