Publisher Health

Cardiovascular disease remains the leading cause of racial disparities in mortality between Black and white people in the United States. New research from the University of Chicago Medicine suggests that parental incarceration may be contributing to these health gaps.
According to the new study, people who experienced a parent or parental figure’s incarceration anytime before the age of 18 had higher levels of hypertension and coronary disease biomarkers than people whose parents were not incarcerated. These results indicate that mass incarceration may have transgenerational health consequences.
Adverse childhood experiences (ACEs) are difficult experiences that have been associated with long-term effects on physical and psychological health. The incarceration of a parental figure is an ACE that disproportionally affects marginalized communities, but its physical impacts have been understudied.
“There was very little data on its association with cardiovascular risks,” said Elizabeth Tung, MD, Assistant Professor of Medicine at UChicago and the lead author on the study. “We set out to fill that gap in understanding.”
The researchers analyzed data from over 9,600 young adults between the ages of 33 and 44 in the National Longitudinal Study of Adolescent to Adult Health (Add Health) — a robust, nationally representative dataset. They found that a staggering 14.1% of all participants and 21.4% of Black participants reported having been exposed to incarceration of a parent or parental figure during childhood. Tung notes that these figures reflect mass incarceration rates in the 1980s and 1990s, when study participants were less than 18 years old. These people were more likely than their peers to develop hypertension in adulthood, and they had higher levels of high-sensitivity C-reactive protein (hsCRP), a marker of inflammation that health experts use to estimate risk of future coronary events.
The researchers did not find a correlation between parental incarceration and other markers of cardiovascular risk they examined, such as diabetes, hyperlipidemia and heart disease. However, Tung pointed out that these markers are more likely to emerge in middle age and beyond, whereas hypertension tends to emerge in young adulthood — the age group examined in this study.
“From a societal perspective, it’s important to consider our approach to incarceration in the U.S. and how racial disparities in incarceration may be contributing to health disparities,” said Tung. She pointed out that there are multiple areas where resources can prove helpful to families affected by incarceration. Legal aid partners can provide legal support and also connect families to social services and public benefits, which may in turn be able to address some of the economic insecurities that often arise. On the healthcare side, clinicians can offer family counseling and mental health resources to affected children.

Starting a robust exercise program sooner after surgery could prevent patients with dislocated shoulders from sustaining a repeat injury and help them return to sport faster.
University of Adelaide researchers spent three years analysing evidence from 3,600 existing studies and found a tailored exercise program commencing three to six weeks after surgery was the best approach for preventing a secondary shoulder dislocation.
“Patients who dislocate their shoulder have a high risk of doing it again within six months, and can suffer from recurrent instability,” said the University of Adelaide’s Dr Timothy Lathlean, an Accredited Exercise Physiologist (AEP) and Post-Doctoral Research Fellow at the Adelaide Medical School and the South Australian Health and Medical Research Institute (SAHMRI).
“Our analysis found those who embarked on a robust exercise program after surgery were twice as likely to avoid a recurrent injury than those who used exercise alone to recover from their injury.”
The researchers found starting a multimodal program — a combination of exercises targeting strength, coordination, balance and muscular control — soon after surgery produced better results than standard care programs that rely on strength training only.
The review focused on patients who suffered from first time shoulder dislocations that occurred in a forward direction, due to a direct blow to the shoulder. This type of injury often happens while playing sport or in workplace accidents.
Shoulder dislocations are particularly common among young males between the ages of 16 and 30 because they are more likely to play contact sports and have physically challenging occupations.

A new study, published in The Journal of Nutrition, suggests that extreme dietary habits involving carbohydrates and fats affect life expectancy. Researchers from Nagoya University Graduate School of Medicine in Japan led by Dr. Takashi Tamura found that a low carbohydrate intake in men and a high carbohydrate intake in women are associated with a higher risk of all-cause and cancer-related mortality and that women with higher fat intake may have a lower risk of all-cause mortality. Their findings suggest that people should pursue a balanced diet rather than heavily restricting their carbohydrate or fat intake.
While low-carbohydrate and low-fat diets are becoming popular as a way to promote weight loss and improve blood glucose levels, their long-term effects on life expectancy are less clear. Interestingly, recent studies conducted in Western countries suggest that extreme dietary habits for carbohydrates and fats are associated with a higher risk of mortality. However, few studies have explored these associations in East Asian populations, including Japanese individuals who typically have relatively low fat and high-carbohydrate dietary intakes.
The authors conducted a follow-up survey over a period of 9 years with 81,333 Japanese people (34,893 men and 46,440 women) to evaluate the association between carbohydrate and fat intakes and the risk of mortality. Daily dietary intakes of carbohydrates, fats, and total energy were estimated using a food frequency questionnaire and calculated as a percentage of total energy intake for carbohydrates and fats. Carbohydrate intake quality (i.e., refined compared with minimally processed carbohydrate intake) and fat intake quality (i.e., saturated compared with unsaturated fat intake) were also assessed to examine the impact of food quality on the association with mortality.
They found that men who consumed less than 40% of their total energy from carbohydrates experienced significantly higher risks of all-cause and cancer-related mortality. The trend was observed regardless of whether refined or minimally processed carbohydrate were considered. On the other hand, among women with 5 years or longer of follow-up, those with a high carbohydrate intake of more than 65% had a higher risk of all-cause mortality. No clear association was observed between refined or minimally processed carbohydrate intake and the risk of mortality in women.
For fats, men with a high fat intake of more than 35% of their total energy from fats had a higher risk of cancer-related mortality. They also found that a low intake of unsaturated fat in men was associated with a higher risk of all-cause and cancer-related mortality. In contrast, total fat intake and saturated fat intake in women showed an inverse association with the risk of all-cause and cancer-related mortality. They concluded that this finding does not support the idea that high fat intake is detrimental to longevity in women.
“The finding that saturated fat intake was inversely associated with the risk of mortality only in women might partially explain the differences in the associations between the sexes,” Dr. Tamura stated. “Alternatively, components other than fat in the food sources of fat may be responsible for the observed inverse association between fat intake and mortality in women.”
This study is extremely important because restricting carbohydrates and fats, such as extremely low-carbohydrate and low-fat diets, are now popular dieting strategies aimed at improving health, including the management of metabolic syndrome. However, this study shows that low-carbohydrate and low-fat diets may not be the healthiest strategy for promoting longevity, as their short-term benefits could potentially be outweighed by long-term risk.
Overall, an unfavorable association with mortality was observed for low-carbohydrate intake in men and for high carbohydrate intake in women, whereas high fat intake could be associated with a lower mortality risk in women. The findings suggest that individuals should carefully consider how to balance their diet and ensure that they are taking in energy from a variety of food sources, while avoiding extremes.

Fresh discoveries about a type of immune cells could give lung cancer patients a more accurate prognosis and better identify who will benefit from immunotherapies.
Researchers found that the location in and around tumours of cytotoxic T cells, which play a key role in fighting cancer, may help predict patient survival and indicate whether or not treatments will work.
The findings could help to pave the way for improved immunotherapies — powerful but expensive life-extending treatments which currently fail in 80 per cent of cases — allowing them to work more effectively in more patients, researchers say.
Experts caution, however, that further research and tests are needed alongside the integration of new technologies before any application in clinical practice is possible.
Lung cancer is one of the most common cancers worldwide and is the leading cause of cancer-related deaths. It is often diagnosed at an advanced stage when conventional treatments are less effective.
For this Cancer Research UK-funded study, University of Edinburgh researchers investigated why immunotherapy fails so often against the disease by examining molecules that can interfere with the activity of T cells, a type of white blood cell that fights disease.
Immunotherapies work by boosting the activity of cytotoxic T cells, which play a key role in patrolling the body to detect and kill cancer cells, but often become ‘exhausted’ when battling tumours.

After menopause an estimated 1 in 4 women may develop irregular heart rhythms — known as atrial fibrillation — in their lifetime, with stressful life events and insomnia being major contributing factors, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
Atrial fibrillation may lead to blood clots, stroke, heart failure or other cardiovascular complications. It primarily affects older adults, and more than 12 million people in the U.S. are expected to develop atrial fibrillation by 2030, according to the American Heart Association.
“In my general cardiology practice, I see many postmenopausal women with picture perfect physical health who struggle with poor sleep and negative psychological emotional feelings or experience, which we now know may put them at risk for developing atrial fibrillation,” said lead study author Susan X. Zhao, M.D., a cardiologist at Santa Clara Valley Medical Center in San Jose, California. “I strongly believe that in addition to age, genetic and other heart-health related risk factors, psychosocial factors are the missing piece to the puzzle of the genesis of atrial fibrillation.”
Researchers reviewed data from more than 83,000 questionnaires by women ages 50-79 from the Women’s Health Initiative, a major U.S. study. Participants were asked a series of questions in key categories: stressful life events, their sense of optimism, social support and insomnia. Questions about stressful life events addressed topics such as loss of a loved one; illness; divorce; financial pressure; and domestic, verbal, physical or sexual abuse. Questions about sleeping habits focused on if participants had trouble falling asleep, wake up several times during the night and overall sleep quality, for example. Questions about participants’ outlook on life and social supports addressed having friends to talk with during and about difficult or stressful situations; a sense of optimism such as believing good things are on the horizon; and having help with daily chores.
During approximately a decade of follow-up, the study found: About 25% or 23,954 women developed atrial fibrillation. A two-cluster system (the stress cluster and the strain cluster). For each additional point on the insomnia scale, there is a 4% higher likelihood of developing atrial fibrillation. Similarly, for each additional point on the stressful life event scale, there is a 2% higher likelihood of having atrial fibrillation.”The heart and brain connection has been long established in many conditions,” Zhao said. “Atrial fibrillation is a disease of the electrical conduction system and is prone to hormonal changes stemming from stress and poor sleep. These common pathways likely underpin the association between stress and insomnia with atrial fibrillation.”
Researchers noted that stressful life events, poor sleep and feelings, such as depression, anxiety or feeling overwhelmed by one’s circumstances, are often interrelated. It’s difficult to know whether these factors accumulate gradually over the years to increase the risk of atrial fibrillation as women age.
Chronic stress has not been consistently associated with atrial fibrillation, and the researchers note that a limitation of their study is that it relied on patient questionnaires utilized at the start of the study. Stressful life events, however, though significant and traumatic, may not be long lasting, Zhao notes. Further research is needed to confirm these associations and evaluate whether customized stress-relieving interventions may modify atrial fibrillation risk.
Study details and background: Participants were recruited between 1994 and 1998. The average age of the 83,736 women included in the study was about 64 years old. Approximately 88% of the group were women who self-identified as white; 7.2% identified as Black women; and 2.9% self-identified as Hispanic women. As women live longer, they may face higher risk and poorer outcomes associated with atrial fibrillation. While high blood pressure, obesity, Type 2 diabetes and heart failure are recognized risk factors, more research is needed about how the exposure to psychosocial stress and overall emotional well-being over time may affect the potential development of atrial fibrillation.

Grandparents appeared to serve as an important private safety net when COVID-19 first hit the U.S., according to a study led by a Washington State University researcher.
The pandemic’s arrival in 2020 coincided with a surge of nearly 510,000 children living in “doubled-up” households, co-residing with other adults in addition to their parents or parents’ partners. While these living arrangements had already been increasing before COVID-19, this was an additional increase beyond what would be expected based on previous trends — and most of those children, about 460,000, were living with grandparents.
The surge was temporary, however, and those households returned to expected levels in 2021. The researchers detailed their findings in the journal Demography.
“Despite the health risks associated with co-residing with larger families during COVID, economic and instrumental needs still led Americans to live together. I think that really speaks to the strength and importance of family ties as a safety net in the U.S.,” said Mariana Amorim, a WSU sociologist and the study’s lead author.
Using survey data collected by the U.S. Census, Amorim and co-author Natasha Pilkauskas of University of Michigan analyzed the trends for children in doubled-up households from 2015-2021. About 15.3% of children lived in these types of households in 2015, and there was an incremental average increase of about 0.1 percentage points each year, but from 2019 to 2020 the share of children in these arrangements jumped from 15.7% to 16.3%, an increase six times greater than expected.
The people moving into these doubled-up arrangements tended to be families headed by single mothers and mothers who had never married or who were not working as well as families with children under the age of six. There was also a larger than usual increase in Black and Hispanic children living in multigenerational households.
The authors said these demographics suggest the surge in co-residence was driven by both the need for economic and other instrumental support-such as childcare and perhaps to some degree elder care on the part of the grandparents. These needs appeared to outweigh concerns over spreading COVID-19 to more vulnerable older relatives.
The authors also uncovered a seasonality in trends of “doubling up.” Before the pandemic, increases in these co-residing households tended to follow a pattern with more co-residence occurring in late fall and winter. The researchers speculate that this may follow already established seasonal patterns of births and divorces. When the pandemic hit, it upended that seasonal pattern, with more people moving into doubled-up households in spring and summer of 2020 before decreasing later in that year and normalizing in 2021.
“We found this type of co-residence to be really short lived. This really drives home the idea that doubling up, particularly living with grandparents, is a strategy that’s used to address economic or instrumental needs, but it’s not really the preference for Americans,” said Amorim. “As soon as people are able to move out and live independently, they do.”

A new study has found that 12% of Americans are responsible for eating half of all beef consumed on a given day, a finding that may help consumer groups and government agencies craft educational messaging around the negative health and environmental impacts of beef consumption.
Those 12% — most likely to be men or people between the ages of 50 and 65 — eat what researchers called a disproportionate amount of beef on a given day, a distinction based on the latest Dietary Guidelines for Americans, which suggest 4 ounces per day of meat, poultry, and eggs combined for those consuming 2200 calories per day.
The study, published in the journal Nutrients, analyzed data from the CDC’s National Health and Nutrition Examination Survey, which tracked the meals of more than 10,000 adults over a 24-hour period. The global food system emits 17 billion tons of greenhouse gases a year, equivalent to a third of all planet-warming gases produced by human activity. The beef industry contributes heavily to that, producing 8-10 times more emissions than chicken, and over 50 times more than beans.
“We focused on beef because of its impact on the environment, and because it’s high in saturated fat, which is not good for your health,” said the study’s corresponding and senior author Diego Rose, professor and nutrition program director at Tulane University School of Public Health and Tropical Medicine.
Rose said the study’s purpose was to assist in targeting educational programs or awareness campaigns to those eating disproportionate amounts of beef. Honing messaging around the environmental impact of beef production is crucial at a time when climate change awareness is higher than ever.
Rose said he and fellow researchers were “surprised” that a small percentage of people are responsible for such an outsized consumption of beef, but it’s yet to be determined if the findings are encouraging for sustainability advocates.
“On one hand, if it’s only 12% accounting for half the beef consumption, you could make some big gains if you get those 12% on board,” Rose said. “On the other hand, those 12% may be most resistant to change.”
The study also found that those who were not disproportionate beef consumers were more likely to have looked up USDA’s MyPlate food guidance system.

Living in a racially segregated neighborhood puts Black children at a higher risk of having elevated blood lead levels, and this association has persisted over more than two decades, according to new research from the Children’s Environmental Health Initiative, which is led by University of Illinois Chicago Chancellor Marie Lynn Miranda.
The study, published in Pediatrics, analyzed data from the early 1990s and from 2015 from blood lead level tests of more than 320,000 children younger than 7 in North Carolina. Researchers found that while overall lead levels for non-Hispanic Black children decreased over those 25 years, their levels were still higher in both time periods if they lived in segregated neighborhoods. This was true even when adjusting for socioeconomic status, meaning that racial segregation — and the environmental and social burdens that accompany that — creates tangible and long-term health impacts.
“In the United States, you can draw a direct line between slavery, the segregation policies that followed the end of slavery and the distribution of where people live today. There is an enduring legacy,” said Miranda, lead author on the study and a professor of pediatrics at UIC. “Children of color, in particular, non-Hispanic Black children, are exposed to more lead — and racially segregated communities not only have higher levels of lead exposure, but must contend with other adverse social and environmental exposures going on at the same time.”
In addition to the analysis of lead tests made available by the Childhood Lead Poisoning Prevention Program of the North Carolina Department of Health and Human Services, the researchers created a local, spatial measure of racial residential segregation for the entire U.S. based on census tract data. This allowed the researchers at the Children’s Environmental Health Initiative to look at the evolution of racial residential segregation and blood lead levels in tandem.
They found that racial residential segregation increased in 68% of census tracts across the U.S. between 1990 and 2015.
“In North Carolina in that same time frame, we find that neighborhoods that remain highly racially segregated still hold the highest levels of blood lead concentrations among children, especially among non-Hispanic Black children,” said Aaron Lilienfeld Asbun, statistician at CEHI. These results are especially troubling as health impacts of childhood lead exposure include reduced IQ and increased behavioral problems.
These results help shift the focus from viewing health disparities as tied to something unchangeable — a person’s race — to a factor that can be modified, in this case the state of a child’s home environment and neighborhood.
The researchers hope the study helps convince pediatricians and public health officials of the importance of ensuring that children from racially segregated neighborhoods get tested for lead, as well as encouraging communities to dedicate resources to lead abatement in these neighborhoods. In addition, pediatricians may provide improved care if they assess patients within the context of where they live and what social and environmental stressors characterize their home environments.
Coauthors of the paper are Joshua Tootoo, director of training and geospatial sciences at CEHI, and Mercedes Bravo, faculty research affiliate at Duke University.

A new study has revealed important associations between the gut microbiome and eczema in infancy and has established the basis for the potential prevention and treatment of eczema via modulation of the gut microbiota. The study was published in mSystems, a journal of the American Society for Microbiology.
“The problem of eczema is increasing, and our study shows it could be a result of unwanted changes in the gut bacterial content. The first year of life could be a critical period to restore the gut bacteria to a more desirable composition,” said the study’s principal investigator Paul Chan, M.D., professor of microbiology at The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
In the new study, Dr. Chan and colleagues invited pregnant women who were close to term to participate in the research. They collected their information on health, lifestyle and events during pregnancy and delivery. After delivery, the researchers visited the women and collected information on their babies’ diet, health and medication. The researchers arranged follow-up clinics to check the babies’ health conditions and any eczema problems. The researchers characterized the development and determinants of the gut microbiome in a cohort of 112 term Chinese children by sequencing 713 stool samples collected at nine time points from birth to 3 years of age using 16S rRNA gene sequencing.
The researchers revealed alterations in the composition and alpha and beta diversity of the gut microbiota across the first 3 years of life. They identified mode of delivery, feeding mode and intrapartum antibiotics as the major determinants of the early-life gut microbiome, the effects of all of which persisted up to 12 months. Importantly, by conducting a nested case-control study, they showed that alterations in the infant gut microbiota precede the development of eczema. Interestingly, they identified a depletion of Bacteroides and an enrichment of Clostridium sensu stricto 1 in the gut microbiome of infants with eczema at 1 year old. The same patterns were also observed in C-section born infants within the same time frames, suggesting a role of the gut microbiota in previously reported associations between C-section and increased risk of eczema.
“Our study found that the gut bacterial content of babies changes drastically over the first 3 years of life,” said Dr. Chan. “The mode of delivery and feeding, and the use of antibiotics around the time of delivery affects the gut bacterial content. We observed characteristic changes in the gut bacterial content before the babies present with eczema. Remarkably, those bacterial changes were also observed in babies delivered by C-section. Nevertheless, the link between C-section and eczema requires further studies to verify. Gut bacteria may play a role in preventing or treating eczema.”

The human immune system is adaptive, remembering past infections and training itself to guard against future similar infections. But what happens when people have compromised immune systems due to chronic conditions, aging, or medications that decrease immunity as a side effect? In such cases, people can get opportunistic infections, so called because the germs causing illness would have been eradicated by a fully healthy immune system. Conditions and medicines causing immune suppression are on the rise, and so are patients experiencing opportunistic infection. Now, researchers from the University of Missouri School of Medicine have uncovered a sex-based variance in the trained immune memory response to infection in mice that might translate to humans.
The researchers found that female mice were more vulnerable to opportunistic infection from a bacterial pathogen to which they had previously been exposed when progesterone levels were naturally elevated as part of their reproductive cycle.
“Differences in immune response in males and females have been observed before. For instance, males had increased morbidity and severity of COVID-19 from SARS-CoV-2 infections,” said Dr. Adam Schrum, associate professor in the Department of Molecular Microbiology and Immunology. “But females are known to suffer other infections worse than males. Our research found that female mice were far more vulnerable to opportunistic bacterial infection than male mice because of a sex-based difference in their trained immunity.”
To understand why the immune systems of female and male mice responded differently to a bacterial pathogen, the researchers examined whether the reproductive cycle affected immune training. They found that elevated progesterone levels correlated with lower trained immune responses. To test this more fully, the researchers gave the female mice progesterone blockers and found that their trained immune response was subsequently enhanced.
“The female mice had significantly restored trained immune response when progesterone was blocked, reaching comparable levels to those of male mice,” said Schrum. “Sex hormone-based modulation of immune function needs more study to be fully understood, but as a first step we can conclude that immune training is influenced by a progesterone-dependent mechanism that results in a sex bias in mice.”
In addition to further study to understand how and why progesterone specifically influences trained immune responses in mice, the researchers pointed out that because mice have shorter estrous cycles than the human menstrual cycle, further research is needed to understand how sex hormones might affect human immune training.