It turns out that getting in the Christmas spirit can be good for your mental health

A study has found that performing small acts of kindness for others can give us a better outlook on things and help us to better deal with stress. "Stressful days usually lead us to have a worse mood and poorer mental health, but our findings suggest that if we do small things for others, such as holding a door open for someone, we won't feel as poorly on stressful days," researcher Emily Ansell said. The findings suggest "prosocial behavior" might someday be a useful course of treatment for people suffering from chronic stress or depression. Previous lab-based studies have shown similar results, but Ansell and her team wanted to see if they held true in the real world. Researchers had 77 adults use their cellphones to report stressful events, acts of kindness, and their emotional state every day for two weeks. The participants averaged one or two helpful acts per day. But those who logged more than that had improved well-being and were less affected by stress. "The holiday season can be a very stressful time, so think about giving directions, asking someone if they need help, or holding that elevator door over the next month," Ansell said. "It may end up helping you feel just a little bit better."

People who have a higher sense of purpose in life are at lower risk of death and cardiovascular disease

"Possessing a high sense of purpose in life is associated with a reduced risk for mortality and cardiovascular events," according to the study by Drs. Randy Cohen and Alan Rozanski and colleagues at Mt. Sinai St. Luke's-Roosevelt Hospital, New York. While the mechanisms behind the association remain unclear, the findings suggest that approaches to strengthening a sense of purpose might lead to improved health outcomes. Using a technique called meta-analysis, the researchers pooled data from previous studies evaluating the relationship between purpose in life and the risk of death or cardiovascular disease. The analysis included data on more than 136,000 participants from ten studies - mainly from the United States or Japan. The US studies evaluated a sense of purpose or meaning in life, or "usefulness to others." The Japanese studies assessed the concept of ikigai, translated as "a life worth living." The study participants, average age 67 years, were followed up for an average of seven years. During this time, more than 14,500 participants died from any cause while more than 4,000 suffered cardiovascular events (heart attack, stroke, etc). The analysis showed a lower risk of death for participants with a high sense of purpose in life. After adjusting for other factors, mortality was about one-fifth lower for participants reporting a strong sense of purpose, or ikigai. A high sense of purpose in life was also related to a lower risk of cardiovascular events. Both associations remained significant on analysis of various subgroups, including country, how purpose in life was measured, and whether the studies included participants with pre-existing cardiovascular disease. There is a well-documented link between "negative psychosocial risk factors" and adverse health outcomes, including heart attack, stroke, and overall mortality. "Conversely, more recent study provides evidence that positive psychosocial factors can promote healthy physiological functioning and greater longevity," according to the authors. The new analysis assembles high-quality data from studies assessing the relationship between purpose life and various measures of health and adverse clinical outcomes. The researchers write, "Together, these findings indicate a robust relationship between purpose in life and mortality and/or adverse cardiovascular outcomes." While further studies are needed to determine how purpose in life might promote health and deter disease, preliminary data suggest a few basic mechanisms. The association might be explained physiologically, such as by buffering of bodily responses to stress; or behaviorally, such as by a healthier lifestyle. "Of note, having a strong sense of life purpose has long been postulated to be an important dimension of life, providing people with a sense of vitality motivation and resilience," Dr. Rozanski comments. "Nevertheless, the medical implications of living with a high or low sense of life purpose have only recently caught the attention of investigators. The current findings are important because they may open up new potential interventions for helping people to promote their health and sense of well-being."

Training in meditation and other mindfulness-based techniques brings lasting improvements in mental health and quality of life for patients with inflammatory bowel diseases (IBD)

"Our study provides support for the feasibility, acceptability, and effectiveness of a tailored mindfulness-based group intervention for patients with IBD," concludes the research report by Dr. David Castle, a psychiatrist at St. Vincent's Hospital, Melbourne, Australia, and colleagues. More research is needed to demonstrate the clinical benefits of mindfulness techniques - including whether they can help to reduce IBD symptoms and relapses. The researchers evaluated a mindfulness-based stress reduction (MBSR) program tailored for patients with IBD. The study included 60 adults with IBD: Crohn's disease or ulcerative colitis. The patients' average age was 36 years, and average duration of IBD 11 years. Twenty-four patients had active disease at the time of the study. The MBSR intervention consisted of eight weekly group sessions plus a daylong intensive session, led by an experienced instructor. The program included guided meditations, exercises designed to enhance mindfulness in daily life, and group discussions of challenges and experiences. Participants were also encouraged to perform daily "mindfulness meditation" at home. Thirty-three patients agreed to participate in the MBSR intervention, 27 of whom completed the program. Ratings of mental health, quality of life, and mindfulness were compared to those of the 27 patients who chose not to participate (mainly because of travel time). The MBSR participants had greater reductions in anxiety and depression scores, as well as improvement in physical and psychological quality of life. They also had higher scores on a questionnaire measuring various aspects of mindfulness - for example, awareness of inner and outer experiences. Six months later, MBSR participants still had significant reduction in depression and improvement in quality of life, with a trend toward reduced anxiety. The patients were highly satisfied with the mindfulness intervention. Anxiety, depression, and decreased quality of life are common in patients with IBD. Psychological distress may lead to increased IBD symptoms and play a role in triggering disease flare-ups. Previous studies have shown benefits of MBSR for patients with a wide range of physical illnesses, but there is limited evidence on mindfulness-based interventions for patients with IBD. The new results show that the MBSR approach is feasible and well-accepted by patients with IBD. The study also suggests that training patients in mindfulness practices to follow in daily life can lead to significant and lasting benefits, including reduced psychological distress and improved quality of life. Dr. Castle comments, "This work reinforces the interaction between physical and mental aspects of functioning, and underscores the importance of addressing both aspects in all our patients."

A randomized trial of people with two common forms of arthritis has found that yoga can be safe and effective for people with arthritis

Johns Hopkins researchers report that 8 weeks of yoga classes improved the physical and mental well-being of people with two common forms of arthritis, knee osteoarthritis and rheumatoid arthritis. The study is believed to be the largest randomized trial so far to examine the effect of yoga on physical and psychological health and quality of life among people with arthritis. "There's a real surge of interest in yoga as a complementary therapy, with 1 in 10 people in the U.S. now practicing yoga to improve their health and fitness," says Susan J. Bartlett, Ph.D., an adjunct associate professor of medicine at Johns Hopkins and associate professor at McGill University "Yoga may be especially well suited to people with arthritis because it combines physical activity with potent stress management and relaxation techniques, and focuses on respecting limitations that can change from day to day." Arthritis, the leading cause of disability, affects 1 in 5 adults, most of whom are under 65 years of age. Without proper management, arthritis affects not only mobility, but also overall health and well-being, participation in valued activities, and quality of life. There is no cure for arthritis, but one important way to manage arthritis is to remain active. Yet up to 90% of people with arthritis are less active than public health guidelines suggest, perhaps due to arthritis symptoms such as pain and stiffness, but also because they are unsure of how best to remain active. The study recruited 75 people with either knee osteoarthritis or rheumatoid arthritis. Participants were randomly assigned to either a wait list or eight weeks of twice-weekly yoga classes, plus a weekly practice session at home. Participants' physical and mental well-being was assessed before and after the yoga session by researchers who did not know which group the participants had been assigned to. Compared with the control group, those doing yoga reported a 20% improvement in pain, energy levels, mood and physical function, including their ability to complete physical tasks at work and home. Walking speed also improved to a smaller extent, though there was little difference between the groups in tests of balance and upper body strength. Improvements in those who completed yoga was still apparent nine months later. Safety was a priority in the study, the authors say. "For people with other conditions, yoga has been shown to improve pain, pain-related disability and mood," says Bingham. "But there were no well-controlled trial of yoga that could tell us if it was safe and effective for people with arthritis, and many health professionals have concerns about how yoga might affect vulnerable joints given the emphasis on changing positions and on being flexible. Our first step was to ensure that yoga was reasonable and safe option for people with arthritis. Our instructors were experienced yoga therapists with additional training to modify poses to accommodate individual abilities." Participants were screened by their doctors prior to joining the study, and continued to take their regular arthritis medication during the study. The researchers have developed a checklist to make it easier for doctors to safely recommend yoga to their patients, Bingham says. People with arthritis who are considering yoga should "talk with their doctors about which specific joints are of concern, and about modifications to poses," suggests Bingham. "Find a teacher who asks the right questions about limitations and works closely with you as an individual. Start with gentle yoga classes. Practice acceptance of where you are and what your body can do on any given day."

Low energy activities that involve sitting down are associated with an increased risk of anxiety, according to new research

These activities, which include watching TV, working at a computer or playing electronic games, are called sedentary behavior. Further understanding of these behaviors and how they may be linked to anxiety could help in developing strategies to deal with this mental health problem. Many studies have shown that sedentary behavior is associated with physical health problems like obesity, heart disease, type 2 diabetes and osteoporosis. However, there has been little research into the link between sedentary behavior and mental health. This is the first systematic review to examine the relationship between anxiety and sedentary behavior. Anxiety is a mental health illness that affects more than 27 million people worldwide. It is a debilitating illness that can result in people worrying excessively and can prevent people carrying out their daily life. It can also result in physical symptoms, which amongst others includes pounding heartbeat, difficulty breathing, tense muscles, and headaches. Megan Teychenne, lead researcher and lecturer at Deakin University's Centre for Physical Activity and Nutrition Research (C-PAN) in Australia, said: "Anecdotally - we are seeing an increase in anxiety symptoms in our modern society, which seems to parallel the increase in sedentary behavior. Thus, we were interested to see whether these two factors were in fact linked. Also, since research has shown positive associations between sedentary behavior and depressive symptoms, this was another foundation for further investigating the link between sedentary behavior and anxiety symptoms." C-PAN researchers analyzed the results of nine studies that specifically examined the association between sedentary behavior and anxiety. The studies varied in what they classified as sedentary behavior from television viewing/computer use to total sitting time, which included sitting while watching television, sitting while on transport and work-related sitting. Two of the studies included children/adolescents while the remaining seven included adults. It was found in five of the nine studies that an increase in sedentary behavior was associated with an increased risk of anxiety. In four of the studies it was found that total sitting time was associated with increased risk of anxiety. The evidence about screen time (TV and computer use) was less strong but one study did find that 36% of high school students who had more than 2 hours of screen time were more like to experience anxiety compared to those who had less than 2 hours. The C-PAN team suggests the link between sedentary behavior and anxiety could be due to disturbances in sleep patterns, social withdrawal theory and poor metabolic health. Social withdrawal theory proposes that prolonged sedentary behavior, such as television viewing, can lead to withdrawal from social relationships, which has been linked to increased anxiety. As most of the studies included in this systematic-review were cross-sectional the researchers say that more follow-up work studies are required to confirm whether or not anxiety is caused by sedentary behavior. Megan Teychenne said: "It is important that we understand the behavioral factors that may be linked to anxiety - in order to be able to develop evidence-based strategies in preventing/managing this illness. Our research showed that evidence is available to suggest a positive association between sitting time and anxiety symptoms - however, the direction of this relationship still needs to be determined through longitudinal and interventional studies."

People who suffer from social anxiety might want to get familiar with fermented foods

A study led by researchers at William and Mary found that college students who eat such foods — think yogurt, sauerkraut, pickles, kimchi — report fewer social anxiety symptoms. The researchers suspect that it's all about the "good" bacteria, or probiotics, in the food. “It is likely that the probiotics in the fermented foods are favorably changing the environment in the gut, and changes in the gut in turn influence social anxiety,” says a lead researcher. "I think that it is absolutely fascinating that the microorganisms in your gut can influence your mind.” More specifically, they think that the bacteria trigger a neurotransmitter called GABA, which is used in anti-anxiety drugs. In their study, the researchers surveyed 700 undergrads about their eating habits and well-being. A post at Bustle cautions that "actual experiments — not just surveys" will need to follow in order to confirm the findings. "But in the meantime, at least we all have an excuse to eat more pickles." Just note that not all pickles or sauerkraut have probiotics, so those who want to indulge should check the label for "live cultures".

People with high levels of cynical distrust may be more likely to develop dementia, according to a new study

Cynical distrust, which is defined as the belief that others are mainly motivated by selfish concerns, has been associated with other health problems, such as heart disease. This is the first study to look at the relationship between cynicism and dementia. "These results add to the evidence that people's view on life and personality may have an impact on their health," said study author Anna-Maija Tolppanen, PhD, of the University of Eastern Finland in Kuopio. "Understanding how a personality trait like cynicism affects risk for dementia might provide us with important insights on how to reduce risks for dementia." For the study, 1,449 people with an average age of 71 were given tests for dementia and a questionnaire to measure their level of cynicism. The questionnaire has been shown to be reliable, and people's scores tend to remain stable over periods of several years. People are asked how much they agree with statements such as "I think most people would lie to get ahead," "It is safer to trust nobody" and "Most people will use somewhat unfair reasons to gain profit or an advantage rather than lose it." Based on their scores, participants were grouped in low, moderate and high levels of cynical distrust. A total of 622 people completed two tests for dementia, with the last one an average of eight years after the study started. During that time, 46 people were diagnosed with dementia. Once researchers adjusted for other factors that could affect dementia risk, such as high blood pressure, high cholesterol and smoking, people with high levels of cynical distrust were three times more likely to develop dementia than people with low levels of cynicism. Of the 164 people with high levels of cynicism, 14 people developed dementia, compared to nine of the 212 people with low levels of cynicism.

Holding cynical beliefs about others may have a negative effect on your income according to research published by the American Psychological Association

"While previous research has associated cynicism with detrimental outcomes across a wide range of spheres of life, including physical health, psychological well-being and marital adjustment, the present research has established an association between cynicism and individual economic success," says Olga Stavrova, PhD, a research associate at the Institute of Sociology and Social Psychology, University of Cologne, Germany, and lead author on the study. The research outlines a series of studies using survey data from the United States and Europe. The first two studies looked at cynicism (as measured by responses to a questionnaire) in national surveys of Americans (1,146 and 497 participants respectively) and income level at a later date. In both studies, a high level of cynicism was associated with lower income. Another study, focusing on a nationally representative sample of approximately 16,000 people in Germany, found that after nine years people with low levels of cynicism earned on average $300 per month more than their more cynical counterparts. The final study examined the potential universality of these findings, looking at survey data from 41 countries to see if societal factors could play a role. The negative association between cynicism and lower income was strongest in countries with higher levels of altruistic behavior, lower homicide rates and lower levels of overall societal cynicism. "There are actually some countries where cynical individuals do not necessarily earn less than their less cynical compatriots," said Stavrova. "These countries are those with pervasively high societal cynicism scores, rare pro-social behavior (e.g., charity donations) and widespread antisocial behavior (as indicated by high homicide rates) - in other words, countries where cynicism might be justified or even somewhat functional." One reason for these findings could be that cynical individuals are less likely to trust others and therefore forgo cooperation opportunities, said Stavrova. They are more likely to suspect mean motives behind other people's behavior, might be less likely to join collaborative efforts and may avoid asking for help in case of need, which may eventually undermine their economic success. "For example, employees who believe others to be exploitative and dishonest are likely to avoid collaborative projects and to forgo the related opportunities," said Stavrova. Similarly, cynical individuals might be likely to over-invest resources on protecting themselves from potential deceit, "covering their backs" at costs of focusing on their jobs. "Occupational success and economic prosperity represent important life goals for many people and promote life satisfaction and psychological well-being," said Stavrova. "Our findings may help in achieving these goals by encouraging people to adopt a more benevolent and idealistic view of human nature and trustful attitude towards their peers."

Practice may not make perfect, but visualization might

New research shows that people who imagined a visual target before having to pick it out of a group of distracting items were faster at finding the target than those who did an actual practice run beforehand. "The idea that we can train our brains to work better is all the rage across society, but our research suggests that the human brain may benefit as much, or even more, from imagining performing a task, than the brain does from practicing a task over and over," says psychological scientist and study author Geoffrey Woodman of Vanderbilt University. "Until now, people have thought that imagining performing a task improved how efficiently people could decide how to respond to objects, or how well those motor responses were executed. To our knowledge, this study is the first demonstration that imagery actually changes how information is processed early on in the visual system," Woodman explains. Imagery, or visualization, is commonly used as a technique to improve performance in various sports. When Woodman heard an interview with legendary tennis player Billie Jean King - in which she attributed her success in tournaments to imagining what the ball would look like coming at her under different conditions - he began to wonder whether visualization might actually improve visual processing and not just motor performance. The research team - including Vanderbilt researchers Robert M.G. Reinhart and Laura J. McClenahan - brought participants to the lab and had them look at a computer screen while their brain activity was recorded via EEG. The participants looked at a series of images, each of which contained a bunch of letter Cs arranged in a ring - importantly, the Cs varied in how they were oriented (i.e., which way the gap in the C pointed). The participants were asked to determine, as quickly and accurately as they could, whether a target - a red or green C with a particular orientation - was present or absent in each image. During one part of the experiment the participants were asked to imagine looking for the target C before the test trial. During another part of the experiment, participants were given an actual trial to practice on before they did the test trial. Imagining enabled participants to search more efficiently, speeding up how quickly they were able to find the target. And participants who imagined searching for the target showed bigger improvements in performance that did the participants who actually practiced the visual search. "We ended up running a fairly large number of experiments because it was so surprising that imagery beat actual practice," says Woodman. The results of these experiments indicated that imagination is superior to practice because it doesn't involve as much visual interference. When participants practice a search, the distracting stimuli (all the non-target Cs) appear to leave traces in memory that interfere with performance on the next visual search. When participants imagine the search, on the other hand, the non-target stimuli receive much less focus, and are therefore less likely to interfere with later performance. The increased efficiency brought on by imagination was also supported by the EEG data, which showed a link between imagination and a pattern of brain activity thought to be specialized for shifting visual attention. "We found that imagining searching for targets changed how strongly the visual system responded to the targets within 200 ms of an array of objects appearing," says Woodman. The researchers point out that these findings have broad implications across a variety of fields: "This study indicates that some of the success of imagery for learning in sports, music, and clinical settings is due to how well our sensory systems process inputs. So using imagery can change information processing in the brain at the earliest levels," Woodman concludes.

When the stakes are high, people in positions of low power may perform better by using self-affirmations to boost their confidence

"Most people have experienced a time in their lives when they aren't performing up to their potential. They take a test or have a performance review at work, but something holds them back," says lead researcher Sonia Kang, Ph.D. "Performance in these situations is closely related to how we are expected to behave." The researchers conducted three experiments to measure performance in pressure-filled situations. When participants were in a position of high power, they tended to perform better under pressure, while those with less power performed worse. Self-affirmations, however, helped to level the playing field and effectively reduced the power differences. "You should reflect on things that you know are good about yourself," says Kang, an assistant professor of organizational behavior and human resource management at the University of Toronto. "Anyone has the potential to do really well. It's how you respond under pressure that makes a key difference." In the first experiment, 134 participants (60% women) were assigned in same-sex pairs to portray a recruiter or job candidate in a competitive negotiation involving the setting of salary, vacation time and other job benefits. To increase the pressure, half of the paired participants were told the negotiation was an accurate gauge of their negotiating skills. Participants in the low-pressure situation were told the exercise would teach them negotiation concepts and was not an accurate gauge of their negotiating abilities. Job candidates, who had a lower power role, performed significantly worse in the high-stakes negotiations than those in the low-pressure group. Recruiters, who held a more powerful role, actually performed better under pressure because their initial expectations for success were magnified, Kang says. In a second experiment, 60 male MBA students were paired together as the buyer or seller of a biotechnology plant. The sellers, who were in a position of power, were more assertive under pressure and negotiated a higher selling price, while the buyers performed worse under pressure. The final experiment used the same biotechnology plant exercise with 88 MBA students (33 male pairs and 11 female pairs), but all participants were told that the exercise would gauge their negotiating skills to raise the stakes. Before the negotiation, half of the participants wrote for five minutes about their most important negotiating skill, while the remaining half wrote about their least important negotiating skill. Buyers who completed the positive self-affirmation performed significantly better in negotiating a lower sale price for the biotechnology plant, effectively reducing the power differences between the buyer and seller. Writing down a self-affirmation may be more effective than just thinking it, but both methods can help, Kang says. Before a performance review, an employee could write or think about his best job skills. Writing or thinking about one's family or other positive traits that aren't associated with the high-stakes situation also may boost confidence and performance. "Anytime you have low expectations for your performance, you tend to sink down and meet those low expectations," Kang says. "Self-affirmation is a way to neutralize that threat."

Recognizing and giving thanks for the positive aspects of life can result in improved mental, and ultimately physical, health in patients with asymptomatic heart failure

"We found that more gratitude in these patients was associated with better mood, better sleep, less fatigue and lower levels of inflammatory biomarkers related to cardiac health," said lead author Paul J. Mills, PhD, professor of family medicine and public health at the University of California, San Diego. Gratitude is part of a wider outlook on life that involves noticing and appreciating the positive aspects of life. It can be attributed to an external source (e.g., a pet), another person or a non-human (e.g., God). It is also commonly an aspect of spirituality, said Mills. Because previous research has shown that people who considered themselves more spiritual had greater overall well-being, including physical health, Mills and his colleagues examined the role of both spirituality and gratitude on potential health markers in patients. The study involved 186 men and women who had been diagnosed with asymptomatic (Stage B) heart failure for at least three months. Stage B consists of patients who have developed structural heart disease (e.g., have had a heart attack that damaged the heart) but do not show symptoms of heart failure (e.g., shortness of breath or fatigue). This stage is an important therapeutic window for halting disease progression and improving quality of life since Stage B patients are at high risk of progressing to symptomatic (Stage C) heart failure, where risk of death is five times higher, according to Mills. Using standard psychological tests, the researchers obtained scores for gratitude and spiritual well-being. They then compared those scores with the patients' scores for depressive symptom severity, sleep quality, fatigue, self-efficacy (belief in one's ability to deal with a situation) and inflammatory markers. They found higher gratitude scores were associated with better mood, higher quality sleep, more self-efficacy and less inflammation. Inflammation can often worsen heart failure. What surprised the researchers about the findings, though, was that gratitude fully or partially accounted for the beneficial effects of spiritual well-being. "We found that spiritual well-being was associated with better mood and sleep, but it was the gratitude aspect of spirituality that accounted for those effects, not spirituality per se," said Mills. To further test their findings, the researchers asked some of the patients to write down three things for which they were thankful most days of the week for eight weeks. Both groups continued to receive regular clinical care during that time. "We found that those patients who kept gratitude journals for those eight weeks showed reductions in circulating levels of several important inflammatory biomarkers, as well as an increase in heart rate variability while they wrote. Improved heart rate variability is considered a measure of reduced cardiac risk," said Mills. "It seems that a more grateful heart is indeed a more healthy heart, and that gratitude journaling is an easy way to support cardiac health."

Research from Brigham Young University shows that loneliness and social isolation are just as much a threat to longevity as obesity

"The effect of this is comparable to obesity, something that public health takes very seriously," said Julianne Holt-Lunstad, the lead study author. "We need to start taking our social relationships more seriously." Loneliness and social isolation can look very different. For example, someone may be surrounded by many people but still feel alone. Other people may isolate themselves because they prefer to be alone. The effect on longevity, however, is much the same for those two scenarios. The association between loneliness and risk for mortality among young populations is actually greater than among older populations. Although older people are more likely to be lonely and face a higher mortality risk, loneliness and social isolation better predict premature death among populations younger than 65 years. "Not only are we at the highest recorded rate of living alone across the entire century, but we're at the highest recorded rates ever on the planet," said Tim Smith, co-author of the study. "With loneliness on the rise, we are predicting a possible loneliness epidemic in the future." The study analyzed data from a variety of health studies. Altogether, the sample included more than 3 million participants from studies that included data for loneliness, social isolation, and living alone. Controlling for variables such as socioeconomic status, age, gender, and pre-existing health conditions, they found that the effect goes both ways. The lack of social connections presents an added risk, and the existence of relationships provides a positive health effect. Previous research from Holt-Lunstad and Smith puts the heightened risk of mortality from loneliness in the same category as smoking 15 cigarettes a day and being an alcoholic. This current study suggests that not only is the risk for mortality in the same category as these well-known risk factors, it also surpasses health risks associated with obesity. "In essence, the study is saying the more positive psychology we have in our world, the better we're able to function not just emotionally but physically," Smith said. There are many things that help to subdue the effects of loneliness. With the evolution of the Internet, people can keep in contact over distances that they couldn't before. However, the superficiality of some online experiences may miss emotional context and depth. Too much texting with each other can actually hurt a romantic relationship, for example. The authors of that texting study note, however, that saying something sweet or kind in a text is universally beneficial.

Men with borderline testosterone levels have higher rates of depression and depressive symptoms than the general population, new research finds

"Over half of men referred for borderline testosterone levels have depression. This study found that men seeking management for borderline testosterone have a very high rate of depression, depressive symptoms, obesity and physical inactivity," said principal study author Michael S. Irwig, MD, FACE, associate professor of medicine and director of the Center for Andrology in the Division of Endocrinology at George Washington University in Washington, DC. "Clinicians need to be aware of the clinical characteristics of this sample population and manage their comorbidities such as depression and obesity." The number of men having their testosterone levels checked has increased dramatically. Studies of the possible association between depression and serum testosterone show inconsistent results, and few studies have been published about adult men referred for the management of borderline testosterone. Dr. Irwig and his colleagues studied 200 adult men between 20 and 77 years of age whose testosterone levels were borderline (between 200 and 350 nanograms per deciliter). The researchers collected the men's demographic information, medical histories, medication use, and signs and symptoms of hypogonadism. They remeasured the men's total testosterone and assessed depression from their medical history and depressive symptoms with the validated Patient Health Questionnaire 9 (PHQ-9). Using a score of 10 or higher on the PHQ-9, 56% of the study participants had significant depressive symptoms, known diagnosis of depression and/or use of an antidepressant. Their rates of depressive symptoms were markedly higher than the 15 to 22% in an ethnically diverse sample of primary care patients and the 5.6% among overweight and obese US adults. The population also had a high prevalence of overweight (39%), obesity (40%) and physical inactivity; other than walking, 51% of the men did not engage in regular exercise. The most common symptoms reported were erectile dysfunction (78%), low libido (69%) and low energy (52%). "This study underscores the utility of a validated instrument to screen for depression, especially as some subjects may deny signs and symptoms during the interview. Appropriate referrals should be made for formal evaluation and treatment of depression," Dr. Irwig said.

A treatment known as mindfulness-based stress reduction (MBSR) may decrease fasting glucose and improve quality of life in overweight and obese women, new research suggests

MBSR is a secular mindfulness meditation program that was developed by Jon Kabat-Zinn, PhD at the University of Massachusetts Medical School. The practice of MBSR involves paying attention to one's thoughts, feelings, and bodily sensations in the present moment in a nonjudgmental and nonreactive manner through mindfulness exercises such as breathing awareness. MBSR may be beneficial for overweight and obese women as it has been shown to reduce stress and improve quality of life. "In overweight and obese women, stress may contribute to increased diabetes and cardiovascular disease," said Nazia Raja-Khan, MD, assistant professor of medicine and obstetrics and gynecology at the Penn State College of Medicine in Hershey, Pennsylvania. "MBSR significantly reduces fasting glucose and improves quality of life without changing body weight or insulin resistance. Increased mindfulness and reduced stress may lead to physiological changes in the hypothalamic-pituitary-adrenal (HPA) axis and/or sympathetic nervous system that result in lower glucose levels." Dr. Raja-Khan and her colleagues conducted a pilot randomized controlled trial of 86 overweight or obese women who were similar in age and body mass index. The women received 8 weeks of either MBSR or health education control (HEC) and underwent fasting blood work and completed questionnaires at baseline, 8 weeks and 16 weeks. The MBSR group's mindfulness scores significantly increased and its perceived stress scores significantly decreased, compared to the HEC group's scores. While sleep, depression, anxiety and overall psychological distress improved in both groups, fasting glucose dropped significantly and quality of life improved significantly in the MBSR group, but not in the HEC group. Weight, body mass index, blood pressure, lipid profile, hemoglobin A1c, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and high-sensitivity C-reactive protein (hsCRP) remained similar with MBSR. "Given the increasing epidemics of obesity and diabetes, this study is particularly relevant to the general public, as it demonstrates that stress management, specifically with mindfulness-based interventions such as MBSR, may be beneficial for reducing perceived stress and blood glucose and improving quality of life in overweight or obese women," said Raja-Khan. "This research supports the integration of mindfulness-based interventions with conventional medical approaches to obesity and diabetes prevention and treatment."

Losing as little as 30 minutes of sleep per day on weekdays can have long-term consequences for body weight and metabolism, a new study finds

"While previous studies have shown that short sleep duration is associated with obesity and diabetes, we found that as little as 30 minutes a day sleep debt can have significant effects on obesity and insulin resistance at follow up," said lead study author Professor Shahrad Taheri, MBBS, PhD, professor of medicine at Weill Cornell Medical College in Qatar, in Doha. "This reinforces earlier observations that sleep loss is additive and can have metabolic consequences." Because of social and work commitments, people often accumulate sleep debt during weekdays and make up for lost sleep over the weekend. But weekday sleep debt may lead to long-term metabolic disruption, which may promote the onset of, or exacerbate the progression of, type 2 diabetes mellitus. "Sleep loss is widespread in modern society, but only in the last decade have we realized its metabolic consequences," Taheri said. "Our findings suggest that avoiding sleep debt could have positive benefits for waistlines and metabolism and that incorporating sleep into lifestyle interventions for weight loss and diabetes might improve their success." Professor Taheri and his colleagues recruited 522 patients with newly diagnosed type 2 diabetes mellitus in the Early Activity in Diabetes trial and randomized them into one of three groups: usual care, physical activity intervention, or diet and physical activity intervention. Participants completed 7-day sleep diaries and calculated their weekday sleep debt. At baseline, the researchers recorded their height and weight to determine obesity status, measured their waist circumference for central adiposity, and analyzed their fasting blood samples for insulin sensitivity. At baseline, compared with participants who had no weekday sleep debt, those who had weekday sleep debt were 72% more likely to be obese, and by the 6-month mark, weekday sleep debt was significantly associated with obesity and insulin resistance. At 12 months, for every 30 minutes of weekday sleep debt at baseline, the risk of obesity and insulin resistance was significantly increased by 17% and 39%, respectively. The authors advise that future interventions designed to slow progression or reverse metabolic disease should consider all factors - including sleep - that affect metabolic function. Looking toward future research, they recommend that consistent optimum sleep hygiene and education may be a key component of successful future trials in metabolic disease control.

Having a high sense of purpose in life may lower your risk of heart disease and stroke, according to a new study led by researchers at Mount Sinai St. Luke's and Mount Sinai Roosevelt

The new analysis defined purpose in life as a sense of meaning and direction, and a feeling that life is worth living. Previous research has linked purpose to psychological health and well-being, but the new Mount Sinai analysis found that a high sense of purpose is associated with a 23% reduction in death from all causes and a 19% reduced risk of heart attack, stroke, or the need for coronary artery bypass surgery (CABG) or a cardiac stenting procedure. "Developing and refining your sense of purpose could protect your heart health and potentially save your life," says lead study author Randy Cohen, MD, a preventive cardiologist at Mount Sinai St. Luke's and Mount Sinai Roosevelt. "Our study shows there is a strong relationship between having a sense of purpose in life and protection from dying or having a cardiovascular event. As part of our overall health, each of us needs to ask ourselves the critical question of 'do I have a sense of purpose in my life?' If not, you need to work toward the important goal of obtaining one for your overall well-being." The research team reviewed 10 relevant studies with the data of more than 137,000 people to analyze the impact of sense of purpose on death rates and risk of cardiovascular events. The meta-analysis also found that those with a low sense of purpose are more likely to die or experience cardiovascular events. "Prior studies have linked a variety of psychosocial risk factors to heart disease, including negative factors such as anxiety and depression and positive factors such as optimism and social support," says Alan Rozanski, MD, study co-author and Director of Wellness and Prevention Programs for Mount Sinai Heart at the Mount Sinai Health System. "Based on our findings, future research should now further assess the importance of life purpose as a determinant of health and well-being and assess the impact of strategies designed to improve individuals' sense of life purpose."

Meditation might be an effective treatment for reducing chronic neck pain

Chronic neck pain can lead to serious comorbidities like depression. Patients with chronic neck pain frequently experience distress. Meditation has been increasingly used as a supportive treatment for individuals with chronic pain. Previous research has shown that chronic pain is associated with distress and that meditation has stress relieving benefits. German researchers compared the effects of meditation on pain, perceived stress and psychological well being. They hypothesized that an eight-week meditation program will decrease pain more effectively than a standardized exercise program and that pain relief will coincide with stress reduction. For the study, 89 patients with chronic neck pain who showed increased perceived stress were randomized into meditation and exercise program groups. Outcomes were assessed at baseline and after eight weeks. Results showed that meditation training significantly reduced pain when compared to the exercise group and pain-related "bothersomeness" decreased more in the meditation group as well. No significant differences between meditation and exercise were found for pain during movement, pain disability, psychological scores and quality of life, which is consistent with the known benefits of exercise on pain-related outcomes. The authors concluded that meditation has unique benefits for producing pain relief and for pain coping.

There's an easy way to beat the workday blues, researchers find, and it doesn't take long: Go for a walk a few times a week during your lunch break

In a study of 75 "physically inactive" people — that is, those who engage in less than 150 weekly minutes of moderate exercise — researchers divided subjects into a walking and a non-walking group (whose members weren't left out: They acted as a control group, then started walking later in the study). Walkers took 30-minute strolls three times during the workweek and twice on weekends. In surveys, walkers said that they felt more enthusiastic and more relaxed than non-walkers. They were also less nervous after their walks, and they felt better in the afternoons on walking days than on other days. They saw physical health benefits, too. Plus, bosses shouldn't mind: "There is now quite strong research evidence that feeling more positive and enthusiastic at work is very important to productivity," a researcher said. “So we would expect that people who walked at lunchtime would be more productive.” One caveat: The study's participants were almost all women, so more research is needed to generalize to men. (Walking might be able to help fight the effects of excessive sitting.)

Might living a structured life with regularly established meal times and early bedtimes lead to a better life and perhaps even prevent the onset of mental illness?

That's what's suggested in a study led by Kai-Florian Storch, PhD, of the Douglas Mental Health University Institute and McGill University. Our daily sleep-wake cycle is governed by an internal 24-hour timer, the circadian clock. However, there is evidence that daily activity is also influenced by rhythms much shorter than 24 hours, which are known as ultradian rhythms and follow a four-hour cycle. Most prominently observed in infants before they are able to sleep through the night, ultradian rhythms may explain why, on average, we eat three meals a day that are relatively evenly spaced across our daily wake period. These four-hour ultradian rhythms are activated by dopamine, a key chemical substance in the brain. When dopamine levels are out of kilter - as is suggested to be the case with people suffering from bipolar disease and schizophrenia - the four-hour rhythms can stretch as long as 48 hours. With this study, conducted on genetically modified mice, Dr. Storch and his team demonstrate that sleep abnormalities, which in the past have been associated with circadian rhythm disruption, result instead from an imbalance of an ultradian rhythm generator (oscillator) that is based on dopamine. The team's findings also offer a very specific explanation for the two-day cycling between mania and depression observed in certain bipolar cases: it is a result of the dopamine oscillator running on a 48-hour cycle. This work is groundbreaking not only because of its discovery of a novel dopamine-based rhythm generator, but also because of its links to psychopathology. This new data suggests that when the ultradian arousal oscillator goes awry, sleep becomes disturbed and mania will be induced in bipolar patients; oscillator imbalance may likely also be associated with schizophrenic episodes in schizophrenic subjects. The findings have potentially strong implications for the treatment of bipolar disease and other mental illnesses linked to dopamine dysregulation.

Mindfulness meditation practices resulted in improved sleep quality for older adults with moderate sleep disturbance in a clinical trial comparing meditation to a more structured program focusing on changing poor sleep habits and establishing a bedtime routine

Sleep disturbances are a medical and public health concern for our nation's aging population. An estimated 50% of individuals 55 years and older have some sort of sleep problem. Moderate sleep disturbances in older adults are associated with higher levels of fatigue, disturbed mood, such as depressive symptoms, and a reduced quality of life. David S. Black, Ph.D., M.P.H., of the University of Southern California, Los Angeles, and colleagues conducted a small clinical trial in Los Angeles in 2012 and their analysis included 49 individuals (average age 66). The trial included 24 individuals who took part in a standardized mindful awareness practices (MAPs) intervention and 25 individuals who participated in a sleep hygiene education (SHE) intervention. Differences between the groups were measured using the Pittsburgh Sleep Quality Index (PSQI), a widely used self-reported questionnaire of sleep disturbances. Participants in the MAPs group showed improvement relative to those in the SHE group. The MAPs group had average PSQI scores of 10.2 at baseline and 7.4 after the intervention. The SHE group had average PSQIs of 10.2 at baseline and 9.1 after the intervention. The MAPs group also showed improvement relative to the SHE group on secondary measures of insomnia symptoms, depression symptoms, fatigue interference and fatigue severity. However, differences between the groups were not seen for anxiety, stress or inflammatory signaling, a measure of which declined in both groups over time. Mindfulness meditation appears to have a role in addressing the prevalent burden of sleep problems among older adults by remediating their moderate sleep disturbances and deficits in daytime functioning, with short-term effect sizes commensurate with the status quo of clinical treatment approaches for sleep problems.

Building on their earlier work that suggested people who meditate have less age-related atrophy in the brain's white matter, a new study by UCLA researchers found that meditation appeared to help preserve the brain's gray matter, the tissue that contains neurons

The scientists looked specifically at the association between age and gray matter. They compared 50 people who had mediated for years and 50 who didn't. People in both groups showed a loss of gray matter as they aged. But the researchers found among those who meditated, the volume of gray matter did not decline as much as it did among those who didn't. Dr. Florian Kurth, a co-author of the study and postdoctoral fellow at the UCLA Brain Mapping Center, said the researchers were surprised by the magnitude of the difference. "We expected rather small and distinct effects located in some of the regions that had previously been associated with meditating," he said. "Instead, what we actually observed was a widespread effect of meditation that encompassed regions throughout the entire brain." As baby boomers have aged and the elderly population has grown, the incidence of cognitive decline and dementia has increased substantially as the brain ages. "In that light, it seems essential that longer life expectancies do not come at the cost of a reduced quality of life," said Dr. Eileen Luders, first author and assistant professor of neurology at the David Geffen School of Medicine at UCLA. "While much research has focused on identifying factors that increase the risk of mental illness and neurodegenerative decline, relatively less attention has been turned to approaches aimed at enhancing cerebral health." Each group in the study was made up of 28 men and 22 women ranging in age from 24 to 77. Those who meditated had been doing so for four to 46 years, with an average of 20 years. The participants' brains were scanned using high-resolution magnetic resonance imaging. Although the researchers found a negative correlation between gray matter and age in both groups of people - suggesting a loss of brain tissue with increasing age - they also found that large parts of the gray matter in the brains of those who meditated seemed to be better preserved, Kurth said.

People who have upbeat outlooks on life have significantly better cardiovascular health, suggests a new study that examined associations between optimism and heart health in more than 5,100 adults

"Individuals with the highest levels of optimism have twice the odds of being in ideal cardiovascular health compared to their more pessimistic counterparts," said lead author Rosalba Hernandez, a professor of social work at the University of Illinois. "This association remains significant, even after adjusting for socio-demographic characteristics and poor mental health." Participants' cardiovascular health was assessed using seven metrics: blood pressure, body mass index, fasting plasma glucose and serum cholesterol levels, dietary intake, physical activity and tobacco use - the same metrics used by the American Heart Association to define heart health and being targeted by the AHA in its Life's Simple 7 public awareness campaign. In accordance with AHA's heart-health criteria, the researchers allocated 0, 1 or 2 points - representing poor, intermediate and ideal scores, respectively - to participants on each of the seven health metrics, which were then summed to arrive at a total cardiovascular health score. Participants' total health scores ranged from 0 to 14, with a higher total score indicative of better health. The participants, who ranged in age from 45-84, also completed surveys that assessed their mental health, levels of optimism, and physical health, based upon self-reported extant medical diagnoses of arthritis, liver and kidney disease. Individuals' total health scores increased in tandem with their levels of optimism. People who were the most optimistic were 50% and 76% more likely to have total health scores in the intermediate or ideal ranges, respectively. The association between optimism and cardiovascular health was even stronger when socio-demographic characteristics such as age, race and ethnicity, income and education status were factored in. People who were the most optimistic were twice as likely to have ideal cardiovascular health, and 55% more likely to have a total health score in the intermediate range, the researchers found. Optimists had significantly better blood sugar and total cholesterol levels than their counterparts. They also were more physically active, had healthier body mass indexes and were less likely to smoke. The findings may be of clinical significance, given that a 2013 study indicated that a one-point increase in an individual's total-health score on the LS7 was associated with an 8% reduction in their risk of stroke, Hernandez said. "At the population level, even this moderate difference in cardiovascular health translates into a significant reduction in death rates," Hernandez said. "This evidence, which is hypothesized to occur through a biobehavioral mechanism, suggests that prevention strategies that target modification of psychological well-being - e.g., optimism - may be a potential avenue for AHA to reach its goal of improving Americans' cardiovascular health by 20% before 2020." Believed to be the first study to examine the association of optimism and cardiovascular health in a large, ethnically and racially diverse population, the sample for the current study was 38% white, 28% African-American, 22% Hispanic/Latino and 12% Chinese.