Latest / Morning Medical with Dr. Chow / Exercise and Gut Health, Mental Health Apps, and Listeria Outbreak in Canada

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Exercise and Gut Health, Mental Health Apps, and Listeria Outbreak in Canada · Morning Medical with Dr. Chow

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  Good morning and welcome to Morning Medical with Dr.
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  Chow.
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  I am Dr.
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  Chi-Ming Chow, and today we have some exciting topics to discuss that could have a significant
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  impact on your health and well-being.
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  First up, let us talk about how exercise can improve your gut health.
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  This might not be the first benefit you think of when you lace up your running shoes, but it
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  is a significant one.
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  Recent research has been shedding light on how physical activity can positively influence the
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  gut microbiome, which is the community of microorganisms living in our digestive tracts.
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  The gut microbiome plays a crucial role in many aspects of our health, including digestion,
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  immunity, and even mental health.
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  An imbalance in this microbial community can lead to a range of health issues, from
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  inflammatory bowel disease to obesity and depression.
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  So, maintaining a healthy gut microbiome is essential.
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  Exercise, it turns out, can be a powerful tool in achieving this balance.
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  Studies have shown that regular physical activity can increase the diversity of the gut
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  microbiome.
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  A more diverse microbiome is generally considered healthier and more resilient.
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  This diversity helps the gut better handle various challenges, such as infections or
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  changes in diet.
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  One study conducted by researchers at the University of Illinois found that exercise can
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  lead to an increase in the production of short-chain fatty acids.
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  These are compounds produced by gut bacteria that have anti-inflammatory properties and can
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  help protect against diseases such as type 2 diabetes and heart disease.
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  Moreover, exercise has been shown to enhance the production of beneficial gut bacteria, such
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  as those that produce butyrate.
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  Butyrate is a short-chain fatty acid that serves as a primary energy source for cells
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  lining the colon.
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  It has been linked to reduced inflammation and improved gut barrier function, which can
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  prevent harmful substances from entering the bloodstream.
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  Interestingly, the type and intensity of exercise can influence the gut microbiome
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  differently.
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  For example, moderate-intensity aerobic exercises, such as brisk walking or cycling,
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  have been found to be particularly effective in promoting gut health.
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  High-intensity exercises, like sprinting or heavy weight lifting, also have benefits but
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  might affect the gut microbiome differently.
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  It is also worth noting that the positive effects of exercise on the gut microbiome can
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  be seen in both young and older adults.
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  This means it is never too late to start reaping the benefits of physical activity for
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  your gut health.
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  Even if you have not been active for a while, gradually incorporating exercise into your
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  routine can make a difference.
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  So, what is the takeaway here?
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  Incorporating regular physical activity into your lifestyle is not just good for your heart,
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  muscles, and mental well-being, but it is also beneficial for your gut health.
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  Whether it is a daily walk, a bike ride, or a session at the gym, moving your body can help
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  keep your gut microbiome in balance.
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  That is all for this segment.
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  Stay tuned as we delve into more fascinating health topics today on Morning Medical with Dr.
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  Chow.
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  The recent surge in people seeking mental health care across the country has led to long
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  wait times for first appointments with therapists and psychiatrists.
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  Now, a new study offers hope that while they wait to get care, patients could still get some
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  relief by using evidence-based smartphone applications and wearable devices to track
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  sleep and activity.
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  The study shows that depression and anxiety symptoms, and suicidality, all decreased
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  measurably when patients were assigned to mobile applications that incorporated
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  mindfulness practices, cognitive-behavioral therapy skills, or prompts that encouraged
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  mood-enhancing activities.
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  The study, conducted at Michigan Medicine, the University of Michigan's academic medical
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  center, is published in JAMA Network Open.
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  It involved just over two thousand patients scheduled to get care in the coming weeks from
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  a mental health provider at outpatient University of Michigan Health or University of
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  Michigan student clinics.
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  Adam Horwitz, Ph.D., the University of Michigan Medical School psychologist who is the paper's
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  lead author, called the results encouraging, with implications for individuals and clinics
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  alike.
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  According to him, having this type of option, especially for people who are motivated enough
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  to seek an appointment and wait for it, could be very valuable when providers have long wait
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  lists.
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  These individuals want to be doing something about their mental health but do not yet have
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  access, so this suggests that providing them with some sort of digital option when their
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  motivation is already high, and they are ready to do something, could begin to make a
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  difference.
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  Nearly all the patients completed standardized mental health assessments both at the start of
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  the study and after six weeks of using the application they had been randomly assigned to
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  install on their smartphone.
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  All participants also wore a study-provided Fitbit or their own Fitbit or smartwatch, to
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  track sleep and physical activity.
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  The study randomly assigned most participants to one of two commercial applications –
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  Silvercloud, which is based on cognitive behavioral therapy principles, and Headspace,
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  which coaches users in mindfulness techniques.
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  Both applications have been shown separately to help alleviate mental health symptoms, but have
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  never been tested against one another.
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  Some study participants were randomly assigned to receive a customized version of the study
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  application called MyDataHelps, either alone or together with one of the commercial
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  applications.
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  Those randomized to receive this application received positive encouraging prompts twice per
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  day based on their activity tracker data -- for example, applauding them for walking or getting
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  a good amount of sleep, or suggesting a simple act to improve their mood.
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  Surprisingly, no matter what group they were in, the participants' scores on standard mental
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  health scales changed for the better by the end of the study period.
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  At the start of the study, depression scores on average were just under thirteen on the
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  twenty-seven-point PHQ-9 scale; all groups dropped by two to three points by six weeks.
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  Scores on the twenty-one-point GAD-7 anxiety scale dropped by one point five to two points
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  across the board.
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  Meanwhile, scores on measures of protection against suicide risk increased slightly, with
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  the most improvement among participants using Headspace.
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  Scores on the suicide risk measurement dropped slightly across the board, indicating lower
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  risk for suicidal behavior.
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  Most of the study participants had their initial appointment with a University of
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  Michigan mental health provider before the end of that six-week period, but the drop in mental
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  health scores was similar for those who had not yet started professional treatment.
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  Horwitz notes that the newly published study, called PROMPT, helped inform the development of
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  a much larger study called COMPASS based at the University of Michigan that just got seventeen
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  point nine million dollars in funding from the National Institute of Mental Health.
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  The COMPASS study will involve not only smartphone applications, wearable activity
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  trackers and standardized mental health assessments, but also genetic tests and other
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  types of data collection.
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  It will involve thousands of University of Michigan Health and University of Michigan
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  student clinic patients who are waiting for their first mental health-related appointment.
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  Both PROMPT and COMPASS seek to help researchers develop a more personalized
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  approach to mental health care.
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  They hope to identify which characteristics make someone more likely to respond positively
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  to different forms of treatment or support, so they can use this knowledge to reduce the time
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  it takes to find the approach that helps each individual.
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  Horwitz notes that people seeking mobile-based mental health support have many applications to
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  choose from – and that most of those applications have not gotten scrutiny through
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  objective research.
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  Headspace and Silvercloud have more objective evidence behind them than most of these
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  applications, he notes.
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  He and his colleagues were surprised but encouraged to see improvement in the group
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  using the customized version of MyDataHelps, too.
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  Part of the reason may have to do with the study population: people who were motivated to
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  seek help for mental health concerns, had already been on a waiting list to get
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  scheduled, and now had been scheduled and were waiting to be seen.
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  Because mental health conditions can wax and wane in their symptom severity, applications
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  that support someone during an especially low-mood or high-anxiety time could be
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  important for helping them endure the time until their first appointment.
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  Horwitz notes that the study participants' clinical providers did not have access to their
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  application data.
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  But, he said, this might be a potential option for clinics moving forward if patients want to
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  grant that access by allowing their application to share a summary with their clinic.
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  Data from mental health applications could even potentially help providers or systems
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  understand which patients need the most-intensive approaches to psychiatric care,
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  and which might be able to do all right with less-intensive care.
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  That could also improve the waiting list situation for all patients, he notes.
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  He likens this to a relay race.
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  If we can use applications to give the patient a bit of momentum on understanding and managing
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  their symptoms, even before they get to clinic, then perhaps that will help them get more out
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  of therapy once they get to clinic and pass the baton from the application to a professional
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  provider.
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  The applications do not have the same effect as therapy, but doing something while waiting is
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  still important.
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  In addition to Horwitz, the study's authors are Elizabeth D.
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  Mills, Ph.D., of the University of Michigan Department of Anesthesiology, Srijan Sen, M.D.,
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  Ph.D., and Amy S.B.
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  Bohnert, Ph.D.
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  Sen, a professor of psychiatry, directs the University of Michigan Eisenberg Family
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  Depression Center and is a member of the Michigan Neuroscience Institute; Bohnert is
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  co-director of the University of Michigan Opioid Research Institute and a professor of
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  anesthesiology.
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  Bohnert and Sen are two of the three leaders of the COMPASS study.
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  The PROMPT study was funded by Precision Health at the University of Michigan and the Eisenberg
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  Family Depression Center as well as the National Institute of Mental Health.
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  Next, let us discuss Listeria contaminations in Canada, which have been making headlines
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  recently.
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  From pre-packaged salads to six-layer bean dips to mushrooms, the latest contamination involves
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  some plant-based beverages.
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  This is not the first time food or drink products have been recalled due to Listeria in
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  Canada.
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  Listeria monocytogenes, widely referred to as Listeria, can be found in soil, vegetation,
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  sewage, and water, as well as in the feces of both animals and humans.
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  People who eat foods contaminated with Listeria may carry the bacteria and not develop
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  listeriosis, but in other cases, it can be deadly.
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  More than a week after the Canadian Food Inspection Agency recalled some oat, almond,
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  and coconut drinks from the Silk and Great Value brands, two people in Ontario have died
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  from listeriosis.
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  In total, Ontario, Quebec, and Nova Scotia have twelve confirmed cases related to this current
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  outbreak, according to the Public Health Agency of Canada.
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  In recent years, about one hundred and thirty-four cases of invasive listeriosis have
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  been reported annually in Canada.
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  In the last few months alone, several products have been recalled over possible Listeria
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  contamination.
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  Recently, enoki mushrooms, certain meat and vegetable products, as well as salad kits and
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  bean dip, were recalled.
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  While none of these incidents led to confirmed cases or deaths in Canada, products had to be
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  tossed due to the risk.
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  So, how does Listeria end up in our food and drinks?
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  Dr.
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  Michael Rieder, a professor in the department of pediatrics, medicine, and pharmacology at
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  Western University, explains that each time you handle a food and process it, you increase the
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  chance of bacteria getting into it.
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  Ultra-processed foods are thought to be at a greater risk of having some type of bacteria in
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  them compared to less processed ones.
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  Keith Warriner, a food scientist at Guelph University in Ontario, adds that outbreaks
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  usually arise from a lapse in the plant's sanitation practices.
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  If you do not do sanitation correctly, you do not monitor it, it does not matter how much you
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  process it, it is going to get contaminated.
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  Though well-established food and drink plants take product safety seriously, monitoring for
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  these contaminations is not always up to speed.
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  The challenge we have is our detection tools are not perfect, says Rieder.
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  Currently, small manufacturers test for bacteria by sending a sample out to a lab.
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  Not every province has a testing facility, so there can be a delay in getting the results
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  back, and by that time, products have likely already been shipped and are sitting on
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  shelves.
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  Plants typically test maybe once a month, some once a week.
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  Rieder says there should be more in-facility testing so that plants get real-time results.
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  A few years ago, he helped create a Listeria test kit, in the hopes of preventing affected
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  products from hitting the shelves.
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  These kits have been approved by the United States Food and Drug Administration and by
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  Health Canada for use in food plants and labs.
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  He says his team is currently working on a swab test that will help manufacturers test whether
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  their environment is also bacteria-free.
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  Listeria monocytogenes is a type of bacteria that can cause listeriosis, a rare but serious
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  illness with symptoms that may start suddenly.
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  But symptoms can also arise up to two months after the bacteria gets into your system.
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  It is sort of like a slow burn, says Lori Burrows, a microbiologist at McMaster
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  University in Hamilton, Ontario.
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  People may not connect the dots between what they ate and getting sick.
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  Symptoms can include vomiting, nausea, cramps, severe headache, constipation, and fever.
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  More severe illness may result in the brain infection meningitis and blood infection in
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  newborns and older adults.
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  Women who are pregnant are also at high risk, as the infection can lead to miscarriage and
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  pregnancy loss.
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  The mom may not feel sick, but it can be very dangerous for the fetus, says Burrows.
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  Dr.
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  Samir Gupta, a respirologist and associate professor of medicine in Toronto, advises that
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  if you know you have consumed a contaminated product and are feeling symptoms like fever,
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  body aches, and watery diarrhea, you should go see a medical provider, especially if you are
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  part of an at-risk group.
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  For people who have a weak immune system, doctors can prescribe antibiotics if they have
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  diarrhea.
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  Stronger antibiotics are given if the patient has a bloodstream infection.
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  Studies suggest that delayed treatment can increase rates of complications and death.
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  Foods tainted with Listeria will not look different, or have a distinct taste or smell.
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  When levels of the bacteria build up on equipment in food processing plants, outbreaks
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  can occur.
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  Listeria can be killed through cooking or pasteurization, but researchers have shown that
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  the bacteria can even survive in fridges and freezers.
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  There are a number of ways you can lower your risk of getting listeriosis.
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  These include washing your hands before and after handling food, cleaning fruits and
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  vegetables, and avoiding certain foods like raw, unpasteurized milk, soft cheeses, or raw
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  meats.
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  Canadians can keep track of product recalls and safety alerts through the Canadian Food
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  Inspection Agency's website.
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  That is all for today’s episode of Morning Medical with Dr.
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  Chow.
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  I am Dr.
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  Chi-Ming Chow, thanking you for tuning in.
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  Stay healthy and informed, and join us next time for more insights into the world of health
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  and medicine.
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  Have a great day!