Weekly Wellness Spotlight

Dear Julie,

n this week’s wellness spotlight, we highlight a study published in the journal Nutrients in June 2019. In this study, lifestyle interventions of diet and exercise regimens were shown to decrease the occurrence of retinal microaneurysms in overweight and obese individuals with impaired glucose tolerance.

Lifestyle Intervention Improves Retinopathy Status—The Finnish Diabetes Prevention Study


Abstract: The aim of the study was to find out whether participation in earlier intervention had an effect on the occurrence of retinopathy in study participants. We also examined risk factors (age, sex, weight, fasting and 2 h glucose, fasting insulin, blood pressure, serum lipids) for early retinal changes. The study included 522 individuals (mean 55 years old, range 40–64 years) with impaired glucose tolerance who were randomized into intervention (weight loss, healthy diet, and physical activity, N = 265) and control groups (N = 257). Intervention lasted for median of four years in 1993–2000, after which annual follow-up visits at study clinics were conducted. In the years 2002–2006 (at least five years after stopping intervention), fundus photography was offered for all study participants in four of five study clinics. Photographs were assessed by two experienced ophthalmologists (A.A. and K.K.), masked for the group assignment. After exclusion of poor quality photographs, the data of 211 individuals (N = 113 for intervention and N = 98 for control group) were included in the present study. The occurrence of microaneurysms was significantly higher in the control (37/98, 38%) than in the intervention group (27/113, 24%; p = 0.029). In the model, including age, sex, diabetes diagnosis before the retinal assessment, body mass index (BMI), and treatment group, the odds ratio for microaneurysms was markedly lower in intervention group (OR 0.52; 0.28–0.97, p = 0.039). The only risk factor that predicted the occurrence of microaneurysms was serum triglycerides at baseline (mean ± SD 1.9 ± 0.9 vs.1.6 ± 0.7, mmol/L, with and without microaneurysms, respectively, p = 0.003). Triglycerides associated with decreased microaneurysms in regression analysis for age, sex, fasting glucose, and intervention group (OR 1.92, p = 0.018). Lifestyle intervention in overweight and obese individuals with impaired glucose tolerance showed decreased occurrence of retinal microaneurysms. Elevated serum triglycerides were associated to the development of early diabetic microangiopathy.


Also in the news: 

A nice reference article to provide patients on chronic inflammation:

Chronic inflammation is long lasting, insidious, dangerous. And you may not even know you have it.

https://www.washingtonpost.com/health/chronic-inflammation-is-long-lasting-insidious-d angerous-and-you-may-not-even-know-you-have-it/2020/01/17/93ab0fa2-316f-11ea-9313-6 cba89b1b9fb_story.html

“Chronic inflammation is involved in not just a few select disorders but a wide variety of very serious physical and mental health conditions,” says Slavich, senior author of a recent paper signed by scientists from 22 institutions urging greater prevention, early diagnosis and treatment of severe chronic inflammation. “Indeed, chronic inflammatory diseases are the most significant cause of death in the world today, with more than 50 percent of all deaths being attributable to inflammation-related diseases.”


Study links lack of motivation to inflammation

A new study published in the journal Trends in Cognitive Sciences has established a link between our dopaminergic drive (the motivation to do things) and chronic low-grade inflammation. The hypothesis presented by the researchers from Emory University is that “inflammatory cytokines signal immunometabolism shifts,” which directly impact mesolimbic dopamine (DA). The mesolimbic pathway, also referred to as the “reward pathway”, is implicated in the willingness to put in effort or seek reward. Researchers explained “reduction of striatal DA that in turn leads to a steeper effort-discounting curve because of reduced perceived ability (can’t) versus preference (won’t) for reward”.

Motivational and neurological impairment has been connected to inflammation, possibly due to sensitivity to immune cytokines. The reason for the alteration in the immune response, effectively downgrading motivation and drive, is to focus energy on healing and conserve precious resources. This study offers a vital opportunity to think about how chronic/persistent low-grade inflammation impacts the pathophysiology of disease. These findings could impact the way we look at behavioral challenges for which a causative factor may be inflammation.

Further research is currently being carried out using the computational framework designed for this study. The framework cross-references low-grade inflammation with the amount of energy that is available to the patient, presenting promising approaches to neurological health in the future.