Positive Health Online

American Heart Association's Irresponsible News Release of the Intermittent Fasting Study

by Richard Z Cheng MD PhD

Originally Published at  https://orthomolecular.activehosted.com/index.php?action=social&chash=9dfcd5e558dfa04aaf37f137a1d9d3e5.321&s=c7ae1002d2f579a22c16a1b89c854212

The American Heart Association (AHA) recently released a news report highlighting a poster presentation that suggested an association between an 8-hour time-restricted eating schedule (intermittent fasting) and a 91% higher risk of cardiovascular disease mortality (AHA 2024, Chen 2024). This AHA's news release quickly spread throughout the internet, causing much confusion to the public. However, this preliminary finding has not undergone full statistical analysis or peer review, and the AHA's premature release of such information has been criticized as irresponsible and potentially misleading.

There are several issues with the AHA's poster presentation:

1. First, it is only a poster presentation of an epidemiological survey study, which has not gone through the required statistical analysis, the necessary adjustments, and a final peer review process before it can be published. For a very influential health organization like American Heart Association to rush the release of such an incomplete study is at the least unscientific and irresponsible to the public and to science.
2. The study was based on 2 questionnaires covering a period of ~15 years (2003 - 2018), before intermittent fasting or time-restricted eating/time restricted feeding became popular terms. These terms did not become popular until much later. The definition of time restricted eating (intermittent fasting) was not clear to both the surveyors and the respondents. This raises questions about the accuracy and validity of the survey results.
3. This study compares a group of 414 people who were surveyed only twice during that period between 2003 and 2018 and who reported eating window within 8 hours a day. The reference group was of 11,831 people who were also surveyed only twice during that period and who reported eating window within 12-16 hours a day. Do you remember your daily eating window of last week, let alone of years ago?
4. The difference in size of the study group (414-person) compared to the reference group (11,831-person) is huge. This requires statistical manipulation to arrive at any meaningful interpretation.
5. The study has not been adjusted for confounding factors. For example, 27% of the 414-person study group were smokers, compared to 16.9% smokers in the 11,831-person reference group. Smoking status is a major cardiovascular and cancer death risk. This huge difference (27% v. 17%) needs to be adjusted during the statistical analysis before any conclusion can be reached. To release such an immature study to the public is against the scientific merit and is irresponsible at least.

A serious scientific study would have all these factors adjusted and the manuscript peer-reviewed before public release. This AHA poster presentation may or may not survive this rigorous publishing process and hence may not be finally published. The AHA's news release of this intermittent fasting study is premature, misleading, bordering pseudo-science and has caused significant confusion and potential damage to the public.

The American Heart Association's conflict of interest with big food and drug companies is a significant concern, as it can influence the organization's health recommendations (Lauerman 2016). Newly released documents reveal that the Academy of Nutrition and Dietetics, which endorses various food products, has financial ties with companies like Nestlé, PepsiCo, Hershey, Kellogg's, General Mills, and others (Reed 2022). Similarly, the American Heart Association has received millions from fast food and processed food manufacturers (Kaplan 2017). Major pharmaceutical companies donate huge sum of funds to healthcare organizations, potentially influencing their focus on treatment rather than addressing the root causes of diseases like poor dietary choices (Kaplan 2017). Canella (2015) and Yanamadala (2012) both highlight the potential for industry influence in scientific events and the creation of front groups to oppose government regulation. This influence is further underscored by Mialon (2022), who found that 95% of the U.S. 2020 Dietary Guidelines Advisory Committee had conflicts of interest with the food and pharmaceutical industries. The need for regulation in the training and practices of nutritionists is emphasized by Pereira (2016), while Nestle (2013) and Mozaffarian (2017) discuss the threat to scientific integrity and the role of the food industry in nutrition research. Mendelson (2011) also notes the prevalence of conflicts of interest in cardiovascular clinical practice guidelines. These studies collectively underscore the need for transparency and regulation to mitigate the influence of big food companies on health organizations like the American Heart Association.

Numerous studies have demonstrated the potential benefits of intermittent fasting for cardiovascular health, weight loss, metabolic health, brain function, longevity, and even autoimmune diseases and cancer (Sun 2024, Cheng 2024). These studies emphasize the positive impact of intermittent fasting on various aspects of health and well-being. From an evolutionary perspective, human ancestors were routinely on intermittent fasting which seems to bestow survival benefits.

I have been practicing intermittent fasting (as part of my integrative and orthomolecular medicine protocol) for myself and have been recommending it to my patients, clients, and audience for more than 10 years with great success (Cheng 2024).

References:

1. AHA. 2024. https://newsroom.heart.org/news/8-hour-time-restricted-eating-linked-to-a-91-higher-risk-of-cardiovascular-death
2. Chen, M et al. 2024. https://s3.amazonaws.com/cms.ipressroom.com/67/files/20242/8-h+TRE+and+mortality+AHA+poster_031924.pdf
3. Cheng, R. A Clinician's Experience of 15 Years of Intermittent Fasting
4. Canella DS, Martins AP, Silva HF, Passanha A, Lourenço BH. Food and beverage industries' participation in health scientific events: considerations on conflicts of interest. Rev Panam Salud Publica. 2015 Oct;38(4):339-43. PMID: 26758226.
5. Critical Analysis of AHA's Irresponsible Release of the Intermittent Fasting Study.
6. Kaplan, J. 2017. A physician's take on "What the Health" (medicaleconomics.com) https://www.medicaleconomics.com/view/physicians-take-what-health
7. Lauerman, K. 2016. Big Soda sponsored 96 health groups - a big conflict of interest, study says - The Washington Post. https://www.washingtonpost.com/news/to-your-health/wp/2016/10/10/big-soda-sponsored-96-health-groups-a-big-conflict-of-interest-study-says/ "Big soda" sponsored 96 health groups - a big conflict of interest, study says - The Denver Post https://www.denverpost.com/2016/10/10/big-soda-sponsored-96-health-groups/
8. Mendelson TB, Meltzer M, Campbell EG, Caplan AL, Kirkpatrick JN. Conflicts of interest in cardiovascular clinical practice guidelines. Arch Intern Med. 2011 Mar 28;171(6):577-84. doi: 10.1001/archinternmed.2011.96. PMID: 21444849.
9. Mialon M, Serodio PM, Crosbie E, Teicholz N, Naik A, Carriedo A. Conflicts of interest for members of the US 2020 dietary guidelines advisory committee. Public Health Nutr. 2022 Mar 21;27(1):e69. doi: 10.1017/S1368980022000672. PMID: 35311630.
10. Mozaffarian D. Conflict of Interest and the Role of the Food Industry in Nutrition Research. JAMA. 2017 May 2;317(17):1755-1756. doi: 10.1001/jama.2017.3456. PMID: 28464165.
11. Nestle M. Conflicts of interest in the regulation of food safety: a threat to scientific integrity. JAMA Intern Med. 2013 Dec 9-23;173(22):2036-8. doi: 10.1001/jamainternmed.2013.9158. Erratum in: JAMA Intern Med. 2013 Oct 14;173(18):1756. PMID: 23925569.
12. Pereira TN, Nascimento FA, Bandoni DH. Conflito de interesses na formação e prática do nutricionista: regulamentar é preciso [Conflict of interest in the training and practices of nutritionists: regulation is necessary]. Cien Saude Colet. 2016 Dec;21(12):3833-3844. Portuguese. doi: 10.1590/1413-812320152112.13012015. PMID: 27925123.
13. Reed, B. 2022. Revealed: group shaping US nutrition receives millions from big food industry | Nutrition | The Guardian https://www.theguardian.com/science/2022/dec/09/academy-nutrition-financial-ties-processed-food-companies-contributions?trk=public_post_comment-text
14. Sun ML, Yao W, Wang XY, Gao S, Varady KA, Forslund SK, Zhang M, Shi ZY, Cao F, Zou BJ, Sun MH, Liu KX, Bao Q, Xu J, Qin X, Xiao Q, Wu L, Zhao YH, Zhang DY, Wu QJ, Gong TT. Intermittent fasting and health outcomes: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials. EClinicalMedicine. 2024 Mar 11;70:102519. doi: 10.1016/j.eclinm.2024.102519. PMID: 38500840; PMCID: PMC10945168.
15. Yanamadala S, Bragg MA, Roberto CA, Brownell KD. Food industry front groups and conflicts of interest: the case of Americans Against Food Taxes. Public Health Nutr. 2012 Aug;15(8):1331-2. doi: 10.1017/S1368980012003187. Epub 2012 Jun 12. PMID: 22687144.

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Findings from European ME Alliance Pan-European ME Patient Survey – EFNA

efna.net

https://www.efna.net/findings-from-european-me-alliance-pan-european-me-patient-survey/

The European ME Alliance (EMEA) has released the findings of a comprehensive survey shedding light on the distressing state of Myalgic Encephalomyelitis (ME,  referred to as ME/CFS in some countries) patients across Europe.

The survey, conducted among more than 11,000 people with ME/CFS in Europe, presents a stark indictment of European and national policies for neglecting the ongoing and protracted suffering of millions of patients and their families impacted by this inadequately studied disease. Therefore, we call on governments, healthcare providers, research agencies, healthcare policymakers, healthcare ministers, politicians, and European organizations to work with EMEA and take action to address the unmet needs of people with ME/CFS.

The results from the survey underscore a concerning lack of recognition and support for individuals grappling with this debilitating disease and paints a stark picture of the overwhelming challenges faced by people with ME/CFS in Europe.

The survey reveals that healthcare systems are failing them, with three out of four patients (74%) feeling that they received little or no health care support, while only 1 out of 8 (12%) had good or very good support.

Key findings from the survey reveal profound disability levels and unmet needs among ME/CFS patients, highlighting the urgent necessity for healthcare systems to acknowledge ME/CFS as a severe physical illness and enhance medical care, financial support, and social services and pursue a fully funded long-term strategy of biomedical research into this disease.

Furthermore, the survey revealed significant disparities in access to medical care and social support across Europe, with varying approaches by national health authorities influencing the course of illness and disease outcomes. The failure of healthcare systems to address adequately the needs of ME/CFS patients has serious consequences, as highlighted by the survey results.

While no objective diagnostic tests for ME/CFS, verified biomarkers, curative medications or treatments for ME/CFS exist, healthcare support nevertheless matters for the management of the symptoms and the improvement of functional capacity, and thus the course of illness. Early diagnosis, activity management (pacing) and avoidance of over-exertion (Post-exertional malaise (PEM) are key to reducing the risk of progression to severe disease.

The survey found that keeping activity levels within the energy envelope – commonly known as pacing – emerged as the most beneficial strategy for managing the condition. Conversely, activity-based therapies were found to exacerbate symptoms, with almost half of respondents reporting a deteriorating course of illness as a result.

The survey strongly refutes the Biopsychosocial (BPS) model, labelling it as a failed and harmful approach to ME/CFS. Therapies involving fixed increases in activity were shown to worsen symptoms, emphasizing the importance of pacing and avoidance of over-exertion.

Persistent myths exist about ME/CFS being an illness that gradually ‘burns out’ and that patients recover over time. Though some patients may indeed improve over time, most do not. Symptoms are severe and can last a lifetime.

A lack of recognition of the disease as a serious physical illness in many countries denies patients a timely diagnosis and access to adequate social and welfare benefits necessary for basic survival, violating their basic human right to the best available health. The survey reveals that long delays in the diagnosis from disease onset are common, averaging 6.8 years across Europe with large variations across countries

ME/CFS must be viewed as a chronic condition as this perception has major implications for welfare benefits and other services provided. Early diagnosis, activity management (pacing) and avoidance of over-exertion are key to help preventing progression to severe disease.

As high-quality prospective studies on typical courses of illness are lacking, large patient surveys such as this one may provide the best information available.

The dire situation for most ME/CFS patients across Europe is, in part, the result of both ignorance and lack of knowledge among health professionals, social workers, and policy makers. Yet ME/CFS has been recognized as a disease of the nervous system by the World Health Organisation since 1969.

Lack of funding biomedical research contributes to ME/CFS being categorized as a high burden under prioritized disease that urgently requires a dedicated EU strategy.

European governments must step up to fund existing, and develop new, Centres of Excellence for ME/CFS to perform a joined-up pan-European strategy of coordinated, collaborative translational biomedical research across Europe that will focus on establishing a full understanding of the disease and the development of treatments to mitigate or cure it.

EMEA has already led the way by establishing collaborative European groups for researchers, clinicians and young/early career researchers and, of course, patients. By collaborating across Europe, we can harness the best talents from the best institutions who are intent on working together. This will assist in building the capacity of research resources within Europe that is necessary for major discovery about this disease to take place. Importantly, it allows the continuation of research and creates the foundations for making progress in establishing European fundamental research into ME/CFS.

Now European governments must act.

EMEA also urges that a specialist discipline for ME be created in all European countries with at least one specialist clinical centre, attached to centres of excellence in each country, along with the development and implementation of a standardized diagnostic and treatment protocol.

EMEA calls on governments to perform a pan-European epidemiological study, using the most up-to-date diagnostic criteria, to determine the prevalence and cost burden of ME in Europe.
As EMEA has previously demonstrated in its ‘ME/CFS in Europe’ webinars it is entirely possible for all European countries to implement SNOMED [Systemized Nomenclature of Medicine] criteria to ascertain the correct prevalence figures.

EMEA urges policymakers and healthcare stakeholders across Europe to heed the findings from the EMEA Pan-European ME Survey and take urgent action to improve the lives of ME patients.

This first-ever Pan-European survey underscores the urgent priority for healthcare systems to recognize ME/CFS as a serious physical illness and provide better medical care, financial support, and social services, as well as a fully funded long term strategy of biomedical research into this disease.

Ignorance, apathy and a lack of research toward myalgic encephalomyelitis in Europe must not be allowed to continue. Failure to act decisively now will perpetuate unnecessary suffering and neglect of people with ME/CFS – a clear abuse violation of human rights for these citizens, who should not be left behind as the world works towards achieving Universal Health Coverage to achieve the 2030 United Nations Sustainable Development Goals.

Read the full survey report, EMEA survey of ME/CFS patients in Europe: Same disease, different approaches and experiences including country profiles on how access to medical care and social support varies across Europe, and how different approaches taken by national health authorities affects the course of illness and disease outcomes, with serious consequences for patients.

For interviews with the study authors, representatives of EMEA or leading researchers or clinicians please contact: info@europeanmealliance.org

Web site:
https://www.europeanmealliance.org/emea-pan-european-survey-uk.shtml

About Myalgic Encephalomyelitis

Myalgic encephalomyelitis should be referred to as ME. In some countries and with some organizations the acronym ME/CFS is used. In order to simplify terminology ME/CFS is used on this occasion, referring to ME.

ME/CFS is a debilitating neurological illness classified as such by the World Health Organisation under ICD-10 G93.3 and ICD-11 8E49.
Post Exertional Malaise (PEM) is a hallmark symptom of ME/CFS, whereby symptoms worsen upon even the slightest physical or mental exertion.

About EMEA

https://europeanmealliance.org/aboutus.shtml
The European ME Alliance is a grouping of European organizations who are involved in supporting patients suffering from myalgic encephalomyelitis (ME or ME/CFS) and are campaigning for funding for biomedical research to provide treatments and cures for this disease.
The Alliance was formed in 2008 by national charities and organizations in Europe. The Alliance currently has representatives from Belgium, Croatia, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Lithuania, Netherlands, Norway, Serbia, Slovenia, Spain, Sweden, Switzerland and the UK and is open to all European groups sharing the same ethos and objectives for ME.
EMEA’S aim is to campaign for appropriate funding of biomedical research into ME/CFS to establish an understanding of the aetiology, pathogenesis and epidemiology of the disease. This should lead to the development of treatments to cure or alleviate the effects of the illness, as well as a correct and consistent view of ME/CFS by healthcare organizations, healthcare professionals, government organizations, the media, patients, and the public.

PODO Launches Mobile Clinic for Quality, Bespoke Orthotics

Christophe Champs of award-winning PODO London is launching a brand-new mobile clinic, meaning you can now get the highest quality bespoke orthotics wherever you are in the world. Since 2016, Christophe has been working with patients at his London clinic to help correct postural and biomechanical issues that are causing pain or putting a client at risk of injury. By testing both the moving gait and the still posture, Christophe can correct misalignment and asymmetry by creating custom-made orthotics to suit the exact needs of each individual client.

Christophe helps private individuals and works regularly with athletes from a diverse range of sports, including cycling, football, running, golf and skiing. Providing a bespoke, specialist service such as this involves not only Christophe’s expertise but also machinery, technology and a large stock of materials. That is why, until now, he has required his athletes and patients to come to his London clinic where everything from initial tests right through to fitting the orthotics is done in one, typically 90-minute, session. Indeed, he has had patients fly in from all over the world to make use of his expertise and unique clinic/workshop setup.

While achieving amazing results for so many in this way, it had become increasingly apparent that Christophe was not necessarily serving his patients as well as he might, particularly as he is frequently working with large sports teams and players, including Women’s football clubs. It was clear that one man travelling to a club made more sense than, say, 15 team members travelling to central London.

This came into sharp focus in early 2023 when Christophe met with the in-house doctor of the Arsenal Football Club and his head physio. Christophe says:

“While the comparison between PODO and a football team – we have 90 mins to get the job done, and we play better at home – was an entertaining way of ruling out PODO offering our services on-site, I realised that it actually wasn’t accurate.”

Christophe’s hopes for the future of PODO included being able to offer his services far more widely, geographically. Describing his work helping people to correct misalignment and avoid associated pain and discomfort as his “passion”, he didn’t want to limit that to London alone.

But he was concerned that moving out of the fixed clinic setting, he would be sacrificing PODO’s high standards, in particular the moulding and craftsmanship of the PODO orthotics, which could then lead to a poorer service – something Christophe was determined to avoid.

After the Arsenal meeting, Christophe went to the clinic’s main provider, reconnected with their original provider in France, and met the other leaders in machinery in Europe, and worked closely with them to create a solution for every single problem that made ‘going mobile’ a challenge including volume, weight and the capacity to travel, for example.

10 months later, Christophe could not be happier with the results. “The mobile workshop isn’t just more compact and transportable in anti-shock and waterproof cases, but the electronics are actually more advanced – even the grinding bench rotates at twice the speed previously achieved. The mobile clinic is just as good as the static clinic in London – meaning all patients get the same quality of service and orthotics. The mobile clinic allows PODO to go on the road whenever, and to wherever, needed. PODO is now visiting sports clubs, gyms, private homes, etc. with all the equipment required to give to the same high quality personalised bespoke service and orthotics fitting that PODO patients expect and that Christophe is known for.

More specifically, it will allow Christophe and PODO to help tackle the large number of knee injuries in Women’s Football that are due to footwear which is not designed for women’s feet. It will also enable him to export the expertise and unique craftsmanship abroad, popping up within hospitals, training camps and private homes outside the UK. PODO Mobile Clinic & Workshop allows everyone access, regardless of location, to high quality custom made and personally fitted orthotics, whether for yourself, friends, family, or an entire athletic team.

For further information please visit  https://www.podo.london/

About Christophe Champs

Christophe Champs is an expert in Biomechanics, and the founder of PODO Clinic and Workshop. Christophe works with clients to help correct postural and biomechanical issues that are causing pain or putting a client at risk of injury. By testing both the moving gait and the still posture Christophe can correct misalignment and asymmetry through creating custom-made orthotics to suit the exact needs of each individual client. For further information please visit  www.podo.london

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Please contact Sophie Inglis, Panpathic Communications
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New Research will Target Earliest Stages of Bone Marrow Cancer 

The opportunity to eradicate a major and incurable bone marrow cancer has been made possible with a new programme funded by Cancer Research UK. 

An interdisciplinary team of researchers will investigate the underpinning biology of the very early stages of the cancer myeloma. This is game changing research because the early stage, called MGUS – [monoclonal gammopathy of unknown significance], is common and only an unpredictable minority of cases go on to develop the killer disease of myeloma. MGUS patients have non-cancerous expansion of immune cells in their bone marrow. In most patients this will be stable for many years and will never cause significant harm. The problem is that in some patients the cells will become more aggressive and cause full-blown cancer.  

For decades it has not been possible to sufficiently tell these two types of patients apart. Until now this challenge has been considered insurmountable resulting in all cases of myeloma being diagnosed very late. However, thanks to the funding by Cancer Research UK it is time to make a change. Using biological and bioinformatic research the team aim to devise ways of accurately predicting which patients with MGUS are truly at risk of developing life threatening myeloma and those that will not.  

With the help of experts in the economic challenges faced by health providers such as the NHS the team will then will design the best possible screening strategies to detect the disease and the quickest possible route to clinical trials of ways to prevent myeloma occurring.  

Lead researcher Chris Bunce is Professor of Translational Cancer Biology, in the School of Biosciences at the University of Birmingham. He said:

“Despite decades of academic and pharmaceutical company research, costing eye watering amounts of money and human endeavour, a cure for myeloma remains elusive.  

“All myeloma cases, however, arise from an easily diagnosed pre-condition that remains virtually ignored by researchers. This funding from Cancer Research UK reverses that stance and turns the focus onto the very early stages of myeloma with a view to stopping the disease in its tracks.” 

The research aims to provide a deeper understanding of how specific chemicals in the blood change as patients transition from MGUS towards developing myeloma. These changes – first identified by researchers at the University of Birmingham – could help distinguish ‘high risk’ MGUS from ‘low risk’ MGUS, as well as helping to identify potential drug targets for treatment. 

Mark Drayson, Professor of Clinical Immunodiagnostics in the University’s Institute of Immunology and Immunotherapy, and co-lead research for the project, said:

“By bringing together different approaches and expertise we aim to overcome the existing barriers to developing an effective test for stratifying risk of progression from MGUS to myeloma that is recognised as both affordable and effective.” 

Dr Marianne Baker, Science Engagement Manager at Cancer Research UK, said:

“To beat cancers that are often diagnosed late, like myeloma, we need to understand the earliest stages of its development – the underlying biology of the disease. This is a historically underfunded area, so we’re excited to see what the project brings; the more our researchers discover, the less room cancer has to manoeuvre. It’s vital we translate results into innovations, like tests that can predict risk, and give treatment the best chance of success.” 

About University of Birmingham

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 8,000 international students from over 150 countries.

Further Information and Media Contact

For media enquiries please contact Beck Lockwood, Press Office, University of Birmingham, Tel: +44 (0)781 3343348: r.lockwood@bham.ac.uk  

Two Cups of Tea Daily can Improve Sleep and Cut Stress

A solution to the nation's poor sleeping habits and stressful lives can be found in a cup of black, green, or herbal tea infusions, according to a study – Tea and Herbal Infusions, Psychological Stress, Anxiety & Sleep Health: A Systematic Review of Human Trials & Mechanistic Studies[1] – which analysed 33 different studies including eight human intervention trials.

The review, commissioned by the Tea Advisory Panel (TAP) (www.teaadvisorypanel.com) and authored by nutrition and well-being experts, found that sleep quality, efficiency and duration, as well as stress management, can be aided by several types of tea including regular black tea – the typical British cuppa – and green tea, German Chamomile, Lavender, Rose, Jasmine, and Passionflower.

One in four adults gets fewer than the recommended 7-9 hours of sleep nightly,[2] according to studies from the UK, US, and Netherlands.[3] The worst affected are women aged 40+ years, who have the shortest sleep durations and poor sleep efficiency, while half of teenagers sleep less than the optimal 8-10 hours a night for their age group. Sleep efficiency is the ratio between trying to get to sleep and actually sleeping.

Author of the new study, and a member of TAP, Dr Tim Bond says:

"Our research has found that a surprising number of different tea types can lower stress and lead to better sleep and relaxation. The herbal tea infusions are probably better known for their calming properties, but studies also confirm that green tea, oolong, and the typical British cuppa have an effect at intakes of just two cups a day.

"This adds to real world data from a survey reviewed by TAP[4] which found that nearly six in ten (57%) UK adults feel relaxed when they drink tea, and half feel calm. Similarly, four in 10 (42%) report that regular tea drinking helps with stress and anxiety and 23% say it combats low mood.

"The active compounds in tea that could help send us to the Land of Nod include polyphenols, L-theanine, theaflavins, thearubigins and gamma (γ)-aminobutyric acid (GABA). Both L-theanine, an amino acid, and GABA have direct effects on the brain, helping to activate pathways that lower stress and create calm and relaxation. Tea is the main natural source of L-theanine in our diet".

GP Dr Gill Jenkins, warns about the health risks of getting too little high-quality sleep, commenting: "Having less than six hours of sleep a night has been found to boost levels of C-reactive protein which indicates that the body is fighting inflammation. Levels of gamma glutamyl transferase, a marker of liver damage, also rise by more than 10% after chronic poor sleep. These and other changes have serious health implications.

"Studies show that sleeping less than seven hours a night is linked with increased risk of type 2 diabetes, obesity, hypertension, depression and impaired immune function.  In the short term, poor quality sleep affects cognitive and task performance, heightens feelings of fatigue, and impedes decision-making. That's why we ignore sleeping problems at our peril".

More proof that drinking tea has positive effects on stress, anxiety, mental well-being and as a result sleep comes from the studies reviewed by Tea and Herbal Infusions, Psychological Stress, Anxiety & Sleep Health: A Systematic Review of Human Trials & Mechanistic Studies. These included:

• A study in young adults found that two daily cups of matcha green tea significantly lowered anxiety;
• Six weeks of black (regular) tea lowered stress hormone levels and increased relaxation in a group of men asked to perform stressful mental tasks. Great news for those people looking to bust stress and sleep troubles;
• Elderly adults drinking lavender tea twice daily had lower anxiety and depression levels;
• Two cups of rose tea daily improved mental well-being in teenage girls;
• Levels of chromogranin A – a stress response – increased in students performing mental stress load tasks.

Dr Tim Bond from TAP comments:

"Stress and poor sleep can become a vicious cycle which seriously impacts on mental performance and physical health. But lifestyle changes including tea drinking and sleep hygiene can make a difference.

"As our new review provides good evidence that even two cups of tea daily can aid sleep quality, relaxation and bust stress due to the high concentrations of L-theanine and polyphenol compounds. Several types are effective including the well-loved British cuppa, green tea, and herbal tea varieties, particularly German Chamomile, Lavender, Rose, Jasmine, and Passionflower.

"Incorporating two cups of tea into our evening routines could make the difference between tossing and turning and getting some serious shut eye".

Further Information 

Please visit www.teaadvisorypanel.com

About The Tea Advisory Panel

The Tea Advisory Panel is supported by an unrestricted educational grant from the UK TEA & INFUSIONS ASSOCIATION, the trade association for the UK tea industry. The Panel has been created to provide media with impartial information regarding the health and wellness benefits of tea. Panel members include nutritionists; dieticians and doctors.

References

1. Ellis, J, Bond, T, Derbyshire, E (2023). Tea and Herbal Infusions, Psychological Stress, Anxiety & Sleep Health: A Systematic Review of Human Trials & Mechanistic Studies.  https://sciforschenonline.org/journals/nutrition-food/NFTOA182.php
2. Recommendations from the American Academy of Sleep Medicine and the Sleep Research Society.
3. Kocevska, D et al. (2021) Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom, and United States: a systematic review and meta-analysis. Nat Hum Behav 2021, 5, 113-122.
4. Independent survey of 1,000 adults in the UK aged 18 to 60 years; data on file and available to view.

Media Source and Further Information

"Paula Figgett" <paula@junglecatsolutions.com>

AI’s Ability to Detect Tumor Cells Could be Key to More Accurate Bone Cancer Prognoses

Researchers have developed a new machine-learning model that can precisely make prognosis predictions for patients with osteosarcoma, based on the density of viable tumor cells post-treatment.

Osteosarcoma is a type of bone cancer that predominantly affects adolescents. Reliable models that can predict prognosis and treatment response can help improve patient outcomes. However, conventional methods relying on the measurement of necrosis rate are limited by inter-assessor variability and may not accurately predict prognosis. Now, researchers have developed an AI model which can accurately measure the density of viable tumour cells after treatment which correlates well with prognosis and individual tumor cell response.

Fukuoka, Japan - Researchers at Kyushu University have developed and validated a machine-learning model that can accurately evaluate the density of surviving tumor cells after treatment in pathological images of osteosarcoma – the most prevalent malignant bone tumor. The model can assess how individual tumor cells respond to treatment and can predict overall patient prognosis more reliably than conventional methods.

Surgery and chemotherapya have significantly improved the outcomes of patients with localized osteosarcoma. However, patients with advanced metastatic disease (the stage where cancerous cells have spread to distant tissues) have a low survival rate. After a standard treatment of surgery and chemotherapy, assessing the prognosis of patients is essential for determining their subsequent individual treatment plans. However, predicting patient outcomes has many challenges. Currently, prognosis relies on necrosis rate assessment, which involves pathologists evaluating the proportion of dead tissue within a tumor. Unfortunately, these methods are limited by variability between pathologists’ assessments and may not accurately predict treatment response.

Recognizing the need for faster and more accurate prognoses, Dr. Kengo Kawaguchi and Dr. Kazuki Miyama, from the Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan, and Dr. Makoto Endo, a lecturer of Orthopedic Surgery at Kyushu University Hospital, along with collaborators, turned to artificial intelligence (AI) for a more nuanced evaluation. The multidisciplinary team headed by Dr. Endo included Kyushu University’s Professor Ryoma Bise, Professor Yoshinao Oda, and Professor Yasuharu Nakashima. Explaining the rationale behind their research, which was published on 22 January, 2024, in  njp Precision Oncology, Dr. Endo says,

“In the traditional method, the necrosis rate is calculated as a necrotic area rather than individual cell counts, which is not sufficiently reproducible between assessors and does not adequately reflect the effects of anticancer drugs. We therefore considered using AI to improve the estimation.”

In phase 1 of the study, the team trained a type of AI, called a deep-learning model, to detect surviving tumor cells and validated its detection performance using patient data. The AI model showed proficiency in detecting viable tumor cells in pathological images, aligning with expert pathologists' capabilities. In phase 2, the researchers analyzed two key measures: disease-specific survival, which tracks the duration after diagnosis or treatment without death directly caused by the disease, and metastasis free survival, which monitors the time post-treatment without cancer cells spreading to distant body parts. They also explored the correlation between AI-estimated viable tumor cell density and prognosis. Notably, the AI model demonstrated comparable detection performance and precision to that of the pathologist, with good reproducibility.

Next, the researchers sorted the patients into groups based on whether the viable tumor cell density was above or below 400/mm². The survival analysis revealed that the high-density group showed a worse prognosis, while the low-density group showed a better prognosis for disease-specific survival and metastasis-free survival. Necrosis rate, on the other hand, was not associated with disease-specific survival or metastasis-free survival. Furthermore, analysis of individual cases revealed that AI-estimated viable tumor cell density was a more reliable predictor of prognosis than necrosis rate.

Overall, these findings suggest that the AI-based measurement of viable tumor cells reflects the inherent malignancy (ability of the cancer to spread) and individual tumor cell response of osteosarcomas. Incorporating AI in the analysis of pathological images improves detection accuracy, reduces inter-assessor variability, and enables timely assessment. Moreover, the estimation of viable tumor cells, which reflects their ability to keep multiplying following chemotherapy, is a more reliable predictor of treatment response than cell death. Large-scale validation of the AI model developed in this study can aid its wider application in real-life clinical settings.

“This new approach has the potential to enhance the accuracy of prognoses for osteosarcoma patients treated with chemotherapy. In the future, we intend to actively apply AI to rare diseases such as osteosarcoma, which have seen limited advancements in epidemiology, pathogenesis, and etiology. Despite the passage of decades, particularly in treatment strategies, substantial progress remains elusive. By putting AI to the problem, this might finally change,” concludes a hopeful Dr. Endo.

Further Information

For more information about this research, see "Viable tumor cell density after neoadjuvant chemotherapy assessed using deep-learning model reflects the prognosis of osteosarcoma," Kengo Kawaguchi, Kazuki Miyama, Makoto Endo, Ryoma Bise, Kenichi Kohashi, Takeshi Hirose, Akira Nabeshima, Toshifumi Fujiwara, Yoshihiro Matsumoto, Yoshinao Oda and Yasuharu Nakashima,  npj Precision Oncology.   https://doi.org/10.1038/s41698-024-00515-y  https://www.nature.com/articles/s41698-024-00515-y . 22 Jan 2024.

About Kyushu University

Founded in 1911, Kyushu University is one of Japan's leading research-oriented institutes of higher education, consistently ranking as one of the top ten Japanese universities in the Times Higher Education World University Rankings and the QS World Rankings. The university is one of the seven national universities in Japan, located in Fukuoka, on the island of Kyushu – the most southwestern of Japan’s four main islands with a population and land size slightly larger than Belgium. Kyushu U’s multiple campuses – home to around 19,000 students and 8000 faculty and staff – are located around Fukuoka City, a coastal metropolis that is –frequently ranked among the world's most livable cities and historically known as Japan's gateway to Asia. Through its VISION 2030, Kyushu U will “drive social change with integrative knowledge.” By fusing the spectrum of knowledge, from the humanities and arts to engineering and medical sciences, Kyushu U will strengthen its research in the key areas of decarbonization, medicine and health, and environment and food, to tackle society’s most pressing issues.

Funding information

This work was supported in part by JSPS KAKENHI (Grant Number JP18K16627 and JP23K08700) and research funds from the Graduate School of Medical Sciences, Kyushu University.

Media Contact and Further Information       

Please contact Danielle Ellenby sysintlkh@jimu.kyushu-u.ac.jp  Tel: +81 92 802 2443