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Healthwatch
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Healthwatch
Can A Routine Vaccine Prevent Dementia?
~5.0 mins read
Shingles vaccination may come with unexpected benefits.
A study of more than 300,000 adults found that among those 70 and older, dementia was less common among those who had received shingles vaccination than among those who did not.
A study of more than 200,000 older adults compared rates of dementia between those receiving a newer (recombinant) shingles vaccine and those who had an older (live) vaccine that is no longer approved in the US. Researchers found that the risk of dementia was lower six years after receiving either vaccine. But the effect was larger for the newer vaccine: those given the recombinant vaccine spent more time living dementia-free (164 days longer) compared with those given the older vaccine.
Examples of exposures might be an illness (like the COVID pandemic), a policy (like a smoking ban in one state), or a vaccination (like the shingles vaccine).
Outcomes might include virtual versus in-person learning during the pandemic, smoking-related illnesses in a state with a smoking ban compared to a state without that ban, or dementia rates among people who did or didn't receive a vaccine.
developed shingles less often
were 3.5% less likely to develop dementia over seven years (a 20% reduction)
were more likely to be protected from dementia if female.
Reduced inflammation: Preventing shingles may prevent harmful inflammation in the body, especially in the nervous system.
Impact on immune function: Vaccination might alter immune function in a way that protects against dementia.
Reducing stroke risk: Some evidence shows that shingles may increase the risk of stroke. A stroke can contribute to or cause dementia, so perhaps vaccination leads to less dementia by reducing shingles-related strokes.
It's fairly common for a medical treatment to cause side effects: think headache, upset stomach, sleepiness, and occasionally more severe side effects. Far more rarely, a side effect provides an unexpected benefit. This might be the case for the shingles vaccine.
Shingles is a painful, blistering skin rash caused by the varicella zoster virus responsible for chickenpox. The virus lies dormant in nerve tissue and can reactivate to cause shingles in anyone who has had chickenpox in the past. A vaccine to prevent shingles is recommended for adults ages 50 and older, and for people 19 and older who have an impaired immune system.
While we know the shingles vaccine is effective at preventing shingles, evidence is mounting that it might also reduce the risk of dementia. Yes, a vaccination to prevent shingles may lessen your risk of dementia.
Dementia is on the rise
Dementia is a devastating condition for those affected and their families. Currently, an estimated nine million people in the US have dementia. The number is expected to double by 2060, primarily because of the aging population. In most cases, no highly effective treatments are available. An effective preventive measure could have an enormous impact, especially if it's safe, inexpensive, and already available.
Can shingles vaccination prevent dementia?
Some (though not all) studies have found that having shingles increases your risk of dementia in the future. And that's led researchers to explore the possibility that preventing shingles through vaccination might reduce dementia risk.
Several studies suggest this is true. For example:
What is a natural experiment?
Perhaps the best evidence suggesting that shingles vaccination prevents dementia comes from a natural experiment recently published in the journal Nature.
A natural experiment takes advantage of real-world circumstances by dividing people into an exposed group and an unexposed group and then comparing specific outcomes.
Natural experiment studies bypass the challenges of having to recruit hundreds or thousands of study subjects who might differ from one another in important ways, or who might alter their behavior because they know they're in a study. The results can be even more valuable than — and as credible as — standard randomized trials.
What did this natural experiment study look at?
In 2013, Wales made the shingles vaccination available to individuals based on their date of birth: anyone born after September 2, 1933, was eligible, while anyone born before that date was not. Researchers took this opportunity to analyze health records of nearly 300,000 people: half were two weeks older than the cutoff date and half were two weeks younger. The study looked at whether people developed dementia over a seven-year period.
Researchers found that compared to those who didn't get the shingles vaccination, those who received it
A study of this type cannot prove that shingles vaccination prevents dementia. But along with the studies cited above, there's a strong suggestion that it does. We'll need additional studies to confirm the benefit. We also want to understand other details of the vaccine's effect, such as whether protection applies more to some types of dementia (such as Alzheimer's disease) than others, and whether the effect of vaccination changes over time.
Why might the shingles vaccine prevent dementia?
With any unexpected finding in science, it's a good idea to ask whether there is a reasonable explanation behind it. Scientists call this biologic plausibility. In general, the more plausible a result is, the more likely it is to hold up in later research.
In this case, several lines of reasoning explain how a shingles vaccine might reduce the risk of dementia, including:
The observation that women had more protection from dementia than men after shingles vaccination is unexplained. It's possible that the immune response to vaccination is different in women, or that dementia develops differently in women compared with men.
The bottom line
All of us can take steps to lower dementia risk, mostly through healthy behaviors such as being active regularly and choosing a healthy diet. Evidence is mounting that shingles vaccination should be added to the list. It's a story worth following. Future studies of the shingles vaccine could even provide insights into how dementia develops, and how to better prevent and treat it.
Until then, get your shingles vaccination if you're eligible for it. It can prevent painful episodes of shingles — and may do much more.
profile/5170OIG3.jpeg.webp
Healthwatch
Can A Routine Vaccine Prevent Dementia?
~5.0 mins read
Shingles vaccination may come with unexpected benefits.
A study of more than 300,000 adults found that among those 70 and older, dementia was less common among those who had received shingles vaccination than among those who did not.
A study of more than 200,000 older adults compared rates of dementia between those receiving a newer (recombinant) shingles vaccine and those who had an older (live) vaccine that is no longer approved in the US. Researchers found that the risk of dementia was lower six years after receiving either vaccine. But the effect was larger for the newer vaccine: those given the recombinant vaccine spent more time living dementia-free (164 days longer) compared with those given the older vaccine.
Examples of exposures might be an illness (like the COVID pandemic), a policy (like a smoking ban in one state), or a vaccination (like the shingles vaccine).
Outcomes might include virtual versus in-person learning during the pandemic, smoking-related illnesses in a state with a smoking ban compared to a state without that ban, or dementia rates among people who did or didn't receive a vaccine.
developed shingles less often
were 3.5% less likely to develop dementia over seven years (a 20% reduction)
were more likely to be protected from dementia if female.
Reduced inflammation: Preventing shingles may prevent harmful inflammation in the body, especially in the nervous system.
Impact on immune function: Vaccination might alter immune function in a way that protects against dementia.
Reducing stroke risk: Some evidence shows that shingles may increase the risk of stroke. A stroke can contribute to or cause dementia, so perhaps vaccination leads to less dementia by reducing shingles-related strokes.
It's fairly common for a medical treatment to cause side effects: think headache, upset stomach, sleepiness, and occasionally more severe side effects. Far more rarely, a side effect provides an unexpected benefit. This might be the case for the shingles vaccine.
Shingles is a painful, blistering skin rash caused by the varicella zoster virus responsible for chickenpox. The virus lies dormant in nerve tissue and can reactivate to cause shingles in anyone who has had chickenpox in the past. A vaccine to prevent shingles is recommended for adults ages 50 and older, and for people 19 and older who have an impaired immune system.
While we know the shingles vaccine is effective at preventing shingles, evidence is mounting that it might also reduce the risk of dementia. Yes, a vaccination to prevent shingles may lessen your risk of dementia.
Dementia is on the rise
Dementia is a devastating condition for those affected and their families. Currently, an estimated nine million people in the US have dementia. The number is expected to double by 2060, primarily because of the aging population. In most cases, no highly effective treatments are available. An effective preventive measure could have an enormous impact, especially if it's safe, inexpensive, and already available.
Can shingles vaccination prevent dementia?
Some (though not all) studies have found that having shingles increases your risk of dementia in the future. And that's led researchers to explore the possibility that preventing shingles through vaccination might reduce dementia risk.
Several studies suggest this is true. For example:
What is a natural experiment?
Perhaps the best evidence suggesting that shingles vaccination prevents dementia comes from a natural experiment recently published in the journal Nature.
A natural experiment takes advantage of real-world circumstances by dividing people into an exposed group and an unexposed group and then comparing specific outcomes.
Natural experiment studies bypass the challenges of having to recruit hundreds or thousands of study subjects who might differ from one another in important ways, or who might alter their behavior because they know they're in a study. The results can be even more valuable than — and as credible as — standard randomized trials.
What did this natural experiment study look at?
In 2013, Wales made the shingles vaccination available to individuals based on their date of birth: anyone born after September 2, 1933, was eligible, while anyone born before that date was not. Researchers took this opportunity to analyze health records of nearly 300,000 people: half were two weeks older than the cutoff date and half were two weeks younger. The study looked at whether people developed dementia over a seven-year period.
Researchers found that compared to those who didn't get the shingles vaccination, those who received it
A study of this type cannot prove that shingles vaccination prevents dementia. But along with the studies cited above, there's a strong suggestion that it does. We'll need additional studies to confirm the benefit. We also want to understand other details of the vaccine's effect, such as whether protection applies more to some types of dementia (such as Alzheimer's disease) than others, and whether the effect of vaccination changes over time.
Why might the shingles vaccine prevent dementia?
With any unexpected finding in science, it's a good idea to ask whether there is a reasonable explanation behind it. Scientists call this biologic plausibility. In general, the more plausible a result is, the more likely it is to hold up in later research.
In this case, several lines of reasoning explain how a shingles vaccine might reduce the risk of dementia, including:
The observation that women had more protection from dementia than men after shingles vaccination is unexplained. It's possible that the immune response to vaccination is different in women, or that dementia develops differently in women compared with men.
The bottom line
All of us can take steps to lower dementia risk, mostly through healthy behaviors such as being active regularly and choosing a healthy diet. Evidence is mounting that shingles vaccination should be added to the list. It's a story worth following. Future studies of the shingles vaccine could even provide insights into how dementia develops, and how to better prevent and treat it.
Until then, get your shingles vaccination if you're eligible for it. It can prevent painful episodes of shingles — and may do much more.
profile/5170OIG3.jpeg.webp
Healthwatch
How And Why To Fit More Fiber And Fermented Food Into Your Meals
~5.0 mins read
Fiber and fermented foods aid the gut microbiome, contributing to better health and mood.
An F may mean failure in school, but the letter earns high marks in your diet. The two biggest dietary Fs — fiber and fermented foods — are top priorities to help maintain healthy digestion, and they potentially offer much more. How can you fit these nutrients into meals? Can this help your overall health as well as gut health?
Fiber, fermented foods, and the gut microbiome
The gut microbiome is a composed of bacteria, viruses, fungi, and other microorganisms living in the colon (large intestine). What you eat, the air you breathe, where you live, and many other factors affect the makeup of the gut microbiome. Some experts think of it as a hidden organ because it has a role in many important functions of the body — for example, helping the immune system function optimally, reducing chronic inflammation, keeping intestinal cells healthy, and providing some essential micronutrients that may not be included in a regular diet.
Your gut communicates with your brain through pathways in the gut-brain axis. Changes in the gut microbiome have been linked with mood and mental health disorders, such as depression and anxiety. However, it's not yet clear that these changes directly cause these types of problems.
We do know that a healthy diet low in processed foods is key to a healthy gut microbiome. And increasing evidence suggests that fiber and fermented foods can play important parts here.
Fiber 101
Fiber's main job is to make digestion smoother by softening and adding bulk to stool, making it pass quickly through the intestines.
But fiber has other benefits for your microbiome and overall health. A high-fiber diet helps keep body weight under control and lowers LDL (bad) cholesterol levels. Research has found that eating enough fiber reduces the risk of heart disease, type 2 diabetes, and some cancers.
What to know about fiber
There are two types of fiber: insoluble (which helps you feel full and encourages regular bowel movements) and soluble (which helps lower cholesterol and blood sugar). However, recent research suggests people should focus on the total amount of fiber in their diet, rather than type of fiber.
If you're trying to add more foods with fiber to your diet, make sure you ease into new fiber-rich habits and drink plenty of water. Your digestive system must adapt slowly to avoid gas, bloating, diarrhea, and stomach cramps caused by eating too much too soon. Your body will gradually adjust to increasing fiber after a week or so.
How much fiber do you need?
The fiber formula is 14 grams for every 1,000 calories consumed. Your specific calorie intake can vary depending on your activity levels.
"But instead of tracking daily fiber, focus on adding more servings of fiber-rich foods to your diet," says Eric Rimm, professor of epidemiology and nutrition at Harvard's T.H. Chan School of Public Health.
Which foods are high in fiber?
Fruits, vegetables, legumes, nuts, seeds, and whole grains are all high in fiber. The Dietary Guidelines for Americans has a comprehensive list of fiber-rich foods and their calorie counts.
What about over-the-counter fiber supplements that come in capsules, powders that you mix with water, and chewable tablets? "If you have trouble eating enough fiber-rich foods, then these occasionally can be used, and there is no evidence they are harmful," says Rimm. "But they should not serve as your primary source of dietary fiber."
Fermented foods 101
Fermented foods contain both prebiotics — ingredients that create healthy changes in the microbiome — and beneficial live bacteria called probiotics. Both prebiotics and probiotics help maintain a healthy gut microbiome.
What to know about fermented foods
Besides helping with digestion and absorbing vital nutrients from food, a healthy gut supports your immune system to help fight infections and protect against inflammation. Some research suggests that certain probiotics help relieve symptoms of gut-related conditions like inflammatory bowel disease and irritable bowel syndrome, though not all experts agree with this.
Many foods that are fermented undergo lacto-fermentation, in which natural bacteria feed on the sugar and starch in the food, creating lactic acid. Not only does this process remove simple sugars, it creates various species of good bacteria, such as Lactobacillus or Bifidobacterium. (Keep in mind that some foods undergo steps that remove probiotics and other healthful microbes, as with beer or wine, or make them inactive, like baking and canning.)
The exact amounts and specific strains of bacteria in fermented foods vary depending on how they are made. In addition to probiotics, fermented foods may contain other valuable nutrients like enzymes, B vitamins, and omega-3 fatty acids.
How often should you eat fermented foods?
There is no recommended daily allowance for prebiotics or probiotics, so it is impossible to know precisely which fermented foods or quantities are best. The general guideline is to add more to your daily diet.
Which fermented foods should you choose?
Fermented foods have a range of tastes and textures because of the particular bacteria they produce during fermentation or that are added to foods. Yogurt is one of the most popular fermented foods (look for the words "live and active cultures" on the label). Still, many options are available if you are not a yogurt fan or want to expand your fermented choices. Kimchi, sauerkraut, kombucha, and pickles are a few examples.
As with fiber, probiotics are also marketed as over-the-counter supplements. However, like all dietary supplements, they do not require FDA approval, so there is no guarantee that the types of bacteria listed on a label can provide the promised benefits — or are even in the bottle. "Therefore, it is best to get your probiotics from fermented foods," says Rimm.
To learn more about the value of fiber, fermented foods, and a healthy gut microbiome, listen to this episode of the Food, We Need to Talk podcast, "Understanding the Microbiome."
profile/5170OIG3.jpeg.webp
Healthwatch
How And Why To Fit More Fiber And Fermented Food Into Your Meals
~5.0 mins read
Fiber and fermented foods aid the gut microbiome, contributing to better health and mood.
An F may mean failure in school, but the letter earns high marks in your diet. The two biggest dietary Fs — fiber and fermented foods — are top priorities to help maintain healthy digestion, and they potentially offer much more. How can you fit these nutrients into meals? Can this help your overall health as well as gut health?
Fiber, fermented foods, and the gut microbiome
The gut microbiome is a composed of bacteria, viruses, fungi, and other microorganisms living in the colon (large intestine). What you eat, the air you breathe, where you live, and many other factors affect the makeup of the gut microbiome. Some experts think of it as a hidden organ because it has a role in many important functions of the body — for example, helping the immune system function optimally, reducing chronic inflammation, keeping intestinal cells healthy, and providing some essential micronutrients that may not be included in a regular diet.
Your gut communicates with your brain through pathways in the gut-brain axis. Changes in the gut microbiome have been linked with mood and mental health disorders, such as depression and anxiety. However, it's not yet clear that these changes directly cause these types of problems.
We do know that a healthy diet low in processed foods is key to a healthy gut microbiome. And increasing evidence suggests that fiber and fermented foods can play important parts here.
Fiber 101
Fiber's main job is to make digestion smoother by softening and adding bulk to stool, making it pass quickly through the intestines.
But fiber has other benefits for your microbiome and overall health. A high-fiber diet helps keep body weight under control and lowers LDL (bad) cholesterol levels. Research has found that eating enough fiber reduces the risk of heart disease, type 2 diabetes, and some cancers.
What to know about fiber
There are two types of fiber: insoluble (which helps you feel full and encourages regular bowel movements) and soluble (which helps lower cholesterol and blood sugar). However, recent research suggests people should focus on the total amount of fiber in their diet, rather than type of fiber.
If you're trying to add more foods with fiber to your diet, make sure you ease into new fiber-rich habits and drink plenty of water. Your digestive system must adapt slowly to avoid gas, bloating, diarrhea, and stomach cramps caused by eating too much too soon. Your body will gradually adjust to increasing fiber after a week or so.
How much fiber do you need?
The fiber formula is 14 grams for every 1,000 calories consumed. Your specific calorie intake can vary depending on your activity levels.
"But instead of tracking daily fiber, focus on adding more servings of fiber-rich foods to your diet," says Eric Rimm, professor of epidemiology and nutrition at Harvard's T.H. Chan School of Public Health.
Which foods are high in fiber?
Fruits, vegetables, legumes, nuts, seeds, and whole grains are all high in fiber. The Dietary Guidelines for Americans has a comprehensive list of fiber-rich foods and their calorie counts.
What about over-the-counter fiber supplements that come in capsules, powders that you mix with water, and chewable tablets? "If you have trouble eating enough fiber-rich foods, then these occasionally can be used, and there is no evidence they are harmful," says Rimm. "But they should not serve as your primary source of dietary fiber."
Fermented foods 101
Fermented foods contain both prebiotics — ingredients that create healthy changes in the microbiome — and beneficial live bacteria called probiotics. Both prebiotics and probiotics help maintain a healthy gut microbiome.
What to know about fermented foods
Besides helping with digestion and absorbing vital nutrients from food, a healthy gut supports your immune system to help fight infections and protect against inflammation. Some research suggests that certain probiotics help relieve symptoms of gut-related conditions like inflammatory bowel disease and irritable bowel syndrome, though not all experts agree with this.
Many foods that are fermented undergo lacto-fermentation, in which natural bacteria feed on the sugar and starch in the food, creating lactic acid. Not only does this process remove simple sugars, it creates various species of good bacteria, such as Lactobacillus or Bifidobacterium. (Keep in mind that some foods undergo steps that remove probiotics and other healthful microbes, as with beer or wine, or make them inactive, like baking and canning.)
The exact amounts and specific strains of bacteria in fermented foods vary depending on how they are made. In addition to probiotics, fermented foods may contain other valuable nutrients like enzymes, B vitamins, and omega-3 fatty acids.
How often should you eat fermented foods?
There is no recommended daily allowance for prebiotics or probiotics, so it is impossible to know precisely which fermented foods or quantities are best. The general guideline is to add more to your daily diet.
Which fermented foods should you choose?
Fermented foods have a range of tastes and textures because of the particular bacteria they produce during fermentation or that are added to foods. Yogurt is one of the most popular fermented foods (look for the words "live and active cultures" on the label). Still, many options are available if you are not a yogurt fan or want to expand your fermented choices. Kimchi, sauerkraut, kombucha, and pickles are a few examples.
As with fiber, probiotics are also marketed as over-the-counter supplements. However, like all dietary supplements, they do not require FDA approval, so there is no guarantee that the types of bacteria listed on a label can provide the promised benefits — or are even in the bottle. "Therefore, it is best to get your probiotics from fermented foods," says Rimm.
To learn more about the value of fiber, fermented foods, and a healthy gut microbiome, listen to this episode of the Food, We Need to Talk podcast, "Understanding the Microbiome."
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