Why you feel tired all the time By Hannah Nichols

Do you often ask yourself, "Why am I so tired all the time?" If so, this article may be the perfect read for you; we have compiled a list of some of the most common reasons for tiredness and what you can do to bounce back into action.

According to the Centers for Disease Control and Prevention (CDC), around 15.3 percent of women and 10.1 percent of men regularly feel very tired or exhausted in the United States.

Tiredness can cause an array of problems. For example, around 1 in 25 adult driversreport falling asleep at the wheel each month.

About 72,000 crashes and 44,000 injuries each year are a result of drowsy driving, and that's not to mention the estimated 6,000 fatal crashes caused by drowsy drivers.

Everyone feels tired at some point in their lives — whether it's due to a late night out, staying up to watch your favorite TV show, or putting in some extra hours at work.

Often, you can put your finger on the reason you're not feeling your best, but what about those times when you can't pinpoint the cause of your tiredness? What makes you feel tired then?

Medical News Today have researched the possible explanations for why you could be feeling so drained and the steps that you can take to feel re-energized.

Diabetes: Look after your teeth to look after your blood glucose By Honor Whiteman

A new study highlights the importance of oral hygiene for people with type 2 diabetes, after finding that those with the condition may have better blood glucose levels if they look after their teeth.

It is estimated that around 30.3 million people in the United States are living with diabetes. Type 2 diabetes is the most common form, and it accounts for 90–95 percent of all cases.

Type 2 diabetes develops when the body's cells stop responding to the hormone insulin. This is a process known as insulin resistance. Blood glucose levels become too high as a result.

Without effective management of blood glucose levels, a number of serious complications may arise, including nerve damage, or neuropathy, eye problems such as glaucoma and cataracts, and skin conditions.

Previous research has also shown that there is a two-way link between type 2 diabetes and gum disease, or periodontitis; individuals with type 2 diabetes are at greater risk of developing gum disease, and gum disease may increase the risk of type 2 diabetes.

The new study — recently published in The Journal of Clinical Periodontology — suggests that for people who already have type 2 diabetes, good dental hygiene could be key for managing blood glucose levels.

'Deep cleaning' improved HbA1c levels

Led by Miquel Viñas — a professor of microbiology at the University of Barcelona in Spain — the study included 90 adults who had an average hemoglobin A1c (HbA1c) level of 7.7 percent, constituting a diagnosis of type 2 diabetes.

The adults were randomized to one of two groups for 6 months. One of these groups received oral health instructions, as well as scaling and root planing, a non-surgical form of "deep cleaning" that removes tartar and plaque from the surface of the teeth and below the gums.

The other group — the controls — received oral health instructions plus supragingival removal of plaque and tartar, meaning that plaque and tartar are removed from above the gum line only.

Both groups had their HbA1c levels, fasting plasma glucose, and oral bacteria levels measured at 3 and 6 months after the start of the study.

The results revealed that the group that received the deep cleaning experienced significant improvements in HbA1c levels and fasting plasma glucose, while the control group saw no improvements.

The team notes that, in most cases, these improvements corresponded with oral bacteria levels. Previous research has shown that oral bacteria may play an important role in diabetes.

So, it seems that good oral hygiene and regular dental checkups may aid good blood glucose management for people with type 2 diabetes.

"The main conclusion of the study is that the non-surgical treatment of periodontitis improves the glycemic status and levels of glycated hemoglobin, and therefore proves the great importance of oral health in these patients."

Study co-author José López-López, University of Barcelona

Could a bacterium found in milk trigger rheumatoid arthritis? By Ana Sandoiu

New research suggests that a bacterium found in cow's milk and beef may lead to rheumatoid arthritis in people who are already genetically predisposed. The bacterium may be a common trigger for both rheumatoid arthritis and Crohn's disease.

Rheumatoid arthritis is an inflammatory disease that affects more than 1.3 millionadults — the majority of whom are women — in the United States.

Crohn's disease is also an inflammatory disease, and the Crohn's and Colitis Foundation say that it affects up to 780,000U.S. adults.

What do these two diseases have in common, apart from being characterized by inflammation? Quite a lot, actually, according to new research recently published in the journal Frontiers in Cellular and Infection Microbiology.

Both of these conditions share a similar genetic background and are often treated with similar immunosuppressants, because both illnesses are autoimmune disorders.

These similarities intrigued the authors of the new research, who are: Saleh Naser, who is an infectious disease specialist at the University of Central Florida (UCF) in Orlando; Dr. Shazia Bég, who is a rheumatologist at UCF's physician practice; and Robert Sharp, who is a Ph.D. candidate in biomedical sciences at UCF's medical school.

"Here," says Naser, "you have two inflammatory diseases, one affects the intestine and the other affects the joints, and both share the same genetic defect and [are] treated with the same drugs. Do they have a common trigger? That was the question we raised and set out to investigate."

In previous research, Naser had already discovered a link between the bacterium Mycobacterium avium subspecies paratuberculosis (MAP) and Crohn's disease, so the question of whether MAP was also somehow connected with rheumatoid arthritis followed naturally.

In fact, Naser is currently involved in a clinical trial investigating whether or not Crohn's disease can be treated with antibiotics. Thus, if MAP proves to be present in rheumatoid arthritis as well, this condition may also be treatable with antibiotics designed to specifically target this bacterium.

Gene mutation plus MAP means higher risk

The researchers analyzed clinical samples from 100 people with rheumatoid arthritis. Of these, 78 percent had a genetic mutation that they shared with people with Crohn's disease: the PTPN2/22 gene.

Of the people with rheumatoid arthritis with this genetic mutation, 40 percent also had MAP.

"We believe that individuals born with this genetic mutation and who are later exposed to MAP through consuming contaminated milk or meat from infected cattle are at a higher risk of developing rheumatoid arthritis."

Saleh Naser

"We don't know the cause of rheumatoid arthritis, so we're excited that we have found this association," Bég says. "But there is still a long way to go."

Directions for future research

"We need to find out," say the authors, "why MAP is more predominant in these patients — whether it's present because they have RA [rheumatoid arthritis], or whether it caused RA in these patients. If we find that out, then we can target treatment toward the MAP bacteria."

To this end, the researchers plan to carry out further studies, in the hope that their findings will be replicated.

National studies should now also investigate how many patients get both rheumatoid arthritis and Crohn's disease, say the scientists. They themselves plan to examine the association further in people from different countries and of different ethnicities.

"Understanding the role of MAP in rheumatoid arthritis," explains Naser, "means the disease could be treated more effectively. Ultimately, we may be able to administer a combined treatment to target both inflammation and bacterial infection."

Kiwi compound may prevent non-alcoholic fatty liver disease By Honor Whiteman

There is increasing evidence that we are what our mothers ate during pregnancy; if they consumed a high-fat diet, then we might suffer the consequences, be it obesity or non-alcoholic fatty liver disease. A new study, however, may have uncovered a way to prevent the latter.

Researchers discovered that a compound found in kiwi, celery, and papaya — called pyrroloquinoline quinone (PQQ) — prevented the progression of non-alcoholic fatty liver disease (NAFLD) in mice whose mothers were fed a high-fat diet.

Study leader Karen Jonscher, Ph.D. — an associate professor of anesthesiology at the University of Colorado Anschutz Medical Campus in Aurora, CO — and colleagues recently reported their findings in the journal Hepatology Communications.

NAFLD is defined as a buildup of fat in the liver that is not caused by alcohol consumption.

It is estimated that NAFLD affects between 30 and 40 percent of adults in the United States, making it one of the most common causes of liver disease in the country.

Obesity, high cholesterol levels, hypertension, and high triglyceride levels are key contributors to NAFLD, and these conditions often arise as a result of a high-fat diet.

But it's not just the foods we eat ourselves that we need to be concerned about; our health could be at risk as a result of the foods our mothers ate during pregnancy.

How maternal diet affects offspring

In recent years, an overwhelming number of studies have shown that the maternal diet can leave a negative mark on the developing infant.

Last year, for example, Medical News Todayreported on a study suggesting that expectant mothers who consume a high-fat diet can increase their children's risk — and even their grandchildren's risk — of developing breast cancer.

Research has also shown that a poor maternal diet may alter the gut bacteria of offspring in a way that makes them prone to obesity and associated conditions.

"Increasingly, evidence suggests that exposure to maternal obesity creates an inflammatory environment in utero," says Jonscher. "This leads to long-lasting postnatal disruptions of the offspring's innate immune system and gut bacterial health, which may increase the risk for development of fatty liver disease."

In a previous mouse study, the researchers found that PQQ supplementation in obese, pregnant mice prevented mild fat accumulation in the liver of offspring.

PQQ is a compound present in plant-based foods — including kiwi, green peppers, celery, parsley, and papaya — and human breast milk. PQQ is an antioxidant. This means it can help to protect our body against free radicals, which are uncharged molecules that can damage DNA and other cellular components.

For this latest study, Jonscher and colleagues set out to determine whether maternal PQQ supplementation might help to prevent the development of NAFLD in offspring.

A 'potentially safe therapeutic' for NAFLD

To reach their findings, the researchers fed pregnant mice a high-fat, Western-style diet and monitored the health of their offspring.

The team found that the weight of these offspring was around 56 percent higher than offspring born to mice fed a control diet.

Mice born to mothers who had been fed the high-fat diet also demonstrated changes in gut bacteria that were associated with the development of non-alcoholic steatohepatitis (NASH) – a form of NAFLD in which fat buildup in the liver is accompanied by inflammation.

However, when pregnant mice received PQQ alongside their high-fat diets, the researchers found that the NASH-associated gut bacteria changes in their offspring were reversed, and they also showed less weight gain than offspring born to mothers that did not receive PQQ.

Jonscher and colleagues believe these results suggest that PQQ could be a viable candidate for the prevention of NAFLD.

Commenting on their results, the researchers write:

"Although levels in lean versus obese mothers have not been studied in humans or animals, PQQ is a potentially safe therapeutic to test for prevention of developmental programming of NAFLD/NASH."

While PQQ is available as a supplement, Jonscher warns that people should not rush out to buy it just yet. "[I]ndividuals should consult their doctors first before using it," she advises.

Could vitamin D supplements treat IBS? By Honor Whiteman

People with irritable bowel syndrome could alleviate their symptoms by taking vitamin D supplements. This is the conclusion of a new study recently published in the European Journal of Clinical Nutrition.

Irritable bowel syndrome (IBS) is a condition that affects the large intestine. Symptoms include abdominal pain, diarrhea, bloating, and constipation.

It is estimated that IBS affects around 12 percent of people in the United States, and women are almost twice as likely to develop the condition as men.

Precisely what causes IBS remains a mystery, though certain foods and stressful life events are some known triggers for the condition.

Current treatments for IBS include diet and lifestyle changes and medications such as loperamide and laxatives, to help ease abnormal bowel movements.

"IBS is a poorly understood condition which impacts severely on the quality of life of sufferers," says Dr. Bernard Corfe, of the Department of Oncology and Metabolism at the University of Sheffield in the United Kingdom, and the lead author of the new study. "There is no single known cause and likewise no single known cure," he adds.

Previous research has indicated that people with the condition have low levels of vitamin D, which suggests that this vitamin could play a role in IBS.

Vitamin D may ease IBS symptoms

Vitamin D is essential for the human body. Not only is it important for bone health, but the vitamin plays a key role in nerve cell communication and immune system functioning.

Vitamin D deficiency is a known risk factor for rickets — a bone development disorder that affects children — and osteomalacia, a condition in adults whereby the bones become soft.

Studies have also linked low vitamin D to other bone disorders, such as osteoporosis, as well as to inflammatory bowel diseaseand cancer.

To find out more about the link between vitamin D and IBS, Dr. Corfe and his team conducted an analysis of all available literature, including studies that investigated vitamin D levels among people with IBS, as well as studies that looked at symptoms of IBS among people who took vitamin D supplements.

According to the researchers, the evidence to date indicates that vitamin D deficiency is common among people with IBS, and this is the case across ethnicities.

Furthermore, studies show that there is an inverse link between vitamin D levels and the severity of IBS symptoms, the team reports.

Importantly, Dr. Corfe and colleagues say there is also evidence to suggest that vitamin D supplementation could improve the symptoms of IBS.

"The study provides an insight into the condition and, importantly, a new way to try to manage it [...] It is evident from the findings that all people with IBS should have their vitamin D levels tested and a large majority of them would benefit from supplements."

Dr. Bernard Corfe

That said, the researchers stress that larger studies are needed before vitamin D supplementation can be widely recommended for people with IBS

Infant formula upgrade: Prebiotics may boost memory By Tim Newman

By adding prebiotics to infant formula, a group of researchers have enhanced the cognitive performance of piglets. The findings back up earlier work and suggest an important role for prebiotics in brain development.

Anyone who has had children will have heard the phrase "breast is best." This is a given, but, for a wide range of reasons, not every mother can breast-feed their baby.

For this reason, it is important that infant formula provides the best start in life and mimics the incredible capabilities of breast milk as closely as possible.

Already, infant formula is a good substitute, but there is always room for improvement when you are competing against Mother Nature.

Breast milk naturally contains prebiotics, which are small, indigestible fiber molecules; they provide a welcoming environment for gut bacteria.

Having the gut colonized by bacteria early in life is important for the developing immune system and helps prevent infections. Also, studies have shown that adding prebiotics to infant formula can help improve intestinal function and reduce allergies.

A recent study from the University of Illinois' Piglet Nutrition and Cognition Lab investigated what effects adding prebiotics to infant formula might have on pigs. Specifically, they wanted to know whether it would enhance memory and exploratory behavior.

Why study pigs?

Using rats and mice to investigate drugs or biological mechanisms is a well-known and incredibly useful method. However, piglets are more similar to baby humans than rodents are. Their behavior, their digestive systems, and even the way their brain develops are much more similar to us than we are to rats.

Although adding fiber to a piglet's diet to alter the workings of the brain might seem strange, evidence is already mounting that our gut bacteria play an influential role on our mind and mood.

One of the researchers, Stephen Fleming, says, "There hasn't been a lot of work looking at the gut-brain axis in humans, but a lot of rodent work is showing those connections." For instance, in one study, rodents fed prebiotics shortly after birth displayed increased positive social interactions and improved memory.

"This is taking it to an animal model that is a lot closer to human infants and asking if that connection still exists and if we can tease out possible mechanisms."

Stephen Fleming, lead author

The latest study, published in the journal Nutritional Neuroscience, follows on from research by the same scientists in 2016. In their earlier paper, they concluded that adding new ingredients to formula, including prebiotics, might influence brain development and behavior.

Piglets and infant formula

For the new research, 2-day-old piglets were fed infant formula based on cow's milk supplemented with galactooligosaccharide (GOS), a naturally occurring prebiotic, and polydextrose (PDX), a synthetic carbohydrate with prebiotic activity.

When the piglets were 25 days old, they were put through their paces in a range of learning, memory, and stress tests. After 33 days, blood, brain, and intestinal tissue was collected for examination.

To test their memory, the scientists used a "novel recognition test." The pigs were given dog toys to play with; they received a brand new toy and one that they had seen before. If the pig spent more time with the new toy, it was taken as an indication that they recognized it as new and, therefore, preferred it.

Fleming explains why this type of test is useful:

"If you're trying to test for memory, this test is closer to what we'd do with an infant. After all, we don't generally train infants on mazes. We know from previous research this test works for pigs, but this is the first published example of using it in a nutrition context."

They found that pigs who received the PDX- and GOS-enhanced formula spent more time playing with the new toy than those that received standard formula. This was taken to mean that the brain was healthy and learning and memory was improved.

Did the prebiotics make a difference?

To find out whether the prebiotics were having an effect on gut flora, the researchers tested for volatile fatty acids (VFA). Bacteria excrete VFA's as they digest prebiotics, so increased levels indicate increased numbers of bacteria.

As expected, in the pigs that were fed PDX and GOS, VFAs were increased in the blood, brain, and colon. It is possible that VFAs could be involved in gut bacteria's influence on our brain and behavior.

However, in the current study, the expected change in stress-related behavior was not found; despite measuring changes in VFAs, no connection was seen in behavior.

The researchers were also surprised to find that, in the pigs fed the prebiotic, serotoninlevels in the hippocampus went down.

"When you hear less serotonin, there's an immediate reaction to say, 'Well, that's bad,'" Fleming says. But that's not necessarily the case; the pigs didn't display any greater anxiety during stress tests, for instance. This drop in serotonin may have been because of reduced levels of tryptophan, the precursor of serotonin. More research is needed to explore this further.

Although the study could not find an alteration in behavior, they did show that the pig's memory was improved by prebiotics. As part of the growing evidence of gut bacteria's impact on brain function, the results make an interesting read.

"There are so many ways we can alter the composition of the microbiota and they can have very strong benefits. Promoting good 'gut health' remains a strong focus in the field of nutrition," says study co-author Ryan Dilger, associate professor in the Department of Animal Sciences at the University of Illinois in Chicago.

As Dilger says, there is a great deal of interest in gut bacteria's influence on the brain. More work is sure to follow in hot pursuit.

Popular morning sickness drug 'ineffective,' study reveals By Yella Hewings-Martin PhD

Morning sickness can put a real strain on pregnant mothers. And when diet or non-medicinal treatments fail, a drug that contains doxylamine and pyridoxine is often prescribed. However, the drug's effectiveness has been called into question.

In 2017, researchers working at the University of Toronto in Canada and the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, also in Toronto, Canada, reanalyzed a pivotal doxylamine and pyridoxine clinical trial from the 1970s and made a fairly surprising finding: the data had substantial flaws.

Digging even deeper, Dr. Navindra Persaud — from the Department of Family and Community Medicine at St. Michael's Hospital as well as the Department of Family and Community Medicine at the University of Toronto — and colleagues reanalyzed another clinical trial using an updated version of the drug, this one from 2010.

The recent trial was part of the reason that the Food and Drug Administration (FDA) approved the popular morning sicknessdrug known as Diclegis.

Commenting on his findings, Prof. Persaud told me, "The medication seems to be ineffective based on the results of this trial. I was shocked to learn this about a commonly prescribed medication."

The results of Prof. Persaud's analysis are now published in the journal PLOS ONE.

'Only FDA-approved' morning sickness drug

Diclegis is the only drug approved by the FDA for the treatment of morning sickness in pregnancy. According to its manufacturer Duchesnay, it has been prescribed to 33 million women worldwide.

In Canada, where the drug is known as Diclectin, it is prescribed at least once for every two births.

I asked Prof. Persaud why he decided to look into the drug. "I used to prescribe this medication," he explained. "I was taught to prescribe it. The medication was recommended as the first line medication for nausea and vomiting during pregnancy."

"When I looked carefully at the clinical practice guidelines that recommended this medication, they did not cite supporting studies. So I tried to find the basis for the recommendations. It was surprisingly difficult to obtain information about this commonly prescribed drug."

Prof. Navindra Persaud

When the results of the clinical trial were initially published in the American Journal of Obstetrics & Gynecology in 2010, the study authors concluded, "Diclectin [...] is effective and well-tolerated in treating nausea and vomiting of pregnancy."

Drug 'significantly better than placebo'

The study involved 261 pregnant women, all of whom completed a 2-week course of daily Dicletin or placebo treatment. As the authors explained in the paper, "Diclectin led to significantly greater improvement in NVP [nausea and vomiting of pregnancy] symptoms as compared with placebo."

This was based on a drop in what is known as the PUQE score. PUQE stands for pregnancy-unique quantification of emesis/nausea, with a score of 3 meaning no symptoms and a score of 15 being the most severe.