Writing Can Help Injuries Heal Faster: Scientific American


Expressive writing is known to help assuage psychological trauma and improve mood. Now studies suggest that such writing, characterized by descriptions of one’s deepest thoughts and feelings, also benefits physical health.

Researchers in New Zealand investigated whether expressive writing could help older adults heal faster after a medically necessary biopsy. In the study, 49 healthy adults aged 64 to 97 years wrote about either upsetting events or daily activities for 20 minutes, three days in a row. After a time lag of two weeks, to make sure any initial negative feelings stirred up by recalling upsetting events had passed, all the subjects had a biopsy on the arm, and photographs over the next 21 days tracked its healing. On the 11th day, 76 percent of the group that did expressive writing had fully healed as compared with 42 percent of the control group.

boy writing in hospital bed

“We think writing about distressing events helped participants make sense of the events and reduce distress,” says Elizabeth Broadbent, professor of medicine at the University of Auckland in New Zealand and co-author of the study, published in July in Psychosomatic Medicine. Long-term emotional upset can increase the body’s levels of stress hormones such as cortisol, which impedes the immune system. A paper in September in the British Journal of Health Psychology indeed found that writing about an emotional topic lowered participants’ cortisol levels.

The writing in Broadbent’s study may have also sped recovery by improving sleep. Participants who slept more in the week before the biopsy healed faster, perhaps because sleep ramps up many bodily processes involved in healing.

Do You Really Need a Vitamin D Supplement?


A new study says that taking vitamin D supplements for bone-strengthening and protection against osteoporosis is not necessary for healthy middle-aged adults.

But a bone health expert at Cleveland Clinic urges people at risk for vitamin D deficiency to consult their doctors before discontinuing use.

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Studies showed no significant increase in BMD

Recent concerns about the safety risks of taking calcium supplements has led some adults to take vitamin D (without calcium) for bone protection.

The University of Auckland study — a meta-analysis of past studies — found that vitamin D supplements alone had little effect on bone-mineral density (BMD). Investigators combined data from 23 past trials, studying 4082 adults, 92 percent of whom were women. Studies showed no significant increase in BMD in most areas of the body.

In light of this researchers concluded that widespread use of vitamin D for osteoporosis prevention in adults without risk factors for vitamin D deficiency was unwarranted.

Importance of vitamin D shouldn’t be minimized

Chad Deal, MD, was not involved in the study but is Director of the Center of Osteoporosis and Metabolic Bone Disease at Cleveland Clinic.

Though not disagreeing with the study’s conclusions, he worries that the findings may cause some to minimize the positive impact of vitamin D on at-risk people.

“The study is on the effect of vitamin D on BMD, which is modest and not surprising,” says Dr. Deal. “Vitamin D would not be expected to have a large effect unless the patient had severe vitamin D deficiency, in which case the bone density effect could be significant.”

“Patients with vitamin D deficiency should not get the take-home message that vitamin D will not benefit them,” he says.

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Fracture protection and other safeguards

For older, at-risk patients, vitamin D deficiency can have a major impact on fracture, says Dr. Deal. Deficiency can cause osteomalacia, softening of the bone due to impaired mineralization, which makes fractures more likely.

Bone mineral density is not a perfect surrogate for fracture, especially in older patients,” Dr. Deal says.

Vitamin D can also have “huge benefits” on muscle function, cognition and falling, he adds.

Healthy middle-aged adults should talk to their doctor about both their vitamin D and calcium levels to see if they need to be taking vitamin D supplements, either alone or with calcium.

‘Sugar gel’ helps premature babies.


A dose of sugar given as a gel rubbed into the inside of the cheek is a cheap and effective way to protect premature babies against brain damage, say experts.

premature baby

Dangerously low blood sugar affects about one in 10 babies born too early. Untreated, it can cause permanent harm.

Researchers from New Zealand tested the gel therapy in 242 babies under their care and, based on the results, say it should now be a first-line treatment.

Their work is published in The Lancet.

Sugar dose

Dextrose gel treatment costs just over £1 per baby and is simpler to administer than glucose via a drip, say Prof Jane Harding and her team at the University of Auckland.

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This is a cost effective treatment and could reduce admissions to intensive care services which are already working at high capacity levels”

Andy Cole Bliss

Current treatment typically involves extra feeding and repeated blood tests to measure blood sugar levels.

But many babies are admitted to intensive care and given intravenous glucose because their blood sugar remains low – a condition doctors call hypoglycaemia.

The study assessed whether treatment with dextrose gel was more effective than feeding alone at reversing hypoglycaemia.

Neil Marlow, from the Institute for Women’s Health at University College London, said that although dextrose gel had fallen into disuse, these findings suggested it should be resurrected as a treatment.

We now had high-quality evidence that it was of value, he said.

Andy Cole, chief executive of premature baby charity Bliss, said: “This is a very interesting piece of new research and we always welcome anything that has the potential to improve outcomes for babies born premature or sick.

“This is a cost-effective treatment and could reduce admissions to intensive care services, which are already working at high capacity levels.

“While the early results of this research show benefits to babies born with low blood sugars, it is clear there is more research to be done to implement this treatment.”

Vitamin D pills’ effect on healthy bones queried.


Supplements

Healthy adults do not need to take vitamin D supplements, suggests a study in The Lancet which found they had no beneficial effect on bone density, a sign of osteoporosis.

But experts say many other factors could be at play and people should not stop taking supplements.

University of Auckland researchers analysed 23 studies involving more than 4,000 healthy people.

The UK government recommends children and over-65s take a daily supplement.

The New Zealand research team conducted a meta-analysis of all randomised trials examining the effects of vitamin D supplementation on bone mineral density in healthy adults up to July 2012.

The supplements were taken for an average of two years by the study participants.

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I’m not surprised they didn’t find any evidence of the effects of vitamin D on bone density because there are so many other factors involved…”

Dr Laura Tripkovic University of Surrey

Bone mineral density is a measure of bone strength and measures the amount of bone mineral present at different sites in the body. It is often seen as an indicator for the risk of osteoporosis, which can lead to an increased risk of fracture.

The trials took place in a number of different countries including the UK, the US, Australia, Holland, Finland and Norway.

Although the results did not identify any benefits for people who took vitamin D, they did find a small but statistically significant increase in bone density at the neck of the femur near the hip joint.

According to the authors, this effect is unlikely to be clinically significant.

Free up resources

Prof Ian Reid, lead study author, from the University of Auckland, said the findings showed that healthy adults did not need to take vitamin D supplements.

“Our data suggest that the targeting of low-dose vitamin D supplements only to individuals who are likely to be deficient could free up substantial resources that could be better used elsewhere in healthcare.”

Writing about the study in The Lancet, Clifford J Rosen from the Maine Medical Research Institute agrees that science’s understanding of vitamin D supports the findings for healthy adults, but not for everyone.

“Supplementation to prevent osteoporosis in healthy adults is not warranted. However, maintenance of vitamin D stores in the elderly combined with sufficient dietary calcium intake remains an effective approach for prevention of hip fractures.”

The Department of Health currently recommends that a daily supplement of vitamin D of 10 micrograms (0.01mg) should be taken by pregnant and breastfeeding women and people over 65, while babies aged six months to five years should take vitamin drops containing 7 to 8.5 micrograms (0.007-0.0085mg) per day.

Additional factors

Dr Laura Tripkovic, research fellow in the department of nutritional sciences at the University of Surrey, said the study was important but very specific.

“I’m not surprised they didn’t find any evidence of the effects of vitamin D on bone density because there are so many other factors involved in osteoporosis, like genes, diet and environment.

“To pin it all on vitamin D… it’s difficult to do that.”

Dr Tripkovic said it was no good taking vitamin D supplements if people didn’t also maintain a healthy, balanced diet containing calcium and take plenty of exercise.

She said most healthy people should be able to absorb enough vitamin D naturally, through sunshine and diet.

“But if people are worried about their vitamin D levels then a multi-vitamin tablet would do. If you have bone pain and muscle aches then you should go and see your GP and discuss it.”

We get most of our vitamin D from sunlight on our skin, but it is also found in certain foods like oily fish, eggs and breakfast cereals.

However, taking too much vitamin D in the form of supplements can be harmful because calcium can build up and damage the kidneys.

Experts advise taking no more than 25 micrograms (0.025mg) a day.

The UK guidance is currently being reviewed.