The largest study to date of the genetic underpinnings of Alzheimer’s has uncovered five new gene mutations that make people more vulnerable to the memory-robbing disease.

The international team of scientists analysed the DNA of more than 94 000 people collected by the four groups that make up the International Genomic Alzheimer’s Project.

The body’s instruction manuals

“The ability to combine data from so many research groups gave us the power to detect new links to the causes of Alzheimer disease,” said study co-lead author Brian Kunkle. He is an associate scientist at the University of Miami’s John P. Hussman Institute for Human Genomics.

Margaret Pericak-Vance, director of the institute, added that “this is an exciting time to be studying Alzheimer disease” – the most common cause of dementia in the elderly.

“Genes contain the body’s instruction manuals, and we now have a much better understanding of how to read the instructions related to Alzheimer disease as the initial step to translation to clinical care,” she explained in a University of Miami news release.

Learning more about how the five gene variants influence Alzheimer’s risk could improve knowledge on how the disease begins and provide potential new targets for drugs, the study authors said.

Rare genetic variants

The researchers also found that certain gene variants that bind to a protein called tau may affect development of Alzheimer’s at an earlier stage than previously thought. And they discovered a formerly unknown common feature between early-onset and late-onset Alzheimer disease – how certain proteins called amyloid precursor proteins are broken down.

The latter finding suggests that some treatments developed for early-onset Alzheimer’s may also work for late-onset disease, according to the study published in the journal Nature Genetics.

The investigators also found that rare genetic variants – those that occur in less than 1% of a population – likely play an important role in Alzheimer disease.

Alzheimer’s disease is a brain disorder that slowly destroys memory and thinking skills. In most people with Alzheimer’s, symptoms first appear in their mid-60s. According to the US National Institute on Aging, more than 5.5 million Americans may have Alzheimer’s.

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Your grandparents’ chronic aches and pains might best be eased with a little weed, a new study suggests.

Not only did people over 75 who took medical marijuana report less pain, their use of pot-based capsules, tinctures and e-cigarettes allowed a third of these patients to reduce their use of opioid painkillers, researchers found.

Potentially positive medical benefits

“Medical marijuana, in my opinion, is an excellent choice for patients with chronic disease, including chronic pain,” said senior researcher Dr Laszlo Mechtler, medical director of the Dent Neurologic Institute in Amherst, New York.

The study tracked 204 elderly patients who had been prescribed medical marijuana to deal with pain through New York state’s medical marijuana programme, Mechtler said.

All were given products containing various ratios of tetrahydrocannabinol (THC) and cannabidiol (CBD), most often tinctures that were applied with an eyedropper under the tongue, Mechtler said.

THC is the chemical in marijuana that causes intoxication, while CBD has been associated with a number of potentially positive medical benefits.

About seven out of 10 patients experienced some symptom relief, researchers found.

Half said their chronic pain diminished, 18% said they slept better, nerve pain improved in 15%, and anxiety was quelled in 10%.

Some downsides

“A majority of patients came back and said, ‘I’m better,'” Mechtler said. “The efficacy rates were quite high. Most patients felt their quality of life had improved.”

Three-fourths of the people treated had been diagnosed with chronic pain, Mechtler said. Other conditions included cancer (6%), neuropathy (5%), multiple sclerosis (5%), epilepsy (3%) and Parkinson’s disease (2%).

There were some downsides. Initially, 34% of patients experienced side effects from medical marijuana, most commonly sleepiness (13%), balance problems (7%) and gastrointestinal issues (7%).

After adjustments in dose, only 21% continued to have side effects. Ultimately, 3% of participants stopped taking medical marijuana due to side effects.

A one-to-one ratio of THC to CBD proved most effective while limiting side effects, Mechtler said.

The findings were to be presented at the American Academy of Neurology annual meeting, being held 4–10 May in Philadelphia. Such research is considered preliminary until published in a peer-reviewed journal.

Mechtler was particularly encouraged by the reduction of reliance on opioid painkillers in these patients.

‘Study really hit home’

“In the midst of an opioid epidemic in this country, with 115 people dying every day, anything that can decrease the potential for opiate use is a win/win situation,” Mechtler said. “Nobody overdoses on medical marijuana.

“I have not seen an abuse of medical marijuana, especially in this age group. Our grandparents are not abusing medical marijuana,” he continued. “They want improved quality of life. They want to come off the opioids, which have a long list of side effects.”

The results jibe with other studies on medical pot, said Dr Diana Martins-Welch, an attending physician in palliative medicine at Northwell Health in Long Island, New York.

“This study really hit home with a lot of what I was seeing in the other survey data that’s been put out there regarding cannabis and chronic pain,” she said.

Martins-Welch tends to prescribe very low doses of THC in her preparations, but added that it was “not surprising at all to me that the one-to-one ratio tended to cause the least amount of side effects. That’s the ratio I tend to stick with when possible.”

Significant cost

Better studies need to be performed regarding medical marijuana, particularly randomised controlled trials, Martins-Welch said.

“Honestly, it’s going to have to be federally legal before we can do the robust studies that are required of medicine in general,” she said. Currently, medical marijuana is legal in about two-thirds of states.

In the meantime, better-off seniors will be the only ones likely to benefit from medical marijuana, Mechtler said.

Prescriptions cost anywhere from $125 (±R1 780) to $500 (±R7 129) a month, out of pocket, he said.

“People with chronic disease just can’t afford that,” Mechtler said. “Thirty-five percent of my patients can’t afford it at all, period, and 70% complain of the significant cost and how it affects their quality of life financially.”

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The glasses feature Disney characters but contain a toxic metal associated with known health risks.

The BBC finds a rogue salesman peddling antibiotics at the wrong dose.

For people with the deadly skin cancer melanoma, one dose of the drug Keytruda before surgery might stop the cancer in its tracks, according to a ground-breaking new study.

Keytruda (pembrolizumab) is a PD-1 inhibitor, an immunotherapy drug that triggers the body’s immune response to attack cancer cells. According to results of this study, the drug’s effects peak as early as seven days after treatment – much earlier than previously seen in other studies.

Cured within three weeks

Moreover, patients who had a year of this immunotherapy treatment after surgery were free of their cancer for more than two years, the longest follow-up so far on patients with melanoma.

“Anti-PD-1 works extremely rapidly, achieving immunological responses peaking in most patients within one to three weeks,” said study co-author John Wherry. He’s director of the Penn Institute for Immunology at the University of Pennsylvania.

About a third of the patients were “essentially cured within three weeks, highlighting the rapidity of immunotherapy for cancer,” Wherry said.

And in those patients whose cancer returned, researchers found revealing patterns in the way cancer adapts to the drug – discoveries that could lead to better ways to treat such patients.

Keytruda is the drug responsible for the remission of former President Jimmy Carter’s cancer in 2015. Carter, then 90, had melanoma that spread to his brain and liver. Treatment with Keytruda appears to have cured him.

The drug isn’t cheap, costing about $150 000 (roughly R2.1 million) a year. Keytruda is covered by most insurance, including Medicare, but co-pays can be high, according to the Kaiser Family Foundation.

A ‘complete response’

For the study, researchers gave 27 patients with advanced melanoma a single dose of Keytruda three weeks before surgery.

Eight patients had what researchers described as a complete response, meaning less than 10% of the cancer cells remained at the time of surgery. All eight remained cancer-free for up to 25 months of follow-up.

Researchers also investigated how tumour cells in patients whose cancer returned were able to develop a resistance to Keytruda. The investigators found two causes – tumour mutations and increased activity of cells that naturally suppress the immune system.

Knowing the factors that cause a lack of response to the drug may help to identify patients who might benefit from other therapies in combination with PD-1, Wherry said.

Dr Steven Savona, a physician at Northwell Health’s Monter Cancer Center in Lake Success, New York, was not involved with the study, but reviewed the findings. He said the fast-acting immune response offers a new approach to a disease that used to be approachable only with surgery.

Many will die

Savona said it could make the surgery simpler, and if used in combination with other treatments, surgery might not even be necessary for some patients.

“This might be a new approach for patients with limited but advanced melanoma, but we do need additional testing to prove that,” said Savona.

Merck, Inc., maker of Keytruda, supplied the drug for the study but did not fund the trial.

Melanoma is the deadliest form of skin cancer. The American Cancer Society estimates that more than 96 000 new melanomas will be diagnosed in the United States this year, and 7 200 people will die from the disease.

Standard treatment includes surgery followed by a year of drug treatment in high-risk patients.

The report was published in the journal Nature Medicine.

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If you have type 2 diabetes and you want to do your heart a favour, a new study suggests you should let your diet get a little nutty.

Folks with type 2 diabetes who ate five or more servings of certain kinds of nuts weekly dropped their odds of heart disease by about 20%, compared to people who ate less than a serving a month. A serving in the study was defined as one ounce.

Not all nuts are created equal

Noshing five or more weekly servings of nuts also appears to lower the risk of premature death from heart disease or any other cause by about one-third for people with type 2 diabetes.

Not all nuts are created equal, however. Nuts grown on trees seemed to provide more heart-health benefits than peanuts, which grow underground.

Tree nuts include walnuts, almonds, cashews, Brazil nuts, pistachios, pecans, macadamias, hazelnuts and pine nuts.

“Our findings suggest that nut consumption, especially tree nuts, is beneficial for the prevention of cardiovascular disease [heart disease and stroke] and premature deaths among individuals with diabetes,” said study author Gang Liu. He’s a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health, in Boston.

The study was funded by the US National Institutes of Health.

More research needed

What is it about nuts that makes them so heart-healthy for people with diabetes?

Liu said that nuts seem to help control blood sugar, blood pressure and cholesterol. Eating nuts also appears to help dampen inflammation and improve blood vessel health.

The current study focused on people with type 2 diabetes, and Liu said there isn’t yet enough research to know if nuts would provide the same benefit to people with type 1 diabetes.

However, when asked if people without diabetes might see heart benefits from nuts, he said, “Based on our findings and existing evidence, I would say that nuts are beneficial for people with and without diabetes.”

Heart specialist Dr Terrence Sacchi agreed that nuts can be beneficial. “This observational study provides more evidence that certain types of nuts perhaps have some effect on diabetes and heart disease,” Sacchi said. He’s the chief of cardiology at NewYork-Presbyterian Brooklyn Methodist Hospital in New York City.

But Sacchi added a few caveats. “Nuts are good in moderation, but you can’t be eating 18 handfuls of nuts. A serving is a handful. Nuts contain a lot of fat; it’s good fat, but gaining weight would counteract any benefit,” he explained.

No proven cause and effect

Sacchi also pointed out that it’s important to limit the salt in nuts, because excess salt can increase your heart disease and stroke risk. He said the best type of nuts are raw, unsalted nuts.

The study included diet and health information from more than 16 000 people before and after they were diagnosed with type 2 diabetes. The study covered about two decades. Because it was an observational study, it cannot prove cause and effect.

During the study period, more than 3 000 people developed heart disease or stroke. More than 5 600 of the study volunteers died. Of those, nearly 1 700 died from heart disease or stroke.

The researchers found that when people ate more nuts after a diabetes diagnosis, they lowered their risk of heart disease or stroke more than 10%. Eating more nuts was also tied to about a 25% reduction in premature death from heart disease or another cause.

Each additional serving of nuts was linked to a 3% decreased risk of heart disease and stroke, as well as a 6% drop in the risk of dying of cardiovascular disease.

The study findings were published online in the journal Circulation Research.

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Women should have access to daily essentials while in hospital, health officials say.

Let’s get the obvious reason you overeat out of the way: Food tastes really good. And some of it tastes really, really good. The truth, though, is that everyone likes food, yet some people struggle to find their stopping point more than others.

We asked Men’s Health Nutrition Adviser, Dr Michael Roussell, to help you understand why. “Being aware of the reasons you might overeat can help you identify the behaviours that are holding you back from the results you want,” says Roussell. Use his advice so that you can fill up – without filling out.

1. You use food as a reward (too often)

“Food is more than just calories,” says Roussell. “It’s part of your culture and your experiences, and it’s also a great reward.” And that’s all good. But it’s easy to make rewarding yourself with food a regular habit, rather than a special event.

Ever had a hard day at work and say, “I deserve a glass of wine” – and then proceed to drink the whole bottle? And have you ever done that more than once in a week? “You need to be realistic about the caloric cost of using food as a frequent reward,” says Roussell. Start noting all the places that you allow high-calorie meals or binge-drinking to creep in because you “deserve it”. If it’s once a day, or even once every two or three days, you’ve identified a key area where you need to adjust your mindset.

Read more: Why you get cravings and how to beat them

2. You frequently say, ‘What the hell!’

See if this sounds familiar. You eat a slice of pizza for a snack, and immediately grab another. You hesitate, but then think, ‘What the hell, I’ve already blown my diet. I might as well eat the whole thing!’ (Researchers literally call this the “what the hell effect”.)

Try to keep a logical perspective: Having an extra piece or two of pizza isn’t a big deal in the grand scheme of your diet. “You can just eat a little less later in the day, or adjust your diet a little tomorrow,” says Roussell. “Just remember that there’s a big difference between eating 1 000 extra kilojoules of pizza versus 4 000 or more.”

There’s room for error, especially if you plan for it.

Read more: Try our quick muscle recipe: pizza eggs

3. You’re too tough on yourself

“The worst things you can do are beat yourself up when you eat junk food, or feel bad if the scale isn’t moving,” says Roussell. “Shame can drastically damage your weight loss efforts.”

For example, in one study, University of Toronto researchers rigged scales to make dieters think they had gained five pounds even though the participants had actually lost weight. Those who felt greater shame about their weight gain subsequently ate more ice cream than those who weren’t as bothered by their results. Wake Forest University scientists observed similar findings.

The bottom line: “If you eat too much of a food that you really didn’t want to eat, don’t beat yourself up,” says Roussell. “Vow to do better the next time and move on.”

Read more: 6 reasons why you’ve stopped losing weight

4. You eat out too much

According to the USDA, more than 40% of meals are eaten away from home. “The loss of control over portion sizes often leads to overeating,” says Roussell.

“Restaurants entice customers by offering bigger meals,” says Roussell. “And unfortunately, many of us are conditioned to clean our plates instead of listening to our bodies.”

Roussell’s advice: “Look online for a restaurant’s nutrition information ahead of time, and determine what’s appropriate.” At some chains, you can often request a “half order”. If you’re going to a more upscale establishment, simply plan ahead strategically so that you can allocate more calories for the meal – guilt-free.

Read more: 4 mistakes that make you fat

5. You’re distracted

How often do you just eat – without watching TV, browsing Facebook, or working at your desk?

“Multitasking lessens your body’s ability to sense the amount of food you are eating and thus how full it should make you,” says Roussell. “In fact, studies show that eating while you watch a screen of any kind leads to consuming more food and a reduced ability to remember how much you ate.”

Roussell’s advice: Engage in eating as its own activity, and be mindful of what you’re putting in your mouth. British researchers discovered that those who could recall exactly what they ate for lunch downed 30% less than those who couldn’t. The scientists say that remembering recent eating might enhance awareness of how satiating the food was, which then has an effect on subsequent consumption.

Read more: 7 weight loss snacks that will actually keep you full

6. You’re really tired

Lack of sleep and the ensuing fatigue has major implications on your ability to control overeating. Read: Being tired saps your willpower.

A 2013 study in Proceedings of the National Academy of Sciences found that not getting enough sleep can cause people to eat up to 5% more kilojoules per day – primarily after dinner. Fatigue also increases stress, another driver of willpower depletion.

Focus on getting seven to nine hours of sleep each night to help strengthen your dietary resolve and curb overeating.

And for best results, try to keep a consistent sleep schedule, so that you aren’t as inclined to oversleep on the weekends. A recent Australian study found that people who sleep later than normal on Saturday and Sunday have greater levels of fatigue on Monday and Tuesday than those who rise at their regular time.

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