Community Based Psychosocial Education Can Improve Mood Disturbance in Breast Cancer Survivors at Various Stages of Their Recovery.

BACKGROUND: Psychosocial distress can contribute to avoidance, refusal, or discontinuation of cancer treatment, which could impact recovery and survival. AIMS: The aim of the present study was to evaluate the effectiveness of a community based psychosocial program on alleviating mood disturbance in breast cancer survivors at different stages of their breast cancer journey. METHOD: A total of 37 women participated in an 8-week psychosocial program at their local community centre. The weekly 3-hour program was delivered in a small group format. Program components included health education, behavioural training, cognitive behavioural therapy, art therapy and stress-management. Questionnaires aimed at assessing psychiatric morbidity and mood adjustment were administered at the beginning of the program (Pre) and at the completion of the program (Post). RESULTS: Group data revealed a significant reduction in psychiatric morbidity and improved psychological adjustment. When participants were divided into degree of psychiatric morbidity (mild, moderate, severe, very severe) a significant reduction in the reporting of anxiety symptoms in the mild, moderate, severe and very severe groups was reported; depression symptoms in the severe and very severe groups were noted, and anger, confusion and somatic symptoms in the mild group were noted. The level of activity was also significantly improved in the very severe group. CONCLUSIONS: A structured community based psychosocial program is beneficial to women struggling to come to terms with the emotional consequences of breast cancer at all stages of recovery.

Consuming a small-moderate dose of red wine alone can alter the glucose-insulin relationship.

The aim in the present study was to assess the effect of small-moderate red wine ingestion on the level of serum insulin and plasma glucose when nutritional status is varied. Twenty nondiabetic males (19-22 years) participated in the study. In the fasting trial, all participants underwent a 6 h fast prior to consuming 4 standard units of red wine (40 g alcohol) or the equivalent amount of placebo as dealcoholized wine (containing <0.5% alcohol, 0% resveratrol) over a 135 min period. Alternatively, in the feeding trial, participants consumed food for 45 min prior to ingesting 4 standard units of red wine (40 g alcohol) or placebo over 135 min. Serum insulin and plasma glucose were assessed at regular 45 min intervals during all trials. The results showed a significant decrease in the level of serum insulin and no significant change in plasma glucose concentration in the fasting trial. Alternatively, a significant alcohol-induced decrease in plasma glucose and no change in serum insulin occurred when red wine alone was consumed after food. It was concluded that red wine can alter the glucose-insulin relationship and ingesting red wine alone (without food) should not be encouraged in nondiabetic individuals.

Sugar alters the level of serum insulin and plasma glucose and the serum cortisol:DHEAS ratio in female migraine sufferers.

Early work has highlighted that a large percentage of migraineurs may have an altered glucidic methabolis due to carbohydrate-induced hyperinsulinism. The aim of this study was to assess the effect of sucrose on biomarkers of energy metabolism and utilization in migraineous females. A total of 16 participants (8 = Migraine, 8 = Non-migraine) at the mid-point of their menstrual cycle underwent a 15-h fast prior to ingesting 75 g sucrose dissolved in 175 g water. Blood sampling for the assessment of serum insulin, serum cortisol and serum dehydroepiandrosterone sulfate (DHEAS) and plasma glucose was conducted upon arrival at 09:00 h and then at regular 15-min intervals across a 150-min experimental period. The results showed a significant alteration in serum insulin and plasma glucose following sucrose ingestion in the migraine and non-migraine groups. In addition, significant group differences were observed in the level of serum insulin, serum DHEAS, and the cortisol:DHEAS ratio with migraine participants on average recording a higher sucrose-induced serum insulin level and lower DHEAS level and cortisol:DHEAS ratio when group data was compared. It was concluded that while sucrose consumption may potentiate serum insulin in migraineurs this does not result in the development of sucrose-induced hypoglycemia in migraine or non-migraine participants.

Migraine: A disorder of metabolism?

The treatment and prevention of migraine within the last decade has become largely pharmacological. While there is little doubt that the advent of drugs (e.g. triptans) has helped many migraine sufferers to lead a normal life, there is still little knowledge with respect to the factors responsible for precipitating a migraine attack. Evidence from biochemical and behavioural studies from a number of disciplines is integrated to put forward the proposal that migraine is part of a cascade of events, which together act to protect the organism when confronted by a metabolic challenge.

Effect of sucrose consumption on serum insulin, serum cortisol and insulin sensitivity in migraine: evidence of sex differences.

The aim of this study was to compare the effect of sucrose on biomarkers of energy metabolism and utilization in migrainous men and women. A total of 20 participants (7=Migraine (female), 5=Migraine (male), 8=Non-migraine control) submitted to an oral sucrose tolerance test (OSTT), which required them to fast for 15 h overnight and then ingest 75 g sucrose dissolved in 175 g water at 9 AM the next morning. Blood sampling for the assessment of serum insulin, serum cortisol and plasma glucose was conducted upon arrival at 0900 h and then at regular 15-min intervals across a 150-min period. Comparison of insulin sensitivity indexes that rely on fasting glucose and insulin data failed to find evidence of insulin resistance in migraineurs or controls. Prior to sucrose consumption the level of fasting serum cortisol at 0-min on average was significantly higher in migraineurs. However, no significant group differences in the level of fasting serum insulin and plasma glucose at 0-min were noted. Following sucrose consumption: the level of serum insulin was significantly higher in female migraineurs; the level of serum cortisol was significantly higher in male migraineurs; glucose/insulin (G/I) ratio was significantly higher in male migraineurs at 135-min and 150-min; insulin/cortisol (I/C) ratio was significantly different with the I/C ratio lower in male migraineurs and higher in female migraineurs; area under the curve (AUC) insulin was significantly different across groups with AUC insulin lower in male migraineurs and higher in female migraineurs; and AUC cortisol was significantly higher in male migraineurs. It was concluded that the effect of sucrose on biomarkers of energy metabolism and utilization in male and female migraineurs is not the same. Therefore, the factors underlying migraine pathogenesis in men and women may also be different.

Ingesting alcohol prior to food can alter the activity of the hypothalamic-pituitary-adrenal axis.

There is an increasing evidence that long-term alcohol intake can promote damage to most of the body's major organs. However, regular consumption of a small-moderate amount of alcohol is often recommended as being beneficial to health and of concern is that the effect of ingesting commercially available alcohol products on steroid hormone synthesis under variable nutritional conditions has not been thoroughly investigated. Many individuals consume alcohol alone prior to a meal and the aim of the present study was to assess the effect of consuming a small-moderate amount of commercially available alcohol on the level of salivary cortisol and salivary dehydroepiandrosterone sulfate (DHEAS) before and after a meal. A total of 24 males aged 19-22 years participated in the current investigation. The experimental procedure required participants to fast for 6 h before being asked to ingest either 40 g alcohol in the form of red wine (n=8), low alcohol and high beer (n=8), white wine (n=8) or the equivalent amount of placebo over a 135-min period before consuming food for 45-min. The level of blood alcohol, salivary cortisol and salivary DHEAS was assessed upon arrival and then at regular 45-min intervals during the 180-min experimental period. The results showed that the consumption of alcohol and placebo can significantly lower the level of salivary cortisol. However, the effect of consuming a small-moderate amount of commercially available alcohol on the level of salivary DHEAS was dependent on the nutritional content of the beverage with red wine promoting no change, white wine promoting a significant decrease, and beer having a variable effect on salivary DHEAS concentration when compared to placebo. It was concluded that the effect of commercially available alcohol on the HPA axis is not the same for all alcohol products and both the nutritional status of participants and the nutritional content of the alcoholic beverage being administered should be taken into consideration when investigating the effect of alcohol on the HPA axis.

Is decreased appetite for food a physiological consequence of alcohol consumption?

Despite the overwhelming evidence linking alcohol to the development of disease, the contribution of alcohol toxicity to ill health remains controversial. One of the major problems facing researchers is the fact that alcoholic beverages, which contribute little to the nutritional requirements of the body, are often substituted for food and nutritional deficiency alone can promote cell damage. Long-term alcohol intake can decrease the total amount of food consumed when food is freely available and the alcoholic individual is often held accountable for their irregular eating behaviour. Assessment of meal composition has highlighted that appetite for food-containing carbohydrate (in particular) is altered in moderate-heavy drinkers but at present there is insufficient biochemical evidence to confirm or deny this observation. The biochemical processes associated with appetite are many and it would be impossible to address all of these events in a single paper. Therefore, the aim of this review will be to focus on one of the major biochemical markers of appetite for carbohydrate in order to put forward the suggestion that a decreased appetite for food could be a physiological consequence of consuming some forms of alcohol.

Effect of moderate white wine consumption on serum IgA and plasma insulin under fasting conditions.

BACKGROUND/AIMS: The present study aims to investigate the contribution of alcohol toxicity to the development of malnutrition by assessing the effect of consuming a moderate amount of white wine on plasma insulin and serum IgA under fasting conditions. METHODS: A total of 5 non-alcoholic males aged between 19 and 22 years participated in the current investigation. The experimental procedure required participants to undergo a 6-hour fast before ingesting 4 standard units of alcohol (40 g) in the form of white wine over a 120-min period. The level of blood alcohol, plasma insulin and serum IgA was assessed at 30-min intervals across the 120-min experimental period. RESULTS: Consuming alcohol promotes a significant increase in serum IgA in the absence of any change in plasma insulin or ketone production in fasted individuals. CONCLUSION: White wine prior to a meal does not promote glucose metabolism and utilization and may increase the risk of developing a transient diabetic condition due to an alteration in energy metabolism.

Effect on plasma insulin and plasma glucose of consuming white wine alone after a meal.

BACKGROUND: Rodent studies have highlighted the possibility that alcohol may promote a significant decrease in the level of glucose-stimulated plasma insulin concentration. The aim of this study was to investigate whether a similar alcohol-induced decrease in plasma insulin occurs in humans, by assessing the level of plasma insulin and plasma glucose when a moderate amount of commercially available bottled white wine is consumed alone after a meal. METHODS: Eight nondiabetic men aged 19 to 22 years participated in this investigation. Participants were required to consume some food for 45 min before ingesting three standard units of white wine (30 g of alcohol) over 90 min. Plasma insulin and plasma glucose levels were assessed at regular 45-min intervals across the experimental period. RESULTS: The data showed a significant alcohol-induced decrease in the level of plasma insulin and a nonsignificant trend for a decrease in plasma glucose concentration in all participants after 15 g of alcohol had been consumed alone after a meal. CONCLUSIONS: These findings highlight the possibility that white wine, if consumed alone after a meal, may significantly alter energy utilization and possibly cause an alteration in glucose metabolism.