Working long hours in low socioeconomic status jobs 'increases diabetes risk'

A new study published in The Lancet Diabetes & Endocrinology claims people who work more than 55 hours a week doing jobs of low socioeconomic status are at significantly higher risk of developing type 2 diabetes, compared with those who work fewer hours.

Researchers say people who work long hours doing jobs of low socioeconomic status - such as manual work - are much more likely to develop type 2 diabetes that those who work fewer hours.

Long working hours have previously been associated with poor health outcomes. A study recently reported by Medical News Today, for example, found a higher risk of coronary heart disease among people who work more than 60 hours a week.
The researchers of this latest study, led by Mika Kivimäki, professor of epidemiology at University College London in the UK, notes that past studies have also linked long working hours to stress, unhealthy lifestyles, depressive symptoms and disturbed sleep, which they say are factors that can contribute to development of diabetes.
"However, the direct association between long working hours and incident type 2 diabetes has been assessed in only a few studies," the researchers add.
With this in mind, the team conducted the largest study so far to investigate how long working hours influence the risk of type 2 diabetes.

Long hours in low socioeconomic status jobs 'increases type 2 diabetes risk by 30%'

To reach their findings, the team analyzed data from a selection of published and unpublished studies looking at the effect of long working hours on type 2 diabetes. The data involved 222,120 men and women from the US, Europe, Japan and Australia, and participants were followed up for an average of 7.6 years.
When the researchers compared people who worked 55 hours or more each week with those who worked the standard 35-40 hours a week, they found no significant difference in the risk of developing type 2 diabetes.
However, when they compared results by socioeconomic status, the team found that participants with jobs of low socioeconomic status - such as jobs involving manual labor - who worked 55 hours or more each week were 30% more likely to develop type 2 diabetes, compared with those who worked 35-40 hours a week.
"The strong socioeconomic patterning in the results was surprising," Prof. Kivimäki told MNT. "The higher the person's position in the socioeconomic hierarchy was, the less working long hours was linked to diabetes risk. So, high socioeconomic position appears to protect against the 'diabetogenic' effects of long working hours."
The researchers note that this finding remained even after accounting for age, sex, obesity status, smoking and physical activity. It also remained when the researchers excluded participants who do shift work, which has previously been linked to increased risk of obesity and type 2 diabetes.

'Working long hours in such groups could be marker of other risk factors'

Although the team did not investigate the reasons for this association, they hypothesize that it could be down to a number of factors. Those who work long hours in low socioeconomic status jobs may be more likely to have less sleep and less time to engage in physical exercise, for example, which may increase the risk of type 2 diabetes.
"It is also possible that working long hours in low socioeconomic groups is a marker of other risk factors, such as low pay and financial constraints," said Prof. Kivimäki. "Those with a high socioeconomic status are less likely to have such hardships."
Commenting on their overall findings, Prof. Kivimäki says:

"The pooling of all available studies on this topic allowed us to investigate the association between working hours and diabetes risk with greater precision than has been previously possible.
Although working long hours is unlikely to increase diabetes risk in everyone, health professionals should be aware that it is associated with a significantly increased risk in people doing low socioeconomic status jobs."

When MNT asked Prof. Kivimäki if people in low socioeconomic status jobs should reduce their working hours to reduce diabetes risk, he replied that no studies have suggested that lowering working hours would have such an effect.
"For this reason, my recommendation for people who wish to decrease their risk of type 2 diabetes is to eat and drink healthfully, be physically active, avoid overweight, do not smoke, and keep blood glucose and lipids levels within the normal range. This applies both to individuals who work long hours and those who work standard hours."
He added that in future research, the team plans to investigate the link between long working hours and other health outcomes, such as coronary heart disease, stroke and excessive alcohol consumption.
In an editorial linked to the study, Dr. Orfeu Buxton, of Pennsylvania State University, and Dr. Cassandra Okechukwu, of Harvard School of Public Health in Boston, MA, say that this study offers a "solid foundation" for further research into the risks and interventions for diabetes.
"The results remained robust even after controlling for obesity and physical activity," they add, "which are often the focus of diabetes risk prevention, suggesting that work factors affecting health behaviors and stress may need to be addressed as part of diabetes prevention."
MNT recently reported on a study from the Centers for Disease Control and Prevention (CDC), revealing that rates of diabetes in the US leveled off between 2008 and 2012.

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'Increased risk of venous thromboembolism among NSAID users'

You have probably heard that the most nutritious foods are the ones that are the most colorful. There are even several fad diets that tell you to avoid any white or colorless food, but don't write off cauliflower and other white veggies just yet.
The grain-refining process used in white breads and pastas are processed to remove the bran and the germ parts of the grain, which lower fiber and B vitamin content so it's perfectly fine to avoid these nutrient-lacking foods. Cauliflower, by contrast, is naturally high in both fiber and B-vitamins.
As part of the brassica family, more commonly known as cruciferous vegetables, cauliflower contains antioxidants and phytonutrients that can protect against cancer, fiber that helps with satiety, weight loss and a healthy digestive tract, choline that is essential for learning and memory as well as many other important nutrients.
Cauliflower even ranks among the top 20 foods in regards to ANDI score (Aggregate Nutrient Density Index), which measures vitamin, mineral and phytonutrient content in relation to caloric content. To earn high rank, a food must provide a high amount of nutrients for a small amount of calories.
This MNT Knowledge Center feature is part of a collection of articles on the health benefits of popular foods. It provides a nutritional breakdown of cauliflower and an in-depth look at its possible health benefits, how to incorporate more cauliflower into your diet and any potential health risks of consuming cauliflower.

Contents of this article:

1. Nutritional breakdown of cauliflower
2. Possible health benefits of consuming cauliflower
3. How to incorporate more cauliflower into your diet
4. Potential health risks of consuming cauliflower

Nutritional breakdown of cauliflower

According to the USDA National Nutrient Database, one cup of chopped raw cauliflower (1/2 inch pieces, about 107 grams) contains 27 calories, 2 grams of protein, 0.3 grams of fat, and 5 grams of carbohydrate (including 2.1 grams of fiber and 2 grams of sugar).

Cauliflower contains antioxidants and phytonutrients that can protect against cancer, fiber that helps with satiety, weight loss and a healthy digestive tract.

Eating one cup of raw cauliflower will provide 77% of your vitamin C needs, 20% of vitamin K, 10% or more of vitamin B-6 and folate needs for the day, as well as smaller amounts of thiamin, riboflavin, niacin, pantothenic acid, calcium, iron, magnesium, phosphorus, potassium and manganese.

Possible health benefits of consuming cauliflower

Consuming fruits and vegetables of all kinds has long been associated with a reduced risk of many adverse health conditions. Many studies have suggested that increasing consumption of plant foods like cauliflower decreases the risk of obesity, diabetes, heart disease and overall mortality while promoting a healthy complexion, increased energy, and overall lower weight.

Cancer

Cauliflower contains antioxidants that help prevent cellular mutations and reduce oxidative stress from free radicals. One of these is indole-3-carbinol or I3C, commonly found in cruciferous vegetables like cabbages, broccoli and cauliflower/ I3C has been shown to reduce the risk of breast and reproductive cancers in men and women.²
For the past 30 years, eating a high amount of cruciferous vegetables has been associated with a lower risk of cancer; namely lung and colon cancer. Recently, studies have suggested that the sulfur-containing compounds (namely sulforaphane) that give cruciferous vegetables their bitter bite are also what give them their cancer-fighting power.
Sulforaphane is now being studied for its ability to delay or impede cancer with early promising results associated with melanoma, esophageal, prostate and pancreatic cancers. Researchers have found that the sulforaphane compound can inhibit the enzyme histone deacetylase (HDAC), known to be involved in the progression of cancer cells. The ability to stop HDAC enzymes could make sulforaphane-containing foods a potentially powerful part of cancer treatment in the future.¹

Digestion

Cauliflower is high in both fiber and water content, which helps to prevent constipation, maintain a healthy digestive tract and lower the risk of colon cancer.
Adequate fiber promotes regularity, which is crucial for the daily excretion toxins through the bile and stool, but good digestion is far from all that fiber can do for your body.
Recent studies have shown that dietary fiber may play a role in regulating the immune system and inflammation, consequently decreasing the risk of inflammation-related conditions such as cardiovascular disease, diabetes, cancer, and obesity.
According to the Department of Internal Medicine and Nutritional Sciences Program of the University of Kentucky, high fiber intakes are associated with significantly lower risks for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increased fiber intake has also been shown to lower blood pressure and cholesterol levels, improve insulin sensitivity, and enhance weight loss for obese individuals.

Memory

Choline is a very important and versatile "vitamin-like factor" in cauliflower that helps with sleep, muscle movement, learning and memory. Choline also helps to maintain the structure of cellular membranes, aids in the transmission of nerve impulses, assists in the absorption of fat and reduces chronic inflammation.³

Strong bones

Low intakes of vitamin K have been associated with a higher risk for bone fracture and osteoporosis. Adequate vitamin K consumption improves bone health by acting as a modifier of bone matrix proteins, improving calcium absorption and reducing urinary excretion of calcium.⁴

How to incorporate more cauliflower into your diet

An excellent substitute for traditional pizza crust - made from cauliflower.

Cauliflower is most commonly found fresh or frozen. When choosing fresh cauliflower, look for a firm head with no dark spots and bright green leaves attached to the stem. Store in the refrigerator in a plastic bag for up to five days.
New and trendy ways to use cauliflower include cauliflower crust pizza, cauliflower "rice" and buffalo cauliflower "wings."
Try some of these delicious, healthy recipes that incorporate cauliflower:
Creamy cauliflower soup with white cheddar

Garlic parmesan mashed cauliflower with chives

Curry-spiced cauliflower with breadcrumbs

Potential health risks of consuming cauliflower

Foods that are high in fiber such as beans, cabbage, cauliflower, broccoli, lentils, Brussels sprouts, onions, whole grains and cereals may cause increased bloating and flatulence however most people can tolerate these foods in proper portions.
Since vegetables and whole grains are a healthy part of the diet, increase your intake of these foods gradually and monitor your symptoms to determine which foods could be causing bloating.
If you are taking blood-thinners such as Coumadin (warfarin) it is important that you do not suddenly begin to eat more or fewer foods containing vitamin K, which plays a large role in blood clotting.
It is the total diet or overall eating pattern that is most important in disease prevention and achieving good health. It is better to eat a diet with a variety than to concentrate on individual foods as the key to good health.

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UK-based chemists report 'designer proteins' breakthrough

A potential breakthrough in techniques to develop drugs to treat diseases as diverse as cancer and Alzheimer's has been reported by chemists at the University of Leicester in the UK.

Amino acids are used to make all proteins - the Leicester team refers to them as "Mother Nature's building blocks," as they are essential for life.

The Jamieson Research Group in the Department of Chemistry at the University of Leicester claim to have developed a new process for generating a specific synthetic amino acid.
Amino acids are used to make all proteins - the Leicester team refers to them as "Mother Nature's building blocks," as they are essential for life.
"We are very proud of this research," says lead scientist Dr. Andrew Jamieson, "it has taken several years of hard work to master the chemistry techniques to create these new building blocks, but now that we have conquered it, we have access to new building blocks that people have only ever dreamed of before!"
There are 20 naturally produced amino acids in total. By contrast, the new chemical synthesis of unnatural amino acids pioneered by the Leicester team could be used to make designer mini-proteins with entirely new structures and functions from those found in nature.
The researchers say they are particularly interested in using the designer proteins to create innovative new treatments for cancer and Alzheimer's disease.
Dr. Jamieson explains:

"Unnatural amino acids, the building blocks, are described as chiral, meaning they have 'handedness.' A robust synthesis to selectively produce molecules with a particular handedness has not previously been reported. Our new practical method allows us to selectively synthesize only the 'right handed molecules.'
This new research is important because it has uncovered a new, easier and quicker way to make these building blocks which can be used to make new drugs. We now have access to new building blocks to develop innovative new protein drugs for the treatment of disease."

Dr. Jamieson mentions that a student also used the building blocks to synthesize a toxin produced by a sea snail, which the team hopes to develop as a new painkiller.

Other amino acid developments

Back in April, chemists from the University of California, San Francisco (UCSF) reported a similar breakthrough in creating, for the first time, enzyme-like activity using peptides (chemical compounds comprised of amino acids) that are only seven amino acids long.
Ivan V. Korendovych, assistant professor of chemistry who co-led the UCSF study, said:
"It was the first time that a peptide this small self-assembled to produce an enzyme-like catalyst. Our finding suggests that amyloids, whose buildup leads to Alzheimer's in the brain, may also have served as the blueprint for larger, modern-day enzymes."
Also this year, researchers at the University of North Carolina (UNC) published results in the Proceedings of the National Academy of Sciences, reporting that they re-engineered a chain of amino acids in a type of dengue virus.
The UNC investigators think their research may not only provide a potential vaccine for dengue fever, but could also contribute to vaccine development for diseases such as severe acute respiratory syndrome (SARS) and human immunodeficiency virus (HIV).

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Fruit and veg consumption tied to mental health

By now, most of us are aware that eating fruits and vegetables is good for our physical health. But a new study published in the BMJ Open suggests eating five a day is linked to better mental well-being.

Eating your "5 a day" increases changes of higher mental well-being, the researchers say.

A previous study suggested that consuming five portions of fruits and vegetables a day is the optimum amount for lowering the risk of death from any cause, which contradicts another study that suggested we should be eating seven portions of fruit and veg a day.
The researchers from this latest study, led by Dr. Saverio Stranges of the University of Warwick Medical School in the UK, used data from the Health Survey for England, which included nearly 14,000 adults over the age of 16.
This survey collected detailed information on the mental and physical health of the participants, as well as their health-related behaviors, demographics and socio-economic characteristics.
In addition, the team assessed the participants' mental well-being using the Warwick-Edinburgh Mental Wellbeing Scale, putting the top 15% of participants in the "high mental well-being" group, the bottom 15% in the low group, and those between 16-84% in the middle group.

'The higher the veg and fruit intake, the lower the chance of low well-being'

Overall, the researchers found that high and low mental well-being were typically associated with the participants' fruit and vegetable intake.
In detail, 35.5% of participants with high mental well-being ate five or more portions of fruits and vegetables a day, compared with only 6.8% who consumed less than one portion.
Additionally, 31.4% of the individuals from the high mental well-being group ate three to four fruit and veg portions per day, and 28.4% ate one to two.
"The data suggest that [the] higher an individual's fruit and vegetable intake, the lower the chance of their having low mental well-being," says Dr. Stranges.
The researchers also considered other health-related behaviors - such as smoking, alcohol intake and obesity - and found that only smoking and fruit and vegetable intake were consistently associated with mental well-being.
Dr. Stranges explains:

"Along with smoking, fruit and vegetable consumption was the health-related behavior most consistently associated with both low and high mental well-being. These novel findings suggest that fruit and vegetable intake may play a potential role as a driver, not just of physical, but also of mental well-being in the general population."

Alcohol intake and obesity were associated with low, but not high mental well-being, the researchers add.

Enhancing well-being while preventing cancer

According to the team, high mental well-being is more than simply the absence of symptoms or illness - it is the condition of feeling good and functioning well. They add that optimism, happiness, self-esteem, resilience and good relationships are also part of this mode of being.
According to co-author Prof. Sarah Stewart-Brown, mental illness "is hugely costly to both the individual and society, and mental well-being underpins many physical diseases, unhealthy lifestyles and social inequalities in health."
She says enabling people to maintain good well-being is important from a research perspective.
"Our findings add to the mounting evidence that fruit and vegetable intake could be one such factor and mean that people are likely to enhance their mental well-being at the same time as preventing heart disease and cancer," she adds.
When asked about whether the study accounted for physical activity, Dr. Stranges told Medical News Today that one of the limitations of the study was that such data "was not available in the Health Survey for England," leaving room for further study.

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CDC: Ebola cases in West Africa could exceed 550,000 by January

In their latest report on the current Ebola epidemic in West Africa, the US Centers for Disease Control and Prevention urge that immediate interventions be put in place quickly, and warn that the "cost of delay will be devastating."

If current trends continue, they say the future number of cases in Liberia and Sierra Leone could exceed 550,000 by January. That estimate is based on reported cases. If under-reporting is taken into account, their calculations suggest that figure is likely to be nearer 1.4 million.
While the Centers for Disease Control and Prevention (CDC) say they cannot guarantee the accuracy of their estimates, they are clear about their key messages: "if conditions remain unchanged, the situation will rapidly become much worse," and they serve as "a warning and a call to action."
The CDC report their calculations - and how they arrived at them with a new model - in their latest Morbidity and Mortality Weekly Report (MMWR). The report details the CDC estimates for future Ebola cases in Liberia and Sierra Leone, where the epidemic is uncontained and out of control.

Number of cases doubling every few weeks

The report notes that on March 22, 2014, there were 49 reported cases of Ebola virus disease (usually referred to as Ebola) in Guinea, where the current outbreak in West Africa began.

According to the CDC, there will be up to 21,000 cases of Ebola in Liberia and Sierra Leone by the end of September.

By the end of August, the outbreak had spread to neighbouring Liberia and Sierra Leone, and the total number of probable, confirmed and suspected cases had risen to 3,685.
The CDC estimate that by the end of September, there will be around 8,000 Ebola cases - or as many as 21,000 cases if corrections for under-reporting are included - in Liberia and Sierra Leone.
And if current trends continue, "without additional interventions or changes in community behavior," these figures will rise to around 550,000 cases - or 1.4 million including under-reported cases.
The estimates assume the current conditions of disease transmission will remain unchanged. The main driver of the estimates is that in Liberia, the number of cases is doubling about every 15-20 days, and in Sierra Leone and Guinea, they are doubling around every 30-40 days.

EbolaResponse modeling tool takes into account disease stages and types of isolation

For their calculations, the CDC constructed a new modelling tool called EbolaResponse, comprising an Excel spreadsheet containing a set of formulae and assumptions.
The model allows researchers to estimate the daily movement of patients within disease stages (i.e. susceptible, incubation, infectious, recovery or death) using probabilities for three different types of isolation.
The three different types of isolation are: hospitalization (such as in an Ebola treatment unit or medical care facility), home with effective isolation (a home or community setting where there is reduced risk of disease spread, including safe burial where needed), and home with no effective isolation.
Ideally, Ebola treatment units and appropriate medical care facilities have infection control procedures that prevent disease spread, but the CDC note this is not always the case. So the model assumes there is an average daily risk that transmission will occur - however this is fewer than one person infected per infectious patient.
The model includes information from previous Ebola outbreaks - for example, periods of infectivity, time between exposure and illness. There is no evidence that the virus is spreading differently from previous outbreaks.
To estimate the number of under-reported cases, the report uses a factor of 2.5. This was calculated using estimates of beds-in-use from the model and comparing them to expert opinions of actual beds-in-use on a given day (August 28th). The difference is a potential under-reporting correction factor (1.5 more beds were being used than the model estimated.)

'Cost of delay will be devastating'

The CDC say we know how to control and stop the epidemic. The model suggests this will require about 70% of people infected with Ebola be cared for in Ebola treatment units, or if these are full, they should be cared for at home or in a community setting, where risk of disease is reduced and burials are conducted safely.
Every month of delay in reaching this 70% target will increase the number of cases and deaths, and the need for more beds and resources. "The cost of delay will be devastating," say the CDC.
If we are to avoid the catastrophic scenario the model projects for January, effective interventions need to occur quickly, says the federal agency. This includes "appropriate disease control methods, communication, changes in community behavior, and adequate resources (such as staff, beds, equipment, supplies)."
The CDC model estimates the number of beds that would be needed in medical facilities and Ebola treatment units, but it is not designed to give details of resources such as enhanced protection measures to minimize disease spread.
In a recent Science editorial, Peter Piot, who in 1976 co-discovered the Ebola virus in Zaire (now Democratic Republic of Congo) while working at the Institute of Tropical Medicine in Antwerp, Belgium, says that the current Ebola crisis requires a "rapid response at a massive global scale."
Now a professor at the London School of Hygiene & Tropical Medicine, Prof. Piot says the epidemic in West Africa is the result of a "perfect storm" that combines dysfunctional health services, low trust in Western medicine and governments, denials that the Ebola virus exists, and unhygienic burial practices.
Meanwhile, the UN Security Council has resolved that the Ebola outbreak in Africa constitutes a threat to international peace and security, and calls on member states to respond urgently to the crisis.
The crisis is so urgent that an expert panel of the World Health Organization (WHO) concluded in August that it would be ethical to evaluate unregistered investigational treatments for Ebola virus disease in people.
To this end, the aid agency MSF/Doctors without Borders, recently reported that Ebola treatment trials are to be fast-tracked in West Africa for the first time.

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