Category Archives: Body & Mind

Improving Health Outcomes among Head and Neck Cancer Patients

Tomorrow (2.17.12) – Free lecture/Seminar at Temple University

Improving Health Outcomes among Head and Neck Cancer Patients

Carolyn Y. Fang, PhD
Associate Professor and Co-Leader of the Cancer Prevention & Control Program
Fox Chase Cancer Center
941 Ritter Annex (Public Health Conference Room)
February 17, 12-1 pm

Studies of head and neck cancer patients have noted that the social environment may be associated with various cancer outcomes, including survival. To date, the potential mechanisms that may underlie such associations have not been well-studied in this population. This seminar will present data from our studies that highlight key pathways linking the social environment with biological processes that may impact cancer outcomes in this patient population. In addition, directions for future interventions designed to enhance survivorship will be discussed.

Sponsored by the Social & Behavioral Health Interventions (SBHI) lab and the Department of Public Health, Temple University

Honesty–Humility: New Correlate of Job Performance

Arrogance + Humility
A new study of job performance indicates that beyond the Big 5 Personality traits (openness, conscientiousness, extraversion, agreeableness, and neuroticism) honesty and humility are unique predictors of job performance.

I came across the article today, just as I myself experienced the benefits of being humble and honest in a work situation. But a better example comes from some wisdom shared with by my friend Léo Walton:

Upon entering the Neuroscience PhD program at the University of Wisconsin Léo mentioned that at first he felt like he was expected to know everything. Soon he realized that he could contribute more and be more successful in the program by admitting what he DID NOT know (which certainly takes honesty and humility). He was able to receive more valuable feedback and job-related information. Those around you, peers and supervisors alike, when they have a clearer picture of where you are coming from, are more likely to provide information that is useful to you, meets you at your current level of understanding, allowing you to then do a better job and be more effective and targeted in your work.

I think this is an incredibly powerful personality trait, especially in fields where collaboration is required.
But, I would imagine that this attribute could be important in many areas of life besides work. For example, we are told that in our social and romantic relationships honesty is crucial. How true.

I think the take-away message from this article can be summed up nicely by this quote from Malcolm X; “Don’t be in a hurry to condemn because he doesn’t do what you do or think as you think or as fast. There was a time when you didn’t know what you know today.

In other words, you can’t know everything, and admitting what you don’t know only puts you in a position to be more successful in the future.

Psychoneuroimmunological Pathways: Social Stress & Inflammation

Alexy Grey art

A recent study from researchers at the UCLA Cousin’s Center for Psychoneuroimmunology revealed a connection between brain activity in the regions that respond to stress and anxiety in social situations and inflammatory immune responses. This lends support to the mind-body (psychology-physiology) connection in the exacerbation of diseases like asthma, cardiovascular disease, cancer, and depression. I was excited to blog about these findings because they are relevant to my ongoing research “Life Stress, Social Problem Solving and Asthma”.

Essentially, I am hypothesizing that asthma patients who can more effectively cope with and adapt to stressful life situations will have better control over their asthma and have a better quality of life. The pathways that I suggest in my model are behavioral (i.e. medication adherence, seeking follow-up care, environmental asthma management strategies, etc), psychological (i.e. more effective coping and problem solving results in less anxiety and stress) and biological (i.e. anxiety and stress are associated with changes in immunology/inflammation and airway physiology).

The findings of the UCLA researchers are looking at the biological pathways from a very direct angle; measuring brain activity and inflammation in concert. While these findings are interesting and support the mind-body connection on a new level, there is still something lacking in terms of payback. That is to say, even if we can understand the tendencies and mechanics of the mind-body connection what good will come of it?

Perhaps my training has skewed my perspective but I suggest that the good will come from psychology and the science of health behavior. We can teach people coping skills and encourage them to engage in more adaptive life strategies. This can change their perception of their abilities to cope, changing their experience of stress, improving their disease self-management and, as this study suggests, support balance in the immune system.

School-based obesity intervention also increased math performance

University of Miami researchers implemented a 2-year multidimensional obesity intervention that included food service personnel, teachers, parents, community-based nutrition educators, and the children. They found that in the children who receive school-provided lunches that more students who received the intervention stayed within the healthy body mass index (p=.02) AND improved their math performance (p<.001) in comparison to student who did not receive the intervention.

Not actual lunch from the study

While the researchers could not identify exactly why the academic scores improved, their results suggest that improving nutrition may be an investment with returns in many areas. It seems that the First Lady and her efforts to reduce and prevent obesity may do more than just improve the health of our nation. It may also represent a much needed adjustment to the education system as well!

The body-mind connection will not be denied!

Yoga reduces general inflammation

yoga_bio

A newly published study has found that the regular practice of yoga can lower the levels of pro-inflammatory cytokines in the blood stream. Cytokines are signalling molecules that regulate the various cellular components of inflammation, an immune-based response to threat (physical or psychological). Long-term inflammation contributes to many health conditions including cardiovascular diseases, arthritis, and asthma.

In this study conditions of stress were implemented through tasks such as holding their bare foot in very cold water, or solving increasingly difficult math problems without a calculator. The researchers also found that those who practiced yoga had less dramatic responses (less increase in cytokine activity, less self-reported anxiety and stress) to the stressors.

The results of this study speak to the wide-ranging benefits of yoga, and other relaxation techniques. This study also highlights the fact that we can train ourselves to have less severe reactions to stressors in our lives. Over time these benefits can really add up, resulting in long-term improvements in physical and mental health.

Is STRESS getting a bad rap?

Stress research is a huge and growing field of science. Stress can trigger and exacerbate many types if physical (heart disease, diabetes, asthma, obesity, etc) and mental disorders (anxiety, depression, etc). Stress has also been shown to negatively impact the immune system on a cellular level. It’s no wonder we hear so much about how stress is bad.

But, what most reports fail to highlight is that we only really need to worry about chronic stress. Chronic stress, as mentioned in the pre-requisite entry, is more dangerous because of the long-term health effects posed by an elongated stress response. So, why is stress getting a bad rap (or why do I think so)? Two reasons: 1. Failure to differentiate between chronic stress and acute stress/normal stress. 2. Failure to recognize that some (acute) stress is good for you! That’s right, I said it. Some stress is good for you! Let’s take an example that everyone can relate to: TAXES!

Most people would agree that doing taxes is stressful. I concur. But let’s break down the experience. Tax time comes around, and you start to feel the tension, the worry, the pressure. Why do you feel those things? It could be a number of things, but most likely you have that reaction because doing taxes is unpleasant, and could cost you time and money. The idea of taxes is also unpleasant because it’s something we must do. If we don’t there are potentially major repercussions (i.e. audit, jail time). Taxes also have potential to affects our financial security and even potentially affect our home life and relationships. The actual tasks associated with taxes are also unpleasant; the forms and language are confusing, the mathematical calculations, etc. Essentially everyone finds these experiences unpleasant. The big questions are “How do you deal with the unpleasantness? How do you cope?” Some people suck it up, gather the appropriate forms, envelopes, stamps, software, whatever is needed, put aside some time, and file their taxes, on time. Other people avoid filing their taxes, either through procrastination, or by failing to file entirely.

If you avoid your taxes (or dealing with any stressor), you are setting yourself up to experience stress over a longer period of time, whether you put it off until the last minute, or you don’t do them at all, in either case you are going to worry about your taxes more and for a longer period of time, thus welcoming and contributing to chronic stress in your life. Not good.

If you approach your taxes, engage the process, and take the steps necessary to complete the task, then you will successfully remove the stressor, sooner rather than later. Good for you!

So what’s the real difference in these two reactions? Everyone experiences some initial stress associated with doing taxes, but some people, over the long-term experience less stress associated with taxes (or with their job, relationship, bills, whatever). The major difference is that individuals who engage the process of doing these taxes used the initial feelings of stress to inform and guide their behaviors. Individuals who avoided doing their taxes did not gain anything from the experience of stress.

Stress is part of our physiology (and psychology) for good reasons. Stress can be very informative. It tells us when something is wrong, when we are in danger, or something in our life needs attention. Stress acts like a signal system that tells us to take action (whether it be run from the hungry lion, or deal with our taxes, or whatever the source of stress may be). Acute stress is not something to be avoided, it is meant help us recognize how and when there opportunities to reduce long-term experiences of stress. Problems arise when we ignore and avoid responding to our stress, or do so lackadaisically, or irrationally.

Let’s go back to the question at hand: Is stress getting a bad rap?

Yes, I think so. Current societal trends encourage eliminating all stress from our lives. Instead of eliminating or avoiding all stress, we should engage it. We should be listening to the stress our lives. Use it to inform our decisions, guide our actions, help us prioritize and be a source of motivation. As it stands, based on our current conceptualization of stress, I suggest that we are missing an opportunity to live more productive and efficient lives and live with less chronic stress.

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*The ideas from this post stem from various pre-existing theories of stress, namely Social Problem Solving Theory (see D’Zurilla & Goldfreid, 1971; D’Zurilla & Nezu, 1982). Social Problem Solving (SPS) Theory is part of my current asthma research and will be discussed in more detail in its own entry. Stay tuned!

WHAT IS STRESS? A pre-requisite entry for “Is stress getting a bad rap?”

Stress is a major buzz word in today’s society. That’s not likely to change anytime soon. Talk of stress permeates daily news articles, talk shows and websites (like this one!). You can create a RSS feed about stress, and there are articles about reducing the stress associated with using RSS feeds!

Why has stress become such a hot topic, for both the lay person and the research community? Well, stress affects everyone! And, it is associated with a wide variety of health issues. Besides the more well known diseases, like heart disease and diabetes, you can find articles about stress contributing to practically any disease or condition. Here’s a bit on stress causing hair loss. Here’s one on stress causing ADHD. So we get it, stress is bad for your health.

But hang on a minute! Hold your horses!
Hold your horses!

Stress has many definitions (engineering, health, economic, etc). One must be very clear, especially in research, about what definition of “stress” you are using. Stress, in terms of health, is the psychological and physical response to our perceptions of our circumstances being threatening or overwhelming. The things in our life that elicit the stress response are called “stressors”. So, just to be clear, stressors are the cause and stress is the response.

Stress, as a response, originally evolved as an adaptive mechanism. When animals (and humans) are presented with a threat to well-being, (example, a hungry lion chasing you) the stress response, characterized by increased cortisol, heart rate, respiration, adrenaline, etc, helps you escape the threat of the lion! Our perception of the lion as stressful/threatening and the physiological changes that follow help us survive.

Stressors today are very different from the hungry lion (e.g. worry/anxiety about money troubles, traffic jams everyday after work, relationship troubles, etc). Most contemporary stressors are not threatening our immediate survival, but we still experience stress. Unfortunately, for humans, most of our stressors don’t go away like a lion might. The stressors of contemporary living are longer lasting and there are more of them and as a result we experience a continually activated stress response (chronic stress).

This point is well illustrated by the title of Robert Sapolsky’s book “Why Zebra’s Don’t Get Ulcers”. The idea is that once the lion has stopped chasing the zebra, the stress response shuts off (and the zebra doesn’t get an ulcer).

Both short-term/acute and chronic stress are driven by a hormone called cortisol. Cortisol causes and helps trigger many of changes characteristic of the stress response mentioned above. While those changes are helpful in the short-term, to escape the lion, if continually activated the stress response can have a massively negative impact on the cardiovascular system, immune system, nervous system, digestion, sleep, mood, etc, basically all aspects of health.

Once we understand what stress is, many important questions follow:

1. What are the stressors in our life?
2. Is there something about the way we perceive our world, our situations that makes us experience life as more stressful than it ought to be? Are we causing ourselves stress?
4. How can we reduce the negative impact of stress?
5. Why are some people more negatively affected by stress than others?

I could start to answer these questions, but, instead, I’d like to ask a couple questions that I don’t think are being asked enough: Is stress all that bad? Is stress getting a bad rap? I’ll address those questions in the next post!

Obesity linked to smaller brain size

Fat shadowObesity (which currently affects about 26% of the world’s population) is associated with a wide range of health problems. Obese individuals are more likely to develop:

-Heart disease and stroke
-High blood pressure
-Diabetes
-Cancer
-Gallbladder disease and gallstones
-Osteoarthritis
-Gout
-Breathing problems, such as sleep apnea and asthma
Depression
-A generally poorer quality of life

and we can now add to that list: SMALLER BRAIN.

Researchers at UCLA Neurology have found a correlation between body mass index and brain weight. Their findings indicate that individuals who are obese tend to have smaller and lighter brains (6% smaller).

The most pronounced differences were observed in the prefrontal cortex (executive region of the brain, responsible for cognition (planning, decision making, etc)), and the parts of the brain that support memory, such as the hippocampus. The differences in brain mass and size made the brains of obese individuals look 16 years old than those of healthy weight. The researchers believe that these differences put obese individuals at a much higher risk for Alzheimer’s and dementia and reduced cognitive abilities.

However, some researchers are skeptical; suggesting that this may be a chicken or egg situation. Some of the brain areas that were found smaller in the obese also control aspects of eating and metabolism. They suggest that shrinkage in these brain areas may lead to obesity, rather than the other way around.

Regardless, the number of health risks associated with obesity are significant. Solution? As always, proper diet and exercise.

Power Naps: Put them in your toolbox.

A few days ago I was feeling quite drowsy and kind of “blah” all afternoon.  After work I lay down and napped for a mere 6 minutes.  My alarm went off, and I popped up, feeling incredible!  Then I  did a little dance, rapidly punched the air around me a bunch of times, and went about my evening feeling totally awesome. It was amazing, and it inspired me to finally write this entry on power naps.

If you’ve never experienced the joy (and sometimes pure exhilaration) of a successful power nap, it’s like nothing else.   Power naps can reduce burnout and stress and increase alertness, energy level, mood, cognition, memory, and creativity, all of which can have a positive influence on other aspects of your life, your job, relationships, etc.  But first, what is a power nap?

powernap

Simply put, power naps are short naps, with a strong emphasis on “short”.  They can last anyway from 2-3 minutes to 30 minutes.  Basically, you need only enough time to fall asleep, and give your brain and body a rest, a chance to restart/reboot.  It’s actually quite similar to restarting a computer that is lagging.

The single most important thing when power napping is not to oversleep.  Once you’ve gone past the 30 minute mark you are in danger of death.  Just kidding! But, you are in danger of feeling even more tired, and extremely groggy.  Again, the trick is in the brevity of the power nap.

However, some research revealed even greater improvements in task performance after a 1 hour nap.  They found that 1 hour long naps allow for up to 4 times as much “slow wave sleep” the type of sleep that they say is characteristic of memory consolidation, learning and restoring perceptual processing.

In my modest opinion, a nap that lasts more than 20 minutes has three major downfalls: 1. you have a greater chance of “sleep inertia” (waking up groggy and not being able to pull yourself out it).  2.  You’ve defeated some of the purpose of the power nap, in that it really doesn’t take up much of your time and 3. if 10 or 15 minutes isn’t enough and you feel like you need an hour nap that probably means that you aren’t getting enough rest at night and that you really just need to adjust your nighttime sleep habits.

In any case, you need to find out what works best for you.  Some people take more time to fall asleep and just won’t get anything out of a 5 minute nap.  For me, I can set my alarm to go off 8 minutes later, take 1-3 minutes to fall asleep and get in a quick dream, and wake up feeling amazing.  This is inline with Lahl et al. (2008) who found that even 6 minutes of sleep can be beneficial.   But what is it about power naps that works so well and feels so good?

The power in power naps have a number of explanations.  Researchers at NIMH suggest that much the fatigue or “burn out” we experience mid-day has to do with vision.  As we work, the visual cortex becomes loaded with information that is need of processing, and memory consolidation.  They suggest that burnout is the brains mechanism for limiting any further influx of information so that the work we have already done can be successfully consolidated in memory.

Another explanation of the benefits of power naps is that they have been shown to decrease levels of cortisol, a stress hormone.  Allowing cortisol levels to return to baseline can have wide-ranging impacts on your mood, breathing, heart rate, muscle tension, digestion and more.  I had hoped to find more research on the biochemical and hormonal changes that occur as a result of power napping, but was unable to find it…  From my experience I feel an increased alertness so intense that it can’t be explained by resting the visual cortex or a decrease in some hormone.  I would suspect that some surge in adrenaline or epinephrine may be involved.  If anyone knows of this sort of research, I’d love to see it.

It might take some practice, but once mastered, power naps are a wonderful tool, whether it be during the work day, or a Friday evening before you go out for the night.  And, power naps are healthier and more effective than any amount of caffeine.    This lady is not nearly pumped up enough about the effectiveness of power naps.  Probably because if she was smiling this picture would be way to ridiculous.

pillowig