"The conventional view serves to protect us from the painful job of thinking."    J. K. Galbraith

I recently wrote a blog post "Kidney donation: why it's well worth considering".  I commented that most blog posts on this website are primarily written for fellow health professionals & others interested in an evidence-based approach to stress, health & wellbeing.  However this sequence of posts about kidney donation are different in that they are written mainly for other potential kidney donors and their friends & families.  I hope a personal story about a fellow donor's experience will be helpful, especially as my background in medicine & psychology may colour these posts usefully.

There has been a ripple of media interest - and rightly so - in the recent Lancet article  "Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study."  The article's abstract reads "The health benefits of leisure-time physical activity are well known, but whether less exercise than the recommended 150 min a week can have life expectancy benefits is unclear.  We assessed the health benefits of a range of volumes of physical activity in a Taiwanese population.  In this prospective cohort study, 416,175 individuals (199,265 men and 216,910 women) participated in a standard medical screening programme in Taiwan between 1996 and 2008, with an average follow-up of 8·05 years (SD 4·21).  On the basis of the amount of weekly exercise indicated in a self-administered questio

A new meta-analysis in the Journal of the American Medical Association tells it like it is: television viewing damages our health.  The paper's title is "Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality" and its abstract reads:

The August 11th edition of the British Medical Journal reported: "Having strong social relationships seems to have an effect on survival comparable to that of quitting smoking and larger than controlling traditional risk factors, such as obesity or hypertension. A meta-analysis of social relationships and mortality looked at 308,849 participants aged 63.9, on average, at baseline; 29% died during the follow-up of 7.5 years.  Overall, strong social relationships improved the odds of survival by 50%. Similar results were found for two aspects of relationships, defined by the researchers as structural (integration in social networks) and functional (received or perceived social support), although the link with integration was somewhat stronger.

Here are half a dozen recent research papers on depression (all details & abstracts to these studies are given further down this blog posting).  Yonkers et al's publication is a very welcome one - "The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists."  At last here's a major review giving good advice on this extremely important subject.  To learn more it's worth getting hold of a copy of the complete text.  You may have access to this through your academic department.  If not, authors are usually happy to send a PDF via email when asked to - emails can be dug out via a little Google detective work.  Following the [Abstract/Full Text] link will also provide various access routes including a low-cost patient information option.  In further work looking at depression

I like the American Journal of Clinical Nutrition (AJCN).  It comes out monthly and nearly always has an article or two that I find interesting and helpful.  The AJCN May edition produced a bumper crop.  Interesting articles included a report by Chen and colleagues (see below for all abstracts) on the effects of encouraging people to reduce their consumption of sugar-sweetened beverages (SSB).  In the 810 US adults they studied, 19% of total daily energy intake came from drinks.  They found "A reduction in liquid calorie intake had a stronger effect than did a reduction in solid calorie intake on weight loss. Of the individual beverages, only intake of sugar-sweetened beverages (SSBs) was significantly associated with weight change. A reduction in SSB intake of 1 serving/d was associated with a weight loss of 0.49 kg ... at 6 mo and of 0.65 kg ...

Looking back over relevant research papers that caught my attention last month, some stand out for me more than the others.  Here are three on depression that stood out and got me thinking.  The Fergusson et al paper looks at links between alcohol abuse and major depression.  There has been debate for years on whether alcohol dependence leads to depression or depression leads to alcohol dependence.  In this kind of debate, it's usually a good bet that both pathways contain some truth.  What this study adds is that often it is the alcohol dependence that is primary.  As the authors state " ... the associations between AAD (alcohol abuse or dependence) and MD (major depression) were best explained by a causal model in which problems with alcohol led to increased risk of MD as opposed to a self-medication model in which MD led to increased risk of AAD." 

Last month's article in the British Medical Journal on the dangers posed by radon gas in buildings jogged my awareness of this important hazard (Gray, Read et al. 2009).  Quoting Wikipedia on radon "Radon is the invisible, radioactive mono-atomic gas that results from radioactive decay of some forms of uranium that may be found in rock formations beneath buildings or in certain building materials themselves. There are relatively simple tests for radon gas, but these tests are not commonly done, even in areas of known systematic hazards." and "According to the United States Environmental Protection Agency, radon is reportedly the second most frequent cause of lung cancer, after cigarette smoking; and radon-induced lung cancer the 6th leading cause of cancer death overall." and "Some ... areas, including Cornwall and Aberdeenshire in the United Kingdom have high enough natural radiation levels that nuclear licensed sites cannot be built there - the sites would already exceed legal radiation limits before they opened, and the natural topsoil and rock would all have to be disposed of as low-level nuclear waste."

Here are a couple of studies on the prevalence of depression and anxiety, and four on risk factors for depression, bipolar disorder and suicide.  Strine et al report on a major survey of depression and anxiety in the United States.  They found "The overall prevalence of current depressive symptoms was 8.7% (range by state and territory, 5.3%-13.7%); of a lifetime diagnosis of depression, 15.7% (range, 6.8%-21.3%); and of a lifetime diagnosis of anxiety, 11.3% (range, 5.4%-17.2%)."  Smoking, lack of exercise, and excessive drinking were all associated with increased likelihood of mental disorders, as too was physical ill health.  Young et al, in a separate study, looked at the likelihood of depression and anxiety becoming persistent.  They estimated - at nearly 3 year follow-up - that the US prevalence of persistent depressive or anxiety disorder was 4.7%.  Only about a quarter of these sufferers were using appropriate medication and only about a fifth appropriate counselling.