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Anxiety and Depression with a Gluten Free Diet

The team set out to examine levels of depression and anxiety between adults with celiac disease following a gluten-free diet and in control subjects drawn from the general population.

For their study, the team used the Hospital Anxiety and Depression Scale to measure levels of anxiety, depression, and likely anxiety or depressive disorder, in 441 adult patients with celiac disease recruited by the German Celiac Society. They then conducted the same assessments on 235 comparable patients with inflammatory bowel disease (IBD), either in remission or with slight disease activity. They did the same for the cross-sample control group of 441 adults from the general population.

The team used regression analysis to test possible demographic and disease-related predictors of anxiety and depression in celiac disease. Demographic predictors included age, sex, social class, and family status. Disease-related predictors included Latency to diagnosis, duration of GFD, compliance with GFD, thyroid disease.

The team found that female gender (P = 0.01) was the main predictor (R(2) = 0.07) of anxiety levels in patients with celiac disease. Female patients had a higher risk for a probable anxiety disorder (OR = 3.6, 95% CI: 1.3-9.4, P = 0.01) Patients who lived alone (OR = 0.5, 95% CI: 0.2-0.9, P = 0.05) enjoyed a lower risk of anxiety disorder. None of the demographic and medical variables for which the team screened predicted either depression levels or risk for a probable depressive disorders.

Patients with celiac disease showed anxiety levels of 6.6 +/- 3.4, and those with IBD, anxiety levels of 6.9 +/- 3.7, both higher than the general population's level of 4.6 +/- 3.3 – (both P < 0.001). Depression levels were similar for people with celiac disease (4.2 +/- 3.4), IBD (4.6 +/- 3.4) and the general population (4.2 +/- 3.8) (P = 0.3). Rates of likely anxiety disorders in people with celiac disease were 16.8%, and 14.0% for IBD, both higher than the rates of 5.7% in the general population (P < 0.001). All three groups showed similar rates of probable depressive disorder (P = 0.1).

Their results provide strong indications that adult women with celiac disease on a gluten-free diet suffer higher rates of anxiety than persons of the general population. They encourage clinicians to provide anxiety screens for adult women with celiac disease on a gluten-free diet.

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Tai Chi reduces arthritis pain

For this study, Chenchen Wang, M.D., M.Sc., and colleagues recruited 40 patients from the greater Boston area with confirmed knee OA who were in otherwise good health. The mean age of participants was 65 years with a mean body mass index of 30.0 kg/m2. Patients were randomly selected and 20 were asked to participate in 60-minute Yang style Tai Chi sessions twice weekly for 12 weeks. Each session included: a 10-minute self-massage and a review of Tai Chi principles; 30 minutes of Tai Chi movement; 10 minutes of breathing technique; and 10 minutes of relaxation.

The remaining 20 participants assigned to the control group attended two 60-minute class sessions per week for 12 weeks. Each control session included 40 minutes of instruction covering OA as a disease, diet and nutrition, therapies to treat OA, or physical and mental health education. The final 20 minutes consisted of stretching exercises involving the upper body, trunk, and lower body, with each stretch being held for 10-15 seconds.

At the end of the 12-week period, patients practicing Tai Chi exhibited a significant decrease in knee pain compared with those in the control group. Using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, researchers noted a -118.80 reduction in pain from baseline between the Tai Chi and control group. Researchers also observed improved physical function, self-efficacy, depression, and health status for knee OA in subjects in the Tai Chi group. “Our observations emphasize a need to further evaluate the biologic mechanisms and approaches of Tai Chi to extend its benefits to a broader population,” concluded Dr. Wang.

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Growing number of women with Gout

The number of women suffering from gout has doubled in the last 20 years, research shows.

The problem is traditionally associated with middle aged men but evidence suggests the disease is also a concern for women. According to a survey, the prevalence of gout in women was 3.5 per cent for ages 60 to 69, 4.6 per cent in the 70 to 79 age group, and 5.6 per cent in those aged 80 or older.

Gout is a common and painful inflammatory arthritis caused by elevated uric acid levels in the blood. When too much uric acid builds up in joint fluid, crystals form and cause joint swelling and inflammation. Dr Hyon Choi, from the Boston University School of Medicine, which conducted the review of previous research, said: “We identified 104 gout cases in women and 200 in men. “Our study found that higher levels of uric acid in the blood increase the risk gout risk for women.”

This study, the first to examine the relationship between uric acid levels and gout risk in women, also evaluated purported risk factors for gout and found that increasing age, obesity, hypertension, alcohol use, and diuretic use to be among the leading contributors for women.

The research team analysed data from 2,476 women and 1,951 men, and evaluated uric acid levels and risk factors for gout that included: age, body mass index (BMI), alcohol consumption, hypertension, medication use – including diuretics and hormone replacement therapy – blood glucose and cholesterol levels, and menopause status. The study looked at men and women from various health sources and records over an average of 28 years. The researchers found age, obesity, alcohol consumption, diuretic use, and hypertension were all independently associated with higher risk of gout incidence in women.

The study was published in the April issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.

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