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."