New research suggests that a diet that's full of fiber appears to lead to more diverse intestinal bacteria (microbiome). In turn, a thriving gut microbiome is linked to a stronger response to an immune therapy for the aggressive skin cancer.
"We found that patients eating a high-fiber diet at the start of therapy were about five times more likely to respond to the anti-PD-1 immunotherapy," said study author Christine Spencer. She's a research scientist with the Parker Institute for Cancer Immunotherapy in San Francisco.
Anti-PD-1 immunotherapy helps the immune system recognize cancer cells as dangerous cells that need to be destroyed, according to the American Cancer Society (ACS). The cancer drugs Keytruda and Opdivo are examples of this type of immunotherapy.
Melanoma is a type of skin cancer. It only accounts for about 1 percent of all skin cancers, but is responsible for most skin cancer deaths, the ACS says.
Several recent studies have suggested that a healthy and diverse gut microbiome might improve the response to melanoma immunotherapy treatments, the researchers said. What wasn't known was how certain diets might improve the microbiome and boost the response to melanoma treatment.
To see what difference diet might make, the researchers collected fecal samples from more than 100 people being treated for melanoma at the MD Anderson Cancer Center, in Houston. With these samples, the researchers could learn what types of bacteria people had in their gut microbiome, as well as how diverse the bacteria in the microbiome were.
The investigators then compared these findings to a previously completed diet/supplement survey to see what type of diet was linked to a more robust gut microbiome.
The findings showed that a high-fiber diet -- one full of vegetables, fruits and whole grains -- was associated with the types of bacteria that had already been linked to a better response to anti-PD-1 therapy.
The researchers also noted that about 40 percent of the people in the study were taking a probiotic supplement. Probiotics contain live bacteria believed to be helpful to maintaining the balance of the microbiome. However, the researchers found that probiotic use was actually linked to lower diversity of the gut microbiome.
And, a lower diversity of the microbiome has been linked to a poorer response to melanoma immunotherapy, the researchers noted.
The study team also looked at a group of almost 50 patients who had complete information on diet and gut microbiome, and found that those on a high-fiber diet were about five times more likely to respond to anti-PD-1 treatment than people eating a low-fiber diet.
Dr. Marcel van den Brink, head of the division of hematologic malignancies at Memorial Sloan Kettering Cancer Center in New York City, said, "This study found a high-fiber diet would lead to better diversity in the gut flora, and greater diversity gave you better outcomes," at least for anti-PD-1 immunotherapy.
"In clinical medicine, we do a great job of monitoring a lot of parameters. But when it comes to monitoring what people eat and effects of diet, we're doing a lousy job," he added.
"Patients and family members ask about diet, and we say, 'Just eat healthy,' and we don't have much more specific guidelines," van den Brink explained.
"So, these types of studies are intriguing. Diet may work in a collaborative way with immune therapy. But, we're not there yet. This was a small study. The research is early," he noted.
Still, van den Brink said that he suspected -- from this study and others, including his own research on the microbiome in blood cancers -- that the gut microbiome likely influences the immune system throughout the body, and he thinks the microbiome "will be relevant for most, if not all, immune therapies in cancer."
Spencer said hers was the first study on diet and melanoma immunotherapy. She agreed more research is needed before doctors can make specific recommendations on diet.
The findings were scheduled for presentation at the American Association for Cancer Research annual meeting, in Atlanta, March 29 to April 3. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.
"We found that patients eating a high-fiber diet at the start of therapy were about five times more likely to respond to the anti-PD-1 immunotherapy," said study author Christine Spencer. She's a research scientist with the Parker Institute for Cancer Immunotherapy in San Francisco.
Anti-PD-1 immunotherapy helps the immune system recognize cancer cells as dangerous cells that need to be destroyed, according to the American Cancer Society (ACS). The cancer drugs Keytruda and Opdivo are examples of this type of immunotherapy.
Melanoma is a type of skin cancer. It only accounts for about 1 percent of all skin cancers, but is responsible for most skin cancer deaths, the ACS says.
Several recent studies have suggested that a healthy and diverse gut microbiome might improve the response to melanoma immunotherapy treatments, the researchers said. What wasn't known was how certain diets might improve the microbiome and boost the response to melanoma treatment.
To see what difference diet might make, the researchers collected fecal samples from more than 100 people being treated for melanoma at the MD Anderson Cancer Center, in Houston. With these samples, the researchers could learn what types of bacteria people had in their gut microbiome, as well as how diverse the bacteria in the microbiome were.
The investigators then compared these findings to a previously completed diet/supplement survey to see what type of diet was linked to a more robust gut microbiome.
The findings showed that a high-fiber diet -- one full of vegetables, fruits and whole grains -- was associated with the types of bacteria that had already been linked to a better response to anti-PD-1 therapy.
The researchers also noted that about 40 percent of the people in the study were taking a probiotic supplement. Probiotics contain live bacteria believed to be helpful to maintaining the balance of the microbiome. However, the researchers found that probiotic use was actually linked to lower diversity of the gut microbiome.
And, a lower diversity of the microbiome has been linked to a poorer response to melanoma immunotherapy, the researchers noted.
The study team also looked at a group of almost 50 patients who had complete information on diet and gut microbiome, and found that those on a high-fiber diet were about five times more likely to respond to anti-PD-1 treatment than people eating a low-fiber diet.
Dr. Marcel van den Brink, head of the division of hematologic malignancies at Memorial Sloan Kettering Cancer Center in New York City, said, "This study found a high-fiber diet would lead to better diversity in the gut flora, and greater diversity gave you better outcomes," at least for anti-PD-1 immunotherapy.
"In clinical medicine, we do a great job of monitoring a lot of parameters. But when it comes to monitoring what people eat and effects of diet, we're doing a lousy job," he added.
"Patients and family members ask about diet, and we say, 'Just eat healthy,' and we don't have much more specific guidelines," van den Brink explained.
"So, these types of studies are intriguing. Diet may work in a collaborative way with immune therapy. But, we're not there yet. This was a small study. The research is early," he noted.
Still, van den Brink said that he suspected -- from this study and others, including his own research on the microbiome in blood cancers -- that the gut microbiome likely influences the immune system throughout the body, and he thinks the microbiome "will be relevant for most, if not all, immune therapies in cancer."
Spencer said hers was the first study on diet and melanoma immunotherapy. She agreed more research is needed before doctors can make specific recommendations on diet.
The findings were scheduled for presentation at the American Association for Cancer Research annual meeting, in Atlanta, March 29 to April 3. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.
Almost half of American firefighters have some form of physical and emotional burnout, with sleep problems and mental health disorders as major factors, a new study finds.
ОтветитьУдалитьResearchers surveyed more than 6,300 firefighters from 66 fire departments nationwide and found that 49% had high levels of physical and emotional burnout in at least one area.
Those who'd been diagnosed with a sleep disorder, particularly insomnia, had a threefold increased risk of emotional burnout, and those with a self-reported diagnosis of post-traumatic stress disorder (PTSD) had up to a fourfold increased risk of burnout.
Sleepiness and short sleep, even among firefighters who did not screen positive for a sleep disorder, were also associated with high levels of burnout, according to the study.
It also found that nearly half of the firefighters got fewer than six hours of sleep in a 24-hour period when working overnight (between 10 p.m. and 8 a.m.), including 24-hour shifts, and 31% reported short sleep patterns the day after overnight work or a 24-hour shift.
"Firefighters are frequently exposed to sleep restriction due to their work schedules, which typically involve 24-hour shifts. These schedules may prevent firefighters from obtaining sufficient sleep in order to feel rested," said study co-leader Alexander Wolkow. He's a postdoctoral research fellow at the Turner Institute for Brain and Mental Health at Monash University in Australia.
"Inadequate sleep during and after work, and into rest periods, may impair firefighters' ability to recover from occupational demands, potentially explaining the heightened burnout risk," Wolkow added in a university news release.
"Given that 84.4% of our sample worked extended duration shifts of 24 or more hours, our findings highlight the need to maximize sleep opportunities during overnight shifts to reduce burnout," Wolkow said.
He pointed out that department policies that help to encourage rest, such as permitting napping and having blackout shades in firehouse sleeping quarters, would benefit firefighters.
"With the high cost of burnout to the individual and organization on the rise, we suggest that reducing sleep and mental health disturbances should be a focus of fire departments' occupational health screening programs, along with [testing] interventions designed to maximize sleep," Wolkow concluded.
The research was conducted by Monash University in collaboration with Brigham and Women's Hospital in Boston. It was published online recently in the Journal of Sleep Research.
Sweet summer fruits make a luscious ending to a meal, but there's no reason to limit them to dessert. Here are three fruity no-cook dishes that will please every palate.
ОтветитьУдалитьFor a sauce with a special flavor punch, add chopped fresh cherries to your favorite salsa recipe. Cherries are loaded with anthocyanins, an antioxidant with a deep red color, and their sweetness gives salsa an added layer of flavor. Try it with grilled chicken or shrimp for a sweet and spicy kick.
Love cantaloupe? Pair it with thinly sliced prosciutto, fresh mozzarella and mint. The melon's sweetness is a great way to balance the saltiness of prosciutto for a filling low-cal appetizer or lunch dish.
Is juicy watermelon more to your liking? It's high in vitamins A and C and the antioxidant lycopene. The deeper the melon's red hue, the more nutrients it has. Its flavor really pops when paired with tangy feta cheese, a good source of calcium.
Watermelon Salad
4 cups baby spinach
4 cups watermelon chunks
2 ounces feta cheese, crumbled
1 jalapeno, seeded and minced
1/2 cup fresh basil leaves, shredded
2 tablespoons extra-virgin olive oil
Salt and black pepper to taste
Arrange spinach on a platter and top with the watermelon. Sprinkle on feta, jalapeno and basil. Drizzle with the oil, and season with salt and pepper as desired.
Yield: 4 servings
Parents who find a sex-based text on their teenager's phone should be on the lookout for other problems in their child's life, a new evidence review suggests.
ОтветитьУдалитьTeens who share sexually explicit images are much more likely to be involved in other troubling activities, including unsafe sex, alcohol and drugs.
"The kids who are sexting are engaging in a lot of other risky behaviors," said senior researcher Sheri Madigan, a child development expert from the University of Calgary in Alberta, Canada.
"We found that youths who were sexting were approximately four times more likely to be also engaging in sexual intercourse, five times more likely to have multiple sexual partners, and half as likely to be using contraception," she continued.
Also, sexting teens were:
Twice as likely to have symptoms of depression and anxiety.
Two and a half times more likely to be smoking or engaging in delinquent behaviors like stealing or vandalism.
More than three times as likely to be using alcohol or drugs.
But the findings are particularly troubling in light of a 2018 study led by Madigan that found 1 out of 4 teens is receiving sexts, and 1 out of 7 is sending them.
Results from the new review line up with what is already known about teens and sexting, said Sameer Hinduja, co-director of the Cyberbullying Research Center at Florida Atlantic University.
"Many risky behaviors among youth tend to occur in a constellation," he said. "If a teen experiments with one risky behavior, that teen typically has experience with other risky behaviors."
For this study, Madigan and her colleagues collected and combined data from 23 previous studies on sexting, involving nearly 42,000 teenagers.
They found significant links between sexting and sexual activity, risky sexual behavior, symptoms of mood disorders, drug and alcohol use, smoking and delinquency.
Further, they found that associations between sexting and either sexual behavior or mood disorders were stronger in younger adolescents, compared to those in their later teens.
It's not clear whether sexting leads to these behaviors, or whether kids inclined to take risks are also more likely to sext, the researchers added. They noted the findings could not prove causation; it only showed an association.
It's very possible that sexting is a gateway that could lead to more experimentation with sex, Madigan said.
"I think sometimes sexting is an initiation into greater sexual behavior," she said. "Sometimes kids use sexting as a starting point. People have called it the modern-day version of flirting."
But other research also has found that when teens are sexting within the confines of a committed relationship, they are not more likely to be engaging in substance abuse and other risk-taking activities, Madigan added.
Those associations are more often found in "youth who are sexting as a method of flirting or sexting in a more casual way," she said.
So what should parents do?
УдалитьHazing and cyberbullying expert Susan Lipkins said the "pat answer" is to remind children that anything they share over the internet is out of their control and could be used against them.
Parents should start teaching their kids about privacy and consent as early as possible, even before they have a phone, she and Madigan advised.
Such conversations should include discussion of "what-if" scenarios, Madigan said: What if someone sends you a photo? What if you're asked to send a nude of yourself? What if someone tries to coerce you into sexting? What if you share a nude with a boyfriend or girlfriend and then you break up?
"But the truth is, the kids will learn all that, they will memorize it and repeat it back to you, and then they will do whatever they want," said Lipkins, a psychologist in Port Washington, N.Y.
The best thing adults can do is create a system for reporting sexts and other cyberbullying behavior, one that is anonymous and allows for verification of complaints, she said.
Otherwise, it's really in the hands of the teens themselves, she added.
"The kids themselves have to decide they don't want to participate," Lipkins said. "'We're not going to pass that photo along. No, I don't want it on my device. No, I don't want to get in trouble for having it. No, it is inappropriate, it is disrespectful to whomever, and I'm not going to participate in this behavior.' When they can say that and protect each other and themselves, that's when it's going to end."
The new report was published June 17 in JAMA Pediatrics.