Tag: health

Could when you eat be as important as what you eat?

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It is close to midnight and I am bingeing both on a Netflix show and leftovers from the fridge. I know I will regret it in the morning – and perhaps for years to come.

With my late-night feasting, I am inadvertently playing fast and loose with a system that evolved to keep my body in sync with the natural 24-hour cycle of day and night. Its effects include setting optimum times to eat, and there is emerging evidence that overriding this schedule can have severe consequences for health.

This article is part of a series on nutrition that delves into some of the hottest trends of the moment. Read more here.

The syncing begins in a small cluster of neurons in the brain called the suprachiasmatic nucleus (SCN), which is the body’s central timekeeper. Its function is to make sure biological processes such as falling asleep occur at the optimal time. The SCN is reset daily by light and darkness, creating a roughly 24-hour cycle called the circadian rhythm. It also coordinates appetite to ensure that we have adequate supplies of energy during the day and can get through a night’s sleep without being awoken by digestion or hunger.

This translates into natural peaks in appetite in the morning and early evening. Processes involved in the digestion, absorption and metabolism of food are similarly coordinated by the SCN to be primed for action at the appropriate times.

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October 29, 2024
The Maker of Ozempic Is Trying to Block Compounded Versions of Its Blockbuster Drug

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Drugmaker Novo Nordisk is taking action to curb the massively popular compounded semaglutide industry, which provides copies of its blockbuster weight-loss drugs Ozempic and Wegovy to patients—often for much lower prices.

The Danish pharmaceutical company is lobbying the US Food and Drug Administration to add semaglutide to the agency’s Demonstrable Difficulties for Compounding (DDC) lists, which would block compounding pharmacies from producing dupes of the drug. In a filing posted by the agency on Tuesday, lawyers for Novo Nordisk reason that semaglutide belongs on these lists “due to the complexities associated with their formulations,” among other reasons.

“These drugs are inherently complex to compound safely, and the risks they pose to patient safety far outweigh any benefits. Novo Nordisk’s aim with this nomination is to ensure that patients receive only FDA-approved, safe, and effective semaglutide product,” says Novo Nordisk director of media relations Jamie Bennett.

FDA press officer Amanda Hils told WIRED via email that the agency “is reviewing the petition and will respond directly to the petitioner.”

If granted, the designation would have seismic implications for the compounding industry—and for the likely millions of people currently taking compounded GLP-1 drugs.

Injectable GLP-1 drugs including semaglutide and tirzepatide have been in shortage since 2022 because of their huge popularity. In the US, when the FDA declares that a drug is in shortage, certain licensed pharmacies are permitted to make “compounded” versions of the medication, which are mixed in-house and are supposed to contain the same active ingredients as the original drug.

Telehealth providers have capitalized on the GLP-1 drug shortage, offering patients compounded versions via quick virtual appointments. The practice has created tension with the pharmaceutical companies that make the brand-name drugs, since the compounded versions are sold at much lower prices. Ozempic and Wegovy can cost around $1,000 a month without insurance, while compounded semaglutide is advertised for as low as $100 a month online.

Unlike generic medications, which are manufactured after drug patents expire, compounded medications are not subject to FDA approval before hitting the market. This means that the FDA cannot vouch for the safety, effectiveness, or quality of compounded drugs before they’re sold to patients. The FDA has received multiple reports of adverse side effects, including hospitalization, related to possible dosing errors associated with compounded semaglutide products.

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October 23, 2024
What the US election will mean for AI, climate action and abortion

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The upcoming US presidential election will determine how the country regulates tech, combats the climate crisis and decides on access to abortion

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October 21, 2024
Why frenemies, or love-hate relationships, are so bad for your health

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Mariana Castel/Millennium Images, UK

When I contemplate the members of my social network, I am mostly filled with unadulterated feelings of love and warmth: I simply can’t wait to see them again, in the knowledge that we will bask in mutual affection and support.

A handful, however, arouse quite different emotions – a mixture of eagerness and dread. They promise encounters that are the conversational equivalent of Russian roulette. In the right mood, these individuals can deliver a fun-filled evening, but if I catch them at the wrong moment, they can drain me of all my goodwill. There is simply no knowing what is to come.

If this sounds familiar, then you too have frenemies. Psychologists call them “ambivalent relationships” and they don’t just have the potential to ruin a good party, they also have surprising consequences for your well-being. According to a wealth of research, these love-hate relationships are often more stressful than interactions with people who are consistently nasty. They can damage your mental and physical health. They might also be prematurely ageing you.

Knowing this, the simple solution would seem to be to cut ties with these people. But our relationships with frenemies aren’t simple, and ditching them isn’t always possible or even desirable. However, a deeper insight into your ambivalent relationships will help you deal with them more effectively. It could make you a better friend, too. Because, when you know the signs to look out for, you might discover that the frenemy in some of your relationships is you.

Since the 1970s, huge studies examining thousands of…

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October 15, 2024
Bird Flu Fears Stoke the Race for an mRNA Flu Vaccine

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It isn’t necessarily obvious what part of a flu virus any potential mRNA vaccine should aim for. “You need to make sure you’re targeting the right part of the virus,” says Scher. With Covid-19, the prominent spike protein fit the bill. But influenza viruses are arguably more complicated and mutate more quickly, meaning that if you pick the wrong protein, your jab could prove less effective than hoped. The flip side, Scher suggests, is that mRNA vaccines could make it possible to target multiple proteins or parts of proteins on the same virus—a multipronged strategy.

And while they’re tricky to develop, the speed with which mRNA vaccines can be produced could be hugely beneficial. Traditionally, flu vaccines contain inactivated viruses that are grown in hens’ eggs. This works reasonably well, but it takes a long time to make such jabs, which means health authorities have to publish their predictions about which strains of flu will be circulating during the upcoming winter well in advance. If you could manufacture vaccines more quickly, you could make more accurate predictions nearer to flu season.

Not only that, researchers hope that a single mRNA shot could one day target 20 or more strains of flu at once, relieving the need for some of this guesswork. Scher’s colleagues are working on such a “universal” flu vaccine.

With clinical trials ongoing, it’s still early days. Sheena Cruickshank, an immunologist at the University of Manchester, has watched reports about emerging mRNA flu jabs with interest but says that questions remain. “We don’t yet know how long-lasting the immunity they produce is,” she says.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, concurs, though he notes that all flu jabs, regardless of how they are made, have a waning immunity problem—your protection could decline by around 10 percent every month following injection.

A concern specific to mRNA vaccines is that they tend to cost more than traditional flu vaccines and must be kept refrigerated, which may make them difficult to roll out in areas with poor infrastructure. Researchers are also concerned that they may meet with more vaccine hesitancy. “The mRNA vaccine platform, per se, is probably the one that seems to get the most misinformation,” notes Cruickshank. “That could be a disadvantage.”

A new wave of mRNA flu vaccines could be particularly impactful for older patients, says Jenna Bartley, an assistant professor at UConn Health, a health research center and hospital. Older people are among the most at risk from flu, but current vaccines are less effective in higher age groups, as their immune response tends to be weaker. mRNA Covid-19 jabs, however, have proven effective in older people as well as younger people.

It may be some time before mRNA jabs are available for seasonal flu. However, if H5N1 starts infecting a lot more people, and especially if we find that it is transmitting frequently between humans, there’s a chance that an mRNA bird flu vaccine could be the first such jab rolled out on a wide scale. US health officials have said that an mRNA H5N1 vaccine could be made available within weeks, if required.

Osterholm agrees that such a timeframe is realistic. The real challenge, he points out, would be getting any new H5N1 vaccine to the people who most need it. Covid-19 jabs emerged in wealthy countries and were delivered to people very quickly, he says, but “for much of the world, that wasn’t the case at all.”

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October 3, 2024
The Vagus Nerve’s Crucial Role in Creating the Human Sense of Mind

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The original version of this story appeared in Quanta Magazine.

It is late at night. You are alone and wandering empty streets in search of your parked car when you hear footsteps creeping up from behind. Your heart pounds, your blood pressure skyrockets. Goose bumps appear on your arms, sweat on your palms. Your stomach knots and your muscles coil, ready to sprint or fight.

Now imagine the same scene, but without any of the body’s innate responses to an external threat. Would you still feel afraid?

Experiences like this reveal the tight integration between brain and body in the creation of mind—the collage of thoughts, perceptions, feelings, and personality unique to each of us. The capabilities of the brain alone are astonishing. The supreme organ gives most people a vivid sensory perception of the world. It can preserve memories, enable us to learn and speak, generate emotions and consciousness. But those who might attempt to preserve their mind by uploading its data into a computer miss a critical point: The body is essential to the mind.

How is this crucial brain-body connection orchestrated? The answer involves the very unusual vagus nerve. The longest nerve in the body, it wends its way from the brain throughout the head and trunk, issuing commands to our organs and receiving sensations from them. Much of the bewildering range of functions it regulates, such as mood, learning, sexual arousal, and fear, are automatic and operate without conscious control. These complex responses engage a constellation of cerebral circuits that link brain and body. The vagus nerve is, in one way of thinking, the conduit of the mind.

Nerves are typically named for the specific functions they perform. Optic nerves carry signals from the eyes to the brain for vision. Auditory nerves conduct acoustic information for hearing. The best that early anatomists could do with this nerve, however, was to call it the “vagus,” from the Latin for “wandering.” The wandering nerve was apparent to the first anatomists, notably Galen, the Greek polymath who lived until around the year 216. But centuries of study were required to grasp its complex anatomy and function. This effort is ongoing: Research on the vagus nerve is at the forefront of neuroscience today.

The most vigorous current research involves stimulating this nerve with electricity to enhance cognition and memory, and for a smorgasbord of therapies for neurological and psychological disorders, including migraine, tinnitus, obesity, pain, drug addiction, and more. But how could stimulating a single nerve potentially have such wide-ranging psychological and cognitive benefits? To understand this, we must understand the vagus nerve itself.

The vagus nerve originates from four clusters of neurons in the brain’s medulla, where the brainstem attaches to the spinal cord. Most nerves in our body branch directly from the spinal cord: They are threaded between the vertebrae in our backbone in a series of lateral bands to carry information into and out of the brain. But not the vagus. The vagus nerve is one of 13 nerves that leave the brain directly through special holes in the skull. From there it sprouts thickets of branches that reach almost everywhere in the head and trunk. The vagus also radiates from two major clusters of outpost neurons, called ganglia, stationed in critical spots in the body. For example, a large cluster of vagal neurons clings like a vine to the carotid artery in your neck. Its nerve fibers follow this network of blood vessels throughout your body to reach vital organs, from the heart and lungs to the gut.

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September 29, 2024
The Gut Might Hold the Key to Treating Long Covid in Kids

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Yonker and her colleagues will administer larazotide to 32 patients between the ages of 7 and 21, who will take the drug for eight weeks; a further 16 patients will receive a placebo. To qualify for the trial, patients must have a detectable presence of the Covid-19 spike protein in their blood. The intention is to see whether reducing intestinal permeability can make a noticeable difference to the young patients’ symptoms and quality of life.

Running such a trial has not been straightforward. “It began last year, but we had to put it on pause for a few months because of staffing and drug supply issues,” says Yonker. “One of the requirements is that we need to ensure that the spike protein is present in the blood, which can involve multiple blood draws from these children, which takes time. Because of this I expect it will take one to two more years to recruit all the patients we need, but I would love to move faster.”

The results, when they emerge, will help researchers determine whether a leaky gut is likely to be a major cause of disease in at least a subset of patients, and whether larazotide should be trialed more widely as a possible treatment.

There could be other gut-related involvement: Brodin believes that in some children, the virus lingers in the gut rather than being fully excreted, enabling it to actively damage the intestinal wall and contributing to gastrointestinal problems. He suspects that this viral persistence can then induce an autoimmune reaction in the bloodstream, causing further symptoms.

Yonker’s trial is also encouraging other pediatric long Covid researchers to initiate their own trials, exploring other theories behind the condition. Danilo Buonsenso, a pediatrician at the Gemelli University Hospital in Rome who conducted the first study examining whether children were developing long Covid, described the study as fascinating. He is now trying to get funding for an ambitious trial testing multiple treatments.

Buonsenso’s work includes studies suggesting that blood clots, as well as inflammation within the lining of the blood vessels known as the endothelium, may play a role in driving certain symptoms. Separately, he led a study that found some children with long Covid also struggle with a condition called postural tachycardia syndrome (POTS) that affects many adults with long Covid, too.

“In my opinion, there will not be a single drug that will solve long Covid, as multiple things are being documented,” he says. “We need to investigate the role of low-dose anticoagulants with known effects on reducing endothelial inflammation. But we also need to look at specific drugs for POTS and specific medications for the neurocognitive symptoms like chronic pain and headache.”

Meanwhile, Yonker’s focus on the gut represents a crucial first step. Given the desperation of children suffering from the condition, and their parents, she is hopeful that if her trial proves successful, it will provide an evidence-based treatment option specifically for children. “I think it’s extremely important to advocate for timely treatment advances in children suffering from long Covid rather than wait for trickle-down guidance, based on what we see from trials in adults,” she says.

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September 27, 2024
Thermacell LIV Smart Mosquito Repellent System Review: Expensive but Effective

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So I have one of those unfortunate blood types that makes me extremely susceptible to mosquito bites. To give you a sense of how bad it is, I got attacked three times while installing the mosquito repellent system I’m reviewing here. Big, nasty, red welts that lingered for days.

I usually take extreme measures to avoid mosquitos, including topical products like OFF! and visits from a professional mosquito control company that sprays citronella all over my backyard every three weeks. Tragically, none of this has been of much help. For most of the summer, I look like Patient Zero for some kind of pox.

This summer I decided I’d had enough. Enter Thermacell’s LIV, an installed mosquito blocker system that can scale to fit your deck or yard, regardless of shape and size.

Invisible Force Field

LIV is not a mosquito-killing system—you’ll need zappers and poisons for that—but rather a repeller technology. It works based on a chemical called metofluthrin, which gives off a vapor that mosquitos apparently hate when heated. Metofluthrin isn’t unique to Thermacell; it’s also the active ingredient in OFF! mosquito lamps and wearable devices, among other products.

Photograph: Christopher Null

LIV is a wired system composed of two main components: a base station, called the Smart Hub, which calls the shots, and as many satellite Repellers as you need. The Smart Hub plugs into wall power and communicates via Wi-Fi with your home network. The Repellers are also wired, daisy-chained to the hub one after another via included cables.

If you’re imagining a low-voltage lighting system, you’re on the right track—only LIV isn’t quite as flexible. Each cable is a fixed 24 feet long—though shorter 10-foot cables are available as a separate purchase—since Repellers must be positioned about 20 feet away from one another. This is because the range of the vaporized metofluthrin is only 10 feet. With a ring of Repellers around your safe zone, you create an invisible anti-mosquito force field as a perimeter, with each Repeller’s coverage zone slightly overlapping.

Setup isn’t difficult, but it is time-consuming and requires some attention to detail. You may not have a lot of flexibility as to where to place the Smart Hub because it needs to reside near an electrical outlet and within the Wi-Fi range of your router—plus it has to be mounted on the wall. Since most homes have few exterior power outlets, finding the Goldilocks spot for the hub can be tricky.

Photograph: Christopher Null

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September 26, 2024
Pilots Are Dying of Tiredness. Tech Can’t Save Them

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In May 2023, Air India launched safety management software called Coruson, as well as BAM (Boeing Alertness Model), a fatigue-mitigation tool integrated into its rostering system, which is used by airlines to create and manage pilot schedules. Coruson, developed by cloud software company Ideagen, centralizes, analyzes, and reports on safety-related data—such as incidents, hazards, and risk assessments. BAM, developed jointly by Boeing and the software company Jeppesen, predicts and manages pilot fatigue by analyzing flight schedules and performance data. These tools were designed to prevent the creation of fatiguing rosters and pairings, Air India CEO Campbell Wilson noted in an internal message to employees. The carrier also introduced two new digital tools for its crew—the Pilot Sector Report app, to help pilots easily submit information on flight performance, incidents, and observations post-flight; and DocuNet, a digital management system that facilitates the storage, retrieval, and sharing of documents (such as flight manuals, training records, and compliance documents).

Despite these measures, the airline was fined by the DGCA in March this year for violating FDTL limits and fatigue management rules. This May, Air India Express cabin staff called in sick en masse to protest against “mismanagement.” This followed a similar protest from the crew, mostly pilots, at Vistara airlines. Both Air India and Vistara are now owned by one of India’s largest conglomerates, the Tata Group, which took over the former from the Indian government in January 2022.

Twenty-five of those who called in sick at Air India Express were terminated. Others were reportedly served an ultimatum. Those sacked were later reinstated by the airline following an intervention by the chief labour commissioner. Nearly a week before, the regional labor commissioner of Delhi had allegedly written to the Tata group chairman pointing to “blatant violations of labour laws” and insisting the legitimate concerns of the cabin crew be looked into. According to CNBC, Vistara employees said the agitation at their end had to do with recent salary updates, which fixed pilot pay at 40 flight hours—down from 70. Protesting first officers claimed that the new salary structure would result in an almost 57 percent pay cut. Under the new terms they would also have to fly up to 76 hours to earn what they were previously earning at 70 hours.

To placate the pilots and get them back to work, management had assured them that salaries for the “extra working hours” would be credited once Vistara was integrated with Air India. At the time, two Air India pilots unions had written to the chairman of the company, saying that such issues were not isolated but systemic. Burnout was the other related issue, with many pilots complaining of inadequate rest and being pushed to their limits.

Captain Singh, a former senior manager at AirAsia, tells WIRED that such effects significantly increase the risk of accidents, but also adversely affect pilot health in the long run. Tail swaps—rushing between different types of aircraft to take off immediately after disembarking from another—have become more prevalent under the 13-hour rules, and can further contribute to exhaustion, as do hasty acclimatization and, most significantly, landing three, four, or more flights consecutively, which Captain Randhawa described as a “severe energy management challenge.”

In the 2024 “Safety Culture Survey” conducted by Singh’s Safety Matters Foundation in July, 81 percent of 530 respondents, primarily medium- to short-haul pilots, stated that bufferless rosters contribute to their fatigue. As many as 84 percent indicated concerns with the speed and direction of shift rotation. “That’s the problem with the new rostering softwares the operators are introducing,” a pilot from a private airline, who requested anonymity, says. “They’re optimizers designed to make pilots work every second of their 13-hour schedule, leaving no breathing room.” The buffer-deficient timetables push pilots to their limits, so any additional pressure—like unpredictable weather—can easily overwhelm them.

Solving this issue with wrist-worn fatigue-measuring devices is contentious. But that isn’t the only problem. A year since they were hyped up, the buzz around fatigue-management tech has all but fizzled out. There have been no updates from IndiGo about the wrist device. Neither IndiGo nor the Thales Group responded to requests to comment.

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September 26, 2024
How much should we worry about the health effects of microplastics?

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There are small pieces of plastic in the food we eat and air we breathe

SIVStockStudio/Shutterstock

It seems that every few months we discover microplastics in a new part of the body. We have found them in our liver, kidneys, lungs and gut. They have even shown up in human breast milk and blood. Last week, they turned up again in eight people’s olfactory bulb, a brain structure crucial for smell.

These plastic fragments are so small – less than five millimetres in size – that they can make their way into our bodies through food, water and even…

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September 25, 2024