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Sleep duration is now considered an essential component for ideal heart and brain health. Life’s Essential 8™ cardiovascular health score replaces Life’s Simple 7™, according to a new Presidential Advisory, Life’s Essential 8 — Updating and Enhancing the American Heart Association’s Construct on Cardiovascular Health, published today in Circulation, the Association’s flagship, peer-reviewed journal.
Other updates to the measures of optimal cardiovascular health, now for anyone ages 2 and older, include a new guide to assess diet; accounting for exposure to secondhand smoke and vaping; using non-HDL cholesterol instead of total cholesterol to measure blood lipids; and expanding the blood sugar measure to include hemoglobin A1c, a key measure to assess Type 2 diabetes risk.
Cardiovascular disease is the number one cause of death in the U.S. and globally. According to the Association’s 2022 Heart Disease and Stroke Statistics Update, approximately 121.5 million people in the U.S. have high blood pressure, 100 million have obesity, more than 28 million people have Type 2 diabetes, and only 1 in 4 adults reported achieving the physical activity and exercise recommended in the U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans, 2nd edition. Various research studies over the past two decades indicate more than 80% of all cardiovascular events may be prevented by healthy lifestyle and management of known cardiovascular risk factors.
“The new metric of sleep duration reflects the latest research findings: sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure or risk for Type 2 diabetes more effectively,” said American Heart Association President Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, who led the advisory writing group and is chair of the department of preventive medicine, the Eileen M. Foell Professor of Heart Research and professor of preventive medicine, medicine and pediatrics at Northwestern University’s Feinberg School of Medicine in Chicago. “In addition, advances in ways to measure sleep, such as with wearable devices, now offer people the ability to reliably and routinely monitor their sleep habits at home.”
The Association first defined the 7 metrics for cardiovascular health in 2010 to identify the specific health behaviors and health factors that drive optimal heart and brain health. Brain health in relation to cardiovascular health was defined in a 2017 American Heart Association Presidential Advisory. It was further acknowledged as an important component of optimal cardiovascular health in the Association’s January 2021 Scientific Statement on the mind-heart-body connection. Findings from both papers are incorporated into Life’s Essential 8™.
After 12 years and more than 2,400 scientific papers on the topic, new discoveries in heart and brain health and in the ways to measure cardiovascular health provided an opportunity to revisit each health component in more detail. Four of the original metrics have been redefined for consistency with newer clinical guidelines or compatibility with new measurement tools. Also, the scoring system can now be applied to anyone ages 2 and older.

About 80% of people in the U.S. have low to moderate cardiovascular health based on the American Heart Association’s new Life’s Essential 8™ checklist according to a new study published today in Circulation, the Association’s flagship, peer-reviewed journal. Life’s Essential 8™, also published today in Circulation, details the Association’s updated guidance to measure cardiovascular health, adding healthy sleep as essential for ideal heart and brain health.
The Life’s Essential 8™ metrics are incorporated into the Association’s My Life Check tool to determine a cardiovascular health score based on eight essential components for ideal heart and brain health: diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose and blood pressure. It is an updated algorithm from the scientifically proven Life’s Simple 7™, which did not include sleep heath. Life’s Essential 8™ also updated some of the previous version’s metrics to be more sensitive to differences among groups of people. In adults, overall cardiovascular health is calculated for each individual by summing the scores for each of the 8 metrics together and dividing the total by 8, to provide a Life’s Essential 8™ score ranging from 0-100. Thus, the highest or healthiest cardiovascular health score possible is 100. Overall scores below 50 indicate “low” cardiovascular health, 50-79 is considered “moderate” and scores of 80 and above indicate “high” cardiovascular health.
According to this first study using Life’s Essential 8™ as the measure for cardiovascular health, among more than 23,400 U.S. adults and children free of cardiovascular disease, the overall cardiovascular health of the U.S. population is well below ideal, with 80% of adults scoring at a low or moderate level. Researchers evaluated health information from the U.S. National Health and Nutrition Examination surveys in 2013-2018 that included more than 13,500 adults (ages 20-79 years) and nearly 9,900 children (ages 2 to 19 years).
The analysis found: Life’s Essential 8™ aligns with Life’s Simple 7™, however, it was more sensitive to differences in cardiovascular health among groups of people and individuals. The average cardiovascular health score based on Life’s Essential 8™ was 64.7 for U.S. adults and 65.5 for U.S. children. The children’s average took into consideration age-based modifications for metrics in diet, physical activity and BMI for children ages 2 through 19 years. Only 0.45% of adults scored 100 on Life’s Essential 8™. 19.6% of U.S. adults had high cardiovascular health; 62.5% moderate; and 17.9% low. Adult women had higher average cardiovascular health scores, of 67, compared to men, with a score of 62.5. In general, U.S. adults scored lowest in the areas of diet, physical activity and BMI. Cardiovascular health scores were generally lower at older ages. Individuals who identify as Non-Hispanic Asian Americans had a higher average cardiovascular health score than other racial/ethnic groups. Non-Hispanic White individuals had the second highest average cardiovascular health score, followed, in order, by Hispanic (other than Mexican), Mexican, and Non-Hispanic Black individuals. Children’s diet scores were low, at an average of 40.6. Adult sociodemographic groups varied notably in cardiovascular health scores for diet, nicotine exposure, blood glucose and blood pressure.
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Male MPs have been trying on vests that simulate the feeling of a hot flush, which some women experience during the menopause.The event was organised in parliament by Labour MP Carolyn Harris and the campaign group Over the Bloody Moon, with former Tory leader Iain Duncan Smith and Shadow Health Secretary Wes Streeting among those taking part.Carolyn Harris, who has spoken openly about her own experience of menopause, said it was “easy to underestimate” the intensity of hot flushes and the impact they have on daily life, and hoped the vests would help male colleagues empathise with the experience.

What’s it like living with an invisible disability in London? About 540,000 people have inflammatory bowel disease (IBD) in the UK and more than 69,000 of them are in the capital.Some sufferers say the lack of toilets is the worst thing about living in the city.Bethany Jacobs has Crohn’s disease and lives with a permanent stoma bag. She said: “I think you do need to break down those barriers and open up these conversations where we talk about invisible illnesses such as Crohn’s disease.”Video by Gem O’Reilly

States will be given vaccine doses from the federal stockpile, but supplies of the safest type are limited.Clinics nationwide will begin offering vaccinations against monkeypox to anyone who may have been exposed to the virus, federal health officials announced on Tuesday.Until now, immunizations were offered only to people with a known exposure.States will receive doses of a safer and newer monkeypox vaccine called Jynneos from the federal stockpile, based on the number of cases and the proportion of the state’s population at risk for severe disease, the officials said at a news briefing.State health authorities may also request supplies of an older vaccine developed for smallpox, which is believed to protect against monkeypox, as well.The Department of Health and Human services will provide 56,000 doses of the Jynneos vaccine immediately and an additional 240,000 doses in the coming weeks. Another 750,000 doses are expected to become available over the summer, and a total of 1.6 million doses by the end of this year.“This vaccine currently has some limitations on supply, and for this reason the administration’s current vaccine strategy prioritizes making it available to those who need it most urgently,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said.The older smallpox vaccine, called ACAM2000, is associated with harsh side effects, including death, in people who are immunocompromised, pregnant women and older adults.The new vaccination plan drew quick criticism from experts, who said the campaign was too small and slow to make an impact. The longer it takes to contain the monkeypox outbreak, the greater the chances that the virus will become entrenched in the United States, particularly among men who have sex with men, researchers warned.“Many of us are concerned that the window is closing for us to be able to eliminate monkeypox,” said Dr. Celine Gounder, an infectious disease expert and editor at large for public health at Kaiser Health News.“If we don’t start vaccinating more quickly and broadly, we’re going to have a very difficult time containing this,” she said. Ideally, tests and vaccines for monkeypox could have been offered at L.G.B.T.Q. Pride events across the country in order to reach men at high risk of contracting the virus, Dr. Gounder added.Some experts said the plan was also unfair to men at risk who will not have access to the Jynneos vaccine, especially those who have H.I.V. and cannot safely take the older smallpox vaccine.“There won’t be enough to meet the need,” said Elizabeth Finley, director of communications for the National Coalition of STD Directors. “Plus, without better testing capacity, a strategy based on contacts with a positive case falls flat.”It’s also not clear what qualifies as a probable exposure, she added: “Do you need to know someone at the event tested positive, or do you just say, ‘Oh, I went to a rave and I want to be safe’?”Many clinicians are worried about side effects and scarring from the older smallpox vaccine, as well as the misinformation and vaccine hesitancy they might fuel, Ms. Finley said. “We’ve had clinicians say that there’s no way in hell they would give somebody ACAM2000,” she said.The Jynneos vaccine, on the other hand, has never been used on this scale, and federal health officials said they would watch for unexpected side effects.The administration has so far provided more than 9,000 doses of Jynneos vaccine and 300 courses of antiviral treatments to 32 jurisdictions in the country, officials said on Tuesday.The European Union is adopting a similar plan, sending 5,300 of its 100,000 Jynneos doses to Spain, which has the most cases, followed by Portugal, Germany and Belgium. Other member states will receive doses in July and August.The number of monkeypox cases has risen sharply in many European countries and in the United States.What to Know About the Monkeypox VirusCard 1 of 4What is monkeypox?

Dame Deborah James was a patron for Bowel Cancer UK, a charity which she said was very close to her heart.The CEO of the charity, Genevieve Edwards, has been remembering Dame Deborah – and says that she saved countless lives by raising awareness of the disease.You can read more about this story here.

There is considerable variation in the management of mantle cell lymphoma across different clinical settings, and some strategies do not always conform with what might be expected, according to an analysis by investigators from Weill Cornell Medicine and other leading health institutions.
In particular, the analysis, published June 28 in the Journal of Clinical Oncology, found that given the relatively low usage in some settings of autologous stem cell transplantation (ASCT), a type of bone marrow transplantation that uses a patient’s own cells, there may be a role for clinical trials that explore new treatments in the absence of this intensive therapy. The data also support more routine use of maintenance therapy after standard therapy in patients 65 and older who are not eligible for ASCT.
“We felt it was important to explore real-world differences in treatment patterns and outcomes for lymphoma patients across both settings, given that new treatments are in development,” said lead author Dr. Peter Martin, the Richard A. Stratton Associate Professor in Hematology and Oncology at Weill Cornell Medicine and a hematologist-oncologist at NewYork-Presbyterian/Weill Cornell Medical Center.
Mantle cell lymphoma is an aggressive form of B-cell non-Hodgkin lymphoma that typically occurs in middle-aged or older adults. Current guidelines for the first-line treatment of patients under 65 recommend an intensive chemotherapy regimen followed by ASCT and maintenance treatment with rituximab, an immunotherapy that binds to cancer cells so the immune system can attack them. For patients over 65 who cannot tolerate the intensive chemotherapy required for ASCT, recommended treatments include bendamustine, a medication that damages cancer cells’ DNA and slows their growth or causes them to die, plus rituximab and a variety of other chemotherapy regimens, including a combination known as R-CHOP. The guidelines acknowledge a lack of clinical trial evidence for the use of maintenance rituximab after bendamustine and rituximab to help prevent recurrence. However, its use has become more prevalent in clinical practice.
The study revealed three important insights. First, ASCT was underutilized in community settings, as only about one in four eligible patients received the treatment compared with almost half of eligible patients in academic centers receiving it. “This result was surprising given that ASCT has been considered the global standard approach for the past ten years,” said Dr. Martin, who is also a member of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine. “The much lower utilization in community settings may reflect a lack of access, as it is unavailable in rural areas, or trace to underlying social and demographic factors.”
Second, Dr. Martin and colleagues found ASCT was not significantly associated with shorter time to disease progression or improved overall survival in either treatment setting. “Stem cell transplantation works very well in young patients” said Dr. Martin. “However, if its use does not improve outcomes compared to immunotherapy and chemotherapy regimens, and it’s underutilized, as our real-world data suggests, future clinical trials of new drug regimens that are accessible to more patients could be designed without requiring ASCT.”
Third, the investigators found that among patients who did not undergo ASCT, the use of maintenance rituximab after its combined administration with bendamustine resulted in significantly longer times to disease progression and overall survival compared to bendamustine alone. For the former group, 74 percent of patients did not need another treatment within three years compared to 51 percent for the group that received bendamustine alone. The three-year overall survival rate for the group that received maintenance rituximab was 84 percent versus 74 percent for the bendamustine-only group. Results were similarly positive for patients who received maintenance rituximab after bendamustine and rituximab and R-CHOP.
“As our study was observational, we have not drawn causal conclusions about the role of ASCT and look forward to the results from phase III clinical trials in progress in Europe and North America for more conclusive direction,” Dr. Martin said. “In the meantime, trials in younger patients should explore less intensive strategies. Similarly, bendamustine-based regimens should likely include the addition of maintenance rituximab.”
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A group of researchers has developed an entirely novel approach to treating eating disorders. The scientists showed that a group of nerve cells in the hypothalamus (so-called AgRP, agouti-related peptide neurons) control the release of endogenous lysophospholipids, which in turn control the excitability of nerve cells in the cerebral cortex, which stimulates food intake. In this process, the crucial step of the signalling pathway is controlled by the enzyme autotaxin, which is responsible for the production of lysophosphatidic acid (LPA) in the brain as a modulator of network activity. The administration of autotaxin inhibitors can thereby significantly reduce both excessive food intake after fasting and obesity in animal models. The article ‘AgRP neurons control food intake behaviour at cortical synapses via peripherally-derived lysophospholipids’ has now appeared in Nature Metabolism.
Eating disorders and especially obesity are one of the most common causes of a variety of diseases in industrialized societies worldwide, especially cardiovascular diseases with permanent disabilities or fatal outcomes such as heart attacks, diabetes, or strokes. The Robert Koch Institute reported in 2021 that 67 per cent of men and 53 percent of women in Germany are overweight. 23 per cent of adults are severely overweight (obese). Attempts to influence eating behaviour with medication have so far proved ineffective. A novel therapy that modulates the excitability of networks that control eating behaviour would be a decisive step towards controlling this widespread obesity.
The research team found an increased rate of obesity and the attendant type II diabetes in people with impaired synaptic LPA signalling. A group led by Professor Johannes Vogt (Faculty of Medicine, University of Cologne), Professor Robert Nitsch (Faculty of Medicine, University of Münster) und Professor Thomas Horvath (Yale School of Medicine, New Haven, USA) has now shown that control of the excitability of neurons in the cerebral cortex by LPA plays an essential role in the control of eating behaviour: AgRP neurons regulate the amount of lysophosphatidylcholine (LPC) in the blood. Through active transport, LPC reaches the brain, where it is converted by the enzyme autotaxin (ATX) into LPA, which is active at the synapse. Synaptic LPA signals stimulate specific networks in the brain, thus leading to increased food intake.
In the mouse model, after a period of fasting an increase in LPC in the blood led to an increase in stimulating LPA in the brain. These mice showed typical food-seeking behaviour. Both could be normalized by administrating autotaxin inhibitors. Obese mice, on the other hand, lost weight when these inhibitors were administered continuously. Johannes Vogt explained: ‘We saw a significant reduction in excessive food intake and obesity through gene mutation and pharmacological inhibition of ATX. Our fundamental findings on the LPA-controlled excitability of the brain, which we have worked on for years, therefore also play a central role for eating behaviour.’ Robert Nitsch sees the findings as an important step towards new drug development: ‘The data show that people with a disturbed synaptic LPA signalling pathway are more likely to be overweight and suffer from type II diabetes. This is a strong indication of a possible therapeutic success of ATX inhibitors, which we are currently developing together with the Hans Knöll Institute in Jena for use in humans.’
These findings on the excitation control of neuronal networks in eating behaviour through lysophospholipids and the new therapeutic possibilities they suggest could in future contribute not only to treating eating disorders, but also neurological and psychiatric illnesses.
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How much is an “acceptable dose” of a pollutant? Are existing studies to measure safety adequate? A systematic literature review by The University of Texas Health Science Center at San Antonio (UT Health San Antonio) suggests that the current system of chemical risk assessment is inadequate and contradictory. The result, say the authors, is an underestimation of the levels of flame retardants and other pollutants needed to cause harmful health effects.
The journal Reviews on Environmental Health published the findings in May. The authors, who included a Canadian environmental research analyst, reviewed 74 toxicology studies (42 in vitro and 32 in vivo) and 74 epidemiological studies. These research works analyzed chemical groups that at high enough levels are linked with disruption of the endocrine system (such as the thyroid) and increased risk of neurodevelopmental deficits (such as autism).
“Our study originated in response to increasing trends in the environmental presence and human body burdens of several types of flame retardants used in products such as televisions, drapes and mattresses,” said study corresponding author Raymond F. Palmer, PhD, professor in the Department of Family and Community Medicine at UT Health San Antonio. “These trends were emerging parallel to an expressed increase in prevalence and burden of thyroid and neurodevelopmental deficits.”
The team sought to test the hypothesis that a method called Margin of Exposure (MOE) to determine acceptable dose is inadequate and potentially harmful because MOE may underestimate human risk. The researchers conducted a review of studies associating levels of pollutant dose with harmful effects in vivo (in the body), in vitro (in a test tube or petri dish), and in epidemiology in animal and human study populations.
The study focused on chemicals classified as non-thyroid endocrine disruptors, developmental neurotoxins and thyroid disruptors.
“Overall, our results suggest a systematic toxicology vs. epidemiology difference that is to the detriment of regulatory agency efforts to establish standards for safety in people,” Dr. Palmer said. The authors seek to kindle dialogue toward reform of safety standards.
The 1976 Toxic Substances Control Act (TSCA) considered approximately 62,000 chemicals as “existing” and not subject to testing or regulation unless proven to “present an unreasonable risk of injury to health or the environment,” said co-author Joel E. Michalek, PhD, professor of population health sciences at UT Health San Antonio. More recent reports put the number of chemicals at 83,000 and assert that the TSCA laws are outdated and need reform.
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Like many neurological diseases, there’s a lot we don’t understand about fragile X syndrome. But, after studying the disorder for several years, Lynne Maquat’s lab knew two important things: the enzyme AKT, which plays a key role in cell growth and survival, and the quality control pathway known as NMD (nonsense-mediated mRNA decay), are both in overdrive in fragile X.
In a new study in the journal Molecular Cell, the team reveals how these two major players interact, highlighting a complex molecular dance that could inform the development of future treatments for fragile X syndrome.
Two paths to pursue
AKT is a hub for cell signaling, helping cells communicate about important processes like cell growth, proliferation and protein production. When cells are stressed — for example, in cancer, diabetes, heart disease and neurological disorders, including fragile X — AKT can send too many (or too few) signals or messages as part of a cell survival mechanism.
NMD is like a molecular guide that helps our cells make smart decisions that (in most cases) improve cellular function and contribute to good health. For example, NMD supports gene expression by flagging and destroying mRNAs (messenger RNAs) that are carrying faulty genetic instructions that could lead to disease. It also helps our cells adjust to changes in development and in their environment, and more rapidly respond to certain stimuli.
Co-lead study authors Hana Cho, Ph.D., and Elizabeth Abshire, Ph.D., discovered how AKT and NMD interact in the context of fragile X: The team started with neural stem cells that lack the FMRP protein, which is needed for normal brain development. Fragile X syndrome occurs when individuals don’t make this protein. They showed that when AKT is in overdrive (as it is in fragile X), it turns on a molecule that is necessary for NMD to occur. Consequently, when AKT is high, NMD is hyperactivated.Drug double whammy