Smoke Gets In Your Eyes -- Your Lungs and Your Brain

"It's not just a few days in these extreme events that you need to protect  yourself."

"It is also the days when the sky looks OK [while air quality indexes or weather reports warn of the presence of smoke]."

Dr. Kai Chen, associate professor, Yale School of Public Health 

 

The health effects of short-term PM_2.5 exposure, and subsequently smoke, can range from relatively minor (e.g., eye and respiratory tract irritation) to more serious health effects (e.g., exacerbation of asthma and heart failure and premature death). In addition, there is initial evidence that short-term smoke exposure may lead to preterm birth (Picciotto et al. 2024) and impact brain function (i.e., cognitive performance as measured through a brain-training game) (Cleland et al. 2022). Fine particles are respiratory irritants, and exposures to high concentrations can lead to persistent coughing, phlegm, wheezing and difficulty breathing. Exposure to PM_2.5 may affect the body’s ability to remove inhaled foreign materials, such as viruses and bacteria, from the lungs. For example, some studies have reported an increase in the risk of COVID-19 cases and deaths in response to wildfire smoke exposure (Zhou et al. 2021; Meo et al. 2021; Schwarz et al. 2022). Although most healthy people will recover quickly from smoke exposure, some may experience health effects such as pulmonary inflammation and transient reductions in lung function (U.S. EPA 2019).

United States Environment Protection Agency  

Vancouver skyline   Wildfires and smoke have always occurred in British Columbia, but they are becoming more frequent and severe as the climate changes. Wildfire smoke is a form of air pollution that can affect your health.  BC Centre for Disease Control 

 

Evaluation of air pollution from wildfires presents unique challenges, compared to air pollution from other sources, such as traffic or industrial point sources, as smoke exposure is seasonal and episodic in nature (Gould et al., 2023). Also, as the number and size of wildfires impacting an area are variable and as smoke production from wildfires is not constant or steady, the concentration of smoke experienced by populations can vary considerably, and can include high levels of exposure for short time periods or moderate exposure levels lasting for several days or longer. Additionally, to evaluate the health effects of wildfire smoke, it is necessary to distinguish the contribution of wildfire smoke from that of other sources of air pollution within the mixture that people are exposed to. To address this, researchers have employed a variety of methods to assess exposure to wildfire smoke for use in health studies including use of land-based PM monitors, satellite imagery, air quality modelling, comparison of fire versus non-fire periods, proximity to wildfire burn area, and self-reports. In these studies, the most commonly used surrogates for wildfire smoke exposure are PM_2.5 (particles with a diameter of 2.5 micrometres or less) and PM₁₀ (particles with a diameter of 10 micrometres or less). For the primary investigations included in the systematic reviews considered here, the health outcome data were based on administrative sources (for example, mortality registries, health care utilization data), surveys, or self-reports. In addition, most of the primary studies focused on short-term or episodic exposure to wildfire smoke (that is, daily exposure), while some of the studies assessing mental health impacts considered health effects in years following the wildfires, and studies of reproductive or developmental impacts considered wildfire smoke exposure during the gestational period. It is noted that the health effects of PM_2.5, a key pollutant in wildfire smoke, have been extensively studied and Health Canada has evaluated the health risks of ambient PM_2.5 (that is, PM_2.5 from all sources combined) (Health Canada 2022). 

Government of Canada 

People who are exposed to smoke from wildfires, according to more recent scientific investigations, are increasingly assailed by lung-damaging toxins, but new discoveries identify that hearts, brains and other body organs are also being damaged by wildfire smoke. Smoke exposure could sound the death knell of up to 1.9 million people in the United States alone, over three decades, according to one 2025 study. Lungs can be penetrated deeply by the concentration of airborne particles known as PM2.5, from wildfires.

 

PM2.5 is a primary pollutant that air quality indexes measure, but fails to reflect other substances that can be contained in wildfire smoke that include lead, mercury and formaldehyde, cautions Karl Nadeau, dean of the University of California, Los Angeles Fielding School of Public Health. Preliminary research suggests that wildfire smoke may be of greater harm than air pollution from more common sources such as car exhaust. Fire in proximity to urban areas, moreover, may be of particular toxicity, through consuming buildings vehicles and electronics.

 

Smoke and flames from the Palisades Fire fill the sky as seen from the Pacific Palisades neighborhood of Los Angeles. | Getty Images

 

Associations between wildfire smoke and cardiovascular hospitalization, diabetes complications, preterm birth, cancer, impaired cognition and other problems, as well as respiratory effects including  attacks of asthma have been associated through scientific analytical studies. Wildfire smoke was linked in a 2024 study to deaths from cardiovascular, digestive, endocrine and kidney diseases. Asthma attacks and heart attacks can increase within an hour, in the presence of the severity of ambient smoke, pointed out professor Michael Brauer with the University of British Columbia.

 

Cognitive effect research has seen a significant expansion, explains Stephanie Cleland, associate professor at Simon Fraser University in British Columbia. Dr. Cleland was lead author of a 2022 study finding smoke exposure to be associated with lower scores on a 'brain training' game. A link between cumulative exposure throughout a school year and lower standardized test scores was also found through research, while other studies indicate a possible association with dementia. 

 

Less dramatic, lower-level exposures over time have an add-on impact, according to Professor Chen, who suggests the wearing of masks to be avoidance-helpful to exposure to ambient smoke during such events, not necessarily only when the surrounding air is redolent of burning, charred wood, and the atmosphere turns grey in reduced visibility with wildfire smoke. One study published in 2025 linked the risk of death from all causes with three-year exposure to wildfire smoke. Yet another 2025 study concluded that as average wildfire exposure increased, North Americans over age 65 suffered a higher risk of dying from chronic obstructive pulmonary disease.  

 

A woman wears an N95 mask to protect herself from high levels of smoke pollution. Daniiielc, Getty Images

 

"The data pretty clearly say that there is no safe level of exposure to wildfire smoke: the more exposure we get, the worse a range of health outcomes. The data also pretty clearly show that our notion of sensitive groups should probably be greatly expanded. In addition to kids, elderly populations, or anyone else with preexisting conditions, like asthma, we need to think about populations like pregnant people whose birth outcomes can be substantially affected by exposure. Portable indoor filtration is often the best option for many households, and well-fitting N95 masks can help when outside. "

"Climate change, and in particular increasing fuel aridity brought about by hotter temperatures and variable rainfall, is playing a central role in the recent rapid increase in wildfire activity and smoke exposure throughout the US. It is certainly not the only factor, but is substantially amplifying the risk brought about by other factors, which include a century of fire suppression that has left abundant fuels in our wildlands, as well as increased human construction and activity in the wildland-urban interface. We can say with strong confidence that climate change has made these events much more likely and much more severe."

Marshall Burke,  associate professor, Stanford Doerr School of Sustainability 

Home Cooking Vs Processed Food Products

Lina Bruins | EyeEm | Getty Images

"While the telomeres do not contain genetic information themselves, they are vital for preserving the stability and integrity of chromosomes, and by extension, the DNA that every cell in our body relies on to function. As we get older, our telomeres get shorter since each time a cell divides, part of the telomere is lost, thus telomere length is considered to be a marker of biological age. In this cross-sectional study of elderly Spanish subjects, we showed a robust association between ultra-processed food consumption and telomere length."                                                                 "Further research in larger longitudinal studies with baseline and repeated measures of telomere length is needed to confirm these observations."                   Research, University of Navarra, Pamplona, Spain

Canadians get nearly half of their total calories from ultra-processed foods, according to previous research from Heart & Stroke. Photo by David Ryder /Getty Images

A year ago, Spanish researchers published findings -- after following 19,899 people over a two-decade period -- that appeared in the British Medical Journal. Researchers from Navarra University sorted processed foods into categories ranging from unprocessed to ultra-processed, four groups in all, to discover that the latter group linked people to early deaths. Five or more servings of ultra-processed foods consumed daily had the result of increasing mortality risk by 62 percent, each additional serving increasing mortality risk by 18 percent. Cancer was seen as the major cause of death, at an average age 58.

According to the May 2019 report: “Processed meats, sugar sweetened beverages, dairy products, and French fries were the main foods contributing to the ultra-processed food consumed". The study pinpointed a wide range of processed foods covering all categories, including chocolate, cookies, potato chips, pizza, meatballs, doughnuts, mayonnaise, margarine, breakfast cereals, milkshakes, soda and sweetened drinks, chicken nuggets, croissants and pastries, processed meats, instant soups, ice cream, and distillation-produced alcohol. 

Researchers at the University of Paris and the University of Montpellier also published the results of a study monitoring dietary habits of 105,159 people over age 18 between the years 2009 and 2018. The conclusion of this study resulted in the finding of a clear link between ultra-processed food consumption and cardiovascular disease. Cardiovascular disease is known to be the main cause of worldwide deaths. "This report is based on an associative study which would normally lead to or be the start of more detailed research. Health professionals continue to promote a combination of a healthy lifestyle and meat has its place in a balanced diet", commented a spokesperson for the Agriculture and Horticulture Development Board, a UK farming body.

More latterly, researchers from the University of Navarra presented a more recent study at the online European and International Conference on Obesity, the study published in the American Journal of Clinical Nutrition, where researchers concluded that those who consume over three servings of ultra-processed foods each day are twice as likely to have shortened telomeres, the protein structure at each end of a chromosome, acting as protection for the chromosome, which researchers recognize as an indicator of aging.

Ultra-processed foods could be linked to ageing cells. (iStock). 

The research analyzed 645 men and 241 women with an average age of 67.7 years, to discover that as consumption of ultra-processed foods increased. the likelihood of having shortened telomeres did as well. "Medium-low" consumption with 2-2.5 servings daily held an increased risk of 29 percent, while "medium-high", with 2-5.3 daily servings saw that risk rise to 40 percent. "High", with over 3 servings daily, saw the consequential risk rise to 82 percent.

As well, an association between consumption of ultra-processed foods and depression, hypertension, overweight/obesity and premature mortality were all identified by the researchers. The Heart & Stroke Association has advice for those concerned enough to avoid frequent ultra-processed foods consumption; to cook at home more frequently, to eat with others and become more wary of food marketing ploys. Items marketed as "wholesome", "nourishing", and "organic", may be anything but.

Life Savers!

"Dog ownership was associated with a 24 percent risk reduction for all-cause mortality as compared to non-ownership."
"Dog ownership is associated with lower risk of death over the long term, which is possibly driven by a reduction in cardiovascular mortality."
Study authors published in Circulation, journal of the American Heart Association

"Dogs offer companionship, reduce anxiety and loneliness, increase self-esteem, and improve overall mood."
"Several studies have shown that acquiring a dog perforce increases physical exercise [as anyone who has unsuccessfully tried to sleep past the time of a dog's routine morning walk can attest]."
"Pet owners tend to be younger, wealthier, better educated, and more likely to be married, all of which improve cardiovascular outcomes."
"The association  between dog ownership and improved survival is real, and is likely at least partially causal."
The most salient benefits of dog ownership on cardiovascular outcomes are likely mediated through large and sustained improvements in mental health, including lower rates of depression, decreased loneliness, and increased self-esteem."
Dr.Dhruv Kazi, cardiologist, Beth Israel Deaconess Medical Center, Boston

A new study undertook to review several decades of evidence on the interdependent relations between dog ownership and mortality. The study focused on dogs as personal companion pets and made no effort to examine any potential longevity and health benefits accruing to cat ownership \. However, that connection was explored in at least one previously-published study, finding that like dog ownership, cat companions too are linked to a decrease in fatal cardiovascular events in their owners.

The study's authors were interested in reconciling differences in previously published literature based on the benefits of dog ownership. Of previous studies not all validated the understanding of companion dogs' beneficial effects on their human companions. Some of those studies indicated a benefit while there were others that came up empty. However, this new study linked to data that indicated among people who had already had cardiovascular issues such as a heart attack and stroke, even greater benefits resulted with dog ownership.

The study came with an accompanying editorial written by cardiologist Dhruv Kazi, who outlined a number of findings; for example well-documented mental health benefits accruing to dog companions adding quality to the lives of their owners. Those who own dogs tend to spend more time outdoors than people without dog companions. The very act of being outdoors, much less being physically active, as when taking a dog for a walk, or playing with it outdoors has beneficial health outcomes.

Even stroking a dog can have the effect of lowering an individual's blood pressure; communion of any kind between person and dog benefits both to the extent that physical and mental health are both impacted positively, the recognized pathway through which dog ownership creates a healthier dynamic allowing the person to live more healthily and with an increased life span. A failing in the research does exist in that randomized controlled trials of dog ownership benefiting mortality are few.

Direct studies have simply been overlooked, of the quality that would instruct a group of individuals to acquire a dog, while another group would be without the benefit of a dog present in their lives. Following which the individuals' health would be tracked over time. As the gold standard of evidence with such controlled randomized trials, should they present the solid evidence that is lacking, it would result in definitive assurances that owning a dog causes people to live longer lives.

Despite which, according to Dr. Kazi, the current balance of evidence is convincing enough. The study review controlled for a variety of socio-economic and demographic factors, finding the longevity effect of dog ownership to be assured. Several randomized, controlled studies on pet ownership generally indicated direct benefits of having a companion animal. One study saw a group of cardiac patients randomly instructed to acquire a dog or a cat; the end result being a reduced blood pressure response to stress.

Yet another saw researchers in Korea randomly assigning nursing home residents pet crickets with the direction that they care for the insects for an eight-week period. It was found that the cricket-caring group showed significant improvements on depression measurements and cognitive ability, relative to the control group

Inflammation Guidance

"That's when it [chronic inflammation] becomes detrimental."
"Chronic inflammation is like a grumbling, low level of inflammation, which can go on for years."
"Hippocrates [the Greek 'father of medicine'] BC, in 400 BC said that exercise is man's best medicine, but his message has been lost over time, and we live in an increasingly sedentary society."
"As we get older, levels of inflammation in the body tend to creep up, but if you keep your weight down and keep physically active then you can prevent inflammaging; it is not inevitable."
Dr.Janet Lord, director, Institute of Inflammation and Ageing, University of Birmingham

"In the late '90s, people started saying that heart disease is an inflammatory disease, and you can lower people's risk by treating them with anti-inflammatory drugs like aspirin."
"If I was to write a book on the Mediterranean diet, I would have that exact same picture [colourful fruits and vegetables, olive oil, whole grains and nuts, salmon, red wine]."
"There isn't a magic anti-inflammatory diet; an anti-inflammatory diet is a generally healthy diet."
"That's [weight gain] a danger signal to cells, and the way we respond to danger is through inflammation. Being obese is a risk factor for heart disease and maybe one of the reasons is that adipose tissue drives low-grade inflammation." 
Dr.Philip Calder, nutritional immunologist, University of Southampton

"Diet, exercise, healthy lifestyle, minimizing stress, getting enough sleep; all of these things are beneficial at the molecular level and the cellular level, as well as just making you feel a lot better."
"One of the things they [senescent cells refusing to die] do is to switch on a pile of inflammatory genes. This aging-related inflammation even has a name: 'inflammaging'."
Dr.Lynne Cox, biochemist, University of Oxford

As people age, low-grade inflammation can increase as age progresses where sex hormones estrogen and testosterone -- both anti-inflammatory hormones -- decline, and inflammation creeps up. Senescent cells grow larger and more stressed, refusing to die, as we age. The best proven strategy against what seems inevitable is to continue to use our bodies. When muscles move, the production of anti-inflammatory cytokines, which counteract inflammation in the muscles and elsewhere in the body, is stimulated. Exercise is key.

Inflammation has been linked to every major age-related disease; heart disease to dementia, Type 2 diabetes and cancer. The process causing pain, heat, redness and swelling with a fall or a sore threat is recognized increasingly as the start of the journey, through inflammation toward ill-health and frailty. "Inflammation is the way your body tries to defend itself against danger", immunologist at University of Manchester, Dan Davis advises. Inflammation helps to see that wounds don't fester and mild infections don't get worse.

Human tissues respond to injury and bacterium or virus infection through the release of chemicals called cytokines which bring forward immune cells whose function is to kill infectious agents and cells; to aid in repairing any damage through creating new tissue. The resulting inflammation is severe and painful, but generally vanishes once the wound or infection has been healed. Chronic inflammation is another thing; associated with age-related diseases and frailty where inflammatory chemicals are lower, but continue to fester.

In atherosclerosis -- a fatty plaque buildup in the blood vessel walls triggers inflammation. Should part of the plaque break away to trigger a clot, the result can be a heart attack or stroke. The buildup of fatty materials creating plaque may be attributable to the presence of inflammation to begin with. Recent research has revealed that statins, prescribed primarily to help lower cholesterol, have an anti-inflammatory effect as well, helping to reduce the risk of heart disease.

Insulin, the hormone enabling glucose to be released from food becomes impaired in the presence of inflammation; the initial movement toward the development of Type 2 diabetes. The body's tissues irritated as glucose levels in the blood increase, triggers additional inflammation. Chronic inflammation activates enzymes in muscles, producing the hormone cortisol which in turn can trigger the breakdown of muscle and bone. "This is one of the reasons why you become frailer as you grow older", Dr. Lord explains.

In a subset of instances there are some scientists who believe that inflammation may be the cause of clinical depression. In middle age, chronic inflammation is being linked increasingly to memory loss and dementia as people grow older. Obesity researchers too are turning their attention to weight gain and the role inflammation plays there. A major source of inflammation is body fat (adipose tissue); as weight is gained, fat cells find it more and more difficult to receive sufficient oxygen.

Smoking or vaping can exacerbate the situation, since some of the inhaled chemicals trigger an immune response. Lack of sleep, emotional stress and a diet high in sugar and certain types of fat are viewed as other sources of low-level inflammation.

Here’s what you can do to reduce inflammation:

• Quit smoking: Smoking damages your blood vessels and promotes atherosclerosis. By quitting, you can cut your heart disease risk in half.
• Maintain a healthy weight: Being overweight increases your risk for multiple diseases. But carrying excess fat around your belly is a red flag for heart disease risk. A type of fat that accumulates in the belly (called visceral fat) secretes a molecule that causes inflammation.
• Increase activity: Exercising for as little as 20 minutes a day can decrease inflammation. You don’t have to do an intense sweat session: Moderate workouts, such as fast walking, are effective.
• Eat a heart-healthy diet: Processed and fast foods produce inflammation. Whole foods, on the other hand, are anti-inflammatory. Eat more fruits, vegetables, whole grains, beans, nuts and fatty fish.

John Hopkins Medicine

Pot Concerns from the Scientific-Medical Community

"I'm not here to demonize cannabis. We don't need to go back to reefer madness. But we can't say it does not harm."
"If we have several million people smoking marijuana every day, we want to know what the effects are."
"When we study a new drug, like a statin, for example, it is a single drug -- a single molecule. We know what receptors it works on, why it works, how it works, and have tested it extensively under rigorous conditions to ensure it is both safe and effective."
"To expect 70 chemicals of unknown dose to exert a specific effect, or even a net positive effect, is magical thinking."
"From a public health perspective, the balance of evidence so far is that using marijuana is not good for your heart, blood vessels and brain."
Dr.Chris Simpson, cardiologist, 2014/15 president, Canadian Medical Association

Marijuana in edible form may have cardiovascular risks for people at risk.

There are 70 cannabinoids of unknown dose in each joint of marijuana. What is a great unknown is the manner in which these chemicals interact with the endocannabinoid system, and thus the effects are unpredictable. Since the growing incidence in North America -- federally in Canada, and state-by-state in the United States -- of cannabis legalization, the belief has grown of the safety and usefulness of marijuana for medical purposes. And nor do recreational users of cannabis think otherwise than that their use of the now-regulated drug is perfectly fine.

That, aside from the growing numbers of high-school students using pot, or e-cigarettes in vaping, grown immensely popular. And with its popularity another concern from the medical-science community over the effect of an unknown substance which is known to have a deleterious effect on the still-maturing brain of people under 21. Much less that vaping has now been associated with lung disease, to the effect that it has now been attributed as the cause of death of 18 people in the United States, and the hospitalization of one thousand. In Canada this same phenomenon is beginning to emerge.

According to Dr. Simpson, preparing to address researchers, health professionals and policy-makers at the Canadian Stroke Congress, someone who has smoked a joint becomes as vulnerable within the passing of an hour to a heart attack as someone who has just finished shovelling a heavy load of snow. The greater the THC content -- the psychoactive compound in marijuana, the higher the risk, stresses Dr. Simpson, explaining that THC serves to activate certain blood vessel receptors. So that, when THC binds to the receptors the buildup of plaque results, making blood "stickier", a condition then leading to blood clot creation.

A man lights a marijuana cigarette  THE CANADIAN PRESS/Joe Mahoney

"In the case of a stroke, a blood clot lets go and travels to the brain", this expert on cannabis interaction with the heart muscle and health conditions leading to stroke explained. He acknowledges the potential that some of the 70 chemicals known to make up marijuana may be useful. On the other hand, marijuana remains a largely unknown quality with respect to human health. It becomes even more complicated to judge the effect on health in marijuana use since people who smoke pot also frequently are cigarette smokers.

"There is this huge popular misconception about cannabis, driven by social media and the cannabis industry, that it is a medicine or it is harmless. "I worry when people say that cannabis is a natural product that has been used for a thousand years and so it must be safe. Countering that belief is tough. There are huge gaps between what people believe and what is reality."
"It hits you like a ton of bricks at the one-hour mark or so and you can overdose very quickly because of the delayed reaction."

A five-year study of hospital statistics from the U.S., looking at a period from 2010 to 2014, shows the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period. The study was presented on Friday during the third day of the World Stroke Congress in Montreal. (Sean Gallup/Getty Images)

Food for Thought

"I think people shouldn't just embark on a vegan diet because it's on trend, and they're following some Instagram guru."
"They should delve deeper and understand that there are nutrient shortfalls."
"Full-blown B12 deficiency is not very common in today's society. [Deriving enough vitamin D the 'sunshine vitamin' from diet is of greater concern , vital for the health of bones, teeth and immune system]."
"Vitamin D-rich foods are mainly oily fish, eggs and things like that [difficult to attain on a vegetarian and vegan diet]."
Helen Bond, dietitian, consultant, spokesperson, British Dietetic Association

Vegan and vegetarian diets could affect your chances of a heart attack (Photo: Getty)

"We observed lower rates of ischaemic heart disease in fish eaters and vegetarians than in meat eaters, which appears to be at least partly due to lower body mass index and lower rates of high blood pressure, high blood cholesterol, diabetes associated with these diets."
Oxford University researchers

“It is based on results from just one study and the increase is modest relative to meat eaters,”'
“Relevance to vegetarians worldwide must also be considered. Participants were all from the UK where dietary patterns and other lifestyle behaviours are likely very different from those prevalent in low and middle-income countries where most of the world’s vegetarians live.”
Professor Mark Lawrence, Public Health Nutrition, Deakin University, Australia

"It does seem that the lower risk of coronary heart diseases does exceed the higher risk of stroke, if we look at the absolute numbers."
"There is some evidence which suggests that very low cholesterol levels might be associated with a slightly higher risk of hemorrhagic stroke."
"[Similarly, other research points to deficiencies of some nutrients, like vitamin B12, may be linked to a higher risk of stroke]."
Tammy Tong, Study lead researcher, nutritional epidemiologist, Nuffield Department of Population Health, University of Oxford

A major study published last week in the British Medical Journal by researchers from Oxford University concludes there is a 20 percent higher risk of stroke among vegetarians and vegans as compared with people those diets include red meat; for that matter any kind of meat. It is the authors' educated guess that this might occur as a result of vegetarians lacking sufficient blood cholesterol. Close to 50,000 Britons were tracked for this study for a period of 18 years.

Conventional wisdom claims vegetarianism represents a healthier alternative to a carnivorous diet, quite the opposite of what this research concludes, in part. Yet, according to nutritionists, an increased risk of stroke represents merely one of the many health risks to complicate the health of vegetarians and people should be aware before they decide to opt for the kind of diet that depends solely on vegetables to the exclusion of meat entirely.

Dietitian Helen Bond feels the results of the Oxford study should be viewed with serious concern. Although the 20 percent accelerated risk in practical terms is "quite small", sample size taken into account (equating to three additional cases of stroke per 1,000 people over ten years), those whose diets avoid meat entirely fail to understand the entire implications of their choice on their health outcomes.

Nutritionist Emma Derbyshire wrote recently in the British Medical Journal that vegans face the potential of deficiency in choline, a nutrient critical for brain health, and one found commonly in eggs, milk and beef. Choline influences memory, mood and muscle control. Although vegans could conceivably reach requisite levels of choline from alternate sources, it is not fully understood by most vegans to impel them to take the necessaryremedial action.

As for B12, also critical to brain health, it is sourced only through the inclusion of animal products in the balanced diet. Lacking this critical vitamin, a greater risk of being fatigued is foreseen, along with a weakening of the immune system.

Food for thought, at the very least.

The research found a 20 per cent increase [Photo: Getty]

“It’s important to emphasize that we’ve looked at two outcomes here. The lower risk of heart disease does seem to outweigh the higher risk of stroke", cautions study co-author Tammy Tong, nutritional epidemiologist. For while the study did focus on a slightly elevated risk of stroke for vegans, it also confirmed that according to other studies, vegetarians and vegans may have a lower risk of heart disease than meat-eaters.

Ten fewer cases of heart disease per 1,000 people over 10 years, versus three more instances of strokes in the same population. 

More Hope for Stroke Victims

"If we can expand the treatment window to 36 hours, that's a time frame that could be relevant to 90 to 95 percent of stroke patients."
"This could really change stroke medicine as we know it. That's a big deal, because stroke is one of the leading causes of disability in most countries around the world."
Gil Van Bokkelen, head, Athersys, therapy development

"If they develop a treatment that improves outcomes for stroke patients and is effective and safe to give within a longer time window, that would be extremely welcome."
Professor Keith Muir, consultant neurologist Queen Elizabeth University Hospital

"This research shows that this new type of stem-cell treatment shows some promise in aiding stroke recovery."
"However, this was a small study and we're looking forward to seeing a larger trial."
Dr.Kate Holmes, assistant director, research, Stroke Association, United Kingdom

Image ©ElenaPavlovich/Shutterstock.com

When someone suffers a stroke and ideally they recognize the symptoms, they must take themselves as soon as possible to a specialist hospital. They are given the space of four hours to begin blood clot-busting treatment. In the event that treatment is undertaken in the first hour post-stroke, the best outcomes can be expected. But most people aren't able to make it to a hospital within the given time frame for optimum results. As a result close to two-thirds of stroke survivors inherit a disability by the time they leave hospital.

That may soon change. Thanks to a stem-cell injection that ideal of a single hour to seek remediation may now be extended, if all goes well, to a full day and a half for most patients of stroke. British patients who were subjects in a trial, receiving treatment 36 hours after a stroke, were able to emerge from the event without permanent disability. A new intravenous solution developed in the United States has proven to simultaneously regenerate damaged tissues while reducing harmful inflammation, stimulating nerve cells aiding in the brain's recovery.

The first trial took place for a number of patients across the United Kingdom and United States, resulting in a 15 percent greater opportunity of a full recovery after 90 days in comparison to subjects placed on a placebo. A year following the stroke, the likelihood of full recovery rose to 25 percent. Those given the stem cells a day and a half following the appearance of first symptoms following a stroke were among those making an "excellent" recovery.

Caution is expressed by independent experts hoping for additional convincing data before celebrating a "miracle" treatment. Even so, the U.S. Food and Drug Administration awarded the new technology the status of fast-tracking, leading the way to a larger study to commence expeditiously. For the new Masters 2 trial, doctors are in the process of enrolling 300 stroke victims to take part. The expectation is that the drug may be licensed by 2021.

The 36 hour window is critical, given that the new stem-cell treatment is not expected to produce a good outcome after that period of time. Damaging immune cells will have left the spleen and begin their journey to the brain after 36 hours, where considerable damage can be anticipated.

Stroke interrupts blood flow to the brain and could produce paralysis and speech problems, among other disabilities. MedicalNewsToday

"Stroke is the second leading cause of death worldwide and the major cause of disability in Europe. A stroke happens when the blood supply to part of the brain is severely reduced, often with severe effects on the body. Depending on the extent of stroke and where it occurs, about a third of stroke sufferers recover quite well, but most still experience some permanent effects and some strokes cause severe disability. Could stem cell treatments help?"
"A stroke happens when the blood supply to one or more parts of the brain is reduced or completely blocked. The blockage may be temporary or permanent and it can be caused in two different ways:

1. In ischaemic stroke a blood clot obstructs the supply of blood to the brain
2. In hemorrhagic stroke a blood vessel bursts and bleeds into the brain

"All parts of the brain need to have a good blood supply to work properly. When the flow of blood is restricted or stopped, vital nutrients and oxygen cannot reach the cells in the brain and they are damaged or die. The effects on the body depend on which part of the brain is damaged and how long the blockage remains. A stroke can affect movement, speech, thought processes and memory. It can cause paralysis in one or more parts of the body, or loss of control of bodily functions. About 40% of people affected by stroke will have permanent symptoms that result in them needing special care. Many people’s symptoms improve significantly following a stroke, but only about 10% of patients recover fully."
"Anyone of any age can have a stroke, but there are some important risk factors. The chance of having a stroke increases with age, for example. Certain ethnic groups are more at risk and a family history of stroke increases the chance that you may be affected. There are also risk factors that we may reduce through lifestyle changes, such as making sure any high blood pressure is treated, eating a healthy diet low in fat and salt, stopping smoking and staying physically active." EuroStemCell

Vitamin D Supplementation

"Numerous studies within the last twenty years have linked vitamin D deficiency or insufficiency to various types of cancer, Alzheimer's disease, Type 2 diabetes, heart disease, pregnancy complications and more."
Dan NEwton, molecular biologist, research scientist, Medical University of South Carolina

"We are starting to see some studies show that vitamin D doesn't have a benefit, even for bone health. However, these studies are in people who have generally good vitamin D blood levels."
"It's not surprising that giving them more of a nutrient they already have enough of doesn't lead to better health outcomes."
James Fleet, professor, nutrition science, Purdue University

"Overall, the clinical trial research has shown that there are some benefits of vitamin D supplementation, but they are more limited than what was originally proposed."
"A few years ago, people believed that vitamin D was a panacea that could prevent every major chronic disease."
"This may be [why the VITAL trial failed to link vitamin D supplementation to a reduction in heart disease or stroke risk] because the amount of vitamin D needed for heart health is relatively modest to moderate, similar to the amount needed for bone health and already achieved by many without taking supplements. For cancer reduction, there may be benefits with larger doses."
"We found a strongly significant reduction in cancer death of 13 percent across the five trials, which included VITAL."
JoAnn Manson, chief, division of preventive medicine at Brigham and Women's Hospital, Harvard Medical School professor, lead author, VITAL study

According to a 2015 report published in the Journal of the American Medical Association, 2012 saw a fourfold increase in vitamin D supplementation by American adults as compared to a decade earlier. This, in recognition of the generally low dietary intake of vitamin D linked to studies widely publicized during that time suggesting its intake could prevent a large and varied types of chronic diseases.

More latterly, uncertainty relating to vitamin D's usefulness based on two recently published studies, has arisen; the first a meta-analysis published in The Lancet Diabetes & Endocrinology, suggesting that vitamin D supplemental intake has not been seen to reduce the risk of falls and fractures, nor has it be understood to have led to clinically significant improvement in bone mineral density.

The Vitamin D and Omega-3 Trial, also referred to as VITAL, represents the second study which focused on whether taking 2,000 international units (IU) of vitamin D daily for men over 40 and women over 55 might prevent cancer and cardiovascular disease over five years. This was a randomized control trial of over 25,000 American participants.

The finding of the report was that "supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than did a placebo". Vitamin D is required for absorption of calcium and phosphorus into bones and teeth, which made it a recognized hormone promoted for its bone health facilitation -- since with a lack of sufficient vitamin D, calcium leaches from bones, resulting in loss of bone strength which can in turn lead to rickets in children and osteomalacia (softening of the bones) or osteoporosis in mature people.

In the Lancet study, only six percent of the 81 trials the analysis depended upon for its conclusion represented people with vitamin D deficiency. The conclusion in view of this fact represents an oversimplification of the trial results. Dr. Manson points out that the reasons her VITAL trial failed to link vitamin D supplementation clearly to a reduction heart disease or stroke risk may be attributable to many causes. She and her colleagues published a meta-analysis of vitamin D supplements linked to health outcomes in the Annals of Oncology. In the studies they interpreted, the dosages of vitamin D went from 833 to 2,000 IU daily.

Cancer develops over several decades, and many of the studies had fewer than five years of followup, pointed out Dr. Manson. It was therefore not to be expected that their study demonstrated that the development of cancer was not statistically at variance for the vitamin D group, versus the control group in their meta-analysis.  The recommended amount of vitamin D from diet and supplements based on bone health search has yet to be set by the National Academy of Medicine.

Should anyone consume three ounces of salmon twice weekly, have a cup of milk and two eggs daily, that would amount to 330 IU of vitamin D each day. Whereas the current recommendations are 400 IU of vitamin D for infants, 600 IU for men and women ages one to 70 years, and 800 IU for adults 71 or older. The human body can synthesize vitamin D with exposure to sun, but the Dietary Reference Intakes for vitamin D make the assumption that most people limit their direct exposure to the sun.

Aside from the fact that sun exposure is mostly seasonal, most people spend most of their time indoors; many people live at northern latitudes and see less sun in their daily lives; and those that do experience frequent sun exposure, most likely use sun protection lotions or clothing cover-ups to reduce skin cancer risks.

Threats of Daylight Savings

"[Dangers exist of possible heart risks linked to the twice-yearly clock changes, spring and fall] especially in the first week after the spring shift."
"For most people, changing the time -- even if only by one hour -- may produce tiredness as a small inconvenience. Other people, however, can have more serious consequences."
"One day [Sunday] is clearly insufficient to become accustomed to waking an hour earlier in the morning."
"Take care in exposing oneself to abrupt changes of temperature in the immediate post-shift days."
Study, researchers, University of Ferrara

"Our body prefers a longer than a shorter day."
"A similar pattern has been suggested for DST transitions [as that of the effect on our biological rhythm when travelling several times zones to the east]."
Dr. Roberto Manfredini, study co-author

Daylight-saving time in 2019 starts on Sunday, March 10 at 2 a.m.

Yutong Yuan/Insider

According to a 2017 study out of University of Washington and University of Virginia, sentences handed down by U.S. federal courts between 1992 and 2003 tended to be longer immediately after the time change. On the Monday after the switch to daylight savings time, judges tended give 5 percent longer sentences than those on the previous and following Monday. According to the researchers, "judges doled out longer sentences when they were sleep-deprived". The authors whose study was published in Psychological Science, pointed out in effect, how grumpy people can be post-change, effecting our attitudes and our work.

Another study on the effects of the time change, presented at the American Academy of Neurology's annual meeting in 2016, found the rate of hospital admissions for ischemic stroke -- when a clot in the arteries blocks blood flow to the brain -- was eight percent higher in the first two days following a time transition in comparison to either two weeks prior or two weeks following the switch to daylight savings.

Now, a new Italian study published in the journal Internal and Emergency Medicine once again points out the deleterious health effects for health-vulnerable people, those with underlying heart conditions, that occur in the wake of those detested time switches. The association between sleep and heart attacks has been demonstrated by studies where less than six hours of sleep is associated with high blood pressure, diabetes, obesity and premature death.

Disrupted sleep leads us to consume increased calories while burning fewer of those calories, and one small study has shown that a single night of disrupted sleep alone can be sufficient to increase insulin resistance. Environmental impacts such as natural disasters can trigger heart attacks. Among the working demographic, Monday mornings are particularly stressful, with higher blood pressure and higher catecholamine levels (hormones involved in the 'fight-or-flight' response) occurring.

Monday, according to the Italian researchers, is as well a critical day for Takotsubo cardiomyopathy, the "broken heart syndrome", characterized by a sudden, temporary weakening of the heart muscle whose causation is thought to be through the onset of sudden emotional stress. Available literature on daylight saving time and heart attack was reviewed by the team from the University of Ferrara who discovered five conducted in Europe and two in the U.S., reflecting a total of 87,994 cases.

All these studies identified an association with an increased frequency of heart attack, with increases ranging from four to 29 percent, while three studies identified a higher incidence of heart attacks on the Monday following the time change. All studies were observational only, with no proof existing respelling cause and effect. Tellingly, it was the spring shift forward when an hour is 'lost' to the day where the deleterious effect was identified.

The circadian rhythm controlling the body's sense of day and night, when to rise and when to sleep, also regulates metabolism in the heart and other vital organs. In sensitive people, the hour of sleep lost may increase heart rate, blood pressure, stress levels and chemicals promoting inflammation. The researchers caution that people should heed the weather, not the fact that days stay brighter and are longer.

Cold weather, they point out, can constrict blood vessels and hence blood flow to the heart, potentially triggering heart attacks in susceptible people. Cardiologist Dennis Ko of Sunnybrook Health Sciences Centre in Toronto explained the association between daylight saving time and heart attacks is doubtless real, but meaningful specifically for those with underlying heart conditions.

Daylight-saving time begins at 2 a.m. on Sunday, March 10.

Brian Snyder/Reuters

Smashing Prescriptive Icons

"This should set the record straight. There's a lot of folks on both sides of this but this study should end the question. There is no benefit for seniors who do not have vascular disease."
"I've spent the last five, six years trying to get all my seniors to stop taking Aspirin [based on the clear risks and unproven benefit]."
"If you look at the new findings, at best it's neutral and at worst it increases the bleeding risk."
Dr. Vincent Bufalino, Advocate Heart Institute, Chicago

The study 'could not identify any subgroup in whom Aspirin was beneficial in preserving good health.' (Gary Cameron/Reuters)

"Taking low-dose aspirin daily doesn’t preserve good health or delay the onset of disability or dementia in healthy older people. This was one finding from our seven-year study that included more than 19,000 older people from Australia and the US."
"We also found daily low-dose aspirin does not prevent heart attack or stroke when taken by elderly people who hadn’t experienced either condition before. However it does increase the risk of major bleeding."
"It has long been established that aspirin saves lives when taken by people after a cardiac event such as a heart attack. And it had been apparent since the 1990s there was a lack of adequate evidence to support the use of low-dose aspirin in healthy older people. Yet, many healthy older people continued being prescribed aspirin for this purpose."
"It means millions of healthy older people around the world who are taking low-dose aspirin without a medical reason may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding."

John McNeil, Professor, Head, School of Public Health & Preventive Medicine, Monash University, Australia

Published in three articles in the New England Journal of Medicine a week ago, a new study of over 19,000 people who were prescribed low-dose Aspirin to be taken daily for an average of 4.7 years found that the long-held trust that Aspirin would reduce the potential of stroke or prevent heart attacks, even dementia and cancer, was not borne out by the study results.

The elderly who were taking this prescribed medication for that very important purpose were not at all advantaged as it was presumed they should be. Their risks of cardiovascular disease, dementia or disability were not reduced, thanks to the supposedly miraculous effects of regularly taking low-dose Aspirin as a preventive. What that regular intake did do, however, was increase the risk to the individual of bleeding of a health-averse, significant effect in the digestive tract, brain or other sites, which required remedial blood transfusions and hospital admission. 

The study leader, Dr. John McNeil of the department of epidemiology and preventive medicine at Monash University in Melbourne, Australia, emphasized that "the ugly facts which slay a beautiful theory", came to the researchers as a surprise; not at all what they had anticipated would be the finding when they set out to test the medically accepted theory of Aspirin as a deterrent to adverse heart conditions in the elderly. They had in actual fact, anticipated that their research would support the belief that Aspirin would help prevent both heart attacks and strokes in the participants of the study.

Not only were the researchers taken by surprise, but it can be safely assumed so will doctors all over the world who have regularly prescribed Aspirin intake for their elderly patients as a preventive, much less the millions of patients who have been faithfully following doctors' orders. Of course, many of those patients, having taken low-dose Aspirin as prescribed in their advanced age for decades, may now be in the position of having heart disease, and the Aspirin use will be continued since under that condition, it is still recognized for its preventive effect in recurring heart attack, as example. 

The simple fact being that evidence does exist that Aspirin is still recommended for people who have already experienced heart attacks or strokes or who are in a  high-risk category that such will occur. For elderly people less at risk, however, the results of this research appear to clearly indicate that it helps not at all, but does pose a risk of internal bleeding. Moreover, the researchers were confronted with one result that has left them in a puzzled state for its inexplicability.

It was found that there was a slightly higher rate of death among those patients who took daily Aspirin, attributable for the most part to an increase in deaths from cancer. The researchers point out that a greater focus through additional studies must be undertaken before firm conclusions can be drawn from that finding, since they've no real idea what to make of it, all the more so since earlier studies suggested that Aspirin could in fact, lower the risk of colorectal cancer. 

Wishing It Were So, Doesn't Make The Grade

"As much as they try and account for different variables, we can’t say definitively that having more than seven drinks a week is going to lead to a lower life expectancy for an individual."
"That’s based on so many factors — their genetic ability to metabolize alcohol, their other overall health and wellness, whether they eat well, exercise, whether they manage their stress."
"From a health perspective, what you’re not supposed to do is save up all your drinks for the weekend. For better health, keep your daily drinking moderate."

"One study comes out saying one thing and other researchers try to replicate those results, and they may or may not. It takes time for a body of evidence to accumulate."
"It’s really important for us not to kind of flip-flop or worry about changing our entire lives based on one study."
Desiree Nielsen, registered dietitian, Vancouver 

Health benefits from drinking alcohol? Sorry, but it’s just another case of something that is too good to be true, say experts. Photograph: Inti St Clair/Getty Images/Blend Images

“Above two units a day, the death rates steadily climb."
"The paper estimates a 40-year-old drinking four units a day above the guidelines [the equivalent of drinking three glasses of wine in a night] has roughly two years’ lower life expectancy, which is around a 20th of their remaining life. This works out at about an hour per day. So it’s as if each unit above guidelines is taking, on average, about 15 minutes of life, about the same as a cigarette."
"Of course, it’s up to individuals whether they think this is worthwhile."
"[It represents] a massive and very impressive study. It estimates that, compared to those who only drink a little, people who drink at the current UK guidelines suffer no overall harm in terms of death rates, and have 20% fewer heart attacks."
David Spiegelhalter, Winton professor, public understanding of risk, University of Cambridge



There was a time -- and it seems not all that long ago -- that pregnant women were urged to drink beer, informed it was a good source of protein and would aid their pregnancy nutritionally. And even now people continue to think that a little alcohol consumed during a pregnancy cannot be harmful to the fetus, even while scientific research is desperately slamming that fiction, pointing out that even small amounts of alcohol taken while pregnant can result in various levels of fetal alcohol syndrome in children whose mothers drank while pregnant.

Now, a new and very large international study finds that those men and women who regularly imbibe over seven drinks on a weekly basis can look forward to their devotion to alcohol coming with a dear price; early death. At the very least, dying at a sooner date than their peers who are careful to studiously restrict alcohol intake to an occasional drink on special occasions. 

"What this is saying is, if you're really concerned about your longevity, don't have more than a drink a day", David Jernigan, alcohol researcher at  Johns Hopkins University, observed. He was not involved in the research that combined 83 studies' results conducted in 19 countries which tracked alcohol consumption for close to 600,000 people. The focus of the researchers was who developed and died from stroke and various types of heart disease.

Roughly half the study participants divulged having had over 100 grams of alcohol weekly. In American terms 100 grams is the equivalent of seven 12-ounce cans of beer, five-ounce glasses of wine, or 1.5 ounce shots of run, gin or other distilled spirits. Among whom researchers discerned a higher risk of stroke, heart failure and associated problems within that group.

The study estimated that 40-year-old men who consume up to the current American guidelines that permit for good health, can expect to sacrifice one to two years of life in contrast to men who take no more than seven drinks each week. Isn't moderation the key in everything in life, to guarantee longer life? The risk inherent in too liberal alcohol consumption may reflect that elevated blood pressure and cholesterol levels result from alcohol consumption. 

Currently, no more than seven drinks weekly for women and 14 for men reflect the recommendations by the U.S. government. Studies found that women react quicker to alcohol effects at amounts lower than do men, attributed in part to women weighing less than men on average, and that blood alcohol concentrations rise quicker in women.

Canada and Sweden reflect similar guidelines to those the Department of Agriculture in the U.S. has set, while countries like Spain and Romania set their upper limit for men at 20 drinks weekly. Until several years back, British guidelines reflected American standards, when the U.K. brought recommendations for men down to match those for women.

Not the Kind of CHIP Anyone Might Crave

"It is beginning to appear that there are only two types of people in the world; those that exhibit clonal hematopoiesis [CHIP] and those that are going to develop clonal hematopoiesis."
Kenneth Walsh, director, hematovascular biology center, University of Virginia School of Medicine

"This clearly wasn't happening by chance."
"We knew we were onto something, but what were we onto?"
Steven McCarroll, geneticist, Broad Institute and Harvard Medical School

"It is almost like a Ph.D in letting go of control. As much as you want to have a plan and a destiny, you also have this thing."
"It's scary and it's terrifying. I don’t want to use the word time-bomb, yet that is how the idea feels."
"There are things I love in life and people I love. You try to live that life."
Brian Gear, project manager, analytical health care data, Boston, diagnosed with CHIP

"Some mutations are just markers of past events without any lasting consequence. Yet others, especially those linked to leukemia, seem to give stem cells a completely new ability to accumulate inside the marrow. The result is actually a sort of survival of the fittest, or fastest growing, stem cells inside the marrow."

"Some mutations may alter the growth properties of the stem cell. Some may just make the stem cell better at surviving in certain less hospitable parts of the bone marrow where some other stem cells can’t thrive."

Dr. David Steensma, blood cancer specialist, Harvard Medical School

CHIP : The bone marrow where mutations are believed to occur

Researchers reported in 2014 discovering that close to the entire supply of white blood cells in a 115-year-old woman's bone marrow was generated by mutated stem cells. They hypothesized that she had at first simply developed two mutated stem cells. Over time those two stem cells multiplied to the extent that they dominated her bone marrow. Although this woman had lived as long as any human might be expected to in an extraordinarily long lifespan, when she died, it was because of a tumour.

Researchers examined medical records of people with these unusual white blood cell mutations to discover these people had a 54 percent increase in the chance of dying within the following decade in comparison with people without CHIP. They would die of heart attacks and strokes. This discovery answered a question that had long vexed the medical profession; how could it be that most people who have heart attacks or strokes have no or few conventional risk factors? What might account for that?

Patients with normal cholesterol and blood pressure levels, for example. People with no familial history of cardiovascular disease. People who had no background of smoking. People who never suffered from diabetes. People whom, logically, heart attacks and strokes should never have targeted. Then scientists discovered the presence of mutated stem cells bizarrely accumulating in bone marrow, the presence of which increases a person's risk of dying within a decade, from a heart attack or stroke, by 40 or 50 percent.

As hugely indicative of the potential for heart attack and stroke is predicatively with high LDL cholesterol levels, or high blood pressure, CHIP has entered the medical picture as an equally high risk, one that presents independently of the usual cholesterol and blood pressure markers. What's more the presence of CHIP is not rare, a condition that becomes more prevalent with age. An estimated 20 percent of people over 60 have CHIP, and likely 50 percent of those in their 80s.

These are mutations that are not genetically endowed, but rather acquired; simply a matter of luck or alternately exposure to toxins such as cigarette smoke. Several groups of researchers independently discovered the presence of CHIP even though they were not involved in heart disease investigation. They had searched databases involving genetic studies of tens of thousands of people whose DNA had been obtained through their white blood cells.

They discovered that large numbers of study participants had blood cells with mutations linked to leukemia, but the same people weren't suffering from cancer; only one or two of the cluster of mutations. It occurred to the investigators that the attack dogs of the immune system -- white blood cells -- are created from stem cells in bone marrow as each day a few hundred stem cells produce blood cells which divide rapidly into the ten billion required to replace the expired ones. And occasionally a stem cell acquires a mutation.

The first to recognize the link between mutated stem cells and the potential for an increased risk of heart attack and stroke was Dr. Benjamin Ebert, chair of medical oncology at the Dana-Farber Cancer Institute, who then turned to Dr. Sekar Kathiresen, a cardiologist and genetics researcher at Massachusetts General Hospital who had genetic data resulting from four more studies. Together they confirmed that CHIP doubled the risk in typical patients of heart attack.

What was missing Was how that came about. They inferred the possibility that mutated white cells caused atherosclerosis. Mutated blood cells began proliferating in laboratory mice given bone-marrow transplants containing stem cells with  CHIP mutation. The mice developed rapidly growing plaques rampant with inflammation as the mutated blood cells proliferated. "For decades people have worked on inflammation as a cause of atherosclerosis, but it was not clear what initiated the inflammation", explained Dr. Ebert.

For the present, since there is no specific protocol that can be advanced to reduce the increased risk that CHIP confers, doctors don't advise that people be tested for its presence. As far as Dr. Steensma is concerned, he would himself, if diagnosed with CHIP, make certain to do his utmost to control heart disease risks, like cholesterol and blood pressure, and ensure a healthy diet intake and exercise be part of his revised lifestyle. Also mentioning that in the near future drugs may be developed to stem artery inflammation.