Multiple courses of antibiotics can make people more sick

Birmingham, Feb 7: According to a new study, social media users are more likely to eat healthy or junk food after getting influenced by their peer group.

The research published in the scientific journal 'Appetite' found that study participants ate an extra fifth of a portion of fruit and vegetables themselves for every portion they thought their social media peers ate. So, if they believed their friends got their 'five a day' of fruit and veg, they were likely to eat an extra portion themselves.

On the other hand, Facebook users were found to consume an extra portion of unhealthy snack foods and sugary drinks for every three portions they believed their online social circles did.
The findings suggested that people eat around a third more junk food if they think their friends also indulge in the same.

The Aston University researchers said the findings provide the first evidence to suggest our online social circles could be implicitly influencing our eating habits, with important implications for using 'nudge' techniques on social media to encourage healthy eating.

Researchers asked 369 university students to estimate the amount of fruit, vegetables, 'energy-dense snacks' and sugary drinks their Facebook peers consumed on a daily basis.

The information was cross-referenced with the participants' own actual eating habits and showed that those who felt their social circles 'approved' of eating junk food consumed significantly more themselves. Meanwhile, those who thought their friends ate a healthy diet ate more portions of fruit and veg. Their perceptions could have come from seeing friends' posts about the food and drink they consumed, or simply a general impression of their overall health.

There was no significant link between the participants' eating habits and their Body Mass Index (BMI), a standard measure of healthy weight, however. The researchers said the next stage of their work would track a participant group over time to see whether the influence of social media on eating habits had a longer-term impact on weight.

The most recent figures from the NHS's Health Survey for England showed that in 2018 only 28 percent of adults were eating the recommended five portions of fruit and vegetables per day. In Wales, this was 24 percent, in Scotland 22 percent and in Northern Ireland around 20 percent. Children and young people across the UK had even lower levels of fruit and veg consumption.

Aston University health psychology Ph.D. student Lily Hawkins, who led the study alongside supervisor Dr. Jason Thomas, said: "This study suggests we may be influenced by our social peers more than we realize when choosing certain foods. We seem to be subconsciously accounting for how others behave when making our own food choices. So if we believe our friends are eating plenty of fruit and veg we're more likely to eat fruit and veg ourselves. On the other hand, if we feel they're happy to consume lots of snacks and sugary drinks, it can give us a license to overeat foods that are bad for our health. The implication is that we can use social media as a tool to 'nudge' each other's eating behavior within friendship groups, and potentially use this knowledge as a tool for public health interventions."

"With children and young people spending a huge amount of time interacting with peers and influencers via social media, the important new findings from this study could help shape how we deliver interventions that help them adopt healthy eating habits from a young age and stick with them for life," said professor Claire Farrow.

A dietitian called Aisling Pigott further mentioned that "Research such as this demonstrates how we are influenced by online perceptions about how others eat. The promotion of positive health messages across social media, which are focused on promoting healthy choices and non-restrictive relationships with food and body, could nudge people into making positive decisions around the food they eat."

"We do have to be mindful of the importance of 'nudging' positive behaviors and not 'shaming' food choices on social media as a health intervention. We know that generating guilt around food is not particularly helpful when it comes to lifestyle change and maintenance," Aisling added.

High-protein diets may help people lose weight and build muscle, but there is a downside to it --a greater heart attack risk. Researchers now report that high-protein diets boost artery-clogging plaque.

The research in mice showed that high-protein diets spur unstable plaque -- the kind most prone to rupturing and causing blocked arteries.

More plaque buildup in the arteries, particularly if it's unstable, increases the risk of heart attack.

"There are clear weight-loss benefits to high-protein diets, which has boosted their popularity in recent years," said senior author Babak Razani, associate professor at Washington University School of Medicine in St. Louis, Missouri.

"But animal studies and some large epidemiological studies in people have linked high dietary protein to cardiovascular problems. We decided to take a look at whether there is truly a causal link between high dietary protein and poorer cardiovascular health," Razani added.

The researchers studied mice who were fed a high-fat diet to deliberately induce atherosclerosis, or plaque buildup in the arteries.

Some of the mice received a high-fat diet that was also high in protein. And others were fed a high-fat, low-protein diet for comparison.

The mice on the high-fat, high-protein diet developed worse atherosclerosis -- about 30 per cent more plaque in the arteries -- than mice on the high-fat, normal-protein diet, despite the fact that the mice eating more protein did not gain weight, unlike the mice on the high-fat, normal-protein diet.

"A couple of a scoop of protein powder in a milkshake or smoothie adds something like 40 grams of protein -- almost equivalent to the daily recommended intake," Razani said.

"To see if protein has an effect on cardiovascular health, we tripled the amount of protein that the mice receive in the high-fat, high-protein diet -- keeping the fat constant. Protein went from 15 per cent to 46 per cent of calories for these mice".

Plaque contains a mix of fat, cholesterol, calcium deposits and dead cells. Past work by Razani's team and other groups has shown that immune cells called macrophages work to clean up plaque in the arteries.

But the environment inside plaque can overwhelm these cells, and when such cells die, they make the problem worse, contributing to plaque buildup and increasing plaque complexity.

"In mice on the high-protein diet, their plaques were a macrophage graveyard," Razani informed.

To understand how high dietary protein might increase plaque complexity, Razani and his colleagues also studied the path protein takes after it has been digested -- broken down into its original building blocks, called amino acids.

"This study is not the first to show a telltale increase in plaque with high-protein diets, but it offers a deeper understanding of the impact of high protein with the detailed analysis of the plaques," said Razani.

"This work not only defines the critical processes underlying the cardiovascular risks of dietary protein but also lays the groundwork for targeting these pathways in treating heart disease," he added.

Researchers have found that patients with peripheral artery disease or stroke were less likely to receive recommended treatments to prevent heart attack than those with coronary artery disease. All three are types of atherosclerotic cardiovascular disease.

Depending on the location of the blockage, atherosclerosis increases the risk for three serious conditions: coronary artery disease, stroke and peripheral artery disease.

"Our study highlights the need for public health campaigns to direct equal attention to all three major forms of atherosclerotic cardiovascular disease," said senior study author Erin Michos from the Johns Hopkins University in the US.

"We need to generate awareness among both clinicians and patients that all of these diseases should be treated with aggressive secondary preventive medications, including aspirin and statins, regardless of whether people have heart disease or not," Michos added.

Since atherosclerosis can affect arteries in more than one part of the body, medical guidelines are to treat coronary artery disease, stroke and peripheral artery disease similarly with lifestyle changes and medication, including statins to lower cholesterol levels and aspirin to prevent blood clots.

Lifestyle changes include eating a healthy diet, being physically active, quitting smoking, controlling high cholesterol, controlling high blood pressure, treating high blood sugar and losing weight.

What was unclear was if people with stroke and peripheral artery disease received the same treatments prescribed for those with coronary artery disease.

This study compared more than 14,000 US adults enrolled in the 2006-2015 Medical Expenditure Panel Survey, a national survey of patient-reported health outcomes and conditions, and health care use and expenses.

Slightly more than half of the patients were men, the average age was 65, and all had either coronary artery disease, stroke or peripheral artery disease.

These individuals were the representative of nearly 16 million US adults living with one of the three forms of atherosclerotic cardiovascular disease.

Compared to participants with coronary artery disease, participants with peripheral artery disease were twice more likely to report no statin use and three times more likely to report no aspirin use.

Additionally, people with peripheral artery disease had the highest, annual, total out-of-pocket expenditures among the three atherosclerotic conditions.

The findings showed that participants with stroke were more than twice as likely to report no statin or aspirin use.

Moreover, those with stroke were more likely to report poor patient-provider communication, poor health care satisfaction and more emergency room visits.

"Our study highlights a missed opportunity for implementing life-saving preventive medications among these high-risk individuals," Michos said.

The study was presented in the virtual conference at the American Heart Association's Quality of Care & Outcomes Research Scientific Sessions 2020.