Why I Stopped Feeling Bad About Feeling Schadenfreude

Scrolling through your feed, you discover it rained throughout your co-worker’s luxury holiday, the one she’d been bragging about for weeks. A sly smile crosses your lips. You hear about a self-righteous politician caught with his pants down, and feel a spasm of glee. And then there was that time your boss had toilet paper stuck to her shoe.

Schadenfreude (the pleasure in others’ misfortunes, from the German schaden, meaning damage, freude, meaning joy) is often a furtive, grubby sort of emotion. Even if you do laugh out loud, and “like” and share, you might well find yourself pausing later, and feel a little over-exposed: Is enjoying others’ misfortunes puerile and undignified, even a little bit nasty?

In the time I’ve spent studying Schadenfreude, I’ve come to believe this emotion has been unfairly maligned. You don’t have to look hard to find moral philosophers and theologians telling you how bad it is. (Kierkegaard thought anyone caught enjoying Schadenfreude should be banished from human society, which made me sweat a little.)

But I’m an ordinary, flawed human, and I get the feeling more and more that Schadenfreude is not just a way of distracting ourselves during the 3 P.M. lull. Sometimes it gets to the heart of what we care about most.

Take our celebration of justice carried out. Oftentimes, we are pleased to see someone suffer because we feel they deserve it—a line-jumper’s shopping bag splits open in the car-park; a colleague who always steals credit is chewed out by the boss. When the swindler Bernie Madoff was imprisoned for 150 years, people cheered—not just in the courthouse, but in their cars, doing their ironing, commuting to work. We might assume Schadenfreude is antisocial, but actually, the opposite is true. It’s the warm glow of justice restored, a celebration of playing fair and abiding by the rules.

Neuroscientists have found that when we see bad people get their comeuppance, the dorsal striatum region of the brain is activated—the same area implicated in narcotics and sex. We crave this buzz of justice so much that we are prepared to pay for it. Even children as young as 6 years old will gleefully part with candy to see a badly behaved puppet thwacked over the head. Schadenfreude, it is increasingly clear, is part of what helps our societies survive.

Schadenfreude can also help us when it comes to keeping power in check. We’ve seen in the last year a procession of men who have abused their positions of authority brought down by the #MeToo movement. Many emotions greet each new revelation: anger, shock, disappointment, disgust. But is there also a little glint of pleasure? And not just because a wrongdoer has finally been caught, but because apparently entrenched hierarchies are being dismantled. When we enjoy the failings and suffering of those in charge—whether that’s piling on with jokes about “binders full of women” or sniggering at a presidential gaffe—there is something mutinous about our laughter, a moment of camaraderie and a tipping back of the scales of power. “Each joke,” wrote George Orwell, is a “tiny revolution.”

Far harder to admit to, though, is feeling an involuntary spasm of Schadenfreude towards a friend or loved one. Not only does it seem bad-hearted, it speaks of far worse lurking underneath, of envy and inferiority, and of a petty, rivalrous craving for one-upmanship. We all know we shouldn’t compare ourselves to one another, that we should be happy with our lot. And yet, when your best friend has a beautiful cashmere sweater that you could not afford, and then that cashmere sweater gets snacked on by moths…

In the end, we should take a spasm of Schadenfreude for what it is—a small ripple in a much larger emotional ocean. It can be a comfort, making life’s unfairnesses easier to swallow. It can even be an antidote to the more dangerous effects of envy unchecked. And in an age bent on perfection, it reminds us that it’s not just us who fails—everyone does. Empathy and Schadenfreude might seem like opposites, but truth is, they can just as often arrive all jumbled up together. That involuntary sly smile does not invalidate the compassion you also feel. It just reminds you that you are human and have a level of emotional flexibility that the average moral philosopher might not be all that comfortable with.

I no longer feel shame about my Schadenfreude. And I think that you don’t need to either. Shame about any emotion is not terribly helpful, if we want to truly understand why we feel that way. Much better to own it, and look it in the eye. For we live in a culture very used to glossing over spiky, difficult, uncomfortable feelings. But if there was ever a time to bring those to light and understand the role they play in our lives, surely that time is now.

This Drugstore Beauty Buy Banishes Body Acne Faster Than Anything Else I’ve Tried

Even though I write about beauty and try the latest and greatest skin-care products, I face my share of acne—especially body acne, as I work out several times a week. Although I’ve tested hundreds of spot treatments, serums, and lotions, the best product for banishing body acne isn’t some secret holy grail find. Rather, I picked it up at the drugstore a few years back and I have been a loyal fan ever since.

The Bottle

AcneFree Body Clearing Acne Spray, which sells for about $10 to $12 a bottle, is designed with application in mind. The spray, which disperses in a continuous, fine mist, is fast-drying and non-sticky. You can apply it to your chest, back, butt—pretty much all the hard-to-reach areas. The can adroitly sprays from any angle, which allows me (someone who isn’t super-bendy, despite my regular yoga practice) to cover my affected areas in seconds flat. Plus, it has a locking twist cap to prevent accidental messes.

The Ingredients

This formula is chock full of good-for-your-skin stuff and is arguably one of the most comprehensive acne-fighting formulas I’ve ever found. Top pimple-fighting ingredients in the spray include glycolic acid, an AHA; 2% salicylic acid, a BHA; and niacinamide, also known as vitamin B3.

“Glycolic acid exfoliates and helps to regulate skin cell shedding, while salicylic acid cuts through oils and grease to get to pores,” explains Mona Gohara, M.D., associate clinical professor of dermatology at Yale University. “Niacinamide is an excellent anti-inflammatory,” she adds, noting it helps to mitigate the redness that often accompanies angry body acne. The spray is also infused with aloe to help further calm redness.

The Experience

As a very active and therefore very sweaty person, body zits are a part of my life. Generally, they’ll magically appear somewhere on my chest, back, or butt (TMI, maybe, but I’m just trying to paint a picture for you!), and that’s where my lack of bendiness comes into play. While my back and butt are not technically hard-to-reach places, they are tricky locations to target with an acne spot treatment.

The drying time for AcneFree Body Clearing Acne Spray is incredibly fast—think under 30 seconds—which allows me to follow up my routine with a body lotion or oil shortly thereafter without having to stress that the zit-busting formula hasn’t soaked in. Since it’s a clear formula, it doesn’t stain or even leave damp marks on fabrics.

In the time that I’ve been using the spray, I’ve found that treating a flare-up takes only 48 to 72 hours. While that may sound like a long time, it’s really not. I would estimate this body spray shaves a full week off of my usual pimple recovery time.

There is one downside to this product, though: It has a bit of a strong chemical smell, kind of like rubbing alcohol. It’s not strong enough to make me sneeze, but something I admit that I will layer on an extra spritz or two of my favorite fragrance after application.

Nonetheless, this acne treatment is almost too good to be true and it’s a must-have for me.

Buy It: AcneFree Body Spray, $10

Related: The 9 Best Skin-Care Tips I’ve Learned in 10 Years of Being a Beauty Editor

Certain state lawmakers aim to loosen childhood vaccine requirements, but legal barriers persist

Despite an uptick in anti-vaccine legislation proposed by state lawmakers in recent years, pro-vaccine bills were more likely to be enacted into law, according to a new study by researchers at Drexel University. The results were published this week in the American Journal of Public Health.

“It is reassuring to know that the legislative process is working in favor of public health. It is concerning that there are so many anti-vaccination bills introduced, but our study shows that those bills are rarely signed into law,” said study principal investigator Neal D. Goldstein, PhD, an assistant research professor in Drexel’s Dornsife School of Public Health.

The use of nonmedical exemptions from vaccination requirements increased nationwide by 19 percent from 2009 to 2013, which has led to a disease resurgence in communities across the United States. However, both pro- and anti-vaccination policies vary widely state-by-state. The Drexel study, which analyzed all proposed and enacted vaccine legislation at the state level between 2011 and 2017, offers one of the first in-depth pictures of the country’s vaccination policy climate.

“If you only look at current laws, that’s history. But analyzing proposed bills gives us a flavor for what’s happening now, and perhaps for what’s to come. Are we seeing trends that may be concerning for the future?” Goldstein said.

During the seven-year study period, 175 bills related to immunization exemptions were introduced in state legislatures, with the volume increasing significantly over time. In 2011, there were 14 total bills proposed, compared to 41 in 2017.

The researchers found that the majority of vaccination legislation activity between 2011 and 2017 was consolidated to four states: New Jersey (29 total bills), New York (28), West Virginia (15) and Mississippi (12). New Jersey introduced the highest number of anti-vaccination bills (24), while New York and West Virginia introduced 14.

Of the 175 vaccination bills introduced, 92 (53 percent) were classified as anti-vaccine, and 83 (47 percent) were classified as pro-vaccine. Thirteen of the total number of bills (7 percent) were signed into law.

Although the majority of proposed legislation would have expanded access to vaccine exemptions, bills that limited exemptions — meaning they eliminated or made it more difficult for parents to opt their children out of mandatory school immunization requirements — were overwhelmingly more likely to be enacted into law. Only one anti-vaccination bill, 2011 Washington bill SB5005, ultimately became law. The law broadened the types of health care providers, beyond licensed physicians, who could sign a vaccination exemption form.

Pro-vaccine laws are an important protector for the public’s health, according to Goldstein, because such a high proportion of the population needs to be vaccinated to prevent an outbreak of contagious diseases. Measles, for example, require about 95 percent of the population to be immunized. Those who choose not to vaccinate their children for non-medical reasons are putting communities at risk, evidenced by states across the country experiencing record-high disease outbreaks this year, Goldstein said.

The recent anti-vaccination movement gained momentum after a study published in The Lancet in 1997, which suggested a link between the MMR (measles, mumps and rubella) vaccine and autism spectrum disorder. The study was subsequently debunked and retracted, and its author, Andrew Wakefield, lost his medical license.

However, that has not stopped a small, vocal minority of Americans from continuing to spread misinformation about the perceived health risks of vaccines. And Goldstein’s recent study shows that the dangerous rhetoric has found its way into state legislatures.

New Jersey Assembly Bill 497, for example, would have exempted children under six years of age from the hepatitis B vaccine requirement if the child’s mother tested negative for hepatitis B during her pregnancy. The bill explicitly linked “multiple sclerosis, chronic arthritis, autism spectrum disorder, and diabetes” as a “diseases or adverse unintended consequences associated with receipt of the hepatitis B vaccine.” There is no scientific evidence to support the bill’s claims, Goldstein said.

“Several of the bills we saw were clearly not evidenced-based,” he added. “This serves as an opportunity for pro-vaccination constituents to become involved in the legislative process and ensure that state laws reflect the state of science.”

Jonathan Purtle, DrPH, an assistant professor at Drexel’s Dornsife School of Public Health, and Joanna S. Suder, JD, deputy attorney general at the Delaware Department of Justice, co-authored this paper.

Karamo Brown Says His Fiancé Had a ‘Severe Anxiety Attack’ That Sent Him to the Hospital

Queer Eye star Karamo Brown and his fiancé Ian Jordan just got engaged a few months ago, and the excited couple is already having conversations about their 2020 wedding. But, as Brown explained at a recent event in New York City, those conversations may have some unintended side effects: After a wedding planning discussion during Thanksgiving, Brown says Jordan had an anxiety attack that landed him in the hospital.

“This is a true story. It’s sad, but it’s also funny,” Brown said, according to Page Six. “This Thanksgiving, we spent the first couple hours in the emergency room because he had a severe anxiety attack, he thought it was a heart attack.”

Brown continued, “They were like, ‘Everything is fine with you, it’s anxiety. What were you talking about before?’ and [my fiancé] was like, ‘He’s been talking about the wedding!'”

The event, which Brown said is “not that far away,” will span over three days. “We can redo a house in three days!” Brown’s Queer Eye costar Tan France joked.

Panic attacks or severe episodes of anxiety can absolutely cause physical symptoms, SELF explained previously.

The symptoms of a panic attack might include a rapid heart rate, shortness of breath, sweating, nausea, as well as headaches, abdominal pain, and chest pain. A panic attack might also come with a feeling of impending doom or that you’re dying.

If those symptoms sound familiar, it might be because they’re very similar to those of a heart attack, and it’s not uncommon for people experiencing panic attacks to go to the ER thinking they’re in danger. But, luckily, if your symptoms are actually caused by a panic attack or anxiety, they won’t cause any lasting damage. (That said, any unexplained chest pain or difficult breathing deserves medical attention.)

Many people have just one panic attack, recover, and never have another one in their life. But other people may have them more frequently—to the point that their panic attacks are triggered by the fear of having a panic attack. If that happens, you might actually have what’s called panic disorder, a type of anxiety disorder marked by multiple panic attacks.

So, if you’re regularly experiencing extreme anxiety or panic attacks—whether or not it’s in relation to a gigantic three-day wedding event—it’s worth talking to your doctor or a mental health professional to assess what’s going on.


Weight cycling is associated with a higher risk of death

Weight cycling is associated with a higher risk of death, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Weight cycling, or the constant losing and gaining of weight (usually from diet), leads to adverse health outcomes. By some estimates, 80 percent of people who lose weight will gradually regain it to end up at the same weight or even heavier than they were before they went on a diet. The Endocrine Society’s Scientific Statement on the causes of obesity found this was because once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger. This combination of lower energy expenditure and hunger creates a “perfect metabolic storm” of conditions for weight gain.

“This study shows that weight cycling can heighten a person’s risk of death,” said lead study author Hak C. Jang, M.D., Ph.D., Professor, Seoul National University (SNU) College of Medicine and Seoul National University Bundang Hospital in Seongnam, Korea. “However, we also concluded that weight loss as a result of weight cycling can ultimately reduce the risk of developing diabetes in people with obesity.”

In the 16-year prospective cohort study, researchers examined 3,678 men and women from the Korean Genome and Epidemiology Study and found weight cycling was associated with a higher risk of death. Interestingly, people with obesity who experienced more weight cycling were less likely to develop diabetes than other study participants. The health benefits of weight loss overshadowed the adverse effects of weight cycling for individuals with obesity looking to lower their diabetes risk.

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Materials provided by The Endocrine Society. Note: Content may be edited for style and length.

Why You Should Let Go of the ‘All-or-Nothing’ Mindset—and How to Do It

Among my clients, the concept of “all-or-nothing” behavior around fitness is all too common. You’re probably familiar with this concept, too, whether in fitness or in other parts of your life. In short, it’s the tendency to operate in extremes—sometimes you’re all in, pushing at 110 percent through a regimented workout routine, or you’re calling it quits before you’re even in your sneakers and out the door, deciding to not exercise at all. There’s no happy medium, no healthy in-between.

This attitude often turns into a vicious cycle of starting and stopping fitness routines, making it basically impossible to reach any of the goals you set for yourself.

Can you relate? Well, I can reassure you, you’re not alone!

Since I see this all-or-nothing mindset so often, I have spent a great deal of time studying why it is so prevalent and what small changes we can make to stop it. Here are four things you can do to start altering your mindset and reaching your goals.

1. Set small, realistic goals and expectations for yourself.

Let’s face it, when it comes to health and fitness, we live in an instant, results-driven world. We’re often presented with promises of six-pack abs, dramatic weight loss, and the perfectly pronounced butt, and all in just a few weeks or months. The truth is, these types of results take going to extreme lengths in both diet and fitness with very little room for error. When people inevitably don’t get the results they anticipate, or perhaps they get the results but have a nearly impossible timing holding onto them because of the extreme ways they changed their lives to get them, they understandably are disappointed and demoralized, and quit altogether until the next big promise comes along.

Remember that extreme results typically take extreme, often unhealthy measures. Long-term lifestyle changes happen when they are done gradually. To start, set small, realistic goals, such as “I will do 20 minutes of cardio two days this week,” or “I will take 15 minutes to work on my push-ups three times this week.” That consistent feeling of success is highly motivating and will keep you going for the long-term.

2. Experiment with different forms of movement to find something you actually enjoy.

Not all exercise is a great match for all people and this plays a big role in long-term success and avoiding the all-or-nothing mindset. You may find yourself at a high-intensity class that leaves you sore and drained for days or you may join a run club only to find you actually hate running. If one form of exercise is too difficult or you don’t enjoy it, you won’t stick with it. When that happens, people often feel defeated, like they’ve failed, prompting them to give up on their routines.

I believe that human beings are built to move and it’s just a matter of finding what movement you enjoy. Experiment, find your thing, and it could end your all-or-nothing relationship with fitness for good!

3. Start with just two days a week and slowly increase that over time.

I can’t tell you how many times I’ve seen people go from nothing mode to working out five or six days a week, in just a week’s time. As you may have guessed, I’m not a huge fan of this approach. In my coaching practice, I advise my clients to work out only two days a week for the first couple of weeks to get conditioned both mentally and physically. Anything more than two to three days a week to start could be setting you up for a big “nothing” period soon to come.

Too much, too soon also increases your risk of injury, which is a good way to land in “nothing” territory very quickly. And even if doing too much too fast feels exciting at first, it will become unsustainable. It will be exhausting not only for your body but also your schedule and your mind.

Small steps equal big, sustainable change. There’s plenty of time to increase exercise frequency after you master two days a week!

4. Know that setbacks will happen, but setting a “comeback date” and leaning on your fitness community to get through them can help.

Whether it be illness, injury, or mental health challenges, there are plenty of things that can force you to take a break from exercising. I’ve struggled with my fair share of these sort of setbacks, and know that making a comeback when you’re ready can be difficult. It’s a time where we’re all at risk for all-or-nothing behavior.

When I have to take some time off from working out, I try to set a “comeback date” and stick to it. If that date comes and goes and injury or illness is still lingering, I set another date, always keeping my eye on my return to my fitness or training plan.

I also recommend staying close to your fitness community, even in times you are out of commission. Whether that’s your running group or students in your fitness class, still meet them for coffee after class or stay active in email chains or Facebook groups. Setbacks are all part of athleticism but it doesn’t have to knock you out of the game. Finding support from others in the fitness community is a great way to stay motivated to get started again as soon as you can.

Overall, keeping your expectations in check and resisting the allure of extreme results will help you avoid the all-or-nothing mindset.

Always be cautious of anything that seems too good to be true. I know it’s tempting but it often ends up in Nothingville, keeping you in a cycle that is preventing you from living out your fitness goals and dreams.

Remember, good things take time (and consistency). You’ve got this!

Louise Green is a plus-size trainer and athlete, activist, and brand consultant working to change the narrative around body size and standards in the fitness industry. She is the founder of the fitness program Body Exchange, and author of Big Fit Girl: Embrace the Body You Have. Follow: Instagram @LouiseGreen_BigFitGirl, Twitter @Bigfitgirl, Facebook @louisegreen.bigfitgirl

When it comes to using birth control, both intention and attitude matter

A new Veterans Affairs study adds to the evidence that women’s intentions around becoming pregnant don’t fully explain whether and how they use contraception. Rather, their attitudes toward becoming pregnant also play a role.

For example, women who don’t plan on getting pregnant, but who nonetheless say it would be fine if it happened, or even that they would be happy about it, may be less likely to use birth control at all, or to use effective methods, than those who aren’t planning a pregnancy but say they would be upset if it occurred.

The finding, reported in the Nov. — Dec. 2018 edition of Women’s Health Issues, doesn’t seem surprising. Some past research has indicated as much. But the new evidence will help round out counselors’ understanding of what drives women’s decisions to use or not use contraception. It may also bolster efforts in VA to improve reproductive health services for women veterans.

Dr. Sonya Borrero, who led the research, says the finding offers a window into the complexity of women’s behaviors around planning or preventing pregnancies.

“Pregnancy intention and attitudes toward a hypothetical pregnancy are not always aligned,” says Borrero, who is with the University of Pittsburgh and VA’s Center for Health Equity Research and Promotion. “Counselors need to be aware of the range of thoughts and attitudes that may be shaping a woman’s behavior when it comes to using contraception.”

And, Borrero points out, intentions and attitudes may be relatively fluid, changing over the course of a few months based on factors like relationship status, financial situation, or social support. She says routine or frequent assessment is needed to help women make the best reproductive decisions.

Borrero’s team conducted phone interviews with 858 women veterans who had recently been VA primary care patients. The work was part of a larger study called Examining Contraceptive Use and Unmet Need among Women Veterans.

The new analysis was limited to women veterans at risk for an unwanted pregnancy. They answered questions about whether they were currently trying to become pregnant or planning to do so in the next year or at any point in the future. “Not sure” was another option.

They also answered questions, on a seven-point scale, about how they would feel if they did become pregnant, regardless of their plan: 1 was “it would be the worst thing that could happen to me,” and 7 was “it would be the best thing that could happen to me.”

Intentions and attitudes were aligned, but not perfectly so. Predictably, most (77 percent) of those intending to become pregnant in the next year said they would be content if it occurred. But at the same time, positive attitudes toward a hypothetical pregnancy were also reported by more than a quarter of the women who said they didn’t want to become pregnant until at least a year down the road (28 percent), and even among many women (14%) who said they had no plans at any time in the future to become pregnant. Only about a third of those who planned no future pregnancies said it would be the “worst thing” if it occurred.

Despite the mismatches that emerged between intention and attitude among many of the women, both factors were independently associated with contraception use. Women who said they “never” wanted to become pregnant were nearly three times more likely to report using contraception, versus those who expressed the intent to become pregnant within the next year. Similarly, women who said becoming pregnant would be the “worst” thing that could happen were nearly three times as likely to use contraception, compared with women who said a pregnancy would be the “best” thing that could happen.

A similar trend was seen regarding methods of birth control. The “never” group was more than three times as likely to be using highly effective methods, versus the “next year” group. The “worst thing” group was more than twice as likely to be using highly effective methods, versus the “best thing” group.

According to the study, “highly effective” methods of birth control include intrauterine devices and subdermal implants. Moderately effective methods include the pill, ring, patch, and injection. The least effective are barrier devices such as condoms, diaphragms, and cervical caps; fertility awareness methods; spermicides; and withdrawal.

The study also observed cultural patterns that have been seen in other research. For example, Hispanic women showed more positive attitudes toward unintended pregnancies than did white or black women. Meanwhile, among black women, neither intention nor attitude was significantly linked to contraceptive use.

“Improved understanding of racial/ethnic differences in pregnancy attitudes would allow for more culturally relevant and inclusive counseling strategies to help women to decrease their risk of undesired or unacceptable pregnancies,” wrote the researchers.

Dr. Amita Vyas, editor-in-chief of Women’s Health Issues, called the study “a strong contribution to the growing body of research that is expanding our understanding of how women make decisions about contraception.” She said it will “help providers offer patient-centered care and assist all clients in achieving their reproductive goals.”

VA and the National Institutes of Health funded the research.

Curry spice boosts exercise performance in mice with heart failure

New research suggests that curcumin, a main ingredient in curry, may improve exercise intolerance related to heart failure. The study is published ahead of print in the Journal of Applied Physiology.

Curcumin, a chemical that comes from the turmeric plant, has been used as a traditional Asian medicine for centuries, primarily to treat gastrointestinal ailments and skin wounds. Studies increasingly suggest that the compound may prevent or limit muscle wasting associated with a number of health conditions, including heart failure.

Heart failure affects more than 6 million people living in the U.S. People with heart failure have a reduced function of the left ventricle — the chamber of the heart that pumps blood out to the rest of the body — called reduced ejection fraction. A decreased ability to exercise (exercise intolerance) is another significant characteristic of heart failure. Previous research has found that higher than normal levels of oxidative stress — an imbalance of two different kinds of molecules that can result in cell damage — contribute to exercise intolerance in people with heart failure. Heart failure is also associated with lower than normal expression of antioxidant enzymes in the muscles, but the reason for this is unclear. Antioxidant enzymes both prevent and repair damage from oxidative stress. Boosting enzyme levels may improve exercise performance in people in heart failure.

Researchers from the University of Nebraska Medical Center theorized that a reduction in the normal signaling of Nrf2, a protein that regulates the expression of antioxidant enzymes, may play a role in the impaired expression of antioxidant enzymes. They examined the effects of curcumin, which is known to promote activation of Nrf2, on a mouse model of heart failure with reduced ejection fraction. One group of mice with heart failure received daily doses of curcumin for 12 weeks, and another group did not receive treatment. The heart failure groups were compared to a control group of healthy mice that received curcumin and an untreated control group.

The research team measured the exercise capacity of all the mice before and after curcumin treatment. The researchers also examined muscle fiber samples to assess enzyme expression levels. They found that expression of Nrf2 increased and levels of antioxidant enzymes improved in the animals with heart failure that were given curcumin. In addition, both groups that received curcumin — even the animals without heart failure — had improved exercise capacity when compared with the untreated groups, suggesting the effects of curcumin on skeletal muscle is not exclusive to heart failure.

“These data suggest that activation of Nrf2 in skeletal muscle may represent a novel therapeutic strategy to improve … quality of life” in people with heart failure with reduced ejection fraction, the researchers wrote.

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

Youth football changes nerve fibers in brain

MRI scans show that repetitive blows to the head result in brain changes among youth football players, according to a new study being presented today at the annual meeting of the Radiological Society of North America (RSNA).

Football has been the subject of much scrutiny in recent years due to growing concerns over the long-term consequences of repetitive head impacts. Players who show signs of concussion are typically removed from games, but many hits to the head are subconcussive — or below the threshold of a concussion — and, therefore, don’t cause any immediate symptoms. There is rising concern that youth football players who experience these collisions in practices and games may be vulnerable to their effects.

“The years from age 9 to 12 are very important when it comes to brain development,” said study lead author Jeongchul Kim, Ph.D., from Wake Forest School of Medicine in Winston-Salem, N.C. “The functional regions of the brain are starting to integrate with one another, and players exposed to repetitive brain injuries, even if the amount of impact is small, could be at risk.”

Dr. Kim and colleagues studied the results of these collisions on youth football players using a novel MRI method that looks at the strain evident on white matter tracts — the bundles of nerve fibers that carry information between different areas of the brain.

“The focus here was on deformations of these fiber bundles,” Dr. Kim said. “Changes from collisions might cause elongation or contraction of these bundles.”

Twenty-six male youth football players, average age 12, underwent MRI studies before and approximately three months after the season was over. For comparison, 22 similarly aged boys who did not participate in contact sports had MRIs on the same schedule.

The MRI results showed that the football players developed changes in the corpus callosum, a critically important band of nerve fibers that connects the two halves of the brain. The primary role of the corpus callosum is to integrate cognitive, motor and sensory functions between the two sides of the brain.

There were signs of greater axial strain (contraction) in some parts of the corpus callosum, and indications of radial strain (expansion) in other parts.

“The body of the corpus callosum is a unique structure that’s somewhat like a bridge connecting the left and right hemispheres of brain,” Dr. Kim said. “When it’s subjected to external forces, some areas will contract and others will expand, just like when a bridge is twisting in the wind.”

The results suggest that repetitive subconcussive head impacts associated with participation in youth contact sports could lead to changes in the shape of the corpus callosum during this critical time of brain development. Dr. Kim cautioned, however, that more evidence is needed to confirm the findings. His group intends to continue studying the players, when possible, to see if any additional deformation occurs.

The ultimate goal of the research, Dr. Kim said, is to provide guidelines for safe football play. MRI may have a role in that process by helping to determine if and when an athlete is able to return to play after a head injury. Positron emission tomography, an imaging technique that can detect signs of inflammation in the brain, is also potentially useful in this regard, according to Dr. Kim.

“It’s best to detect changes at the earliest possible time,” he said.

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Materials provided by Radiological Society of North America. Note: Content may be edited for style and length.

Snoring poses greater cardiac risk to women

Obstructive sleep apnea (OSA) and snoring may lead to earlier impairment of cardiac function in women than in men, according to a new study presented today at the annual meeting of the Radiological Society of North America (RSNA). Moreover, the findings suggested that OSA may be vastly underdiagnosed among snorers.

A common but dangerous sleep disorder, OSA causes an increased risk for left ventricular and, more rarely, right ventricular dysfunction in the heart.

OSA is the most common type of sleep apnea. It occurs when the throat muscles intermittently relax and block the airway while a person sleeps. While there are several symptoms of OSA — such as gasping for air during sleep, waking with a dry mouth, morning headache and irritability — loud snoring is a common sign. Complications of OSA may include daytime fatigue and sleepiness, complications with medications and surgery, and cardiovascular problems.

Researchers investigated cardiac function in relation to diagnosed OSA and self-reported snoring from data available through UK Biobank. A national and international health resource, UK Biobank is open to researchers and follows the health and well-being of 500,000 volunteer participants. Its aim is to improve the prevention, diagnosis and treatment of a wide range of serious and life-threatening illnesses.

For this study, data from 4,877 UK Biobank participants who had received a cardiac MRI were analyzed. The patients were allocated to three study groups: those with OSA (118 patients), those with self-reported snoring (1,886 patients), and those who are unaffected — without OSA or snoring (2,477 patients). There were 396 individuals who did not meet research criteria.

“Our analysis showed that in both genders of the OSA and snoring groups there was an increase in left ventricular mass, meaning that the walls of the heart’s main pumping chamber are enlarged, making the heart work harder,” said lead author Adrian Curta, M.D., radiology resident at Munich University Hospital in Munich, Germany. “We also found that men showed an increase in the ejection fraction of both ventricles.”

Ejection fraction is the percentage of the heart chamber’s total volume that is pumped out with each heartbeat.

When the researchers compared the snoring group to the unaffected group, they found a more significant difference in the left ventricular mass in women than in men. The cardiac changes in the self-reported snorers point to earlier impairment and might be an indication of undiagnosed OSA.

“We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement,” Dr. Curta said. “We also found that the prevalence of diagnosed OSA in the study group was extremely low. Together with the alterations in cardiac function in the snoring group, it leads us to believe that OSA may be grossly underdiagnosed.”

The findings suggest that the transition from snoring to OSA is an evolving process that is associated with left ventricular hypertrophy, an independent predictor for increased adverse events and in-hospital mortality in many procedures.

Dr. Curta stresses the importance for people who snore to get screened for OSA, and cautioned that those with OSA should be properly treated.

“I would encourage people who snore to ask their partner to observe them and look for phases during sleep when they stop breathing for a short while and then gasp for air,” Dr. Curta said. “If unsure, they can spend the night at a sleep lab where breathing is constantly monitored during sleep and even slight alterations can be recorded.”

Treatment is dependent on the cause of an individual’s OSA, Dr. Curta noted. Weight loss, for example, can often improve OSA in overweight individuals. Apart from that, there are surgical techniques and special machines that keep the upper airways open at nighttime by applying continuous positive airway pressure (CPAP).

Since this was a population study, the researchers hope to conduct further studies to gain more insight into the gender differences associated with snoring and OSA.