Features

By Jesus Jimenez

If you wait until you’re thirsty, it’s too late.

Thirst is just one symptom of dehydration, but you shouldn’t wait until you’re parched to drink water, according to Alison Harris, a nurse for on-demand healthcare provider DispatchHealth.

Although staying adequately hydrated is something to be mindful of all year long, it should be especially top of mind in the summer, Harris said.

From June 1 through July 15, MedStar Mobile Healthcare has treated 224 patients suffering from a heat-related illness in the Fort Worth area alone, said Matt Zavadsky, a spokesman for the ambulance service. Of those cases, 53 involved patients whose primary problem was dehydration.

Staying hydrated:

— There’s more to dehydration than you might think.

In addition to increased thirst, dehydration has other common symptoms including dark urine, dry skin, headaches and muscle cramps, Harris said.

Other times, however, the symptoms could be confused for something other than dehydration, according to Harris.

“Sometimes it’s a very vague symptom,” she said. These ambiguous symptoms include feeling sleepy, tired, irritable or confused.

In severe but rare cases, symptoms of dehydration can include convulsions and even delirium, according to Harris.

“Those are the ones that happen quickly.”

— It can take time for dehydration to settle in.

After spending time outside on a hot day, it might seem obvious to get a drink, but it might take longer for dehydration to settle in.

In some cases, dehydration can happen hours or even days later, Harris said.

“Your body is great at compensating until it can’t,” Harris said. This is why experts recommend hydrating days before strenuous activity, such as a marathon, and not waiting until the day of.

— It doesn’t need to be hot outside for someone to become dehydrated.

The summer heat plays a role in dehydration, but it doesn’t take triple-digit temperatures to reach a breaking point.

Other weather conditions — such as humidity levels and dew points also play a role in how much someone sweats.

When it’s muggy outside and humidity and dew points are high, someone might sweat more even if temperatures are relatively mild.

In March 2018, during the Rock ‘n’ Roll Dallas Half Marathon, two runners collapsed because of heat exhaustion. Temperatures that morning were only in the 20ºsC, but humidity levels were much higher.

Dew points — a measure of water vapour in the air — are also another weather condition to consider when being outdoors for several hours.

Once dew points reach 15ºC, conditions will feel slightly muggy. When dew points reach 21º to 24ºC, the air feels thick and oppressive, according to the National Weather Service.

“Make sure you’re listening to your body,” Harris said. “Make sure you’re not afraid to get help.”

— There’s no magic number on the amount of water to drink.

When it comes to how much water someone should drink per day, experts often cite the rule: eight 250-ml glasses per day. That’s a good general rule to follow, Harris said, but everybody is different, so some people might need more and others less.

Other experts recommend measuring daily water intake based on weight. That’s another solid rule, but Harris said it doesn’t account for other factors, such as how many minutes someone exercises per day, what climate that person lives in and how much caffeine or alcohol that person consumes in a day.

Caffeine and alcohol are diuretics, which cause people to lose fluids, Harris said.

“Even if you’re drinking a lot, it comes right back out,” she said.

— It takes more than just water to stay hydrated.

Water is great for staying hydrated, but that’s not all the body needs, Harris said. To stay optimally hydrated, the body needs a mix of water and electrolytes.

“It’s all about balance,” she said.

If they’re not doing so already, anyone who exercises regularly in the heat or spends several hours outdoors should consider drinking sports drinks to replace electrolytes lost through sweat, Harris said.

Prevent heat-related illness:

— Hydrate: Drink plenty of water during the day, especially if you are engaged in any strenuous activity. Sports drinks are a good choice if you’re exercising or working in hot conditions, but water is a good way to hydrate as well.

— Ventilate: Stay in a place where there is plenty of air circulating to keep your body cool. If you are indoors and don’t have access to air conditioning, open windows and use a fan.

— Cover up: Wear light-coloured and loose-fitting clothing to avoid absorbing the sun’s light and trapping heat. Wear a hat to shield yourself from the sun, but once you feel yourself getting warm, remove any items covering your head that can trap heat close to your body.

— Limit activity: Heatstroke can occur in less than an hour when you are participating in strenuous activity during a hot day. If you feel yourself getting hot or lightheaded, stop your activity and rest in a cool place out of the sun. Be sure to drink water or a sports drink before, during and after any strenuous activity.

— Check on loved ones: The elderly are especially vulnerable to heat-related emergencies. Many elderly residents are not aware of how hot it may get in their residence. Call on older friends and family members regularly to assure they are doing OK.

A reasonably priced, economic and compact hatchback that nonetheless looks and feels contemporary, the Suzuki Baleno is the sort of car Jordanian drivers ought to consider in the face of economic squeeze, high fuel prices and ever worse traffic congestion.

Built by the Japanese automaker’s Indian operation, the Baleno is slightly bigger, yet, lower priced than the brand’s much acclaimed Swift model. Designed and engineered with good value in mind, the Baleno is, however, not an austere car, like Suzuki’s much smaller and very affordable entry-level Alto.

Contemporary character

A step up from the Suzuki’s Alto and slightly bigger Celerio models where design clearly follows function, the Baleno places greater emphasis on contemporary aesthetic, and is pitched to closer to and as a somewhat of a more attainable alternative to small European hatchbacks like the excellent Peugeot 208 and outgoing Ford Fiesta.

Modern in appearance, the Baleno has a higher waistline, smaller glasshouse, somewhat sloping roofline and more pronounced body bulges, ridges and character lines to reflect more current trends than the upright Alto and Celerio. 

With smooth and curvy surfacing, athletic stance and diamond-like headlights set far apart and framing a V-like grille that trails off into bonnet ridges towards the A-pillar base, the Baleno’s design has hints of the stylish Alfa Romeo MiTo about it.

Behind its sharp grille-mounted “S” emblem, the driven Baleno GLX is powered by and transverse 16-valve 1.4-litre 4-cylinder engine driving the front wheels through a 4-speed automatic gearbox. Featuring intake side variable valve timing, the Baleno develops 91BHP at 6,000rpm and 96lb/ft torque at 4,000rpm.

Eager and efficient

A responsive and progressive naturally-aspirated engine, the Baleno’s 1.4 is eager to be wrung hard to its rev limit and signals its willing approval as its not unpleasant thrum hardens to an ever softly distant yet raspy snarl.

With a favourable power-to-weight ratio given its low 935kg mass, the Baleno feels light on its feet and picks up speed at a good pace in town driving, with 0-100km/h dispatched in a respectable 11.6-seconds, and can attain 170km/h. Meanwhile, fuel efficiency is frugal at an estimated 5l/100km, combined.

As flexible necessary in mid-range delivery, the Baleno does its best work at high revs, which is just as well, given that with only four speeds, one does tend to rev hard to keep it spinning in its top-end sweet spot.

As smooth and quick shifting as a small city car needs, the fact of the matter is that a small, light and nimble hatchback like this would be much better served with a 5-speed manual gearbox to better exploit its buzzy and eager engine.

Mature manners

With a manual, the Baleno would be lighter, faster, more economical, cheaper and even more fun to drive. That said, the auto version proved to be an agile, responsive and entertaining car with quick, light, eager, tidy and grippy turn-in, and nimble and well controlled through corners and sudden direction changes.

With all the fun hallmarks of a sweet driving light car that is a Suzuki signature, the Baleno rode with more grounded and more refined manner than its light weight and small size would suggest.

With a low seating position, high waistline and a more refined and modern feel, the Baleno felt like a distinctly more mature car than its Celerio sister during back-to-back test drives.

Hunkered ambiance

Comfortable, well-insulated, forgiving and settled for its class, the Baleno rides somewhat like a larger car and features generous front headroom and minimum 355-litre luggage volume, which expands to 1,085-litres. Rear legroom is good for its size but rear headroom isn’t as generous as the boxier Celerio.

Hunkered rather than airy inside, the Baleno’s stylishly modern cabin styling, dark tones, black fabric upholstery and metallic trim meanwhile have a classier, if slightly conservative, ambiance than expected, while plus points include a chunky tilt and reach adjustable steering. 

Driven in GLX trim level, the Baleno comes well-equipped for its JD15,000 price point and includes 3-point seatbelts and headrest for all five passengers, good rear door swing angle, and split-folding rear seats and two child seat latch points, but no rear armrest.

Equipped with front, side and curtain airbags, the Baleno GLX’ safety suite includes ABS brakes with electronic brakeforce distribution. Additionally, it features electric windows, mirrors and remote central locking, automatic A/C and a 4-speaker MP3, Bluetooth and CD sound system.

TECHNICAL SPECIFICATIONS

Engine: 1.4-litre, transverse 4-cylinders

Bore x stroke: 73 x 82mm

Compression ratio: 11:1

Valve-train: 16-valve, DOHC, multi-point injection

Gearbox: 4-speed automatic, front-wheel-drive

Gear ratios: 1st 2.875; 2nd 1.568; 3rd 1.0; 4th 0.697

Reverse/final drive: 2.3/4.375

Power, BHP (PS) [kW]: 91 (92) [68] @6,000rpm

Specific power: 66.3BHP/litre

Power-to-weight: 97.3BHP/tonne

Torque, lb/ft (Nm): 96 (130) @4,000rpm

Specific torque: 94.7Nm/litre

Torque-to-weight: 139Nm/tonne

0-100km/h: 11.6-seconds

Top speed: 170km/h

Fuel consumption, combined: 5-litres/100km (estimate)

Fuel capacity: 37-litres

Length: 3,995mm

Width: 1,745mm

Height: 1,470mm

Wheelbase: 2,520mm

Tread, F/R: 1,420/1,410mm

Tread: 1,520mm

Ground clearance: 120mm

Kerb weight: 935kg

Gross vehicle weight: 1,405kg

Doors/seats: 4/5

Luggage volume, min/max: 355-/1,085-litres

Steering: Power-assisted rack & pinion

Turning circle: 9.8-metres

Suspension: MacPherson struts/torsion beam

Brakes, F/R: Ventilated discs/drums

Tyres: 185/55R16

Price, JD15,000 (on the road, excluding insurance)

Women who develop preeclampsia, a form of dangerously high blood pressure during pregnancy, may face a wide variety of heart problems long after they give birth, a research review concludes. 

Preeclampsia has long been linked to an increased risk of events like heart attacks and strokes years later, but women often don’t experience symptoms until they have a life-threatening problem. For the current analysis, researchers examined results from 13 previously published studies that assessed women’s hearts with echocardiography to look for early warning signals. 

“Previous studies had demonstrated cardiac dysfunction in women with a history of pre-eclampsia but this paper brings together the results of those studies to try and better understand the extent of the problem and the patterns of dysfunction,” said lead author Archana Thayaparan, a researcher at Western Health in Victoria, Australia. 

“This is important for patients as no large studies have been done to investigate this, and most women with pre-eclampsia are unaware of the potential long-term consequences and increased risk of heart disease and stroke,” Thayaparan said by e-mail. 

So-called gestational hypertension, when women who normally don’t have high blood pressure develop it during pregnancy, is fairly common, affecting 6 per cent to 8 per cent of pregnant women. This condition can progress to a more serious and potentially life-threatening version of high blood pressure known as preeclampsia later in pregnancy. 

Women with preeclampsia are more likely to develop “diastolic dysfunction”, which happens when the heart doesn’t fill with blood properly and is a precursor to a form of heart failure. 

In the study, about 19 per cent of women with a history of preeclampsia developed diastolic dysfunction, compared with 5.4 per cent of women with uncomplicated pregnancies. 

With a history of preeclampsia, about 25 per cent of women went on to develop heart failure within 4 to 10 years of giving birth, compared with 7 per cent of women with uncomplicated pregnancies, researchers note in the Australasian Journal of Ultrasound Medicine. 

This suggests that women with a history of preeclampsia should get regular echocardiograms to monitor their hearts for changes that might not yet be causing any symptoms, the study authors conclude. 

The study wasn’t designed to determine whether preeclampsia directly causes later heart problems, or if it might be an early sign of existing problems that emerge under the pressure of pregnancy on a woman’s body. 

“Previous research has shown that traditional cardiovascular risk factors such as BMI and blood pressure play a central role in the development of cardiovascular disease in women who experienced preeclampsia,” said Eirin Haug, a public health researcher at the Norwegian University of Science and Technology in Trondheim, who wasn’t involved in the study. 

Doctors currently advise women with a history of preeclampsia to make lifestyle changes like losing weight, exercising, and eating a heart-healthy diet and to get regular blood pressure checks, Haug said by e-mail. 

“We still lack evidence for the effect of screening and lifestyle modifications on reducing cardiovascular risk in these women,” Haug said. “More research is needed to tailor effective strategies to prevent cardiovascular disease in this group of women.” 

By Ibrahim Mango

Life Coach and Positive Psychologist

Does adopting an optimistic attitude lead to increased success and improved health? Ancient wisdom teaches us the value of optimism and today’s top psychologists, doctors and executives agree.

Omar and Fahed who work in different departments at the same company get laid off from their jobs due to downsizing.

Omar takes the news personally even though the company has always regarded him as a conscientious, productive employee. The layoffs are part of the company’s restructuring plan to reduce costs; they are not related to his performance. 

Omar spends his days replaying in his mind how bad this situation is while watching television and eating crisps. He wrongly assumes that he has been laid off because of his poor performance on the job, that he will be out of a job for a long time and that all aspects of his life will be negatively affected.

Fahed, on the other hand, understands that the layoffs are not related to his performance and that there is a possibility that the company might take him back soon, which is what usually happens during downsizing. Even so, he applies for new jobs, spends quality time with his family and goes back to his exercise routine which he could not always maintain during the busy days he was working for the company. He sees this setback as belonging to only one aspect of his life.

Are humans hard wired to a certain fixed degree of optimism?

Traditional psychologists say yes and that the degree of optimism cannot be changed in adulthood. However, Positive Psychologist Dr Martin Seligman, author of Learned Optimism, explains that what differentiates optimists from pessimists is their explanatory style – the way they explain the events in their lives. By changing the way they explain these events, they can become more optimistic.

Everyone experiences setbacks and failures but optimists:

1. Don’t take failures and setbacks personally (they are not caused by them)

2. See them as temporary (they will last for a short time)

3. Regard them as non-pervasive (they affect only one specific area in their lives)

Pessimists, on the other hand, see setbacks as personal, permanent and pervasive.

Omar and Fahed experienced the same setback, but their explanatory style was different; Omar’s was that of a pessimist and Fahed’s was that of an optimist. This makes a world of difference!

Optimists are healthier

Optimistic people tend to take better care of their health, are often more resilient when it comes to dealing with stress and are likely to suffer less from cardiovascular disease than pessimistic people. Optimists generally have better physical and psychological wellbeing, live longer and are happier than their pessimistic’ counterparts. They expect a better future so they try harder in the face of setbacks because they expect that if they try again, they are likely to get ahead, which is why they are more successful.

Thus, the research suggests that the Islamic proverb is indeed correct: “Be optimistic and you will find goodness.”

Reprinted with permission from Family Flavours magazine

RIO DE JANEIRO — Electronic cigarettes are “undoubtedly harmful” and should be regulated, the World Health Organisation(WHO) said Friday as it warned against the use of vaping products by smokers trying to quit their deadly habit.

The growing popularity of e-cigarettes, battery-powered devices that enable users to inhale addictive nicotine liquids, has raised fears among policymakers worldwide of a new gateway addiction for young people.

While vaping exposes users to lower levels of toxins than smoking, the WHO said the devices still pose “health risks” to users.

“Although the specific level of risk associated with ENDS [electronic nicotine delivery systems] has not yet been conclusively estimated, ENDS are undoubtedly harmful and should therefore be subject to regulation,” the WHO said in a new report on the global smoking epidemic.

There was also “insufficient evidence” to support claims of their effectiveness in assisting smokers trying to quit conventional cigarettes, it said.

“In most countries where they are available, the majority of e-cigarette users continue to use e-cigarettes and cigarettes concurrently, which has little to no beneficial impact on health risk and effects,” the report said.

Big tobacco companies have been aggressively marketing e-cigarette and heated tobacco products in recent years as they seek new customers.

They argue such products are far less dangerous than traditional cigarettes and can help some smokers completely switch to “safer” alternatives. 

But the WHO warned misinformation spread by the tobacco industry about e-cigarettes was “a present and real threat”.

As well as nicotine, e-cigarettes also contained metal-laced aerosols, which Vinayak Prasad, who leads the WHO’s Tobacco Free Initiative, said “are known to damage the heart, all of them are known to damage the lungs”.

“They’re also now looking at the long-term effect whether it can even cause cancer, but it’s not very well established,” Prasad told AFP. 

Restrictions on the use of e-cigarettes around the world is increasing. San Francisco last month banned the sale and manufacture of the products. 

China, home to nearly a third of the world’s tobacco smokers, is also planning to regulate the vaping devices.

More effort was needed to help smokers quit, the WHO said in the report, noting only “30 per cent of the world’s population have access to appropriate tobacco cessation services”, such as counselling, telephone hotlines and medication. 

Without assistance, only 4 per cent of attempts to stop smoking succeed. 

Tobacco claims more than 8 million lives each year either from direct use or second-hand smoke, according to the WHO.

While the number of users has declined slightly since 2007, it remains stubbornly high at 1.4 billion, the vast majority of them men.

“People who quit tobacco can live longer, healthier and more productive lives,” the WHO said.

LONDON — Living healthily with a good diet and regular exercise may help people with a higher genetic susceptibility to dementia to offset the risk of developing it, according to recent research.

The risk of dementia was reduced by 32 per cent in people with a high genetic risk if they had followed a healthy lifestyle, compared with those who had an unhealthy lifestyle, the study, published in the medical journal JAMA on Sunday, found.

People with high genetic risk and an unhealthy lifestyle were almost three times more likely to develop dementia than those with low genetic risk who also lived healthily.

“Our findings are exciting as they show that we can take action to try to offset our genetic risk for dementia,” said Elzbieta Kuzma, a researcher at Britain’s University of Exeter who co-led the study.

Dementia — a brain-wasting disease — affects around 50 million people globally, with nearly 10 million new cases annually — a figure that is set to triple by 2050, according to the World Health Organisation.

Kuzma’s team analysed data from almost 197,000 adults of European ancestry who were aged 60 and older. They found 1,769 cases of dementia over a follow-up period of eight years and grouped those cases into people with high, medium and low genetic risks for dementia.

To assess lifestyle, the researchers looked at the participants’ self-reported diet, physical activity, smoking and alcohol consumption.

Non-smokers who took regular exercise and had a good diet with moderate alcohol intake were considered to have the healthiest lifestyles — and these people were found to have reduced their risk whether they were in high, medium or low genetic risk groups.

David Llewellyn, also of Exeter University, said the findings held an important message that undermined what he described as “a fatalistic view of dementia”.

“Some people believe it’s inevitable they’ll develop dementia because of their genetics,” he said. “[But] you may be able to substantially reduce your dementia risk by living a healthy lifestyle”.

Do you check your heart pulse rate or blood pressure at home? Or maybe you monitor your blood sugar yourself? Perhaps you trust your smartwatch to tell you when to stop exercising and avoid exhaustion. The recent models of Apple Watch let you even perform an ECG (electrocardiogram)! The key question here is how much can you trust these personal medical gadgets? To what extend do they replace going to the hospital or to your physician?

The versatility of personal digital devices is extraordinary. This is due mainly to the fact that they have become small, easy to use and affordable, and also to the wide availability of thousands of software applications associated with the devices and that let you perform countless tasks, from the warm comfort of your home. Most of this was unthinkable a mere 10 or 15 years ago.

One has to admit that playing doctor yourself this way works in most cases. It gives instant results and saves you precious time and money. Moreover, the personal digital instruments you may have at home, including smartphones of course, are based on the same technology, the same electronic chips and the same software that you would find at the hospital or at your doctor’s clinic.

There are still differences; non-negligible ones. Not taking them into consideration can lead to serious trouble.

However, similar to professional equipment your home devices may be, they are still “simplified”, in a certain way. It is like comparing your standard JD600 laptop to a military-grade model that would cost up to 10 times more but that would be much more reliable in every way.

Then there is the reading, the actual interpretation of the results. Medical professionals are trained to “decipher” the numbers, the charts, the graphics that digital instruments produce. They do not always see them exactly the way you do.

Last but not least, physicians know how to put the results in context. They take into consideration a number of factors that you may easily overlook, or simply are not trained to evaluate, and that may greatly affect the final diagnosis — that magic word! Sometimes even doctors find it hard to come up with a diagnosis. They would repeat the test, ask you to take other tests, consult with their colleagues, etc. This complex process is something that you cannot reasonably think of replicating on your own at home.

Earlier this week there was an interesting and long article on cnet.com by Vanessa Orellana titled “Apple Watch ECG vs. hospital EKG” and that tackles the subject above.

Perhaps the wise approach consists of using personal digital devices with care and with the greatest gift given to mankind: common sense. When you are not feeling particular under any form of severe health crisis, and the results you are reading are simple, straightforward and obvious, you can trust them. For instance, most smartphones today can run apps that measure your heart rate simply by pressing your finger against the camera on the back. In most cases it is flawless.

On the other hand, if you are feeling really bad, and regardless of what your home device tells you or what you are reading on it, going to qualified medical care is the only solution.

In other instances, calling your physician to tell him what you have already measured yourself and then let him decide what action to take, may be the smartest approach and the best, safest way to put home digital devices to good use.

Patients at high risk for heart disease who cannot afford newer cholesterol-lowering medications are more likely to have heart attacks, strokes and other cardiovascular events within just one year compared to counterparts who were able to get the drugs, a new study suggests. 

Clinical trials have shown that the new drugs, called PCSK9 inhibitors, can lower LDL-cholesterol significantly and also improve cardiovascular outcomes in people who don’t get enough benefit from statin drugs, which are the first-line treatment for high cholesterol. 

The problem with the newer drugs is the cost. During the period covered by the new study, the cost of the PCSK9 inhibitors in the US was in the range of $14,000 per year, according to the American Heart Association, which last fall encouraged drug companies to lower their prices to improve patient access. Even when patients have insurance, the out-of-pocket costs for these drugs can be prohibitive, earlier studies have shown. 

“One of the most surprising things we saw in this study was a difference in risk in as little as 11.5 months of therapy,” said study coauthor Kelly Myers. “That means there is a beneficial effect in less than a year.” 

Myers is chief technology officer at the FH Foundation, a non-profit research and advocacy organisation focused on familial hypercholesterolemia, a genetic disease that causes high cholesterol levels. 

To take a closer look at the impact of patients’ ability to get the new drugs, the researchers combed through healthcare claims data on 139,036 adults with hypercholesterolemia who were prescribed a PCSK9 inhibitor between August 2015 and December 2017.

When they analysed the data, the researchers found that 88,770 patients (63.8 per cent) had a history of atherosclerosis and 2,899 (2.1 per cent) had a documented diagnosis of familial hypercholesterolemia. Insurers had rejected nearly two-thirds (61 per cent) of the prescriptions, while 15 per cent of patients had opted not to fill their prescriptions, presumably because of the out-of-pocket costs, the researchers said.

A comparison of the patients whose prescriptions had been rejected by insurers to those who had taken PCSK9 inhibitors for 338 days or more showed a 16 per cent increase in risk of a cardiovascular event, such as a heart attack, a stroke, or cardiac bypass surgery over the course of 11.5 months, without the medication. 

Similarly, a comparison of patients who never filled their prescriptions to those who had taken PCSK9 inhibitors for 338 days or more yielded a 21 per cent increase in the risk of cardiovascular events over the same 11.5 month period, the authors reported in Circulation: Cardiovascular Quality and Outcomes.

“This real-world evidence highlights that over eighty thousand individuals being treated for cardiovascular disease or familial hypercholesterolemia had a significantly increased risk of heart attacks and strokes when their PCSK9 therapy prescription was rejected or unfilled,” Myers said. “Coverage decisions that do not take into consideration an individual’s high risk, especially for those with genetic conditions like FH, are a failure of our health system to prevent heart attacks, stroke and death.”

The new findings should spur further research, said Dr. Mary Ann McLaughlin, director of Cardiovascular Health and Wellness at Mount Sinai Heart and an associate professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.

“We should take it as a baseline since there are things you can’t always quantify by just looking at a chart review and billing data,” McLaughlin said. “There could be legitimate reasons for some of the rejection of some of the prescriptions.”

An interesting finding is the 21 per cent higher risk among those who received a prescription but did not fill it, McLaughlin said. “These patients may not be making other types of lifestyle changes, such as adhering to a healthy diet or maybe they are smoking. You can’t tell from this.”

It doesn’t matter how good a drug is, if a patient can’t afford it, said Dr Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.

“The potential for this drug is being frustrated by our payment system which makes it difficult for patients to afford these and other new drugs,” Wu said.

People who tend to eat mostly plants may be less likely to develop type 2 diabetes, a research review suggests. 

Researchers examined data from nine previously published studies with a total of 307,099 participants, including 23,544 people who developed type 2 diabetes. The length of the studies ranged from two to 28 years. All of the studies used food frequency questionnaires to assess participants’ diets.

Overall, people who most closely adhered to a vegan, vegetarian or other type of plant-based diet were 23 per cent less likely to develop type 2 diabetes than people who consumed the least amount of plant-based meals, researchers report in JAMA Internal Medicine.

“Plant-based diets can promote metabolic health and reduce diabetes risk through many pathways, including preventing excess weight gain, improving insulin sensitivity, reducing inflammation and other mechanisms,” said Dr Qi Sun, senior author of the study and a researcher at the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital in Boston. 

People who eat a healthy variety of plant-based meals can lower their diabetes risk even when they’re not strict vegetarians — avoiding meat, poultry and fish — or vegans — also avoiding animal products like milk and eggs.

But they may not benefit as much if their plant-based diet is full of foods like French fries, white bread, and white rice, Sun said by email.

 “It does matter what veggies people eat and how the veggies are processed,” Sun said. “Therefore, consuming healthy plant foods that are not or minimally processed, such as fresh fruits and vegetables, legumes, nuts, and whole grains, should be emphasised.”

People in the study who followed this advice — with the healthiest mix of fruits, vegetables and whole grains in their plant-based diets, were 30 per cent less likely to develop type 2 diabetes than participants who tended to ignore this idea.

Type 2 diabetes, the most common form, is linked to obesity and aging and happens when the body can’t properly use or make enough of the hormone insulin to convert blood sugar into energy. Left unchecked, diabetes can lead to serious complications like nerve damage, blindness, amputations, kidney damage and heart problems.

Doctors typically advise patients with type 2 diabetes to follow a low-calorie, low-fat and low-carbohydrate diet that includes lots of fresh fruits, vegetables and whole grains as well as lean poultry and fish. Fatty, sugary foods are discouraged along with consuming too much red or processed meat.

None of the smaller studies in the current analysis were controlled experiments designed to prove whether a plant-based diet helps prevent diabetes or serious complications from the disease.

Still, the results offer fresh evidence of the potential for good eating habits to help prevent and manage diabetes, said Samantha Heller, a nutritionist at New York University Langone Medical Centre in New York City.

 “Adding more whole plants such as broccoli, edamame, quinoa, extra virgin olive oil, almonds, and berries, to our diet is a great way to help manage type 2 diabetes and weight,” Heller, who wasn’t involved in the study, said by e-mail.

“Higher fibre foods are healthy for the gut microbiome, improve gastrointestinal function, improve insulin sensitivity and help manage blood sugar,” Heller added. “However, it is important to remember that even [portion sizes] of healthy foods matter.”

Heart attack rates dropped among older adults in Scotland in the decade after a nationwide indoor smoking ban took effect, a new study suggests. 

Scotland banned smoking in all enclosed public spaces and workplaces in 2006. There was a 17 per cent reduction in heart attacks in the first year after the ban took effect, compared to just a 4 per cent decline over the same period in England, where public smoking rules didn’t change, the study team notes. 

In Scotland between 2000 and 2016, there were a total of 117,161 heart attacks. 

Among men and women aged 60 and older, the smoking ban was followed by a roughly 13 per cent reduction in heart attacks over the study period. The ban didn’t appear to impact heart attacks for younger people, however. 

“People tend to start smoking when they are young, many years before they reach the age at which heart attacks tend to occur,” said Dr Jill Pell, director of the Institute of Health and Wellbeing at the University of Glasgow in the UK and coauthor of the study. 

“Therefore, any effect from discouraging people from starting to smoke is likely to take more time to become apparent,” Pell said by email. 

Even before the smoking ban, heart attack rates were declining in Scotland, the study team notes in Circulation: Cardiovascular Quality and Outcomes. But the legislation contributed to additional reductions, they conclude. 

In a previous study of the smoking ban, Pell and colleagues found a reduction in heart attacks among both smokers and non-smokers, she said. In a separate study, they also found that the number of smokers trying to quit increased immediately prior to the ban. 

While these studies were not designed to prove whether or how the ban directly prevented heart attacks, “there is likely to be a contribution from both encouraging smokers to quit and from protecting both non-smokers and smokers from other people’s secondhand smoke,” Pell said. 

Heart attack rates dropped slightly more for women over 60: 14 per cent versus 13.2 per cent for men. 

“In younger people overall, there appeared to be less of an impact across the 10-year period,” said Stephanie Mayne, a researcher at the Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania who wasn’t involved in the study. 

“This might be due to changes in other heart disease risk factors, like obesity and diabetes, during the same time period,” Mayne said by email. 

Even so, the results offer fresh evidence of the benefits of avoiding secondhand smoke and living in places where it’s not as easy to start or continue smoking, said Judith Prochaska, a researcher at Stanford University in California who wasn’t involved in the study. 

 “As much as feasibly possible, avoid exposure to secondhand smoke,” said Prochaska, who has received funding from Pfizer and Achieve, companies that make smoking cessation drugs. 

“If you live with someone who smokes, work to set up a policy to limit smoking to outside of the home and not in the car,” Prochaska said by email. “And if you live in an apartment complex that allows smoking, advocate for a change in policy.”