Category: 8. Health

  • Development and validation of a questionnaire to assess women’s hookah smoking: insights from a multi-stage study | BMC Public Health

    Development and validation of a questionnaire to assess women’s hookah smoking: insights from a multi-stage study | BMC Public Health

    This study developed and validated a comprehensive questionnaire (Supplementary Table 3) aimed at identifying factors influencing hookah smoking behavior across personal, interpersonal, and organizational levels. The initial version of the questionnaire was informed by a qualitative study, which provided valuable insights into relevant factors. Through an iterative process, certain items were removed to enhance clarity and relevance, resulting in a refined instrument that was subsequently tested for content validity. The results confirmed the reliability and validity of the questionnaire. The final questionnaire included 81 items aligned with 16 factors. Having tested the face validity, content validity, and construct validity were substantiated. The results offer evidence that this questionnaire is a valid and reliable tool for assessing factors related to hookah smoking among women. To our knowledge, this is the first study to focus specifically on vulnerable populations, such as women who smoke hookah in the Eastern Mediterranean region. Further validation across different sites and cultural contexts would enhance its applicability and provide deeper insights into its broader relevance.

    The need for a questionnaire on women’s hookah smoking in Iran is urgent due to the significant increase in hookah smoking among Iranian women and the adverse effects of consuming this tobacco product on health [24, 25]. Gender differences exist in why men and women start hookah smoking. For example, Iranian men with Turkmen ethnicity often begin smoking due to cultural identity and sense of adulthood [26], while women are more influenced by social approval and emotional needs [14, 27]. These differences suggest that public health strategies should be tailored by gender, and because of this, we need a gender-specific questionnaire. The lack of a questionnaire specifically designed for women shows the need to design one to measure the effective factors in the initiation and continuation of hookah smoking among women. This questionnaire can help develop systematic health promotion initiatives and interventions that specifically address women’s needs and behaviors. There are several questionnaires to evaluate hookah smoking, such as the Hookah Smoking Initiation for Women Questionnaire (HIWQ). This questionnaire was designed using an exploratory sequential mixed methods approach to include six dimensions: drawing the attention of other people, the need to have fun and be relaxed, hookah smoking in the family, availability of hookah, curiosity and having a positive attitude toward hookah. HIWQ aims to assess the initiation of hookah smoking by women. In the questionnaire used in the present study, besides these factors, other issues have also been addressed such as socio-economic deficiencies and role of advertisement and education [13]. Hookah Smoking Obscenity Measurement Scale for Adolescents evaluates the level of obscenity related to hookah smoking among adolescents. This instrument is not specifically designed for women, and considers a specific age group (i.e., adolescents) [12]. The Questionnaire on Smoking Urges for Assessment of Hookah Smoking evaluates the tendency to smoke hookah and, like the previous questionnaire, it is not specifically designed for women [11]. These questionnaires provide a basis for the development of a comprehensive and culturally relevant instrument. It evaluated the beginning and continuation of hookah, which, besides the factors included in these questionnaires, also deals with other factors at the personal, interpersonal and organizational levels.

    These factors include socioeconomic deficiencies, role of advertisement and education, availability, fun and entertainment, hookah smoking in family and relatives, search for peace, attracting others’ attention and approval, physical and mental dependence, color, flavor and sound of hookah, happy environment of coffee shops, pleasant experience of the first puff of hookah smoking, The prevalence of acceptability of hookah smoking in society, false beliefs, Low self-efficacy, Peer pressure, and Family tendencies. These factors showed adequate internal consistency and construct validity and supported their use in evaluating the key factors underlying hookah smoking behavior.

    Our developed and validated questionnaire addresses many dimensions, including low self-efficacy, physical/mental dependence, attracting others’ attention and approval, search for peace, positive attitude towards hookah, false beliefs about personal factors underlying hookah smoking, the color, taste, and sound of hookah, and the pleasant experience of the first puff of hookah. Low self-efficacy, or belief in one’s ability to resist hookah smoking, is a main factor that contributes to hookah smoking. Women with low self-efficacy are more likely to initiate and continue hookah smoking [15]. Self-efficacy assessment helps understand people’s vulnerability to hookah smoking. Moreover, hookah smoking can become addictive and make it hard for women to quit. Assessing the degree of dependence provides insights into the intensity of hookah smoking and the challenges of cessation [15]. Having a positive attitude towards hookah is a major reason for smoking among women. Women who hold more favorable beliefs about hookah are less likely to quit [14, 28]. Assessing attitudes helps identify women at risk of hookah smoking and guides researchers to design interventions to change these attitudes. Meanwhile, the spread of false beliefs about the harmlessness of hookah smoking affects people’s attitudes toward this tobacco product [29]. Some women believe that hookah is less harmful than cigarettes or even has health benefits. The belief that hookah smoking is pleasant and acceptable may add to its popularity among women. It is important to assess these misconceptions to correct them through education. Therefore, individual factors can be effective in women’s hookah smoking, and including relevant questions in questionnaires provides a comprehensive assessment of the risk of hookah smoking in women. This information can guide systematic interventions to prevent hookah initiation, reduce smoking, and promote hookah cessation.

    Interpersonal factors also play a significant role in hookah smoking among women. These factors in the current study include the influence of peers and friends, family preferences, and the role of the family in hookah smoking. These factors are of utmost importance and need to be included in the questionnaire. The role of peers and friends is admittedly an important interpersonal factor involved in hookah smoking among women. Hookah smoking has deep roots in the culture and history of many societies. Climate and cultural norms can affect the prevalence of hookah smoking among women. For example, in some societies like Iran, hookah smoking is considered a social norm and a way to communicate with others as opposed to cigarette which carries stigma for women who smoke [14, 28, 29]. Social norms and peer pressure can initiate, encourage or prohibit the use of hookah. If people closely related to women are hookah smokers, it is more likely that they begin to smoke hookahs too [29]. Friends’ and acquaintances’ smoking can tempt women to smoke hookahs. Including questions about peer pressure in the questionnaire helps recognize the effect of social networks on hookah smoking and informs professionals about interventions that address these relationships. In some cultures, family members may encourage or prohibit hookah smoking, and women may be strongly influenced in their hookah smoking behavior. In this regard, researchers reported that familial habits like having hookah-smoking family members, especially parents or siblings can influence women’s decision to go for hookahs [29, 30]. It can be argued that people can copy hookah smoking by friends and family members and be tempted to smoke due to the availability of hookahs, or the environments that facilitate its use. Including questions about family tendencies in the questionnaire can highlight the role of family in hookah smoking and contribute to interventions that address family dynamics.

    Organizational factors are among the other factors included in this questionnaire as advertisement and education. Advertising can promote hookah smoking by introducing hookah as a social and cultural norm. This could lead to a higher prevalence of hookah smoking among women, as they are more influenced by social norms and cultural expectations [28, 31]. Education can play a significant role in reducing the rate of hookah smoking among women. Educating women on the health risks of hookah smoking can help them make informed decisions about their health.

    In the current study, social factors were also included in the questionnaire. Social factors play a significant role in women’s hookah smoking. These factors included availability, fun and entertainment, socio-economic deficiencies, and happy environment of coffee shops. Easy access to hookah and its low cost are the main factors underlying its prevalence. When hookah is readily available and affordable, women tend more to try it [16]. Moreover, recreational centers where hookah is sold, such as coffee shops and restaurants, can further encourage hookah smoking by providing a pleasant social environment and easy access to hookahs [14, 29]. In addition to the prevalence of hookah smoking in families, the prevalence in public places like coffee shops also familiarizes the young with hookah and gives them easy access to it. The lower cost of hookah compared to other recreational drugs has also attracted many people. The lack of appropriate and large enough social contexts for women, especially recreational facilities, can affect their hookah smoking patterns. This points to the necessity of considering the social and political factors that shape the opportunities and limitations facing women [15]. The political and regulatory system significantly affects the availability of hookahs [27]. Therefore, including questions about social factors in the questionnaire is essential to consider the role of these factors in hookah smoking among women. These factors can provide valuable insights into the social effects of hookah smoking.

    The comprehensive nature of this questionnaire, which includes a wide range of factors, increases its effectiveness in capturing the multidimensional aspects of hookah smoking. Nevertheless, this study has some limitations. First, it was conducted in a single city in Iran, limiting the generalizability of the findings to the wider population of women in Iran or beyond. Further testing in different regions is necessary to enhance the study’s broader applicability. The questionnaire can indeed be applicable to women in other MENA countries as well as in other similar contexts. Second, all data were self-reported, which may introduce recall or reporting biases. Lastly, variations in the use of flavored and non-flavored hookah tobacco, which may influence users’ perceptions and behaviors, were not assessed in this study. Although women in Iran typically smoke mildly flavored hookah tobacco, future studies should account for this important factor.

    Implications of the study

    The present study has major implications for understanding and measuring the complex nature of hookah smoking behavior. Recognition and measurement of these factors give researchers and public health professionals a deeper understanding of the causes and effects of hookah smoking. This knowledge can help with the development of systematic interventions and policies aimed at reducing hookah smoking and its health risks. Future research can use this valid questionnaire to further investigate the factors affecting hookah smoking in different populations and environments. By expanding the scope of research and interventions based on the present findings, stakeholders can attempt to develop goal-oriented strategies to address the complex interplay of personal, interpersonal, and social factors underlying hookah smoking.

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  • Interdisciplinary report illuminates demographic, systemic health factors of dry eye disease

    Interdisciplinary report illuminates demographic, systemic health factors of dry eye disease

    Dry eye disease was more prevalent in women than men, and was found to increase with age, investigators reported. Image credit: ©Rido – stock.adobe.com

    The Tear Film and Ocular Surface Society (TFOS) DEWS III Digest Report, published in June 2025 in American Journal of Ophthalmology, has identified key research published since the 2017 TFOS DEWS II Workshop reports in the form of sex, gender and hormones; epidemiology; pathophysiology; tear film; pain and sensation; iatrogenic; and clinical trial design.1 The report was comprised in an effort to support evidence cited in the TFOS DEWS III Diagnostic Methodology and Management and Therapy reports, and included input from 80 experts in 18 countries, according to TFOS.2

    Study authors, led by Fiona Stapleton, PhD, MSc, of the School of Optometry and Vision Science, UNSW Sydney in NSW, Australia, outlined advancements in tear film research, a clarification of pathophysiological distinctions between aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE) and ocular pain perception, among others.1

    For sex, gender and hormones, study authors focused on studies published after July 1, 2017 and cited significant sex-related differences in the lacrimal gland, meibomian gland, cornea, eye lid blinking, corneal thickness, sensitivity, re-epithelisation, pain assessment, hormonal regulation of the ocular surface and adnexa and dry eye disease (DED)-induced damage, among others.1

    “There have been significant research advances linking sex, hormones and gender to DED. Aging, cancer and hormone therapy increasingly broaden the interdisciplinarity in this field over time,” the report authors stated. “Despite the significant impact of gender-affirming hormone therapy on the entire endocrine system and its effects on physical and mental health, there is limited information on its impact on ocular health. Variations in age, health profile, gender-affirming hormone therapy compliance and barriers to accessing regular healthcare limit the documentation of side effects. Clinicians and future research should consider these variations, as recommended in a recent systematic review on the medical aspects of the transgender and gender diverse population.”

    For epidemiology, DED was found to increase with age and was more common in women than men; signs and symptoms were more common in women with higher rates in younger and older adults. Some of the outstanding questions that remain from the research are issues concerning disease severity, geographic considerations, the generalisability of prevalence measures for DED in children and adults under 40 years of age and a need for appropriately powered studies to determine risk factors in patients under 40. Researchers noted that a limited number of studies exist that explore the prevalence, risk factors, or natural history by disease severity.1

    Opportunities for future research concerning tear film were identified in the needed exploration of the relationship between disordered lipids that result in spreading and increased elasticity as compared to ordered lipids that lead to improved resistance to evaporation. Researchers also called for a more detailed understanding of whether tear biomarkers can be used to differentiate subtypes of DED and referenced the society’s recent Diagnostic Methodology report.1

    “Analyses of microbiome changes across individuals of different ethnicities and countries of residence may provide further insights into its potential role in DED pathogenesis or as a marker for the disease,” the study authors noted. “Understanding the potential role of different microRNAs in DED pathogenesis, DED subtype or as biomarkers could be a highly promising area for future investigation.”

    Recommendations for DED management were also suggested by the study authors under iatrogenic, particularly regarding DED implicated in a variety of anti-glaucoma topical drugs, preservatives and excipients, antibiotics and hormone replacement therapy, among others.1

    “The first step is to investigate which medication is causing DED and try to stop its use. This subtraction can be challenging when discontinuing the treatment, which presents a risk to the eye’s health,” the study authors noted. “Sometimes, multiple drugs and components are involved, or adverse effects appear long after treatment initiation, making identification of which is causing DED even more difficult.”

    References:

    1. Stapleton F, Argüeso P, Asbell P, et al. TFOS DEWS III Digest Report. Am Journ of Opthalmol. 2025. https://doi.org/10.1016/j.ajo.2025.05.040
    2. TFOS dry eye workshop (DEWS) III: completed! Tear Film and Ocular Surface Society. News release. June 10, 2025. Accessed June 18, 2025. https://www.tearfilm.org/dettnews-tfos_dry_eye_workshop_dews_iii_completed/7450_16/eng/

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  • The relationship between grip strength, 6 minute walking distance and working memory in older adults with mild cognitive impairment: an fNIRS study | BMC Geriatrics

    The relationship between grip strength, 6 minute walking distance and working memory in older adults with mild cognitive impairment: an fNIRS study | BMC Geriatrics

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  • Association between the American heart association’s life’s essential 8 score and cognitive function: a cross-sectional NHANES study | BMC Geriatrics

    Association between the American heart association’s life’s essential 8 score and cognitive function: a cross-sectional NHANES study | BMC Geriatrics

    Study population

    This cross-sectional study recruited participants from NHANES 2011–2012 and 2013–2014 (https://www.cdc.gov/nchs/nhanes/index.htm). NHANES is a public health survey program conducted by National Center for Health Statistics (NCHS) in America. The NHANES project recruits participants using a complex, multistage probabilistic sampling design in two-year cycles. NHANES collects information from questionnaires at home, physical and laboratory examinations in mobile examination center (MEC) and telephone interviews. In this study, samples from NHANES 2011–2012 and 2013–2014 were obtained and combined because NHANES project provided the outcome of several cognitive test in these two cycles specifically. There were totally 19,931 participants in these two cycles. Our study implemented a three-stage exclusion protocol: (1) Primary exclusion of 16,530 participants based on age criterion (< 60 years), (2) subsequent removal of 478 cases with incomplete cognitive assessments or missing subjective cognitive questionnaires, followed by (3) elimination of 1,947 individuals lacking essential metrics for LE8 calculation. Finally, we get 976 eligible participants. (Supplement Fig. 5)

    Measurement of LE8 score

    LE8 scoring system is comprised of 8 metrics including 4 behavioral metrics (diet, physical activity frequency and duration, nicotine exposure and sleeping) and 4 biological metrics (blood lipids, blood glucose, blood pressure and BMI score) (Supplement Table 1) [7]. Total LE8 score is the average score of above 8 metrics which range from 0 to 100 with higher score indicate healthier cardiovascular condition. In our study, LE8 score was further classified by quartile into 4 groups named Q1, Q2, Q3 and Q4 with Q1 as reference category.

    Table 1 Baseline characteristic of covariables according to LE8 score quartile

    Of the 8 metrics, diet score was assessed according to Healthy Eating Index 2015 (HEI-2015). NHANES collects dietary data with two 24-hour recalls interviews, one is conducted in person in MEC while the other is on telephone several days later. Researchers are able to calculate the dietary intake of participants by combining 24-hour food intake files from NHANES and food patterns equivalents data from United States Department of Agriculture (USDA) (https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/fped-data-tables/). HEI score includes 13 components of 2 classifications: 9 adequacy components and 4 moderation components. Scoring of dietary components is based on energy density which represents the amount of food components per 1000kcal (Supplement Table 2). Self-report questionnaires from NHANES provides information about physical activity intensity, cigarette smoking behaviors, sleeping duration, diabetes history and medication usage. As for the data of BMI, blood pressure, blood lipid and hemoglobin A1c, blood samples are obtained in MEC and then processed, stored, and transported to laboratories for test. The height and weight used to calculate BMI were measured in the MCE. The full test includes three measurements of both systolic and diastolic blood pressure. When data from all three measurements were available, the average systolic and diastolic blood pressure were calculated. If the full set of three measurements was not available, the average was computed using as many measurements as were available.

    Table 2 Weighted coefficients and confidence interval of LE8 score for cognitive test score

    Measurement of cognitive test score and subjective cognitive performance

    NHANES conducted three widely utilized [11,12,13] cognitive tests for participants aged > 60 years in the cycle of 2011–2012 and 2013–2014. First, the word learning and recall modules from the Consortium to Establish a Registry for Alzheimer’s disease (CERAD test) was conducted to assess immediate and delayed learning ability for new verbal information. The test comprises three sequential learning trials followed by delayed recall. During each trial, participants verbally articulate 10 randomly ordered unrelated words presented sequentially, followed by immediate free recall, with word sequence randomization repeated across trials to minimize order effects. A maximum score of 10 per trial is attainable based on correct item retrieval. Second, the Animal Fluency test (AFT) was performed for assessing the executive function where participants are asked to name as many animals as possible in one minute and one point is given for each named animal. Third, Digit Symbol Substitution test (DSST) was conducted which depend on the rapid processing of information, maintaining attention, and retrieving working memory. Participants are provided with a paper which contains 9 numbers with paired symbols, then they are asked to fulfill 133 boxes nearby the numbers with corresponding symbols as much as possible in 2 min. One point is given for one correct match. In this study, we calculated z-score [(individual test score – mean)/standard deviation] of immediate CERAD test, recall CERAD test, AFT test and DSST test respectively. The total cognitive test score refers to the average of above four z-scores [14]. Higher cognitive test score indicates better cognitive function. Participants who reported “being limited in any way because of difficulty remembering or because experience periods of confusion” were defined as having subjective cognitive performance. Participants were defined as having subjective cognitive performance if the participant answered “yes” to the question: “being limited in any way because of difficulty remembering or because experience periods of confusion”.

    Assessment of other covariables

    We included variables of demographic characteristics and health behaviors that are possibly associated with cognitive function [15], including age (continuous variables), sex (male, female), race (non-Hispanic White, non-Hispanic Black, other Hispanic, other race), education level (college graduate or above, some college or associate degree, high school/GED or less ), the ratio of family income to poverty guideline (< 1.3, 1.3–3.5, > 3.5 ) [16] and alcohol consumption (drinker, non-drinker). Alcohol drinker was defined as those who had at least 12 alcohol drinks a year [17].

    Statistical analysis

    NHANES selected participants with a complex multistage probabilistic sampling design thus all analysis in this study were weighted with provided weight variables: WTDRD1, SDMVPSU and SDMVSTRA. Since we combined the 2011–2012 and 2013–2014 cycle, the weights of the combined study population were calculated as 1/2* WTDRD1 (https://wwwn.cdc.gov/nchs/nhanes/tutorials/module3.aspx).

    Initially, we inspected the characteristic of the study population across four quartiles of LE8 score. After examined the normality of variables’ distribution and the homogeneity of variance, continuous variables were described with mean and standard deviation [mean (SD)] and compare with Wilcoxon rank-sum test while categorized variables were described as the case amount and its percentage [n (%)] and compared with chi-squared test. Afterwards univariable regression (linear regression for cognitive test score, logistic regression for subjective cognitive performance) was conducted to select covariables that were significantly associated with cognitive performance.

    Cognitive performance models

    We constructed three regression models to explore the association between LE8 score and cognitive performance, both as continuous variables and categorized variables. Model 1 wasn’t adjusted. Model 2 was adjusted for age, gender, and race. Model 3 was adjusted for age, gender, race, family income, education, and alcohol consumption. We also applied restricted cubic spline (RCS) models to explore the dose-response relationship in the above three models. The 5th, 35th, 65th, and 95th percentiles of the total LE8 score distribution were chosen as the knots of the RCS curves [18]. The R² (coefficient of determination) metrics were derived from our multivariable linear regression Model3 (Supplement Fig. 6). The P– non-linear value of RCS was obtained using a likelihood ratio test (LRT) to assess whether the higher-order coefficients of RCS curve are significantly different from zero. This test was conducted using the rms package in R.

    Subjective cognitive performance models

    We explored the effect of individual LE8 metrics on cognitive performance in a full-adjusted multivariable regression model. In order to validate the reliability of regression model, Receiver Operating Characteristic (ROC) curves of LE8 (both categorized and continuous) were plotted (Supplement Fig. 6). To assess the predictive capacity of LE8 for subjective cognitive performance, we compared the ROC curves of LE8 in relation to cognitive test scores and subjective cognitive performance. For the ROC analysis, cognitive test score was converted into a binary variable according to the lower quartile.

    Subgroup models

    To identify the subpopulation that benefits most from elevating LE8 score, the study population was stratified by all the variables in Model 3. We then calculated the regression coefficients of LE8 score in different subgroups. P values for interaction were calculated using likelihood ratio tests.

    Cross-validation analysis

    We made stratified ten-fold cross-validation with ten independent repetitions (10 × 10 CV) on both the objective cognitive testing and subjective cognitive assessment datasets. Model performance was quantified using R², providing robust measurement of predictive consistency and variance explicability (Supplement Table 6).

    All statistical tests were two-tailed and conducted with R v. 4.2.1 statistical analysis software. Adobe Illustrator v2023 was used for figure preparation. P < 0.05 was considered statistically significant.

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  • Preventing obesity with an immune-altering gut microbe

    Preventing obesity with an immune-altering gut microbe

    The gut bacteria has potential to become a probiotic or postbiotic to treat obesity and metabolic diseases.

    Credit: iStock.com/Artur Plawgo

    The understudied human gut bacteria P. faecium  counteracted weight gain in mice by reducing inflammation, revealing a potential new way to treat obesity.

    The human gut serves as an intersection point for many processes — digesting food, absorbing nutrients, supporting immunity, and regulating metabolism — that all interact with a vital and dynamic ecosystem: the gut microbiome. 

    What the body absorbs depends on how the intestines — and the microbes living there — break down food, said Nicola Segata, a computational microbiologist at the University of Trento. “There is a clear link between our diet and the composition of our gut microbiome,” he said. 

    Yolanda Sanz first became interested in P. faecium after finding that this bacterium was increased in children with normal weight gain.

    Credit: Yolanda Sanz

    Researchers have found that changes in the gut microbiome are associated with increased risk of obesity. However, “what is still unclear is which are the main biomarkers or microbiome signatures that consistently are linked with obesity,” said Yolanda Sanz, a microbiologist at the Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC).

    In a study published in 2018, Sanz and her colleagues noticed that children who went on to experience excessive weight gain in a four-year period had different microbiomes prior to their weight gain than children who gained a normal amount of weight (1). During this longitudinal study, they found that the bacterial species Phascolarctobacterium faecium  was enriched in children with normal weight gains compared to those who gained excessive weight. This microbe “has long been known to be a regular commensal or inhabitant of our gut microbiome, but we didn’t know much about its role, its function, [or] its significance in our gut,” said Ravinder Nagpal, a microbiologist at Florida State University.

    To dig deeper into the role of this bacterium in obesity, Sanz, Segata, and their labs turned to 7,529 human metagenomic samples to document what microbes are present in the gut of people with and without obesity (2). In a new study, they reported that P. faecium  is associated with non-obesity and that it acted via an innate immune pathway to counteract metabolic changes associated with obesity (3). This microbe could provide a new path to treating obesity.

    To determine this bacterial species’ potential role in obesity, the researchers fed mice a high fat and sugar diet, while giving control mice a low fat and sugar diet. Without intervention, mice on the high-fat, high-sugar diet gained more weight than control mice. However, when the researchers treated these mice with P. faecium, it limited the mice’s weight and body fat increases and improved glucose clearance.

    Mice on the high-fat, high-sugar diet exhibited an increased amount of pro-inflammatory macrophages in the intestines and had higher levels of intestinal type 1 innate lymphoid cells, which are cells involved in many inflammatory disorders (4). The addition of P. faecium  mitigated these changes by boosting the levels of anti-inflammatory macrophages called M2 macrophages and reducing the increase in type 1 innate lymphoid cells. When the team used a small molecule inhibitor to block macrophages from adopting the M2 phenotype, P. faecium’s positive effects disappeared. These results demonstrate that P. faecium’s anti-obesogenic effect occurs by modulating the immune system.

    In the future, it’s possible that P. faecium  could be developed as a probiotic, said Nagpal, who was not associated with the study. He added that in the mouse model, the microbe “effectively showed promise as a therapeutic or preventative.”

    A group of laboratory researchers stand outside on the grass.

    Yolanda Sanz’s research group studies the role of the microbiome in nutrition and health.

    Credit: Yolanda Sanz

    Beyond probiotics, there’s also potential for this bacterium to act as a postbiotic, which are components released from living or dead microorganisms that have health benefits. The researchers found that both living and pasteurized P. faecium  reduced the pro-inflammatory immune response associated with an obesogenic diet. Sanz explained that they still see this effect for pasteurized bacteria possibly because the immune system could be responding to a structural component of P. faecium’s cell wall. Previous work from another team found that the gut commensal Akkermansia muciniphila  had an effect on metabolism and obesity whether it was alive or not (5). In particular, since P. faecium  is anaerobic, Sanz added that it would be easier to develop it as a postbiotic rather than a probiotic as keeping the bacteria alive during manufacturing is challenging due to oxygen exposure.

    Since the bacteria reduce inflammation, Sanz added that P. faecium  has potential applications beyond metabolic disorders and in other conditions where inflammation has a role.

    “The results are quite promising,” said Sanz. “We hope that, in the end, we can progress towards performing clinical trials and getting evidence from humans.”

    References

    1. Rampelli, S. et al.  Pre-obese children’s dysbiotic gut microbiome and unhealthy diets may predict the development of obesity. Commun Biol  1, 222 (2018).
    2. Pasolli, E. et al.  Accessible, curated metagenomic data through ExperimentHub. Nat Methods  14, 1023–1024 (2017).
    3. Liébana-García, R. et al.  Gut commensal Phascolarctobacterium faecium retunes innate immunity to mitigate obesity and metabolic disease in mice. Nat Microbiol  10, 1310-1322 (2025).
    4. Ebbo, M. et al.  Innate lymphoid cells: major players in inflammatory diseases. Nat Rev Immunol  17, 665–678 (2017).
    5. Plovier, H. et al.  A purified membrane protein from Akkermansia muciniphila or the pasteurized bacterium improves metabolism in obese and diabetic mice. Nat Med  23, 107–113 (2017).

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  • Neurosurgeon explains how ‘brain health is pretty easy to achieve’, reveals foods to eat: Dark chocolate, fish, broccoli | Health

    Neurosurgeon explains how ‘brain health is pretty easy to achieve’, reveals foods to eat: Dark chocolate, fish, broccoli | Health

    Take it from a brain surgeon, brain health is one of the most important things to living a quality life: US-based neurosurgeon Dr Brian Hoeflinger said in a March 23 Instagram post. According to him, food plays a significant role in supporting brain health. In the video he shared, Dr Hoeflinger explained ‘how to maintain a healthy brain’, highlighting some amazing brain-boosting foods. Also read | Want to keep your brain sharp? Add these 6 foods to your diet and know their benefits

    Food plays a significant role in supporting brain health. A balanced diet rich in nutrients can help improve cognitive function, boost memory, and reduce the risk of age-related cognitive decline. (Freepik)

    What’s the secret to achieving a healthy brain?

    According to him, incorporating these foods into your diet can have a positive impact on brain health and overall well-being. From fish that are rich in omega-3 fatty acids, and support brain health and cognitive function, to green vegetables that are packed with vitamins and antioxidants that support cognitive function and may reduce age-related cognitive decline, here’s what Dr Hoeflinger suggested.

    He said, “Brain health is super important and is pretty easy to achieve by knowing this: it starts with food. There are fatty fish, including salmon and tuna. There are also green leafy vegetables, like kale, spinach, and broccoli, and berries like strawberries, raspberries, and blueberries. Then there are nuts and seeds like almonds and walnuts, flaxseeds and chia seeds, eggs, and avocados.”

    A little bit of dark chocolate is good for your brain

    He said that even healthy oils are good, and added that green tea, which contains antioxidants and L-theanine, and may improve focus and reduce stress, as well as dark chocolate, which contains flavonoids, and may improve blood flow and boost cognitive function, are an important part of a brain health-friendly diet.

    Dr Hoeflinger said, “Green tea is healthy for your brain, and lastly, a little bit of dark chocolate can be very beneficial for your brain. The foods you eat are just one aspect of keeping a healthy brain. There are so many other things that you can do.”

    Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

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  • Study reveals best way to link alcohol to breast cancer

    Study reveals best way to link alcohol to breast cancer

    The research, undertaken by Oxford Brookes University which has a campus in Swindon, and funded by the charity Prevent Breast Cancer, focused on women aged 40 to 65 in the UK.

    It found that many women in this group were unaware of the connection between alcohol consumption and breast cancer.

    The study, titled ‘Rethinking the message on alcohol and breast cancer with UK women: a Delphi study’, was published in the journal Health Promotion International.

    It involved a three-stage process, which began with a survey of 260 women, followed by seven online focus groups and a collaborative workshop.

    The study’s lead author, Dr Emma Davies, said: “We often think of alcohol as causing liver disease, but there’s plenty of research showing that drinking alcohol can lead to seven types of cancer, including breast cancer.

    “Evidence shows that people who are aware of the link between alcohol and cancer are more supportive of stronger and more effective alcohol policy.

    “This means that raising awareness isn’t just about individual behaviour change, it is about changing how we think about alcohol at all levels of society.”

    The study found that several factors, including cultural norms, mistrust of official messaging, psychological defence mechanisms, and stigma, reduced the effectiveness of health warnings.

    Fear-based messaging was also found to be counterproductive, as it often led to denial rather than proactive change.

    Dr Davies said: “It’s clear that fear, blame and shame don’t work when it comes to raising awareness of the risks associated with drinking alcohol.

    “Cutting back on alcohol can help to reduce the chance of getting cancer, but can also give us plenty of other benefits, such as better sleep and improved mood.”

    The study concluded that narrative-based framing, using personal stories from peers who have experienced breast cancer, was more effective than stark statistics or scare tactics.

    Messages were most accepted when framed positively, highlighting how reducing drinking can empower women and protect their health, rather than through guilt or blame.

    Dr Davies added: “Importantly, we need a clear and evidence-based alcohol policy to reduce risks across the population.

    “We need to understand why people drink and what the emotional and cultural barriers are to giving up or cutting down.

    “We hope our study will equip policymakers, charities, clinicians, and health communicators with an evidence-based roadmap to reshape prevention campaigns and reduce alcohol-related harms, including breast cancer and other cancer cases.”

    For more information and advice on alcohol and cancer, visit the World Cancer Research Fund’s Cancer Prevention Action Week page.


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  • Mpox epidemic is straining African health systems after US aid cuts – Financial Times

    Mpox epidemic is straining African health systems after US aid cuts – Financial Times

    1. Mpox epidemic is straining African health systems after US aid cuts  Financial Times
    2. Multi-country outbreak of mpox, External situation report #54 – 27 June 2025  World Health Organization (WHO)
    3. AHF Urges Vaccine Equity as Mpox Cases Surge in Sierra Leone  AIDS Healthcare Foundation
    4. Health officials encouraged by recent trends in Africa’s mpox outbreaks  CIDRAP
    5. Mpox Surge in Sierra Leone: A Stress Test for National Readiness  Think Global Health

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  • AIIMS gut doctor reveals 5 science backed changes that happen when you quit sugar for 30 days: Liver fat starts to drop | Health

    AIIMS gut doctor reveals 5 science backed changes that happen when you quit sugar for 30 days: Liver fat starts to drop | Health

    Sugar is a bittersweet addition to your diet. While the instant gratification you have after consuming a sugary treat feels like heaven, the harms of it are well-known. According to Harvard Health, while consuming small amounts and occasionally is not harmful, problems occur when you consume too much added sugar, that is, sugar that food manufacturers add to products to increase flavour or extend shelf life.

    When you quit sugar for one month, there are noticeable health changes. (Shutterstock)

    Also Read | Doctor says sedentary living leads to obesity, weaker bones, cancer risk; shares how to be more active: Walk after lunch

    But, what if you were to quit sugar for a month? What would happen inside your body? According to Dr Saurabh Sethi, a gastroenterologist trained at AIIMS, Harvard and Stanford universities, there will be health changes that would lead to some very noticeable lowered disease risks.

    What happens when you quit sugar for 30 days?

    In an Instagram post shared on July 1, Dr Sethi revealed the changes your body goes through when you quit sugar for 30 days. He listed 5 health benefits based on science and explained how the change occurs. He wrote, “No fluff. No noise. Just what works. What happens when you quit sugar for one month? As a GI doctor, here is what’s backed by science.”

    1. Changes in the liver

    According to Dr Sethi, when you stop consuming sugar for 30 days, your liver fat starts to drop, helping heal fatty liver.

    2. Kidney function improves

    The gastroenterologist stressed that after quitting sugar, your kidney function improves, especially if you are insulin resistant or pre-diabetic.

    3. Lower inflammation risks

    Additionally, he pointed out that the inflammation in your arteries goes down, which can benefit your heart health.

    4. Brain fog reduces

    If you are someone who deals with brain fog, quitting sugar might help you. “You may notice clearer thinking and better focus,” Dr Sethi pointed out.

    5. Immunity booster

    Lastly, quitting sugar consumption for 30 days will help your immune system get stronger because sugar weakens white blood cells, and you will retain more key minerals like magnesium, calcium, and zinc.

    Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

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  • New brain scan tool predicts aging speed and dementia risk

    New brain scan tool predicts aging speed and dementia risk

    Any high school reunion is a sharp reminder that some people age more gracefully than others. Some enter their older years still physically spry and mentally sharp. Others start feeling frail or forgetful much earlier in life than expected.

    The way we age as we get older is quite distinct from how many times we’ve traveled around the sun.”


    Ahmad Hariri, professor of psychology and neuroscience at Duke University

    Now, scientists at Duke, Harvard and the University of Otago in New Zealand have developed a freely available tool that can tell how fast someone is aging, and while they’re still reasonably healthy — by looking at a snapshot of their brain.

    From a single MRI brain scan, the tool can estimate your risk in midlife for chronic diseases that typically emerge decades later. That information could help motivate lifestyle and dietary changes that improve health.

    In older people, the tool can predict whether someone will develop dementia or other age-related diseases years before symptoms appear, when they might have a better shot at slowing the course of disease.

    “What’s really cool about this is that we’ve captured how fast people are aging using data collected in midlife,” Hariri said. “And it’s helping us predict diagnosis of dementia among people who are much older.”

    The results were published July 1 in the journal Nature Aging.

    Finding ways to slow age-related decline is key to helping people live healthier, longer lives. But first “we need to figure out how we can monitor aging in an accurate way,” Hariri said.

    Several algorithms have been developed to measure how well a person is aging. But most of these “aging clocks” rely on data collected from people of different ages at a single point in time, rather than following the same individuals as they grow older, Hariri said.

    “Things that look like faster aging may simply be because of differences in exposure” to things such as leaded gasoline or cigarette smoke that are specific to their generation, Hariri said.

    The challenge, he added, is to come up with a measure of how fast the process is unfolding that isn’t confounded by environmental or historical factors unrelated to aging.

    To do that, the researchers drew on data gathered from some 1,037 people who have been studied since birth as part of the Dunedin Study, named after the New Zealand city where they were born between 1972 and 1973.

    Every few years, Dunedin Study researchers looked for changes in the participants’ blood pressure, body mass index, glucose and cholesterol levels, lung and kidney function and other measures — even gum recession and tooth decay.

    They used the overall pattern of change across these health markers over nearly 20 years to generate a score for how fast each person was aging.

    The new tool, named DunedinPACNI, was trained to estimate this rate of aging score using only information from a single brain MRI scan that was collected from 860 Dunedin Study participants when they were 45 years old.

    Next the researchers used it to analyze brain scans in other datasets from people in the U.K., the U.S., Canada and Latin America.

    Faster aging and higher dementia risk

    Across data sets, they found that people who were aging faster by this measure performed worse on cognitive tests and showed faster shrinkage in the hippocampus, a brain region crucial for memory.

    More soberingly, they were also more likely to experience cognitive decline in later years.

    In one analysis, the researchers examined brain scans from 624 individuals ranging in age from 52 to 89 from a North American study of risk for Alzheimer’s disease.

    Those who the tool deemed to be aging the fastest when they joined the study were 60% more likely to develop dementia in the years that followed. They also started to have memory and thinking problems sooner than those who were aging slower.

    When the team first saw the results, “our jaws just dropped to the floor,” Hariri said.

    Links between body and brain

    The researchers also found that people whose DunedinPACNI scores indicated they were aging faster were more likely to suffer declining health overall, not just in their brain function.

    People with faster aging scores were more frail and more likely to experience age-related health problems such as heart attacks, lung disease or strokes.

    The fastest agers were 18% more likely to be diagnosed with a chronic disease within the next several years compared with people with average aging rates.

    Even more alarming, they were also 40% more likely to die within that timeframe than those who were aging more slowly, the researchers found.

    “The link between aging of the brain and body are pretty compelling,” Hariri said.

    The correlations between aging speed and dementia were just as strong in other demographic and socioeconomic groups than the ones the model was trained on, including a sample of people from Latin America, as well as United Kingdom participants who were low-income or non-White.

    “It seems to be capturing something that is reflected in all brains,” Hariri said.

    The work is important because people worldwide are living longer. In the coming decades, the number of people over age 65 is expected to double, reaching nearly one fourth of the world’s population by 2050.

    “But because we live longer lives, more people are unfortunately going to experience chronic age-related diseases, including dementia,” Hariri said.

    Dementia’s economic burden is already huge. Research suggests that the global cost of Alzheimer’s care, for example, will grow from $1.33 trillion in 2020 to $9.12 trillion in 2050 — comparable or greater than the costs of diseases like lung disease or diabetes that affect more people.

    Effective treatments for Alzheimer’s have proven elusive. Most approved drugs can help manage symptoms but fail to stop or reverse the disease.

    One possible explanation for why drugs haven’t worked so far is they were started too late, when the Alzheimer’s proteins that build up in and around nerve cells have already done too much damage.

    “Drugs can’t resurrect a dying brain,” Hariri said.

    But in the future, the new tool could make it possible to identify people who may be on the way to Alzheimer’s sooner, and evaluate interventions to stop it — before brain damage becomes extensive, and without waiting decades for follow-up.

    In addition to predicting our risk of dementia over time, the new clock will also help scientists better understand why people with certain risk factors, such as poor sleep or mental health conditions, age differently, said first author Ethan Whitman, who is working toward a Ph.D. in clinical psychology with Hariri and study co-authors Terrie Moffitt and Avshalom Caspi, also professors of psychology and neuroscience at Duke.

    More research is needed to advance DunedinPACNI from a research tool to something that has practical applications in healthcare, Whitman added.

    But in the meantime, the team hopes the tool will help researchers with access to brain MRI data measure aging rates in ways that aging clocks based on other biomarkers, such as blood tests, can’t.

    “We really think of it as hopefully being a key new tool in forecasting and predicting risk for diseases, especially Alzheimer’s and related dementias, and also perhaps gaining a better foothold on progression of disease,” Hariri said.

    The authors have filed a patent application for the work. This research was supported by the U.S. National Institute on Aging (R01AG049789, R01AG032282, R01AG073207), the UK Medical Research Council (MR/X021149/1), and the New Zealand Health Research Council (Programme Grant 16-604).

    Source:

    Journal reference:

    Whitman, E. T., et al. (2025). DunedinPACNI estimates the longitudinal Pace of Aging from a single brain image to track health and disease. Nature Aging. doi.org/10.1038/s43587-025-00897-z.

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