Tag: health

bookmark_borderHealth And Air Quality

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by Daniel Brouse

Q: What causes the most illness in the United States?
A: Bad air quality

The leading causes of bad air quality are Particulate Matter, Ground Level Ozone, Sulfur Dioxide (SO2) and Nitrogen Oxide (NOx).

Asthma is a chronic lung disease that affects an estimated 16.4 million adults and 7.0 million children in the United States, regardless of age, sex, race, or ethnicity.(1) Although the exact cause of asthma is unknown and it
cannot be cured, bad air quality is believed to be the main cause. In particular, low level ozone is causing an increase in asthma-like symptoms.(2) What many people believe are food allergies are just symptoms of respiratory and immune system damage caused by ozone.

Low level ozone (tropospheric ozone) is highly volatile and is created in large part due to vehicle emissions. “Ground level ozone is a serious problem in cities with lots of traffic, such as Los Angeles, Philadelphia, Houston and New York City. In 2013, according to the American Lung Association, nearly four in 10 people in the United States (38 percent) lived in areas with unhealthful levels of ozone.” (3) The use of ethanol in gasoline is causing a dramatic increase in low level ozone.(4)

The EPA monitors ozone levels and issues action alert days. “Action days are usually called when the AQI gets into the unhealthy ranges. Different air pollution control agencies call them at different levels. In some places, action days are called when the AQI is forecast to be Unhealthy for Sensitive Groups, or Code Orange. In this case, the groups that are sensitive to the pollutant should reduce exposure by reducing prolonged or heavy exertion outdoors. For ozone this includes: children and adults who are active outdoors, and people with lung disease, such as asthma. For particle pollution this includes: people with heart or lung disease, older adults and children.”(5)

“When ozone levels are very high, everyone should be concerned about ozone exposure.”(6)

1. Centers for Disease Control and Prevention (2008)
2. “Although the data are inconsistent, some epidemiological studies suggest that long-term exposure to ozone could play a role in the development of asthma.” — EPA (2015)
3. National Resources Defense Counsel (2014)
4. Gasoline Plus Ethanol Equals Bad Ozone — The Membrane Domain (2009)
5. AirNow — EPA (2015)
6. Are you at risk from ground-level ozone? — EPA (2009)

bookmark_borderMusic Can Ease the Pain

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ENGLAND — The BBC reports: Researchers at Queen Mary University of London said the patients who had listened to music had been less anxious after their surgery and had needed less pain relief.

The Department of Health said doctors should consider the findings. The scientists want hospitals to suggest in NHS information leaflets that patients bring music devices and playlists into hospital with them.

The team reviewed 70 trials, involving about 7,000 patients around the time of surgery, comparing a wide variety of mostly “soothing” music with:

* undisturbed bed rest
* headphones with no music
* white noise
* routine care

The lead author, Dr Catherine Meads, said Pink Floyd’s Dark Side of the Moon album had helped soothe her pain three hours after hip surgery in April.

Music was a safe, cheap and non-invasive option that should “be available to everyone having surgery”, she said.

“Currently music is not used routinely during surgery to help patients in their post-operative recovery.

“The lack of uptake is often down to the scepticism of professionals as to whether it genuinely works, and of course issues of budget and the integration into daily practice.”

Dr Meads added “it was quite a surprise” music had worked under general anaesthetic.

In another study, Prof. Levitin said, “We’ve found compelling evidence that musical interventions can play a health care role in settings ranging from operating rooms to family clinics. But even more importantly, we were able to document the neurochemical mechanisms by which music has an effect in four domains: management of mood, stress, immunity and as an aid to social bonding.”

Playing a musical instrument, singing and dancing provide even greater health benefits.

bookmark_borderEPA: Climate Change Report

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WASHINGTON –The U.S. Environmental Protection Agency (EPA) today released one of the most comprehensive analyses to date on the economic, health and environmental benefits to the United States of global climate action. The peer-reviewed report, “Climate Change in the United States: Benefits of Global Action,” examines how future impacts and damages of climate change across a number of sectors in the United States can be avoided or reduced with global action. The report compares two future scenarios: a future with significant global action on climate change, where global warming has been limited to 2 degrees Celsius (3.6 degrees Fahrenheit), and a future with no action on climate change (where global temperatures rise 9 degrees Fahrenheit). The report then quantifies the differences in health, infrastructure and ecosystem impacts under the two scenarios, producing estimates of the costs of inaction and the benefits of reducing global GHG emissions.

“Will the United States benefit from climate action? Absolutely. This report shows us how costly inaction will be to Americans’ health, our environment and our society. But more importantly, it helps us understand the magnitude of benefits to a number of sectors of the U.S. with global climate action,” said EPA Administrator Gina McCarthy. “We can save tens of thousands of American lives, and hundreds of billions of dollars, annually in the United States by the end of this century, but the sooner we act, the better off America and future generations of Americans will be.”

The report examines how the impacts and damages of climate change across a number of sectors in the United States can be avoided with global action. The findings include:

• Global action on climate change reduces the frequency of extreme weather events and associated impacts. For example, by 2100 global action on climate change is projected to avoid an estimated 12,000 deaths annually associated with extreme temperatures in 49 U.S. cities, compared to a future with no reductions in greenhouse gas emissions. This is more than a 90 percent reduction from what we would expect with no action.

• Global action now leads to greater benefits over time. The decisions we make today will have long-term effects, and future generations will either benefit from, or be burdened by, our current actions. Compared to a future with unchecked climate change, climate action is projected to avoid approximately 13,000 deaths in 2050 and 57,000 deaths annually in 2100 from poor air quality. Delaying action on emissions reductions will likely reduce these and other benefits.

• Global action on climate change avoids costly damages in the United States. For nearly all of the 20 sectors studied, global action on climate change significantly reduces the economic damages of climate change. For example, without climate action, we estimated up to $10 billion in increased road maintenance costs each year by the end of the century. With action, we can avoid up to $7 billion of these damages.

• Climate change impacts are not equally distributed. Some regions of the United States are more vulnerable than others and will bear greater impacts. For example, without action on climate change, California is projected to face increasing risk of drought, the Rocky Mountain region will see significant increases in wildfires, and the mid-Atlantic and Southeast are projected to experience infrastructure damage from extreme temperatures, heavy rainfall, sea level rise, and storm surge.

• Adaptation can reduce damages and costs. For some sectors, adaptation can substantially reduce the impacts of climate change. For example, in a future without greenhouse gas reductions, estimated damages from sea-level rise and storm surge to coastal property in the lower 48 states are $5.0 trillion dollars through 2100. With adaptation along the coast, the estimated damages and adaptation costs are reduced to $810 billion.

The report is a product of the Climate Change Impacts and Risks Analysis (CIRA) project, led by EPA in collaboration with the Massachusetts Institute of Technology, the Pacific Northwest National Lab, the National Renewable Energy Laboratory, and other partners. The CIRA project is one of the first efforts to quantify the benefits of global action on climate change across a large number of U.S. sectors using a common analytic framework and consistent underlying data inputs. The project spans 20 U.S. sectors related to health, infrastructure, electricity, water resources, agriculture and forestry, and ecosystems.

bookmark_borderIs Opposition To GMO Crops Irrational?

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By Daniel Brouse

There is evidence of genetically modified crops for over 8,000 years. There is no evidence of harm from eating GM foods. The Bible compares the grafting of an olive branch to a human being grafted to God. Romans 11:17 — “But some of these branches from Abraham’s tree — some of the people of Israel — have been broken off. And you Gentiles, who were branches from a wild olive tree, have been grafted in. So now you also receive the blessing God has promised Abraham and his children, sharing in the rich nourishment from the root of God’s special olive tree.”

The BBC program “The Inquiry” asks:

“Ask a scientist, and they will almost certainly tell you genetically modified food is safe to eat. Yet an awful lot of consumers disagree. Is their fear of GM food irrational? Earlier this year the Pew Foundation released a US poll which suggested 88% of scientists think GM food is generally safe to eat, while only 37% of the public agree. It is the issue on which American scientists and the general public are most divided, more so than climate change or vaccines. If the scientific consensus says it is safe, should we embrace a technology that could help solve hunger and feed the world? Or is GM food a lightning rod for justified concerns about the impact of global agribusiness and industrial food production?”

Listen to the report.

The BBC report mentions flood-tolerant rice. The Ronald Laboratories of UC Davis state:

“Each year millions of small farmers in the poorest areas of the world lose their entire crops to flooding. Although 24% of the global rice crop is grown in paddies, most rice varieties will die if fully submerged for more than three days. In India and Bangladesh alone, submergence destroys 4 million tons of rice each year, enough to feed 30 million people.

About 50 years ago, breeders discovered an unusual and ancient variety of rice that could withstand 2 weeks of complete submergence. Using conventional approaches, breeders tried to introduce this submergence tolerance trait into rice varieties favored by farmers in India and Bangladesh. However, because the breeding was imprecise, the resulting varieties were rejected by farmers. In the 1990s, rice breeder David Mackill (University of California, Davis) and graduate student Kenong Xu (University of California, Davis) demonstrated that tolerance to complete submergence mapped to the Submergence tolerance 1 (Sub1) Quantitative trait locus (QTL)

In 1996, Ronald began a project with Mackill and Xu, funded by the USDA, to isolate the genes at the Sub1 locus. Over a period of 10 years, Dr. Xu carried out fine mapping and physical isolation of the Sub1 gene in the Mackill and Ronald laboratories at the University of California, Davis (Xu. et. al., 2000). While working as a postdoctoral fellow in Ronald’s laboratory, Xu identified and sequenced the Sub1 QTL genomic region, revealed that it carried three ethylene response transcription factors (ERF) and demonstrated that one of the ERFs, designated Sub1A, was up-regulated rapidly in response to submergence. Xu and Ronald further demonstrated that overexpression of Sub1A conferred robust tolerance to submergence in genetically engineered plants ( Xu. et. al., 2006). This work revealed an important mechanism with which plants control tolerance to environmental stress and set the stage for in-depth molecular-genetic analyses of Sub1A-mediated processes”

Also see: GMO Rice Wins Humanitarian Award

bookmark_borderThe Problem with Roundup Weed Killer

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IARC, the France-based cancer research arm of the World Health Organization, has issued a report finding that Roundup is a probable carcinogen. Though, Monsanto continues to defend the chemical.

“We question the quality of the assessment,” Philip Miller, Monsanto vice president of global regulatory affairs, said. “The WHO has something to explain.”

Glyphosate is the main ingredient in Roundup.

bookmark_borderWhy Do Vegaterians Seem Brain Damaged?

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By Daniel Brouse

“Vegans eat only food of plant origin. Because animal products are the only food sources of vitamin B12, vegans must supplement their diets with a source of this vitamin.” — USDA

Lack of B12 and amino acids results in neurological disorders. (eg Brain Damage)

“Also, the vegan diet is a poor choice for growing children. The process of neurodevelopment requires many things. One of those things is cholesterol. It is involved in the myelin sheath. As adults, we make as much, or even more than we need. As children are actively growing myelin, they need more than they can produce. For those infants still nursing, they get it from Mom. Once weened, they need a source for cholesterol. There is no vegetable source of cholesterol. Denying animal-based foods will have a significantly detrimental impact on a growing child’s neurodevelopment,” added Seth Glass.

More from Humans Are Omnivores

bookmark_borderAntimicrobial Resistance — a Serious Threat to Health

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WHO’s first global report on antibiotic resistance reveals serious, worldwide threat to public health

New WHO report provides the most comprehensive picture of antibiotic resistance to date, with data from 114 countries

 

A new report by the World Health Organization (WHO) –its first to look at antimicrobial resistance, including antibiotic resistance, globally–reveals that this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance–when bacteria change so antibiotics no longer work in people who need them to treat infections–is now a major threat to public health.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security. “Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”

Key findings of the report

The report, “Antimicrobial resistance: global report on surveillance”, notes that resistance is occurring across many different infectious agents but the report focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea. The results are cause for high concern, documenting resistance to antibiotics, especially “last resort” antibiotics, in all regions of the world.

Key findings from the report include:

  • Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, Klebsiella pneumoniae–carbapenem antibiotics–has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.
  • Resistance to one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E. coli–fluoroquinolones–is very widespread. In the 1980s, when these drugs were first introduced, resistance was virtually zero. Today, there are countries in many parts of the world where this treatment is now ineffective in more than half of patients.
  • Treatment failure to the last resort of treatment for gonorrhoea–third generation cephalosporins–has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. More than 1 million people are infected with gonorrhoea around the world every day.
  • Antibiotic resistance causes people to be sick for longer and increases the risk of death. For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection. Resistance also increases the cost of health care with lengthier stays in hospital and more intensive care required.

Ways to fight antibiotic resistance

The report reveals that key tools to tackle antibiotic resistance–such as basic systems to track and monitor the problem–show gaps or do not exist in many countries. While some countries have taken important steps in addressing the problem, every country and individual needs to do more.

Other important actions include preventing infections from happening in the first place–through better hygiene, access to clean water, infection control in health-care facilities, and vaccination–to reduce the need for antibiotics. WHO is also calling attention to the need to develop new diagnostics, antibiotics and other tools to allow healthcare professionals to stay ahead of emerging resistance.

This report is kick-starting a global effort led by WHO to address drug resistance. This will involve the development of tools and standards and improved collaboration around the world to track drug resistance, measure its health and economic impacts, and design targeted solutions.

How to tackle resistance

People can help tackle resistance by:

  • using antibiotics only when prescribed by a doctor;
  • completing the full prescription, even if they feel better;
  • never sharing antibiotics with others or using leftover prescriptions.

Health workers and pharmacists can help tackle resistance by:

  • enhancing infection prevention and control;
  • only prescribing and dispensing antibiotics when they are truly needed;
  • prescribing and dispensing the right antibiotic(s) to treat the illness.

Policymakers can help tackle resistance by:

  • strengthening resistance tracking and laboratory capacity;
  • regulating and promoting appropriate use of medicines.

Policymakers and industry can help tackle resistance by:

  • fostering innovation and research and development of new tools;
  • promoting cooperation and information sharing among all stakeholders.

The report–which also includes information on resistance to medicines for treating other infections such as HIV, malaria, tuberculosis and influenza–provides the most comprehensive picture of drug resistance to date, incorporating data from 114 countries.

bookmark_borderVegetarians Are Less Healthy

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A new study had concluded that vegetarians are less healthy than omnivores:

Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study

Nathalie T. Burkert*, Johanna Muckenhuber, Franziska Großschadl, Eva Rasky, Wolfgang Freidl

Institute of Social Medicine and Epidemiology, Medical University Graz, Graz, Austria

Abstract

Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES). After matching, the total number of subjects included in the analysis was 1320 (N = 330 for each form of diet – vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat). Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk), health care (medical treatment, vaccinations, preventive check-ups), and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors.

Citation: Burkert NT, Muckenhuber J, Großschadl¨ F, Rasky´ ´
E, Freidl W (2014) Nutrition and Health – The Association between Eating Behavior and Various Health
Parameters: A Matched Sample Study. PLoS ONE 9(2): e88278. doi:10.1371/journal.pone.0088278

Editor: Olga Y. Gorlova, Geisel School of Medicine at Dartmouth College, United States of America

Received May 17, 2013; Accepted January 9, 2014; Published February 7, 2014

Copyright: 2014 Burkert et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors have no support or funding to report.

Competing Interests: The authors have declared that no competing interests exist. * E-mail: nathalie.burkert@medunigraz.at

Introduction

Our diet has an impact on our well-being and on our health. Studies have shown a vegetarian diet to be associated with a lower incidence of hypertension, cholesterol problems, some chronic degenerative diseases, coronary artery disease, type II diabetes, gallstones, stroke, and certain cancers [1–7]. A vegetarian diet is characterized by a low consumption of saturated fat and cholesterol, due to a higher intake of fruits, vegetables and whole-grain products [3,4,8]. Overall, vegetarians have a lower body mass index [1,4,5,7,9–12], a higher socioeconomic status [13], and better health behavior, i.e. they are more physically active, drink less alcohol, and smoke less [9,13,14]. On the other hand, the mental health effects of a vegetarian diet or a Mediterranean diet rich in fruits, vegetables, whole-grain products and fish are divergent [9,15]. For example, Michalak et al. [16] report that a vegetarian diet is associated with an elevated prevalence of mental disorders. A poor meat intake has been shown to be associated with lower mortality rates and higher life expectancy [17], and a diet which allows small amounts of red meat, fish and dairy products seems to be associated with a reduced risk of coronary heart disease as well as type 2 diabetes [18]. Additionally, evidence concerning lower rates of cancer,

colon diseases including colon cancer, abdominal complaints, and all-cause mortality is, however, inconsistent [5–7,19–22].

Not only is the intake of certain nutrients, like red meat, associated with an increased health risk [18,23–26],high-caloric intake also plays a crucial role [23,27]. Moreover, there seems to be proof that lifestyle factors like physical activity may be more crucial in lowering disease rates than individual dietary habits [20,28–29]. While, generally speaking, diets based on plants, like vegetarian diets, seem to be associated with a certain health benefit, a lower risk to contract certain chronic diseases [30], and the ability to improve health [31–32], restrictive and monotonous vegetarian diets include the risk of nutritional deficits [2,18,19,30,33]. Baines et al. [9] report that vegetarians take more medication than non-vegetarians.

To summarize, a number of studies have shown vegetarian diets and diets with poor meat intake to be associated with lower mortality rates for certain diseases. Research about the dietary habits in Austria is, however, rather sparse and mainly focused on genetic factors [33–36]. Therefore, the aim of this study was to investigate health differences between different dietary habit groups among Austrian adults.

Methods

Study Design and Study Population

The sample for this cross-sectional study was taken from the Austrian Health Interview Survey (AT-HIS) which ran from March 2006 to February 2007 [37]. The AT-HIS is a standardized survey which is conducted at regular intervals in Austria (currently every eight years). The subjects included in the survey form a representative sample of the Austrian population. They were chosen from the central population register and are distributed across the different geographic regions of Austria. The AT-HIS is part of the European Health Interview Survey (E-HIS; http://www.euhsid.org), an important high-quality survey. The interviews were conducted by free-lancers engaged by the Austrian Statistic Agency. To ensure that all interviews were conducted in the same way, interviewers had to participate in a training day where they were instructed on how to conduct the survey. Time measurement, non-response analyses, and analyses of error dialogs were performed in order to ensure consistency between interview- ers. Additionally, all interviewers were supervised by field supervisors. Overall, 15474 individuals, aged 15 years and older, were questioned in computer-assisted personal interviews (CAPI; 54.7% female; response rate: 63.1%).

While 0.2% of the interviewees were pure vegetarians (57.7% female), 0.8% reported to be vegetarians consuming milk and eggs (77.3% female), and 1.2% to be vegetarians consuming fish and/ or eggs and milk (76.7% female). 23.6% reported to combine a carnivorous diet with lots of fruits and vegetables (67.2% female), 48.5% to eat a carnivorous diet less rich in meat (60.8% female), and 25.7% a carnivorous diet rich in meat (30.1% female). Since the three vegetarian diet groups included a rather small number of persons (N = 343), they were analyzed as one dietary habit group. Moreover, since the vegetarian group was the smallest, we decided to match each of the vegetarians (1) with an individual of each other dietary habit group (carnivorous diet rich in fruits and vegetables (2), carnivorous diet less rich in meat (3) and a carnivorous rich in meat (4)).

Matching Process

In a first step, subjects consuming a vegetarian diet were identified (N = 343). All vegetarians were categorized according to their sex, age (in age-groups spanning 5 years, e.g. 20- to 24-year- olds), and socioeconomic status (SES). Each such vegetarian was then matched with one subject consuming a carnivorous diet rich in fruits and vegetables, one individual eating a carnivorous diet less rich in meat, and one subject consuming a carnivorous diet rich in meat. Only 96.2% of the vegetarians were included in the analyses, since not all of them corresponded to a subject of the same sex, age, and SES from a different dietary habit group. Therefore, the total number of analyzed subjects was 1320 (comprising 330 vegetarians, 330 subjects consuming a carnivo- rous diet rich in fruits and vegetables, 330 individuals eating a carnivorous diet less rich in meat, and 330 subjects consuming a carnivorous diet rich in meat). Each dietary habit group was set-up according to the demographic characteristics shown in Table 1.

Ethical Approval

The study was carried out in compliance with the principles laid down in the Helsinki Declaration. No minors or children were included in the study. Verbal informed consent was obtained from all subjects, witnessed, and formally recorded. The Ethics Committee of the Medical University of Graz approved the consent procedure as well as the conductance of this study (EK- number: 24–288 ex11/12).

The Association between Nutrition and Health

Table 1. Data definition and structure for each of the four dietary habit groups.

Age Sex TOTAL
men women
SES N N N %
15–19 Low 3 22 25 7.6%
Middle 9 19 28 8.5%
High 0 1 1 0.3%
20–29 Low 4 11 15 4.5%
Middle 10 35 45 13.6%
High 5 13 18 5.4%
30–39 Low 3 10 13 3.9%
Middle 6 23 29 8.8%
High 6 11 17 5.2%
40–49 Low 4 6 10 3.0%
Middle 4 20 24 7.3%
High 8 16 24 7.3%
50–59 Low 3 7 10 3.0%
Middle 3 11 14 4.2%
High 1 6 7 2.1%
60–69 Low 3 7 10 3.0%
Middle 1 14 15 4.5%
High 0 2 2 0.6%
70–79 Low 4 8 12 3.6%
Middle 1 2 3 0.9%
High 0 0 0 0.0%
80+ Low 0 5 5 1.5%
Middle 0 3 3 0.9%
High 0 0 0 0.0%
TOTAL Low 24 76 100 30.3%
Middle 34 127 161 48.8%
High 20 49 69 20.9%
TOTAL 78 252 330 100.0%

Note. Data source: Austrian Health Interview Survey (AT-HIS) 2006/07.

N = number of subjects. Analyses were calculated with subjects matched according to their age, sex, and socio-economic status. Each dietary habit group consisted of 330 subjects with the above shown demographic characteristics (330 vegetarians, 330 subjects consuming a carnivorous diet rich in fruits and vegetables, 330 individuals eating a carnivorous diet less rich in meat, and 330 subjects consuming a carnivorous diet rich in meat; N = 1320). SES: A low SES corresponds a SES score between $3 and #6, a middle SES between .6 and # 10, and a high SES a score between .10 and #15. doi:10.1371/journal.pone.0088278.t001

Variables and Measurements

Face-to-face interviews were conducted by questioning the subjects about their socio-demographic characteristics, health- related behavior, diseases, medical treatments, and also psycho- logical aspects.

The independent variable in this study was the dietary habit of individuals. Concerning eating behavior, the respondents were given a list of six different dietary habits and asked which one describes their eating behavior best (1 = vegan, 2 = vegetarian eating milk/eggs, 3 = vegetarian eating fish and/or milk/eggs, 4 = carnivorous diet rich in fruits and vegetables, 5 = carnivorous diet less rich in meat, 6 = carnivorous diet rich in meat).

PLOS ONE | www.plosone.org 2 February 2014 | Volume 9 | Issue 2 | e88278

Participants described their dietary habit, without interviewers giving a clear definition of the various eating categories. Since, overall, only 2.2% of all participants consumed a vegetarian diet, these individuals were analyzed as one dietary habit group. We created a scale that would reflect the animal fat intake for each dietary habit (1 = vegetarian diet, 2 = carnivorous diet rich in fruits and vegetables, 3 = carnivorous diet less rich in meat, 4 = carniv- orous diet rich in meat).

Since age, sex, and the socioeconomic background of subjects all have an influence on health [38–41], we matched the subjects according to these variables in order to control for their influence. The SES of the subjects (ranging between 3 and 15) was calculated using the following variables: net equivalent income, level of education, and occupation. Net equivalent income was calculated based on an equivalence scale provided by the OECD [42], and divided by quintiles. Level of education was measured by an ordinal variable, distinguishing between (1) basic education (up to 15 years of age), (2) apprenticeship/vocational school, (3) secondary education without diploma, (4) secondary education with diploma, and (5) university education. The occupation of the subjects was differentiated into the following five levels: (1) unskilled worker, (2) apprentice/skilled worker, (3) self-em- ployed/middle job, (4) qualified job/academic, (5) executive position. To verify the combination of variables that served to calculate the SES, correlations with the different variables were calculated. They ranged between r = .70 and r = .80.

The body mass index (BMI) and lifestyle factors (physical activity, smoking, and alcohol consumption) were included as covariates in all analyses. The BMI was calculated by dividing the weight of a person in kilograms by the square of their height in meters (kg/m2) [43]. Physical exercise was measured using the short version of the International Physical Activity Questionnaire (IPAQ), a self-reported instrument, which asks for an estimate of the total weekly physical activity (walking, moderate- and vigorous-intensity activity) performed during the last week. The short version of the IPAQ does not discriminate between leisure- time and non-leisure time physical activity. The total MET score was calculated by weighting the reported minutes per week within each activity by a MET energy expenditure estimate that was assigned to each category [44]. Smoking behavior was measured as the number of cigarettes smoked per day. Alcohol consumption was surveyed as the number of days on which alcohol was consumed during the last 28 days.

The dependent variables focusing on ill-health included self- perceived health, ranging from 1 (very good) to 5 (very bad), and impairment to health, ranging from 1 (very impaired) to 3 (not impaired). We further assessed the presence of 18 specific chronic conditions (asthma, allergies, diabetes, cataract, tinnitus, hyper- tension, cardiac infarction, apoplectic stroke, bronchitis, arthritis, sacrospinal complaints, osteoporosis, urinary incontinence, gastric or intestinal ulcer, cancer, migraine, mental illness (anxiety disorder or depression), and any other chronic condition). Each condition was coded as present (1) or absent (0). We calculated a total frequency score by summing up the chronic conditions present (0–18, sum index). Additionally, a vascular risk score was calculated by summing up the variables ‘‘hypertension’’, ‘‘en- hanced blood cholesterol level’’, ‘‘diabetes’’, and ‘‘smoking’’ (0–4, sum index). Each variable was coded as present (1) or absent (0).

A dependent variable concerning health care was created as the sum index of the number of doctors consulted in the last 12 months (0–8, sum index). Each of the 8 medical treatments (general practitioner, gynecologist, urologist, dermatologist, oph- thalmologist, internist, orthopedist, and ENT physician) was coded as ‘‘consulted’’ (1) or ‘‘not consulted’’ (0). The number of

The Association between Nutrition and Health

andsex,age,socio-economic 28lastthedays) (N = 1320).
meatin p-value .000 .000 .002 .000 .150 .000 .003 .005 .033
3 4 4 4 4 3 4 4 4
carnivorous diet rich SD 0.87 0.61 1.60 0.73 1.22 2.13 1.05 withsubjects matched according to their which alcohol was consumed during
N= 330 M 1.57 2.73 1.03 1.98 1.60 3.61 1.26
habitdietarydifferentthebetweengroups. carnivorousdiet rich in fruits carnivorous diet less vegetablesand330=NvegetarianN = 330 rich in meat N = 330 MSDM SD M SD 1.500.941.78 0.90 1.46 0.87 2.710.662.62 0.62 2.72 0.59 1.001.601.29 1.64 0.92 1.29 1.960.742.02 0.75 2.01 0.71 1.681.331.69 1.27 1.43 1.02 3.652.283.22 2.15 3.59 2.02 1.391.071.25 1.07 1.29 1.07 Ndeviation,standard=SDmean,=M2006/07.= number of subjects, p = probability.
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multivariate test result,
3
carehealthandhealthinDifferences2.Table Measure Health generallyhealthreported-Self Impairment conditionsChronic riskVascular careHealth doctor)thetovisitsof(numbertreatmentsMedical vaccinationsofNumber healthpreventiveofNumber usedofferscare HIS)-(ATSurveyInterviewHealthAustriansource:DataNote. 1 score),MET(totalactivityphysicalBMI,forcontrollingstatus doi:10.1371/journal.pone.0088278.t002
1 means
a higher score
2
1 results,
2 worse
1 2 means
2 1 score
a higher
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The Association between Nutrition and Health

Table 3. Differences in suffering from various chronic conditions between the different dietary habit groups.

Carnivorous diet rich in Carnivorous diet less Carnivorous diet
Chronic condition Vegetarian fruits and vegetables rich in meat rich in meat p-value (x2)
Asthma 4.8% 3.3% 3.9% 4.5% .772
Allergies 30.6% 18.2% 20.3% 16.7% .000
Diabetes 2.7% 4.2% 2.4% 2.4% .455
Cataract 4.2% 3.0% 3.3% 1.8% .348
Tinnitus 4.8% 4.8% 4.8% 3.6% .840
Hypertension 11.5% 10.6% 12.4% 15.5% .260
Cardiac infarction 1.5% 1.5% 0.9% 0.6% .610
Apoplectic stroke 1.2% 1.8% 1.5% 1.8% .610
Bronchitis 3.9% 3.6% 2.4% 3.0% .701
Arthritis 8.5% 7.6% 8.8% 10.3% .662
Sacrospinal complaints 26.7% 24.8% 18.2% 23.9% .060
Osteoporosis 6.4% 4.8% 3.6% 5.8% .415
Urinary incontinence 2.1% 3.9% 2.7% 6.4% .023
Gastric or intestinal ulcer 4.2% 4.2% 1.5% 3.6% .169
Cancer 4.8% 3.3% 1.2% 1.8% .022
Migraine 15.8% 11.8% 9.1% 12.1% .074
Mental illness (anxiety 9.4% 4.8% 5.8% 4.5% .036
disorder or depression)
Any other chronic conditions 8.8% 5.5% 5.8% 6.7% .308

Note. Data source: Austrian Health Interview Survey (AT-HIS) 2006/07. Percentage of subjects suffering from the different chronic conditions. p (x2): probability value of Chi-Square-Test. Analyses were calculated with subjects matched according to their age, sex, and socio-economic status (N = 1320). doi:10.1371/journal.pone.0088278.t003

vaccinations was analyzed by calculating a sum index combining 8 different vaccinations (influenza, tetanus, diphtheria, polio, FSME, pneumococci, hepatitis A and B; 0–8, sum index). Each vaccination was coded as present (1) or absent (0). In addition, preventive health care was analyzed by calculating a sum index of the variables ‘‘preventive check-ups’’, ‘‘mammography’’, ‘‘prostate gland check-up’’, and ‘‘Papanicolaou test’’ (0–4, sum index). Each variable was coded as present (1) or absent (0).

The dependent variable concerning quality of life was measured using the short version of the WHOQOL (WHOQOL-BREF) [45]. Four domain scores (physical health, psychological health, social relationships, and environment) were calculated. These domain scores ranged between 4 and 20.

Statistical Analysis

In a first step subjects with different dietary habits (vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, carnivorous diet rich in meat) were matched according to their sex, age, and SES. Differences in lifestyle factors (BMI, total MET score, number of cigarettes smoked per day, and alcohol consumption in the last four weeks) between the different dietary habit groups were calculated by multivariate analysis of variance.

In order to analyze the differences between the dietary habit groups, multivariate analyses of variance were calculated for the three domains: (1) health (self-reported health, impairment due to health problems, number of chronic conditions, vascular risk), (2) health care (number of visits to the doctor, number of vaccinations, number of used preventive care offers), and (3) quality of life (physical and psychological health, social relation- ships, and environment). To address the bias of lifestyle factors impacting health, analyses of variance were calculated, controlling

for the aforementioned lifestyle variables (BMI, physical activity, smoking behavior, and alcohol consumption).

In the domain of ‘‘health’’, the two variables ‘‘self-reported health’’ and ‘‘impairment due to health problems’’ were originally assessed using an ordinal scale. Therefore, we controlled the results using non-parametric tests (Kruskal Wallis Test). Since the results were the same, only results of the analyses of variance are reported.

In addition, Chi-square tests were calculated for the aforemen- tioned 18 chronic conditions in order to establish which one occurs significantly more often, depending on the form of nutrition. p- values ,.050 were considered as statistically significant. All analyses were calculated using IBM SPSS software (version 20.0) for Windows.

Results

Participant Characteristics and Lifestyle Differences between the Dietary Habit Groups

In total, we analyzed the data of 1320 individuals (330 in each dietary habit group). Each dietary habit group was set-up according to the demographic characteristics shown in Table 1. Overall, 23.6% of all subjects were male and 76.4% female. 40.0% of the individuals were younger than 30 years, 17.8% between 30 and 39 years, 17.6% between 40 and 49 years, 9.4% between 50 and 59 years, 8.4% between 60 and 69 years, 4.4% between 70 and 79 years, and 2.4% than 80 years or older. 30.3% of the subjects had a low SES (they had an SES score of #6), 48.8% a middle one (SES between .6 and #10), and 20.9% had a high SES (SES.10).

Our multivariate analysis regarding lifestyle showed a significant main effect for the dietary habit of individuals (p = .000), showing

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that the different dietary habit groups differ in their overall health behavior. However, results of the univariate analyses showed that the dietary habit groups only differ concerning their BMI and their alcohol consumption.

Concerning BMI: vegetarians have the lowest mean BMI (M = 22.9), followed by subjects eating a carnivorous diet less rich in meat (M = 23.4), rich in fruits and vegetables (M = 23.5), and rich in meat (M = 24.9). Heavy meat eaters differ significantly from all other groups in terms of their BMI (p = .000).

Concerning physical exercise: no significant difference was found in the total MET score between the various dietary habit groups (p = .631).

Concerning smoking behavior: the number of cigarettes smoked per day did not differ between the various dietary habit groups (p = .302).

Concerning alcohol consumption: Subjects following a vegetar- ian diet (M = 2.6 days in the last 28 days) or a carnivorous diet rich in fruits and vegetables (M = 3.0 days) consume alcohol signifi- cantly less frequently than those eating a carnivorous diet less rich in meat (M = 4.4 days) or rich in meat (M = 4.8 days; p = .000).

Health Differences between the Dietary Habit Groups

In the domain of health, the multivariate analysis of variance showed a significant main effect for the dietary habit of individuals (p = .000). Overall, vegetarians are in a poorer state of health compared to the other dietary habit groups. Concerning self- reported health, vegetarians differ significantly from each of the other groups, toward poorer health (p = 000). Moreover, these subjects report higher levels of impairment from disorders (p = .002). Vegetarians additionally report more chronic diseases than those eating a carnivorous diet less rich in meat (p = .000; Table 2). Significantly more vegetarians suffer from allergies, cancer, and mental health ailments (anxiety, or depression) than the other dietary habit groups (Table 3). Subjects who eat a carnivorous diet rich in meat more often report urinary incontinence (p = .023). No differences between individuals consuming different forms of diet were found regarding their vascular risk (p = .150; Table 2).

Differences in Health Care between the Dietary Habit Groups

Our multivariate analysis regarding health care has shown a significant main effect for dietary habits (p = .000) and confirmed that, overall, subjects with a lower animal fat intake demonstrate worse health care practices. Vegetarians and subjects eating a carnivorous diet rich in fruits and vegetables consult doctors more often than those eating a carnivorous diet less rich in meat (p = .003). Moreover, vegetarians are vaccinated less often than all other dietary habit groups (p = .005) and make use of preventive check-ups less frequently than subjects eating a carnivorous diet rich in fruits and vegetables (p = .033; Table 2).

Differences in Quality of Life between the Dietary Habit Groups

Regarding quality of life, the main effect of the multivariate analysis of variance showed no significant difference between the dietary habit groups (p = .291). The results obtained in the univariate analyses of variance, however, revealed that vegetarians have a lower quality of life in the domains of ‘‘physical health’’ (p = .026) and ‘‘environment’’ (p = .037) than subjects consuming a carnivorous diet less rich in meat. Moreover, vegetarians have a lower quality of life regarding ‘‘social relationships’’ than individuals eating a carnivorous diet rich in fruits and vegetables,

The Association between Nutrition and Health

value-p .291 .026 .116 .043 .037 BMI,forphysical
2 3 3 3 3
carnivorous diet rich in meat SD 2.86 2.24 16.88 2.63 16.45 2.08 sex, and socio-economic status controlling
N= 330 M 17.40 16.66 last 28 days) (N = 1320).
carnivorous diet less rich in M SD 2.90 2.33 16.96 2.38 16.56 1.98 subjects matched according to their age, alcohol was consumed during the
meat N = 330 17.68 16.88 p = probability.
dietarydifferentthebetweenlife habit groups. carnivorous diet rich in fruits 330=Nvegetarianand vegetables N = 330 SDM M SD 3.2617.16 17.52 2.95 2.7416.50 16.75 2.42 2.8216.59 16.99 2.49 2.2616.16 16.44 2.11
mean.=M2006/07.HIS)-(ATSurveySD = standard deviation. N = numbersubjects.of result,testmultivariate andday),percigarettesof(numberalcohol consumption (number of dayswhichon
result ofcomparison.univariatecalculatedAnalyseswerewith
3
qualityinDifferences4.Tableof Measure lifeofQuality healthphysicalWHOQOL healthpsychologicalWHOQOL relationshipssocialWHOQOL environmentWHOQOL InterviewHealthAustriansource:DataNote. 1 behaviorsmokingscore),MET(totalactivity doi:10.1371/journal.pone.0088278.t004
2
1 1 results,
1 1 better
a higher score means
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or those with a carnivorous diet less rich in meat (p = .043). All results are shown in Table 4.

Discussion

Overall, our findings reveal that vegetarians report poorer health, follow medical treatment more frequently, have worse preventive health care practices, and have a lower quality of life. Concerning the variable ‘‘eating behavior’’, we tried to generate a variable that would reflect the animal fat intake (1 = vegetarian, 2 = carnivorous diet rich in fruits and vegetables, 3 = carnivorous diet less rich in meat, 4 = carnivorous diet rich in meat). The mean BMI of subjects is coupled in nearly linear progression with the amount of animal fat intake. This is in line with previous studies showing vegetarians to have a lower body mass index [1,4,5,7,9– 12].

Our results have shown that vegetarians report chronic conditions and poorer subjective health more frequently. This might indicate that the vegetarians in our study consume this form of diet as a consequence of their disorders, since a vegetarian diet is often recommended as a method to manage weight [10] and health [46]. Unfortunately, food intake was not measured in more detail, e.g. caloric intake was not covered. Hence, further studies will be necessary to analyze health and its relationship with different forms of dietary habits in more detail.

When analyzing the frequency of chronic diseases, we found significantly higher cancer incidence rates in vegetarians than in subjects with other dietary habits. This is in line with previous findings, reporting that evidence about cancer rates, abdominal complaints, and all-cause mortality in vegetarians is rather inconsistent [5–7,19–22]. The higher cancer incidence in vege- tarians in our study might be a coincidence, and is possibly related to factors other than the general amount of animal fat intake, such as health-conscious behavior, since no differences were found regarding smoking behavior and physical activity in Austrian adults as reported in other studies for other countries [9,13,14]. Therefore, further studies will be required in Austria in order to analyze the incidence of different types of cancer and their association with nutritional factors in more depth.

Several studies have shown the mental health effects of a vegetarian diet to be divergent [9,15,16]. Vegetarians in our study suffer significantly more often from anxiety disorder and/or depression. Additionally, they have a poorer quality of life in terms of physical health, social relationships, and environmental factors.

Moreover, the use of health care differs significantly between the dietary habit groups in our study. Vegetarians need more medical treatment than subjects following another form of diet. However, this might be due to the number of chronic conditions, which is higher in subjects with a vegetarian diet.

Among the strengths of our study are: the large sample size, the matching according to age, sex, and socioeconomic background, and

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The Association between Nutrition and Health

the standardized measurement of all variables. Other strengths of our study include considering the influence of weight and lifestyle factors on health, e.g. physical exercise and smoking behavior.

Potential limitations of our results are due to the fact that the survey was based on cross-sectional data. Therefore, no statements can be made whether the poorer health in vegetarians in our study is caused by their dietary habit or if they consume this form of diet due to their poorer health status. We cannot state whether a causal relationship exists, but describe ascertained associations. More- over, we cannot give any information regarding the long-term consequences of consuming a special diet nor concerning mortality rates. Thus, further longitudinal studies will be required to substantiate our results. Further limitations include the measure- ment of dietary habits as a self-reported variable and the fact that subjects were asked how they would describe their eating behavior, without giving them a clear definition of the various dietary habit groups. However, a significant association between the dietary habit of individuals and their weight and drinking behavior is indicative for the validity of the variable. Another limitation concerns the lack of detailed information regarding nutritional components (e.g. the amount of carbohydrates, cholesterol, or fatty acids consumed). Therefore, more in-depth studies about nutri- tional habits and their effects on health are required among Austrian adults. Further studies should e.g. investigate the influence of the various dietary habits on the incidence of different cancer types. To our knowledge this is the first study ever in Austria to analyze differences in terms of dietary habits and their impact on health. We admit that the large number of participants made it necessary to keep the questions simple, in order to cover the large sample. Overall, we feel that our results are of specific interest and contribute to extant scientific knowledge, notwith- standing some limitations regarding causes and effects.

Conclusions

Our study has shown that Austrian adults who consume a vegetarian diet are less healthy (in terms of cancer, allergies, and mental health disorders), have a lower quality of life, and also require more medical treatment. Therefore, a continued strong public health program for Austria is required in order to reduce the health risk due to nutritional factors. Moreover, our results emphasize the necessity of further studies in Austria, for a more in- depth analysis of the health effects of different dietary habits.

Author Contributions

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bookmark_borderForaging For Food in the Winter

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Winter foraging can be one of the toughest challenges; however, if you do a little preparation in the fall, the buried treasures will yield healthy results.

Find out more from the Guide To Edible Plants’ Foraging for Food in the Winter.

Chives, Garlic Greens, Mint, Carrot Greens, Parsley

bookmark_borderCircadian Rhythms

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National Institute of General Medical Sciences —

What are circadian rhythms?

Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism’s environment. They are found in most living things, including animals, plants and many tiny microbes. The study of circadian rhythms is called chronobiology.

Circadian rhythm.

Are circadian rhythms the same thing as biological clocks?

No, but they are related. Our biological clocks drive our circadian rhythms.

What are biological clocks?

The biological clocks that control circadian rhythms are groupings of interacting molecules in cells throughout the body. A “master clock” in the brain coordinates all the body clocks so that they are in synch.

What is the master clock?

The “master clock” that controls circadian rhythms consists of a group of nerve cells in the brain called the suprachiasmatic nucleus, or SCN. The SCN contains about 20,000 nerve cells and is located in the hypothalamus, an area of the brain just above where the optic nerves from the eyes cross.

Do circadian rhythms have a genetic component?

Yes. Researchers have already identified genes that direct circadian rhythms in people, fruit flies, mice, fungi and several other model organisms used for studying genetics.

Does the body make and keep its own circadian rhythms?

Circadian rhythms are produced by natural factors within the body, but they are also affected by signals from the environment. Light is the main cue influencing circadian rhythms, turning on or turning off genes that control an organism’s internal clocks.

How do circadian rhythms affect body function and health?

Circadian rhythms can influence sleep-wake cycles, hormone release, body temperature and other important bodily functions. They have been linked to various sleep disorders, such as insomnia. Abnormal circadian rhythms have also been associated with obesity, diabetes, depression, bipolar disorder and seasonal affective disorder.

How are circadian rhythms related to sleep?

Circadian rhythms are important in determining human sleep patterns. The body’s master clock, or SCN, controls the production of melatonin, a hormone that makes you sleepy. Since it is located just above the optic nerves, which relay information from the eyes to the brain, the SCN receives information about incoming light. When there is less light—like at night—the SCN tells the brain to make more melatonin so you get drowsy.

How are circadian rhythms related to jet lag?

Jet lag occurs when travelers suffer from disrupted circadian rhythms. When you pass through different time zones, your body’s clock will be different from your wristwatch. For example, if you fly in an airplane from California to New York, you “lose” 3 hours of time. So when you wake up at 7:00 a.m., your body still thinks it’s 4:00 a.m., making you feel groggy and disoriented. Your body’s clock will eventually reset itself, but this often takes a few days.

Sleeping flies.

How do researchers study circadian rhythms?

Scientists can learn about circadian rhythms by studying humans or by using model organisms that have similar “clock” genes. Basic researchers doing these experiments can control the subject’s environment by altering light and dark periods and then look for changes in gene activity or other molecular signals.

How does circadian rhythm research contribute to human health?

Understanding what makes biological clocks tick may lead researchers to treatments for sleep disorders, jet lag and other health problems. Learning more about the genes responsible for circadian rhythms will also enhance our understanding of biological systems and the human body.

Learn more:
Tick Tock: New Clues About Biological Clocks and Health
A Light on Life’s Rhythms: Profile of Cara Altimus

NIGMS is a part of the National Institutes of Health that supports basic research to increase our understanding of life processes and lay the foundation for advances in disease diagnosis, treatment and prevention. For more information on the Institute’s research and training programs, see http://www.nigms.nih.gov.

Content reviewed November 2012