Category Archives: Mind Building

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How to Treat Body Dysmorphic Disorder, According to Experts

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If you or a loved one are dealing with body dysmorphic disorder, you may be hesitant to ask for help. It’s common to believe that psychological treatment won’t be the answer to your concerns. In fact, if you have BDD, you may have already sought “treatment” in other ways, such as with an aesthetician, dermatologist, hair stylist, dentist, or cosmetic surgeon, depending on the “flaw” you want addressed.

Body dysmorphic disorder, also called body dysmorphia, is a mental health condition that involves an unhealthy and excessive preoccupation with one’s physical appearance. Usually, people with BDD are preoccupied with one feature, such as the nose, eyes, teeth or mouth, hands, or knees.

While it’s common for people with BDD to seek cosmetic treatment, masking or changing the perceived flaw isn’t an effective treatment option. Cognitive behavioral therapy (CBT) should be the first line of treatment for BDD, Elyse Resch, RDN, an eating disorder therapist and one of the originators of intuitive eating, tells Health. Rather than masking a physical feature, CBT helps people address their underlying thoughts and beliefs about their bodies.

CBT for BDD can also involve exposure techniques that aim to reduce the repetitive behaviors and habits around the physical preoccupation, such as skin picking or hair pulling.

RELATED: Your Skin-Picking Habit Might Be Something More Serious

The same kind of treatment can be effective in people with poor body image and eating disorders. For example, as a college senior struggling with body dysmorphia, I underwent many CBT sessions and was given “homework” such as challenging myself to wear shorts to the gym instead of leggings.

The goal of my homework was to make me realize that people were not, in fact, staring at my legs, and that I had developed a false belief—if I wear shorts, everyone will stare at my cellulite and hate me—due to poor self-esteem.

Whether you have distorted body image, an eating disorder, or BDD, the idea is to move from body distrust to body trust, Resch says.

Physical health and safety are the priorities in each one of these conditions. No matter the clinical definition or diagnosis, a distorted sense of self can lead to health complications like nutrient deficiencies, skin conditions, hair loss, fatigue, hormonal complications, and more.

Without trusting one’s body, it will be difficult to halt unhealthy habits like skin picking, purging, or compulsive exercise, Resch says. Ultimately, you must learn to trust and accept that your body is the way it is, and there’s no need to change it.

"No one walks around saying, 'I'm just gonna work on getting three inches taller,'" Resch says. “We accept that we cannot change our height or the size of our feet. So why can’t we accept our hips or our nose or our hair?”

RELATED: 9 Ways to Help a Friend With an Eating Disorder

At-home coping strategies for BDD

While CBT is the most effective course of treatment, there are some things you can do at home if you struggle with your sense of self. Resch recommends the following tactics:

  • Spend less time on social media, and unfollow accounts that make you feel bad about yourself.
  • Make a list of things you love about yourself.
  • When you feel intrusive thoughts creeping up, engage in a hobby you love.
  • Spend more time doing constructive activities, such as writing, painting or drawing, and taking walks.
  • Identify triggering events or images, and write down what you feel when you experience these things.
  • Find a safe person who you can talk to at any time about your feelings.

Additionally, use the many free resources available to you. The Body Dysmorphic Disorder Foundation (BDDF) and the National Eating Disorders Association (NEDA) are just two helpful resources available online.

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Older adults with blood cancers: How they fare

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Although the majority of patients who have blood cancers are older adults, they make up only a small percentage of participants in the clinical trials that lead to new therapies. That’s because the standard research methods used in oncology (cancer medicine) are not ideal for identifying certain vulnerabilities linked to aging, such as having multiple chronic diseases and being frail.

To help remedy that situation, the American Society of Clinical Oncology (ASCO) issued a guideline recommending that older adults who have cancer receive a geriatric assessment to see if they are at increased risk for experiencing side effects from medication and other complications from cancer and its treatment. Recently, a team of researchers examined older adults who have cancer to see whether their ability to manage daily activities as measured by these assessments was linked to staying alive longer. The team published their study in the Journal of the American Geriatrics Society.

A key part of the geriatric assessment is to determine how well an older adult performs the basic activities of daily living (ADLs). These include bathing, dressing, getting themselves from a chair to the bed (and vice versa), eating, grooming, and using the toilet. The geriatric assessment also takes into account an older adult’s ability to perform instrumental activities of daily living (IADLS), or activities necessary for them to live on their own in the community. These activities include shopping, preparing meals, housework, taking medication, and handling their finances.

The researchers studied how performing daily activities was linked to survival and also to the use of medical care for adults living with cancer and aged 75 years and older. The researchers suspected that being unable to perform their daily activities would mean higher rates of death and unexpected visits to the Emergency Department (ED) and admissions to the hospital.

Participants included 464 people who on average were nearly 80 years old; 65 percent were male. All the participants were treated for blood cancers, including leukemia, multiple myeloma, and lymphoma, at the Dana-Farber Cancer Institute in Boston. About 38 percent of the participants had an aggressive form of blood cancer.

Of the participants, 11 percent reported they had trouble with at least one ADL and almost 27 percent had trouble performing at least one IADL.

The researchers also looked at a group of 318 participants who had visited the ED or had unplanned hospitalizations. Of them, 17 percent had at least one ED visit and 19 percent had at least one unplanned hospitalization. The five most common causes of hospitalization were pneumonia, fever, sepsis (the medical term for a blood infection), pain, and congestive heart failure.

For their main findings, the researchers reported that participants who had trouble performing at least one IADL had a higher risk for death, ED visits, and unplanned hospitalizations. This risk was not affected by how old they were, whether they had other chronic illnesses, how aggressive their cancers were, or the intensity of their cancer treatment.

What’s more, the researchers found that many of the patients who were dependent in performing their IADLS (meaning they relied on help from others) also had higher rates of age-related conditions, such as memory issues, problems with mobility, and feelings of loneliness or depression. The researchers concluded from their study that it is not only important to ask about function for older adults with blood cancer but to also screen for age-related conditions that could limit functioning. Treating these other conditions to improve function might help older adults better tolerate the stress of blood cancers and their treatment, the researchers suggested.

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Materials provided by American Geriatrics Society. Note: Content may be edited for style and length.

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The carbon offset market: Leveraging forest carbon’s value in the Brazilian Amazon

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As companies seek and are required to reduce their greenhouse gas emissions, the world’s carbon markets are expanding. A government-run program in the Amazon rainforest in northwestern Brazil transforms forest carbon value into public wealth by focusing on labor rather than land rights. In the Brazilian state of Acre, some of the revenue from carbon credits is distributed to rural laborers and family farmers without land rights. A Dartmouth study just published examines Acre’s forest carbon program, and the benefits and risks associated with this approach, including the potential impact on labor, state power and efforts to prevent deforestation. The study’s findings are published in the Journal of Peasant Studies.

“In resource rich areas in the rainforest, powerful actors have often profited at the expense of indigenous peoples and other local communities, who are often displaced from their land. Efforts to value forest carbon threaten to do the same. Through Acre’s carbon value program, in contrast, the state government attempts to create an inclusive, green economy in a way that also expands its social welfare initiatives. There are also risks to this approach” says study author, Maron Greenleaf, a lecturer and research associate in the department of anthropology at Dartmouth College.

In many other forest carbon credit programs, land has to be privately owned. In contrast, “through Acre’s system, poorer people are not excluded from forest carbon’s value because of their lack of formal land rights. Rather, many benefit from it,” explained Greenleaf. “This is an example of how we’re seeing environmental policy being harnessed to create new kinds of economies.”

Acre’s 2010 System of Incentives for Environmental Services (SISA) focuses on environmental services, including carbon sequestration, to protect the approximately 86 percent of the state (total of 164,000 sq km) that is forested. SISA’s carbon program is an example of Reducing Emissions from Deforestation and Forest Degradation (REDD+), which prioritizes sustainable forestry management and conservation practices to combat climate change.

With Acre’s 2017 agreements with Britain and Germany, and others, demand for Acre’s forest carbon value appears to be relatively strong. One such agreement is Acre’s 2010 Memorandum of Understanding with California. This month, the California Air Resources Board , which regulates the carbon market within the state, will determine whether or not to adopt the “Tropical Forest Standard.” Considered to be a model of tropical forest protection, Acre is the most likely jurisdiction to be approved under the Standard, which would allow for its carbon credits to be purchased by California-based companies. This would be the first time that REDD+ credits are accepted into a cap and trade market.

Greenleaf’s insights on Acre’s carbon offset program are based on her fieldwork conducted in 2012 and 2013-14. As part of her research, she interviewed “rural producers,” who practice small-scale farming for subsistence and markets, and engage in local wage labor and/or cattle ranching. These include “posseiros,” who have land claims based on informal possession.

In the study, Greenleaf discusses the complexity of the land tenure process in Acre. There may be land conflicts and land usage, which may be dictated by culturally specific arrangements, including overlapping individual and/or collective claims — nuances that are not reflected on maps. She explains how if REDD+ was not administered by the Acreano Government, many rural laborers and family farmers might not be able to participate in this program; obtaining formal title from the government can be challenging or next to impossible, requiring resources and documentation that many lack.

Shifting allocation of carbon value to “green labor” provides an alternative that bypasses some of the challenges associated with the recognition of land rights, but does not eliminate them, as seeking land title is not only a path for upward mobility for the poor but also integral to identity and status. Even if rural laborers lack sufficient evidence to demonstrate formal land claims, Greenleaf explains how the small economic benefit that they may receive from the state could help make their land claims “less easily dismissed” in the future. At the same time, she points out that this model reinforces Acre’s state power and enables the government to make decisions over the land “as forest carbon’s presumptive owner.” The question looms as to whether Acre’s progressive, carbon value program will continue on its path of inclusive forest protection, particularly in the wake of the 2018 Brazilian elections, and whether other entities will look to adopt this model.

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Materials provided by Dartmouth College. Note: Content may be edited for style and length.

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Medical guidelines may be biased, overly aggressive in US

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Dr. Sunita Sah practiced general medicine for several years in the United Kingdom’s National Health Service. When she came to the United States, she noticed something strange.

The U.K. guidelines for tests such as mammograms and colon cancer screenings drastically differed from those in the U.S. — even though they were based on the same medical evidence.

“Having colonoscopy at the age of 50 — that struck me as rather odd when I moved to the U.S., because you don’t really hear about people having colonoscopies as a screening procedure in the U.K.,” said Sah. “It’s much less invasive to test for blood in the stool. It’s also less costly and doesn’t have the risks of undertaking a colonoscopy.”

Now an assistant professor of management and organizations at Cornell, Sah and Ismail Jatoi of the University of Texas Health, San Antonio, say the treatment guidelines recommended by medical specialist organizations are more likely to call for greater use of health care services and exacerbate overdiagnosis, overtreatment and spiraling health care costs. Their commentary, “Clinical Practice Guidelines and the Overuse of Health Care Services: Need for Reform,” appeared March 18 in the Canadian Medical Association Journal.

The implications are significant, she said, because guidelines are supposed to provide standard evidence-based treatment practices for all doctors.

“The recommendations put out by specialty organizations — like the American College of Cardiology or the American College of Radiology — show specialty bias in recommending more aggressive and/or more frequent screening procedures,” said Sah, an expert on conflict of interest. “In the U.S. in particular, where the fee-for-service compensation model dominates medicine, which is different from countries like the U.K., you see even more recommendations for greater use of health care services.”

Specialty bias refers to the tendency of physicians to recommend the treatments in which they are trained to deliver. For example, localized prostate cancer can be treated with either surgery or radiation.

“If you go to a surgeon, chances are that they are more likely to recommend that you have surgery; if you go to a radiation oncologist, they are more likely to recommend that you have radiation,” she said. “They each often believe that the treatment that they’re trained in is the better one.”

In the case of screening for colorectal cancer, the American College of Gastroenterology’s panel — all of whom were gastroenterologists — recommended colonoscopy as the best strategy.

But the United States Preventive Task Force, with no gastroenterologists or gastrointestinal surgeons, recommended testing the stool, sigmoidoscopy (an exam of only the lower part of the colon) or colonoscopy as a last resort. Stool testing was also recommended by the European Society of Medical Oncology panel, which consisted of six medical oncologists, no gastroenterologists and one gastrointestinal surgeon. The panel said there was limited evidence that screening colonoscopy is effective.

“Colonoscopies are more invasive than stool testing and come with potentially greater risks and costs for patients — but increased clinical volume and profits for gastroenterologists,” Sah said.

Specialty guidelines are also subject to fee-for-service bias, according to the commentary. Doctors who receive a payment for each treatment may tend to recommend that treatment more often, because they have a financial interest in it.

“The bias is not necessarily malicious or intentional,” Sah said. “In a fee-for-service environment, they may be biased to do more rather than less, so it becomes a habit.”

But more is not necessarily better, she said. “Sometimes the risks of those procedures are just not worth the benefits.”

The authors call for a reduction in conflicts of interest in the fee-for-service model, and more professional diversity in the makeup of the guideline committees. “You need a variety of different voices on those committees,” Sah said.

And patients could ask their doctors which guidelines they follow and why. “Ask them questions,” she said. “Ask your doctor to explain their thought process in recommending the particular guideline and the advantages or disadvantages of one guideline versus another.”

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Study measures gluten in gluten-free labeled restaurant food

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Even tiny amounts of gluten in foods are troublesome for people with celiac disease, and restaurants may be the hardest places to avoid the protein, finds a study by Benjamin Lebwohl, MD, MS, Celiac Disease Center at NY-Presbyterian Hospital and assistant professor of medicine and epidemiology at Columbia Mailman School. More than half of gluten-free pizza and pasta dishes in restaurants tested positive for the presence of gluten; about one-third of supposedly gluten-free foods had detectable gluten. Results are published in the American Journal of Gastroenterology.

“Patients have long suspected that gluten contamination in restaurant foods is a frequent occurrence, and these results support that,” said Lebwohl. “Our findings suggest that pizza, pasta and foods served at dinner were more likely to have a problem.”

Lebwohl used data uploaded by users of the portable device Nima Gluten Sensor which restaurant patrons use to test foods. The manufacturer supplied 5,624 food tests by 804 users over 18 months. The research showed 32 percent of tests revealed detectable gluten in dishes that were supposed to be gluten-free.

Gluten-free pasta samples were positive in 51 percent of tests; gluten-free pizza contained gluten for 53 percent. Gluten was detected in 27 percent of breakfasts, 29 percent of lunches and 34 percent of dinners.

There are limitations to the data, notes Lebwohl. “Users may have uploaded results that surprised them the most.” Also, the device is very sensitive. To be labeled gluten-free in the U.S., a product must contain less than 20 parts per million. “The device can detect levels as low as 5 to 10 ppm, which most do not consider clinically significant, so a ‘gluten found’ result does not necessarily mean ‘unsafe for celiac disease.’ The device also does not detect certain forms of gluten, such as fermented gluten. So both false positives and false negatives will affect this estimate.”

Lebwohl suspects that gluten-free foods are inadvertently contaminated, and “the solution may be better education for food preparers.”

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Materials provided by Columbia University’s Mailman School of Public Health. Note: Content may be edited for style and length.

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Scientists explore causes of biodiversity in perching birds

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New research by a global team of scientists has resulted in significant strides in ornithological classification and identified possible causes of diversity among modern bird species.

The study, coauthored by researchers at the University of Tennessee, Knoxville and published in Proceedings of the National Academy of Sciences, focuses on perching birds, or passerines. Comprised of over 6,000 species, this group — which constitutes over half of all known bird species — includes familiar birds such as robins, jays, bluebirds, finches, and sparrows.

Scientists analyzed genetic samples and fossils of all major groups within the passerine family to better understand the way these species are related. The large data set allowed for much more accurate inferences into the development of perching birds.

The result is the most accurate and comprehensive “tree of life” of passerine species to date.

The report also includes an analysis of the impact some events in Earth’s history could have had on passerines’ biodiversity.

“Our main discovery is that the evolution of perching birds around the world was determined in part by connections between continents over the Earth’s history, as well as changes in global climate,” said Michael Harvey, a postdoctoral fellow with UT’s Department of Ecology and Evolutionary Biology. “We found, for example, evidence that glaciations during the Oligocene Epoch (between 24 and 33 million years ago) wiped out a lot of perching birds, but that the warming period immediately after prompted the evolution of many of the groups of perching birds alive today.”

Another large portion of the study looks at the origin of perching birds, including a finding that perching birds originated on the Australian landmass around 47 million years ago.

“However, not just one single event in earth’s history explains how they became so diverse and widespread,” said Elizabeth Derryberry, UT assistant professor of ecology and evolutionary biology. “Instead, diversification and dispersal of this group has been affected by a number of different climatological and geological events, such as glaciation, global temperature changes and colonization of new continents.”

According to Harvey, the next step is to fill in the missing gaps in passerine evolution not fully explained by Earth’s history.

“We found that changes in geology and climate cannot explain everything,” he said. “Future research needs to focus on explaining those aspects of bird evolution that are not determined by the Earth’s geological and climatic history, but instead by the evolution of new characteristics in the birds themselves. For example, did the evolution of the ability to complete long-distance migrations in some perching birds help them get to new areas, or lead to the evolution of new species?”

Derryberry believes the research serves as a template for future exploration.

“The study provides a framework for how to conduct these types of analyses on large radiations and should provide a path forward for this type of research on all birds,” she said.

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Materials provided by University of Tennessee at Knoxville. Note: Content may be edited for style and length.

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Health24.com | Depression plus HIV can turn deadly

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When it coincides with HIV, depression appears associated with an increased risk of death, a new study says.

Researchers analysed data from the US Veteran’s Aging Cohort Study to compare the risk of death among those with and without depression, and the association between depression and death among those with and without HIV, the virus that causes Aids.

Increased risk of death

Depression was assessed in two ways: by clinical diagnostic codes and by a depressive symptoms questionnaire.

Among those with HIV infection, a 23% increased risk of death was associated with greater levels of depression as determined by the questionnaire. But there was no significantly increased risk of death when depression was assessed by the diagnostic codes.

For those without HIV, a 6% increased risk of death was associated with greater levels of depression measured by the codes. But there was no significant increased risk of death when depression was assessed by the questionnaire.

The Boston University School of Medicine study was published online in the journal HIV Medicine.

“Our findings reinforce the need to assess and treat depressive symptoms and major depressive disorder in patients with and without HIV infection to potentially reduce [death] risk,” corresponding author Kaku So-Armah said in a school news release. So-Armah is an assistant professor of medicine.

No cause-and-effect relationship

Clinical guidelines recommend routine screening for depression, but adherence to those guidelines varies, resulting in under-diagnosis of depression among HIV patients, according to the researchers.

“This needs to be improved,” the authors wrote. They called for more effective depression screening and integration of depression treatment into HIV primary care.

Depression is the most commonly reported mental health disorder among Americans with HIV, affecting 20% to 40%.

Depression has been linked with an increased risk of death in people with chronic diseases such as heart disease, end-stage kidney disease and diabetes.

This new study cannot prove a cause-and-effect relationship. Several previous studies have found an association between depression and an increased risk of death among people with HIV, but there is conflicting data.

Image credit: iStock

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Health24.com | Medical lessons learned from the Thai soccer team cave rescue

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For weeks last summer, the world was riveted by frantic efforts to find and rescue a soccer team of 12 Thai boys, along with their coach, who’d become trapped deep in a cave complex on June 23.

Exploring the caves in a northern province of Thailand, the group had become isolated after monsoon rains cut off their means of escape.

Difficult and challenging scenario

However, all 13 were eventually rescued by trained divers after being spotted more than 4km inside the cave complex on 2 July.

Now, doctors who treated the boys immediately upon rescue describe how blankets, a special warming device and the anaesthetic ketamine were all used to help ease the deep-cold hypothermia the boys suffered during their rescue ordeal.

“The Thai rescue team is to be applauded for safely and successfully preparing the young hypothermic patients for transport in an admittedly difficult and challenging scenario,” noted one US emergency medicine expert, Dr Robert Glatter, who read over the new report.

Glatter is an emergency physician at Lenox Hill Hospital in New York City.

The article outlining the post-rescue emergency care of the boys and their coach was written by Dr Chanrit Lawthaweesawat, of the Medical Association of Thailand, Dr Richard Harris, of SA Health in Adelaide, Australia, and their associates.

They explained that “with impending monsoon rains and concerns about falling oxygen levels in the cave, a plan to urgently extricate the patients was developed.”

Shivering can be harmful

As part of the plan, the boys were given the anaesthetic ketamine and also equipped with a pressurised air mask supplying them with 80% oxygen.

As Glatter explained, “ketamine helps to reduce shivering [intense muscular contractions], which is an evolutionary response to increase heat or core body temperature.”

However, in already hypothermic people, shivering can harm metabolism and brain function – something the rescue team was very concerned about.

Furthermore, shivering uses up vital oxygen, and that means “lower levels of oxygen in the bloodstream, increased carbon dioxide production and build-up of the waste product in the body known as lactic acid,” Glatter said. “Shivering also leads to an increase in the pressure in the brain.”

So, supplying the kids with additional oxygen via the pressurised face mask was crucial, he said.

Each boy and their coach was also wrapped in a cloth blanket, a special “heater blanket” and a whole-body foil wrap upon emerging from the cave system, the physicians reported in the New England Journal of Medicine.

A good neurological outcome

The boys were also gradually helped to recover from hypothermia buy using a “forced-air warming device”, Lawthaweesawat and colleagues wrote.

Warmed saline, delivered by intravenous injection, also helped to raise core body temperatures.

Overall, the emergency medical team reacted well to the situation, Glatter believes.

“Avoiding a further drop in core body temperature, while minimising a reduction in their oxygen levels, was critical to reducing the adverse effects of hypothermia on the heart and brain,” he said.

“The use of ketamine combined with adequate delivery of oxygen was an important step in ensuring a good neurological outcome. Along with use of warm intravenous fluids and blankets, their approach was successful,” Glatter said.

Image credit: iStock

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Health24.com | You could be a lifesaver – simple CPR doubles the odds of a cardiac arrest patient surviving

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If a few minutes of your time could save a person’s life, would you do it?

In a new study, researchers found that any type of bystander CPR – including just performing chest compressions – significantly improves the chances of survival for people who suffer an out-of-hospital cardiac arrest.

A cardiac arrest is when your heart suddenly stops beating.

“Bystanders have an important role in out-of-hospital cardiac arrest. Their actions can be lifesaving,” said study first author Dr Gabriel Riva. He’s a Ph.D. student at the Karolinska Institute in Stockholm.

Standard CPR involves chest compressions and mouth-to-mouth breathing. But hands-only CPR is becoming more widespread, so researchers wanted to compare 30-day survival rates for the two methods.

The researchers analyzed data on more than 30 000 people in Sweden who suffered out-of-hospital cardiac arrest during three time periods: 2000-2005, 2006-2010 and 2011-2017. Over those three periods, 39% received standard CPR and 20% received hands-only CPR.

During the study period, hands-only CPR was gradually adopted into Sweden’s CPR guidelines.

Bystander CPR rates rose from 41% in 2000-2005 to just over 68% in 2011-2017.

Standard CPR rates were about 35% in the first period, and 38% in the third period, the findings showed.

Hands-only CPR rates rose from about 5% in the first time period to 14% in the second, and then to 30% in the third period – an overall sixfold increase, the study authors noted.

During the 18-year study, patients receiving standard and hands-only CPR were twice as likely to survive 30 days as patients who received no CPR, according to the report published online April 1 in the journal Circulation.

“We found a significantly higher CPR rate for each year, which was associated with higher rates of compression-only CPR,” Riva said in a journal news release.

“CPR in its simplest form is just chest compressions. Doing only chest compressions doubles the chance of survival, compared to doing nothing,” Riva explained.

Cardiac arrest is a leading cause of death, the American Heart Association (AHA) says. It is often fatal if no immediate action is taken. Each year, there are more than 325 000 out-of-hospital cardiac arrests in the United States.

If you witness a cardiac arrest, the AHA recommends that you call emergency services and begin to push hard and fast in the center of the person’s chest until help arrives. Push at a rate of 100 to 120 compressions per minute, which corresponds to the beat of the song Stayin’ Alive by the Bee Gees.

Image credit: iStock

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Health24.com | Poor diet is killing more people than smoking, large new study suggests

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Bad diets are shortening lives worldwide – killing more people globally than either smoking or high blood pressure, a large, new research study suggests.

The study, of nearly 200 countries, linked poor diet quality to nearly 11 million deaths globally in 2017. That translated to 22% of deaths among all adults that year.

Not just too much junk food

Previous research has linked tobacco use to eight million deaths per year worldwide, and high blood pressure to just over 10 million deaths. But it’s not surprising that diet is so critical, said lead researcher Dr Ashkan Afshin, of the University of Washington in Seattle.

Poor nutrition helps drive many health conditions, from high blood pressure to type 2 diabetes, he noted.

And it’s not just a matter of people eating too much junk food, which is common in wealthy nations like the United States.

“We often talk about the foods that are ‘bad,’ and what you shouldn’t eat,” Afshin said. “But this is also about what you should eat.”

The analysis pointed to some eating habits with particularly strong links to higher death rates: diets high in sodium, and those low in whole grains, fruits and vegetables, and nuts and seeds.

Basically, Afshin said, it all supports a common refrain when it comes to diet advice: Eat fewer processed foods and more “whole” plant-based foods.

More plant-based foods

That is the bottom line, agreed Dr Andrew Freeman, who directs cardiovascular prevention and wellness at National Jewish Health in Denver.

“People are missing a lot from their diets,” he said. “If you include more whole, plant-based foods, that will push out some of the bad things.”

Freeman, who was not involved in the study, recently headed a research review examining some diet “hypes” – certain foods touted as having heart benefits.

The conclusion? The best evidence supports not miracle foods, but an overall diet high in fruits and vegetables, legumes and nuts, and fibre-rich whole grains.

For the new study, Afshin’s team used published nutrition surveys to look at typical dietary intakes across 195 countries, plus published research on the relationship between various diet factors and disease risks.

For example, to estimate the impact of salty diets, the researchers looked at the evidence on urinary sodium levels and changes in blood pressure – and then estimated the relationship between those blood pressure changes and disease outcomes.

Healthy foods shortchanged

There were, not surprisingly, differences in the typical diet across world regions: People in the United States and Canada tended to eat the most processed meats and trans fats from packaged foods, for example.

But consumption of sugary drinks and sodium was too high in nearly all world regions, the researchers noted.

Meanwhile, healthy foods were short-changed almost universally, with a few exceptions: People in Central Asia tended to eat enough vegetables, while those in parts of Latin America, Africa and South Asia typically got plenty of legumes.

On the whole, though, unbalanced diets were a health threat everywhere. Oceania and East Asia had the highest proportion of “diet-related” deaths from heart disease, for example. Diet-related deaths from type 2 diabetes complications were highest in the United States and Canada.

The impact of diet was seen not only in death rates, but in quality of life, according to Afshin.

Society needs to promote whole foods

In 2017, poor diets were associated with 255 million disability-adjusted life years – a summary of overall life years lost, plus time lived with a disability.

The findings were published in The Lancet journal.

To Freeman, it all points to the huge impact diet choices have on people’s longevity and well-being. “I don’t know how many alarms we need before we start making changes,” he said.

But it’s not only individuals who need to pay attention, both Freeman and Afshin said: Society as a whole, including health care systems and policymakers, needs to promote healthy whole foods over processed foods, red meat and butter.

It’s never too late to make wise diet changes – and Freeman said that patients are often motivated to “get off pills” for managing conditions like high blood pressure.

But ideally, he noted, people shouldn’t wait until diseases have developed.

Image credit: iStock

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