COVID-19 pandemic may have increased mental health issues within families

April 13, 2021

Science Daily/Penn State

When the COVID-19 pandemic hit in early 2020, many families found themselves suddenly isolated together at home. A year later, new research has linked this period with a variety of large, detrimental effects on individuals' and families' well-being and functioning.

The study -- led by Penn State researchers -- found that in the first months of the pandemic, parents reported that their children were experiencing much higher levels of "internalizing" problems like depression and anxiety, and "externalizing" problems such as disruptive and aggressive behavior, than before the pandemic. Parents also reported that they themselves were experiencing much higher levels of depression and lower levels of coparenting quality with their partners.

Mark Feinberg, research professor of health and human development at Penn State, said the results -- recently published in the journal Family Process -- give insight into just how devastating periods of family and social stress can be for parents and children, and how important a good coparenting relationship can be for family well-being.

"Stress in general -- whether daily hassles or acute, crisis-driven stress -- typically leads to greater conflict and hostility in family relationships," Feinberg said. "If parents can support each other in these situations, the evidence from past research indicates that they will be able to be more patient and more supportive with their children, rather than becoming more harsh and angry."

Feinberg added that understanding what can help parents maintain positive parenting practices, such as a positive coparenting relationship, is key for helping protect children during future crises -- whether those crises are pandemics, economic shocks or natural disasters.

While cross-sectional studies have suggested there has been a negative impact of the pandemic on families, the researchers said this study is one of the first to measure just how much these factors have changed within families before and after the pandemic hit.

According to the researchers, previous research has found that periods of financial stress, such as the Great Depression and the 2008 recession, have led to higher levels of parent stress, mental health problems and interparental conflict, which can all lead to more harsh, and even abusive, parenting.

When the COVID-19 pandemic hit, Feinberg said it led to not only financial stress within families, but also problems related to being isolated together, issues managing work and childcare, and general fear related to the sudden health threat that was poorly understood.

"When the pandemic hit, like many people, I was very anxious and worried," Feinberg said. "I saw the tensions and difficulties my daughter and I were having being home together 24/7. So, when I realized that our existing studies and samples of families gave us an opportunity to learn something about how families would cope during the crisis, my team and I moved into action."

For the study, the researchers used data from 129 families, which included 122 mothers and 84 fathers, with an average of 2.3 children per family. The parents answered an online questionnaire that asked them about their depressive symptoms, anxiety, the quality of their relationship with their coparent, and externalizing and internalizing behavior they observed in their children, among other measures.

Because the participants were part of a longer study measuring these factors over prior years, the researchers already had data on these parents and children from before the pandemic.

The researchers found that parents were 2.4 times more likely to report "clinically significant" high levels of depression after the pandemic hit than before. They were also 2.5 times and 4 times more likely to report externalizing and internalizing problems, respectively, in their children at levels high enough that professional help might be needed.

Feinberg said that while it makes sense that families would experience these difficulties, he was shocked at the magnitude of the declines in well-being.

"The size of these changes are considered very large in our field and are rarely seen," Feinberg said. "We saw not just overall shifts, but greater numbers of parents and children who were in the clinical range for depression and behavior problems, which means they were likely struggling with a diagnosable disorder and would benefit from treatment."

Feinberg put the size of the declines in parent and child well-being in perspective by pointing out that the increase in parents' levels of depressive symptoms in the first months of the pandemic was about twice as large as the average benefit of antidepressants.

The researchers said that as the risk of future pandemics and natural disasters increases with the effects of climate change, so will the likelihood of families facing stressful conditions again in the future

"Getting ready for these types of crises could include helping families prepare -- not just by stocking up on supplies, but also by improving family resiliency and psychological coping resources," Feinberg said. "In my view, that means providing the kinds of family prevention programs we've been developing and testing at the Prevention Research Center for the past 20 years."

For example, Feinberg explained that their research shows that the Family Foundations program helps new parents develop stronger capacities for cooperation and support in their relationship with each other as coparents, which is a key dimension of family resiliency.

Feinberg said future research will examine whether families who went through Family Foundations or other programs were more resilient, maintained better family relationships, and experienced smaller declines in mental health during the pandemic.

Jacqueline Mogle, Jin-Kyung Lee, Samantha L. Tornello, Michelle L. Hostetler, Joseph A. Cifelli and Sunhye Bai, all at Penn State; and Emily Hotez, University of California, also participated in this work.

The National Institute of Child Health and Development and The Huck Institutes of the Life Sciences at Penn State helped support this research.

https://www.sciencedaily.com/releases/2021/04/210412142720.htm

Health declining in Gen X and Gen Y

March 19, 2021

Science Daily/Ohio State University

Recent generations show a worrying decline in health compared to their parents and grandparents when they were the same age, a new national study reveals.

Researchers found that, compared to previous generations, members of Generation X and Generation Y showed poorer physical health, higher levels of unhealthy behaviors such as alcohol use and smoking, and more depression and anxiety.

The results suggest the likelihood of higher levels of diseases and more deaths in younger generations than we have seen in the past, said Hui Zheng, lead author of the study and professor of sociology at The Ohio State University.

"The worsening health profiles we found in Gen X and Gen Y is alarming," Zheng said.

"If we don't find a way to slow this trend, we are potentially going to see an expansion of morbidity and mortality rates in the United States as these generations get older."

Zheng conducted the study with Paola Echave, a graduate student in sociology at Ohio State. The results were published yesterday (March 18, 2021) in the American Journal of Epidemiology.

The researchers used data from the National Health and Nutrition Examination Survey 1988-2016 (62,833 respondents) and the National Health Interview Survey 1997-2018 (625,221 respondents), both conducted by the National Center for Health Statistics.

To measure physical health, the researchers used eight markers of a condition called metabolic syndrome, a constellation of risk factors for heart disease, stroke, kidney disease and diabetes. Some of the markers include waist circumference, blood pressure, cholesterol level and body mass index (BMI). They also used one marker of chronic inflammation, low urinary albumin, and one additional marker of renal function, creatinine clearance.

The researchers found that the measures of physical health have worsened from the Baby Boomer generation through Gen X (born 1965-80) and Gen Y (born 1981-99). For whites, increases in metabolic syndrome were the main culprit, while increases in chronic inflammation were seen most in Black Americans, particularly men.

"The declining health trends in recent generations is a shocking finding," Zheng said. "It suggests we may have a challenging health prospect in the United State in coming years."

Zheng said it is beyond the scope of the study to comprehensively explain the reasons behind the health decline. But the researchers did check two factors. They found smoking couldn't explain the decline. Obesity could help explain the increase in metabolic syndrome, but not the increases seen in chronic inflammation.

It wasn't just the overall health markers that were concerning for some members of the younger generations, Zheng said.

Results showed that levels of anxiety and depression have increased for each generation of whites from the War Babies generation (born 1943-45) through Gen Y.

While levels of these two mental health indicators did increase for Blacks up through the early Baby Boomers, the rate has been generally flat since then.

Health behaviors also show worrying trends.

The probability of heavy drinking has continuously increased across generations for whites and Black males, especially after late-Gen X (born 1973-80).

For whites and Blacks, the probability of using street drugs peaked at late-Boomers (born 1956-64), decreased afterward, then rose again for late-Gen X. For Hispanics, it has continuously increased since early-Baby Boomers.

Surprisingly, results suggest the probability of having ever smoked has continuously increased across generations for all groups.

How can this be true with other research showing a decline in overall cigarette consumption since the 1970s?

"One possibility is that people in older generations are quitting smoking in larger numbers while younger generations are more likely to start smoking," Zheng said. "But we need further research to see if that is correct."

Zheng said these results may be just an early warning of what is to come.

"People in Gen X and Gen Y are still relatively young, so we may be underestimating their health problems," he said. "When they get older and chronic diseases become more prevalent, we'll have a better view of their health status."

Zheng noted that the United States has already seen recent decreases in life expectancy and increases in disability and morbidity.

"Our results suggest that without effective policy interventions, these disturbing trends won't be temporary, but a battle we'll have to continue to fight."

https://www.sciencedaily.com/releases/2021/03/210319125436.htm

Can drinking cocoa protect your heart when you're stressed?

March 31, 2021

Science Daily/University of Birmingham

Increased consumption of flavanols -- a group of molecules occurring naturally in fruit and vegetables -- could protect people from mental stress-induced cardiovascular events such as stroke, heart disease and thrombosis, according to new research.

Researchers have discovered that blood vessels were able to function better during mental stress when people were given a cocoa drink containing high levels of flavanols than when drinking a non-flavanol enriched drink.

A thin membrane of cells lining the heart and blood vessels, when functioning efficiently the endothelium helps to reduce the risk of peripheral vascular disease, stroke, heart disease, diabetes, kidney failure, tumour growth, thrombosis, and severe viral infectious diseases. We know that mental stress can have a negative effect on blood vessel function.

A UK research team from the University of Birmingham examined the effects of cocoa flavanols on stress-induced changes on vascular function -- publishing their findings in Nutrients.

Lead author, Dr. Catarina Rendeiro, of the University of Birmingham's School of Sport, Exercise and Rehabilitation Sciences, explains: "We found that drinking flavanol-rich cocoa can be an effective dietary strategy to reduce temporary impairments in endothelial function following mental stress and also improve blood flow during stressful episodes."

"Flavanols are extremely common in a wide range of fruit and vegetables. By utilizing the known cardiovascular benefits of these compounds during periods of acute vascular vulnerability (such as stress) we can offer improved guidance to people about how to make the most of their dietary choices during stressful periods."

In a randomized study, conducted by postgraduate student Rosalind Baynham, a group of healthy men drank a high-flavanol cocoa beverage 90 minutes before completing an eight-minute mental stress task.

The researchers measured forearm blood flow and cardiovascular activity at rest and during stress and assessed functioning of the blood vessels up to 90 min post stress -- discovering that blood vessel function was less impaired when the participants drank high-flavanol cocoa. The researchers also discovered that flavanols improve blood flow during stress.

Stress is highly prevalent in today's society and has been linked with both psychological and physical health. Mental stress induces immediate increases in heart rate and blood pressure (BP) in healthy adults and also results in temporary impairments in the function of arteries even after the episode of stress has ceased.

Single episodes of stress have been shown to increase the risk of acute cardiovascular events and the impact of stress on the blood vessels has been suggested to contribute to these stress-induced cardiovascular events. Indeed, previous research by Dr Jet Veldhuijzen van Zanten, co-investigator on this study, has shown that people at risk for cardiovascular disease show poorer vascular responses to acute stress.

"Our findings are significant for everyday diet, given that the daily dosage administered could be achieved by consuming a variety of foods rich in flavanols -- particularly apples, black grapes, blackberries, cherries, raspberries, pears, pulses, green tea and unprocessed cocoa. This has important implications for measures to protect the blood vessels of those individuals who are more vulnerable to the effects of mental stress," commented Dr. Rendeiro.

https://www.sciencedaily.com/releases/2021/03/210331114734.htm

Wisdom, loneliness and your intestinal multitude

March 25, 2021

Science Daily/University of California - San Diego

The evolving science of wisdom rests on the idea that wisdom's defined traits correspond to distinct regions of the brain, and that greater wisdom translates into greater happiness and life satisfaction while being less wise results in opposite, negative consequences.

Scientists have found in multiple studies that persons deemed to be wiser are less prone to feel lonely while those who are lonelier also tend to be less wise. In a new study, published in the March 25, 2021 issue of the journal Frontiers in Psychiatry, researchers at University of California San Diego School of Medicine take the connection between wisdom, loneliness and biology further, reporting that wisdom and loneliness appear to influence -- and/or be influenced by -- microbial diversity of the gut.

The human gut microbiota is comprised of trillions of microbes -- bacteria, viruses, fungi -- that reside within the digestive tract. Researchers have known for a while about the "gut-brain axis," which is a complex network that links intestinal function to the emotional and cognitive centers of the brain.

This two-way communication system is regulated by neural activity, hormones and the immune system; alterations can result in disruptions to stress response and behaviors, said the authors, from emotional arousal to higher-order cognitive abilities, such as decision-making.

Past studies have associated gut microbiota with mental health disorders including depression, bipolar disorder and schizophrenia, as well as personality and psychological traits regarded as key, biologically based components of wisdom. Recent research has connected the gut microbiome to social behavior, including findings that people with larger social networks tend to have more diverse gut microbiotas.

The new Frontiers in Psychiatry study involved 187 participants, ages 28 to 97, who completed validated self-report-based measures of loneliness, wisdom, compassion, social support and social engagement. The gut microbiota was analyzed using fecal samples. Microbial gut diversity was measured in two ways: alpha-diversity, referring to the ecological richness of microbial species within each individual and beta-diversity, referring to the differences in the microbial community composition between individuals.

"We found that lower levels of loneliness and higher levels of wisdom, compassion, social support and engagement were associated with greater phylogenetic richness and diversity of the gut microbiome," said first author Tanya T. Nguyen, PhD, assistant professor of psychiatry at UC San Diego School of Medicine.

The authors said that the mechanisms that may link loneliness, compassion and wisdom with gut microbial diversity are not known, but observed that reduced microbial diversity typically represents worse physical and mental health, and is associated with a variety of diseases, including obesity, inflammatory bowel disease and major depressive disorder.

A more diverse gut microbiota may be less susceptible to invasion by outside pathogens, which could contribute to and help promote better resilience and stability of the community.

"It is possible that loneliness may result in decreased stability of the gut microbiome and, consequently, reduced resistance and resilience to stress-related disruptions, leading to downstream physiological effects, such as systemic inflammation," the authors wrote.

"Bacterial communities with low alpha-diversity may not manifest overt disease, but they may be less than optimal for preventing disease. Thus, lonely people may be more susceptible to developing different diseases."

The relationship between loneliness and microbial diversity was particularly strong in older adults, suggesting that older adults may be especially vulnerable to health-related consequences of loneliness, which is consistent with prior research.

Conversely, the researchers said that social support, compassion and wisdom might confer protection against loneliness-related instability of the gut microbiome. Healthy, diverse gut microflora may buffer the negative effects of chronic stress or help shape social behaviors that promote either wisdom or loneliness. They noted that animal studies suggest that gut microbiota may influence social behaviors and interactions, though the hypothesis has not been tested in humans.

The complexity of the topic and study limitations, such as the absence of data about individuals' social networks, diet and degree of objective social isolation versus subjective reports of loneliness, argue for larger, longer studies, wrote the authors.

"Loneliness may lead to changes in the gut microbiome or, reciprocally, alterations of the gut milieu may predispose an individual to become lonely," said Dilip V. Jeste, MD, Distinguished Professor of Psychiatry and Neurosciences at UC San Diego School of Medicine and senior author of the paper. "We need to investigate much more thoroughly to better understand the phenomenon of the gut-brain axis."

https://www.sciencedaily.com/releases/2021/03/210325150024.htm

Frequent consumption of meals prepared away from home linked to increased risk of early death

March 25, 2021

Science Daily/Elsevier

Dining out is a popular activity worldwide, but there has been little research into its association with health outcomes. Investigators looked at the association between eating out and risk of death and concluded that eating out very frequently is significantly associated with an increased risk of all-cause death, which warrants further investigation. Their results appear in the Journal of the Academy of Nutrition and Dietetics, published by Elsevier.

Eating out is a popular activity. The US Department of Agriculture recently estimated that Americans' daily energy intake from food away from home increased from 17 percent in 1977-1978 to 34 percent in 2011-2012. At the same time, the number of restaurants has grown steadily, and restaurant-industry sales are forecasted to increase significantly.

Although some restaurants provide high-quality foods, the dietary quality for meals away from home, especially from fast-food chains, is usually lower compared with meals cooked at home. Evidence has shown that meals away from home tend to be higher in energy density, fat, and sodium, but lower in fruits, vegetables, whole grains, and protective nutrients such as dietary fiber and antioxidants.

"Emerging, although still limited, evidence suggests that eating out frequently is associated with increased risk of chronic diseases, such as obesity and diabetes and biomarkers of other chronic diseases," explained lead investigator Wei Bao, MD, PhD, assistant professor, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. "However, little is known about the association between eating meals away from home and risk of mortality.

Investigators analyzed data from responses to questionnaires administered during face-to-face household interviews from 35,084 adults aged 20 years or older who participated in the National Health and Nutritional Examination Survey 1999-2014. Respondents reported their dietary habits including frequency of eating meals prepared away from home. "We linked these records to death records through December 31, 2015, looking especially at all-cause mortality, cardiovascular mortality, and cancer mortality," noted first author Yang Du, MD, PhD candidate, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.

During 291,475 person-years of follow-up, 2,781 deaths occurred, including 511 deaths from cardiovascular disease and 638 deaths from cancer. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, and body mass index, the hazard ratio of mortality among participants who ate meals prepared away from home very frequently (two meals or more per day) compared with those who seldom ate meals prepared away from home (fewer than one meal per week) was 1.49 (95% CI 1.05 to 2.13) for all-cause mortality, 1.18 (95% CI 0.55 to 2.55) for cardiovascular mortality, and 1.67 (95% CI 0.87 to 3.21) for cancer mortality.

"Our findings from this large nationally representative sample of US adults show that frequent consumption of meals prepared away from home is significantly associated with increased risk of all-cause mortality," commented Dr. Du.

"This is one of the first studies to quantify the association between eating out and mortality," concluded Dr. Bao. "Our findings, in line with previous studies, support that eating out frequently is associated with adverse health consequences and may inform future dietary guidelines to recommend reducing consumption of meals prepared away from home."

"The take-home message is that frequent consumption of meals prepared away from home may not be a healthy habit. Instead, people should be encouraged to consider preparing more meals at home," concluded the investigators.

Future studies are still needed to look more closely at the association of eating out with death from cardiovascular disease, cancer, dementia, and other chronic diseases.

"It is important to note that the study design for this research examines associations between frequency of eating meals prepared away from home and mortality. While encouraging clients to consider preparing healthy meals at home, registered dietitian nutritionists might also focus on how selections from restaurant menus can be healthy. Tailoring strategies to each client by reviewing menus from restaurants they frequent can help them make healthy food choices," added co-investigator Linda G. Snetselaar, PhD, RDN, LD, FAND, professor and chair, Preventive Nutrition Education, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA, and Editor-in-Chief of the Journal of the Academy of Nutrition and Dietetics.

https://www.sciencedaily.com/releases/2021/03/210325084824.htm

Want a longer, healthier life? Resolve your arguments by day's end

March 25, 2021

Science Daily/Oregon State University

A recent Oregon State University study found that when people feel they have resolved an argument, the emotional response associated with that disagreement is significantly reduced and, in some situations, almost entirely erased.

That reduction in stress may have a major impact on overall health, researchers say.

"Everyone experiences stress in their daily lives. You aren't going to stop stressful things from happening. But the extent to which you can tie them off, bring them to an end and resolve them is definitely going to pay dividends in terms of your well-being," said Robert Stawski, senior author on the study and an associate professor in the College of Public Health and Human Sciences. "Resolving your arguments is quite important for maintaining well-being in daily life."

Researchers have long been aware of how chronic stress can affect health, from mental health problems such as depression and anxiety to physical problems including heart disease, a weakened immune system, reproductive difficulties and gastrointestinal issues.

But it's not just major chronic stressors like poverty or violence that can inflict damage.

"Daily stressors -- specifically the minor, small inconveniences that we have throughout the day -- even those have lasting impacts on mortality and things like inflammation and cognitive function," said Dakota Witzel, lead author and a doctoral student in human development and family studies at OSU.

For the study, Stawski and Witzel used data from the National Study of Daily Experiences, an in-depth survey of more than 2,000 people who were interviewed about their feelings and experiences for eight days in a row.

The researchers looked at reports of both arguments and avoided arguments, defined as instances where the person could have argued about something but chose to let it slide so as not to have a disagreement. They then measured how the incident affected the person's reported change in negative and positive emotions, both for the day of the encounter and the day after it occurred.

The measure of how an experience affects someone emotionally, an increase in negative emotions or a decrease in positive emotions, on the day it occurs is known as "reactivity," while "residue" is the prolonged emotional toll the day after the experience occurs. Negative and positive affect refer to the degree of negative and positive emotions a person feels on a given day.

Results showed that on the day of an argument or avoided argument, people who felt their encounter was resolved reported roughly half the reactivity of those whose encounters were not resolved.

On the day following an argument or avoided argument, the results were even starker: People who felt the matter was resolved showed no prolonged elevation of their negative affect the next day.

The study also looked at age-related differences in response to arguments and avoided arguments and found that adults ages 68 and older were more than 40% more likely than people 45 and younger to report their conflicts as resolved. But the impact of resolution status on people's negative and positive affect remained the same regardless of age.

The researchers had several explanations for older adults' higher rate of resolution: Older adults may be more motivated to minimize negative and maximize positive emotions as they have fewer years remaining, which is consistent with existing theories of aging and emotion. They may also have more experience navigating arguments and thus be more effective at defusing or avoiding conflict.

"If older adults are really motivated to maximize their emotional well-being, they're going do a better job, or at least a faster job, at resolving stressors in a more timely fashion," Stawski said.

While people cannot always control what stressors come into their lives -- and lack of control is itself a stressor in many cases -- they can work on their own emotional response to those stressors, he said.

"Some people are more reactive than other people," he said. "But the extent to which you can tie off the stress so it's not having this gnawing impact at you over the course of the day or a few days will help minimize the potential long-term impact."

In future research projects, Stawski and Witzel hope to further unpack the nature of people's disagreements to measure which contexts and relationships provoke the most stressful arguments.

https://www.sciencedaily.com/releases/2021/03/210325084833.htm