Medical News Today: Is crab and other seafood safe to eat during pregnancy?

When a woman is expecting, the foods she eats, medications she takes, and even chemicals from the products she puts on her skin can potentially cross the placenta to the baby. So, is crab and other seafood safe to eat during pregnancy?

Due to concerns over mercury consumption, there are several seafood products pregnant women should not eat.

Fortunately, when fully cooked, crab or imitation crab can usually be eaten in moderation by someone who is pregnant.

Can you eat crab when pregnant?

can you eat crab when pregnant
Cooked crab is safe to eat in moderation.

According to 2017 recommendations from the U.S. Food and Drug Administration (FDA) and Environmental Protection Agency (EPA), cooked crab is one of the best seafood choices to eat while pregnant.

The FDA also noted that it is most beneficial to eat a wide variety of fish.

A pregnant woman should not eat raw crab, however. Eating raw crab increases the risk for food poisoning, particularly in older adults, children, and pregnant women.

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Can you eat imitation crab when pregnant?

Imitation crab is cooked, so it is usually safe for a pregnant woman to eat. However, it is crucial to ask if there are other raw products in foods, such as sushi, before eating them.

Imitation crab is typically less expensive than real crab and contains pollock, egg whites, artificial flavoring, and sugar.

While this combination may taste similarly to crab, it is not as nutritious as crab itself.

Imitation crab is low in omega-3 fatty acids that are especially beneficial during pregnancy. However, imitation crab is similar in calories and protein to authentic crab.

Seafood to eat and avoid during pregnancy

Seafood is an excellent source of omega-3 fatty acids. Experts state that eating at least 8 ounces of fish rich in omega-3 fatty acids per week can benefit the growing baby.

These benefits include reducing the risk of premature delivery and fostering brain and vision development.

The FDA recommend eating 2 to 3 servings per week of cooked, low-mercury fish choices, such as:

  • catfish
  • crab
  • crawfish
  • freshwater trout
  • haddock
  • lobster
  • pollock
  • salmon
  • scallops
  • shrimp
  • whitefish

Pregnant women can also have 1 serving per week of the following:

  • bluefish
  • carp
  • Chilean sea bass
  • mahi-mahi
  • snapper
  • tilefish
  • tuna (albacore, white, or yellowfin)

It is essential to cook the above seafood, especially during pregnancy, to reduce the risk of food poisoning.

Seafood to avoid

People should not eat seafood that is usually served raw during pregnancy. These foods include sashimi, raw oysters, clams on the half shell, ceviche, poke, tuna tartare, or tuna carpaccio.

Pregnant women should avoid fish high in mercury. These fish include:

  • mackerel
  • shark
  • swordfish
  • tilefish
  • marlin
  • orange roughy
  • tuna (big eye)

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Risks and considerations

you can eat cooked crab when pregnant if prepared on a separate chopping board
When someone is pregnant, they should not eat raw crab and should prepare raw food separately.

Consuming raw fish and shellfish can cause food poisoning, as they may contain the bacteria Salmonella and Vibrio vulnificus. Symptoms of food poisoning include vomiting, diarrhea, and stomach pain.

In addition to the dangers surrounding raw food, a person should take precautions when preparing seafood and crab.

Safe food handling and preparation is vital when eating crab, fish, or any raw meat.

People should store live crabs in well-ventilated containers and fresh crab in a refrigerator at less than 40°F or well-packed in ice. Storage containers should be airtight.

When preparing raw crab, it is essential to keep raw and cooked seafood on separate cutting boards, plates, and utensils.

In addition to these risks, exposure to mercury can be toxic to a fetus. It can lead to neurological problems and congenital abnormalities.

As a result, avoiding high-mercury fish is vital for keeping the fetus healthy and safe.


When cooked, both crab and imitation crab are safe to eat during pregnancy. Practicing careful food preparation and always cooking seafood thoroughly are other ways people can protect themselves and the growing fetus from food poisoning dangers.

Avoiding high-mercury fish, such as shark and swordfish, is also essential to ensure a person avoids any harm to their developing baby.

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Medical News Today: A supple aorta might slow brain aging

According to a study in older adults, memory performance as we age may be associated with the flexibility of the largest artery in our body: the aorta.
Happy older adult
Cognitive decline with age might not be inevitable.

As we grow older, there is an inevitable decline in many of our body’s functions. This includes cognitive ability.

Memory can suffer as we enter the later years of life. However, some are affected by this slide more than others.

Because the population of the United States is living longer, it is more important than ever to understand what mechanisms are behind cognitive decline.

Is it possible to maintain good memory into old age? Researchers in Swinburne University’s Centre for Human Psychopharmacology in Melbourne, Australia, are trying to answer this question.

Their results were published in the Journal of Alzheimer’s Disease.

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The role of the aorta

In particular, the team is interested in the potential relationship between cognitive decline and the elasticity of the aorta. The aorta is the main artery in the body, carrying blood from the heart and down through the abdomen before splitting off into smaller arteries.

It is a huge blood vessel with walls so thick they need their own blood supply. It is also particularly elastic, allowing it to swell with each heartbeat, thereby helping to maintain a consistent blood pressure. However, with age, the aorta, along with the other arteries, become less supple.

Lead author Greg Kennedy explains why elasticity in the aorta may yield clues about age-related decline in memory function:

“A healthier, more elastic aorta is also theorized to protect cognitive function by reducing the negative effects of excessive blood pressure on the brain.”

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Fitness, elasticity, and memory

The team wanted to see whether a more elastic aorta would mean better memory performance in older adults.

So, they recruited 102 people aged 60–90. They rated their fitness levels using a simple 6-minute walking test, and they assessed their aortic flexibility and memory performance.

As expected, they found that higher fitness levels and more flexible aortas predicted better performance in a memory test.

People generally are less fit and have stiffer arteries as they age, which seems to explain the difference in memory ability that is usually attributed to ‘getting older.'”

Greg Kennedy

Interestingly, however, the level of fitness did not correlate with the participants’ aortic flexibility. According to the study authors, this might be because the study only measured current fitness.

But, lifetime fitness levels are likely to play a significant role in how the arteries perform over time. More work will be needed to dig into this a little deeper.

Kennedy says, “The results of this study indicate that remaining as physically fit as possible, and monitoring central arterial health, may well be an important, cost-effective way to maintain our memory and other brain functions in older age.”

These findings are in line with a huge body of research into age-related cognitive decline: remaining physically fit is likely to keep us mentally fitter for longer.

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Medical News Today: What to know about glossitis

Glossitis is typically characterized by an inflammation of the tongue. It can also cause changes in the tongue’s texture and color.

Along with swelling, glossitis can change the color and surface texture of the tongue because the condition causes the small bumps on the surface to shrink, creating a shiny, red surface.

Severe cases of glossitis can be painful and affect the way a person talks or eats.

There are different types of glossitis, including:

  • Acute glossitis. This often develops suddenly and can have severe symptoms.
  • Chronic glossitis. Chronic inflammation of the tongue is often the result of an underlying condition.
  • Atrophic glossitis also called Hunter’s glossitis. Here, the many of the tongue’s small bumps (papillae) shrink, which changes the surface of the tongue, making it appear glossy.
  • Median rhomboid glossitis. A Candida yeast infection often causes this type of glossitis.


Symptoms of glossitis include pain and swelling in the tongue and difficulty swallowing.

The symptoms of glossitis vary from person to person. They may also differ according to the underlying cause of the condition.

Common symptoms of glossitis include:

  • a swollen tongue
  • pain in the tongue
  • burning or itching in the tongue
  • change in the texture of the surface of the tongue due to the change in the size and shape of papillae
  • different color of the tongue’s surface
  • loss of ability to speak or eat properly
  • difficulty swallowing

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There is a variety of possible causes of glossitis, including:

Allergic reaction

When glossitis occurs due to an allergic reaction, a person is most likely to develop acute glossitis and have sudden tongue swelling and pain. An allergy to a particular food, drug, or specific irritant can cause this type of reaction.

Injury to the mouth

Injuries to the mouth, such as small cuts from braces or burns from hot food, might cause the tongue to inflame and swell.

When dental braces cause glossitis, a person is more at risk for chronic glossitis due to the risk of repeated injury to the mouth and tongue.


Certain diseases can cause glossitis, especially those where nutritional deficiencies occur, such as celiac disease, protein-calorie malnutrition, and pernicious anemia.

Diseases that attack the immune system, such as Sjögren’s Syndrome, can cause changes in the mouth that lead to glossitis.


Bacterial, viral, and fungal infections can all cause glossitis. However, oral herpes, which is a viral infection, and fungal yeast infections are among the most likely infections to cause glossitis.

Nutritional deficiencies

Iron deficiencies occur when a person does not have enough iron in their blood. This can trigger glossitis since low levels of iron lead to low levels of myoglobin, a substance in the blood that plays a significant role in the health of all the muscles in the body, including the tongue.

A vitamin B12 deficiency may also lead to glossitis.


If a person has symptoms of glossitis, they can visit a dentist or a doctor. At the exam, the medical professional will take a medical history and assess any symptoms the person reports.

The doctor or dentist will then examine the person’s mouth and tongue thoroughly. They will note any abnormalities in the tongue’s surface and look for blisters or bumps on the tongue or gums.

They may also take a swab of saliva for testing and order blood work to check for underlying nutritional deficiencies or diseases.

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Image of glossitis <br>Image credit: Klaus D. Peter, 2012</br>
If infection or disease has caused glossitis, a doctor may prescribe medication.
Image credit: Klaus D. Peter, 2012

Treatment for glossitis depends on its cause. Generally, glossitis responds well to treatment once a doctor has determined the underlying cause.

Doctors may prescribe medications for people with glossitis that is caused by disease or infection. Antibiotic, antifungal, or antiviral drugs may help clear up a bacterial, fungal, or viral infection, respectively.

A doctor may prescribe dietary supplements for someone with glossitis due to a nutritional deficiency. The doctor may also recommend ways to add more of the missing nutrient into a person’s diet.

If a nutrient deficiency is due to an underlying disease, such as celiac disease, a doctor may recommend treatment that includes dietary changes to manage the underlying condition.


It may not always be possible to prevent glossitis. However, a person can lower their risk of developing the condition by:

  • maintaining a healthful diet
  • practicing good oral hygiene with regular brushing, flossing, and mouthwashes
  • avoiding irritants, such as spicy foods, cigarettes, and acidic foods


A person with glossitis can generally expect to make a full recovery, although this will take time and require proper treatment. During treatment, avoid eating foods that may irritate the tongue, and maintain good oral hygiene through brushing and flossing.

If the symptoms do not go away after some time, seek medical attention. In cases where the tongue is severely swollen and starts to block the airways, a person should seek emergency medical attention or call emergency services as severe swelling may indicate a serious underlying condition.

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Medical News Today: Finding it hard to cut down on processed foods? Here’s why

We know that processed foods are bad for us, and that though they may be tasty, they do not bring us any nutritional benefits. How come we find it so hard to say no to those chips, donuts, and crackers?
cheesy puffs
We know that processed foods aren’t good for us, but how do our brains react?

Many processed foods — such as potato chips, donuts, crackers, cookies, and fries — have a high content of both (saturated) fat and carbohydrates.

However, they also have little to no nutritional value.

Instead, they are packed with “empty calories,” meaning that they can build up our fat levels without providing us with much energy.

If we consistently eat processed foods, or if our diets consist mainly of these, this will gradually increase our risk of metabolic conditions, such as obesity or diabetes, and of other complex diseases, such as cancer.

None of this is new information. Still, though we are aware of the consequences and know which foods are better for our health, many of us still find it difficult to steer clear of these tempting snacks. Why is this?

Researchers from four countries — Germany, Switzerland, the United States, and Canada — have now conducted a series of experiments investigating what happens in the brain when a person is confronted with foods high in carbs, foods that have a high fat content, and foods that are high in both carbs and fats (typically processed foods).

The researchers’ findings indicate that, while we may be pretty good at instinctively estimating the nutritional value of foods that are rich either in carbs or in fats, we seem to be worse at evaluating the nutritional value of processed foods, which are high in both.

“The biological process that regulates the association of foods with their nutritional value,” says senior author Dana Small, from Yale University’s Modern Diet and Physiology Research Center in New Haven, CT, “evolved to carefully define the value of a food so that organisms can make adaptive decisions.”

“For example, a mouse should not risk running into the open and exposing itself to a predator if a food provides little energy,” she explains.

When it comes to processed foods, however, this age-old “cost vs. benefit” mechanism seems to malfunction in humans — so suggests the new study, published in the journal Cell Metabolism.

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Processed foods trigger a reward response

The main study involved 206 participants, who were, in the first instance, shown images of snacks whose calories came primarily from either their content of fats, carbs, or a mix of the two.

All of these snacks were then rated by each participant on four counts: liking, familiarity, estimated energy density, and caloric content.

“On a subsequent day,” the scientists explain in their paper, “[the participants] arrived [with empty stomachs] to the laboratory and were fed a standard breakfast of 426 [kilocalories] from orange juice, cheddar cheese, whole-wheat toast, white toast, strawberry jam, and butter.”

Three hours after this varied breakfast, the participants were all subjected to functional MRI scans as they participated in a bidding game, in which they were shown the pictures of different snacks with different nutritional values. They were asked to say how much they would pay for each.

Based on these experiments, the researchers made several fascinating findings. First, they saw that the fat and carbohydrate combo stimulates the brain’s reward system more intensely than foods that are just high in carbs, or only high in fat, do on their own.

Two particular brain regions — the dorsal striatum and the mediodorsal thalamus, which have both been linked to reward mechanisms — have been identified as responsive to the presence of foods with a high fat and carb content.

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These brain circuits were, in fact, more active in the presence of fat- and carb-rich foods than in that of an individual’s selected favorite food, a sweeter food choice, a more energy-dense snack, or even a more generous portion size.

Then, in the bidding game, it became apparent that, given a limited amount of money to invest, the participants were more likely to pay more for fat- and carb-rich foods than for snacks only rich in carbs, or which only had a high fat content.

“Surprisingly, foods containing fats and carbohydrates appear to signal their potential caloric loads to the brain via distinct mechanisms,” says Small.

Our participants were very accurate at estimating calories from fat and very poor at estimating calories from carbohydrate. […] [W]hen both nutrients are combined, the brain seems to overestimate the energetic value of the food.”

Dana Small

Is this about adaptation to food?

Small and her colleagues hypothesize that this may be due to the fact that our brains have not had enough time to adapt appropriately to the advent of foods that may be pleasurable but do not actually bring us many nutritional benefits.

The researchers explain that our prehistoric ancestors only had access to animal meat and plants, as they were available in nature.

And, Small says, “In nature, foods high in fat and carbohydrate are very rare and tend to have fiber, which slows metabolism. By contrast, it is very common for processed foods to have high fat and high carbohydrate loads.”

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Processed foods — such as donuts or potato chips — haven’t been around very long. In fact, they have only existed for about 150 years, the scientists note.

This, they believe, could mean that unlike with unprocessed or minimally processed foods, we have not yet developed a brain response that allows us to better regulate what we eat and in what quantities.

In any case, the positive signals that our brains circulate when faced with foods that are rich in fats and carbs combined can lead to the reinforcement of unhealthful eating habits, which may lead to obesity.

“[The study’s] results imply that a potentiated reward signal generated by foods high in both fat and carbohydrate may be one mechanism by which a food environment rife with processed foods high in fat and carbohydrate leads to overeating,” the researchers conclude.

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Medical News Today: What is a urine specific gravity test?

A urine specific gravity test compares the density of urine with the density of water. It allows doctors to see the concentration of all particles that are present in the urine.

The test involves collecting a urine sample that will help give a doctor an idea of a person’s kidney function and hydration status.

What is it used for?

urine specific gravity test in sample pot held by gloved hand.
A urine specific gravity test can diagnose kidney problems.

A urine specific gravity test gives information about how well the kidneys concentrate the urine and a person’s hydration status.

The primary function of the kidneys is to maintain a healthy fluid and electrolyte balance. The kidneys excrete excess water and minerals from the body in the form of urine. When the body needs more water, the kidneys retain fluid.

A doctor will use a urine specific gravity test if they suspect that a person is dehydrated, has impaired kidney function, or has a condition that can alter the body’s fluid status, such as diabetes insipidus.

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The test should not be uncomfortable and is usually brief. The doctor might request multiple urine specific gravity tests in one day to see how well the kidneys compensate for a possible problem.

A person may be asked to collect a “clean catch” specimen so as not to contaminate the sample with bacteria from the skin.

To collect a clean catch specimen, a person must clean the urethral area before urinating, then collect the urine sample midstream in a specimen cup.

The doctor will send the urine sample to a laboratory for testing. A laboratory technician performs the test using a refractometer, which projects light into the sample and helps determine the density of the urine.

Less commonly, a technician may use dipstick method. The dipstick will change color according to the content of the urine.

Preparing for the test

Avoid beetroots before a urine specific gravity test.
Avoid beets before a urine specific gravity test.

Preparation for a urine specific gravity test is typically simple and straightforward. A person may need to stop taking certain medications before the test, particularly those that contain sucrose.

People should avoid any foods that can change the color of the urine for a few days leading up to the test. These foods include:

  • beets
  • blackberries
  • fava beans
  • carrots
  • rhubarb

People should also let their doctor know if they have recently received intravenous contrast dye for a medical test.

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Understanding and interpreting the results

Although it varies slightly between different laboratories, the normal urine specific gravity values are between 1.002 and 1.035.

A doctor will explain a person’s results to them, especially if the value is outside of the normal range.

Urine tends to be darker and has higher specific gravity when a person does not consume enough fluids. Urine is lighter and has lower specific gravity when a person is well-hydrated.

Urine specific gravity tests can give a more precise measurement of the urine’s concentration than just looking at the color alone.

Causes of high and low readings

Doctor sitting on couch with patient explaining kidney problem.
Kidney failure may cause low specific gravity.

In cases of high specific gravity, a person may be mildly dehydrated and should drink more clear fluids.

In cases of low specific gravity, a person may be drinking too much fluid or have a condition that makes them thirsty.

Further testing is often needed to determine if a heart condition, kidney problem, or metabolic disorder is the cause of the abnormal result.

Low specific gravity suggests that urine is too diluted.

Conditions that cause low specific gravity include:

  • diabetes insipidus
  • kidney failure
  • drinking too much fluid due to increased thirst
  • damage to kidney tubular cells

High specific gravity suggests that the urine is too concentrated.

Conditions that cause high specific gravity include:

Excess substances in the urine can also cause high specific gravity.

Substances include:

  • glucose
  • proteins
  • red or white blood cells
  • bacteria

The doctor may perform additional urine testing, including urinalysis, urine culture, urine osmolality, urine pH, or ketone testing. Results from these other tests will help the doctor make an accurate diagnosis.

How to lower specific gravity

If a person has high specific gravity due to dehydration, then the doctor will probably advise them to drink more fluids.

If a person is severely dehydrated or unable to drink, doctors can provide intravenous fluids.

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A urine specific gravity test is a straightforward test that looks at the concentration of a person’s urine. The test is easy to do but may involve temporarily changing one’s diet or stopping certain medications.

Urine concentration shows how well the kidneys are functioning or may point to an underlying condition that is altering the body’s fluid status.

A person can usually treat mild dehydration by drinking more fluid. In severe cases, a person may require intravenous fluids.

In the case of overhydration, a doctor will recommend further testing to diagnose the cause and outline a treatment plan.

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Medical News Today: How can disc desiccation be treated?

The spine is made up of bones called vertebrae, in between which are small fluid-filled discs. Desiccation of those discs is a common disorder caused by the tissues becoming dehydrated.

The discs between the vertebrae in the spinal column absorb shock and impact and prevent the bones from rubbing against each other.

There are five different sections of the spine:

  • Cervical spine (neck): The first seven bones at the top of the neck.
  • Thoracic spine (mid back): The 12 bones below the cervical spine.
  • Lumbar spine (low back): The five bones below the thoracic spine.
  • Sacral spine: The five bones below the lumbar region.
  • Coccyx: The final four bones of the coccyx are fused together and support the pelvic floor.

Disc desiccation is a normal part of aging. The discs can become smaller and less flexible as they dehydrate, and can eventually start to break down or degenerate.

What are the symptoms?

Model of spinal column showing discs and vertebra.
Disc desiccation is the dehydration of discs between the vertebrae.

The symptoms of desiccation depend on the area of the spine that is affected.

Cervical spine disc desiccation causes neck pain, while lumbar disc desiccation will cause pain in the lower back.

Other symptoms of disc desiccation include:

  • stiffness
  • weakness
  • burning or tingling sensation
  • numbness in the legs or feet
  • reduced or painful movement
  • sciatica

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Aging is the most common cause of desiccated discs, though it can occur in younger people as well.

Other causes of disc desiccation include:

  • accident or trauma
  • weight gain or loss
  • repetitive movements, such as heavy lifting that strains the back

How is it diagnosed?

Doctor performing physical examination of older mans back
A physical examination can diagnose disc dessication.

Disc desiccation and degenerative disc disease are among the most common causes of lower back pain.

Most people learn that they have this condition when they see their doctor about their pain. The doctor will start by taking a history and performing a physical exam.

In addition to asking about previous medical or surgical conditions, the doctor will want to know about the pain, including:

  • when it started
  • what makes it better
  • what makes it worse
  • the type of pain
  • how often it occurs
  • if it radiates to other areas

The doctor may feel the back, legs, and arms during the physical exam to determine where the pain is occurring or radiating too.

The doctor may move the arms and legs to see if there is a decrease in the range of motion, and test the strength of the various muscles. Sensation in the limbs and deep tendon reflexes will also be tested.

A doctor will use all the information to figure out what area of the back or which particular disc may be affected.

Additional testing may be ordered after the initial visit, including:

  • X-ray
  • CT (computed tomography) scan
  • MRI (magnetic resonance imaging) scan

These tests allow the doctor to look directly at the bones and structure of the spine, including the shape and size of the discs.

Dessicated discs may appear smaller or thinner, and the bones themselves may appear to have some damage if they are rubbing against each other.

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Treatment options

Swimming senior person.
Exercise may increase back muscle strength.

No treatment may be necessary if desiccated discs are not causing significant pain or interfering with daily life.

Basic home remedies include:

  • avoiding painful or uncomfortable positions
  • using a brace around the back when lifting something heavy
  • increasing strength of the back muscles through core exercises and weight loss
  • taking over-the-counter (OTC) or prescription pain relievers when needed
  • using steroid injections or a local anesthetic to relieve pain and inflammation

Surgery may be necessary if these measures do not work.

There are many different ways that surgery can help with a desiccated disc. Possible procedures may include:

  • Fusion: The surgeon will join together the vertebrae surrounding the desiccated disc. This helps to stabilize the back and prevent movement that can worsen pain or discomfort.
  • Decompression: The surgeon will remove extra bone or a disc material that has moved out of place in order to make more room for the spinal nerves.
  • Correction: The surgeon will make the repairs necessary to correct an abnormal curvature of the spine, if there is one. This can help relieve pain and increase range of motion.
  • Implants: Artificial discs, or spacers, can be placed in between vertebrae to stop the bones from rubbing.

Someone who is considering surgery should find a spinal specialist who can present the options that are best for their situation. Getting a second or third opinion may help someone to find the best approach.


Taking steps to prevent disc desiccation and degeneration is essential.

Prevention methods are good for general health and wellbeing and include the following:

  • Stay hydrated: Not drinking enough water each day can cause the body to function less well or not retain enough water, including the discs.
  • Don’t smoke: Cigarette use can directly affect the discs in the back and increase the rate of disc degeneration.
  • Maintain a healthy weight: Being overweight or obese puts extra pressure on the back and spine, which can cause the desiccation and decay of the intervertebral discs.
  • Take regular exercise: Participating in regular cardio and weight-training exercises can strengthen the bones and muscles and promote good range of motion in the back. People can ask their doctor or a physical therapist for specific exercises that support the back muscles.


Disc desiccation is a common and natural effect of aging. In most cases, taking precautions at home and making lifestyle changes can manage or prevent pain from worsening.

If someone’s daily life is impacted, consulting with the doctor or spinal specialist may help them to identify treatments that can reduce pain or increase daily motion.

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Medical News Today: What is refeeding?

Refeeding syndrome can develop when someone who is malnourished begins to eat again. The syndrome occurs because of the reintroduction of glucose, or sugar. As the body digests and metabolizes food again, this can cause sudden shifts in the balance of electrolytes and fluids. These shifts can cause severe complications, and the syndrome can be fatal.

It can take as few as 5 successive days of malnourishment for a person to be at risk of refeeding syndrome. The condition can be managed, and if doctors detect warning signs early, they may be able to prevent it.

Symptoms of the syndrome usually become apparent within several days of treatment for malnourishment.

What are the causes of refeeding syndrome?

patient being fed intravenously
Refeeding syndrome can occur when food is reintroduced to a person who is malnourished.

If a person does not eat enough, the body can quickly go into starvation mode and become malnourished.

After an extended period of starvation, the ability to process food is severely compromised.

A malnourished body produces less insulin, and this inhibits the production of carbohydrates.

If the body has insufficient carbohydrates, it uses fat reserves and stored proteins for energy.

If, over time, the body continues to rely on reserves of fat and protein, this can change the balance of electrolytes. Levels of vitamin and electrolytes diminish as the body tries to adapt to starvation mode. Potassium, phosphorus, magnesium, calcium, and thiamine levels are commonly affected.

When food is reintroduced, the body no longer has to rely on reserves of fat and protein to produce energy.

However, refeeding involves an abrupt shift in metabolism. This occurs with an increase in glucose, and the body responds by secreting more insulin. This can result in a lack of electrolytes, such as phosphorous.

Refeeding syndrome can cause hypophosphatemia, a condition characterized by a phosphorus deficiency. It can also lead to low levels of other important electrolytes.

The harmful effects of refeeding syndrome are widespread, and they can include problems with the:

  • heart
  • lungs
  • kidneys
  • blood
  • muscles
  • digestion
  • nervous system

If doctors are unable to treat the syndrome, it can be fatal.

Who is at risk?

Refeeding syndrome affects people who do not receive enough nutrition.

This may be because of:

  • starvation
  • malnourishment
  • extreme diets
  • fasting
  • famine

The following medical conditions can also increase the risk of developing refeeding syndrome:

Undergoing particular surgeries, especially weight loss surgeries, can also increase a person’s risk.

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Electrolytes play an essential role in the body. When the balance is skewed, the most common complication is hypophosphatemia, which is a lack of phosphorus.

Symptoms of hypophosphatemia include:

  • confusion or hesitation
  • seizures
  • muscle breakdown
  • neuromuscular problems
  • acute heart failure

Refeeding syndrome can also lead to a lack of magnesium. Hypomagnesemia is the name for dangerously low levels of magnesium.

Signs and symptoms of hypomagnesemia include:

  • low calcium levels, or hypocalcemia
  • low potassium levels, or hypokalemia
  • weakness
  • fatigue
  • nausea and vomiting
  • abnormal heart rhythms

Refeeding syndrome can also cause potassium levels to drop dangerously low. This can lead to:

  • fatigue
  • weakness
  • excessive urination
  • breathing problems, such as respiratory depression
  • heart problems, such as cardiac arrest
  • ileus, which involves a blockage in the intestines
  • paralysis

Other symptoms include:

  • hyperglycemia, or high blood sugar
  • mental problems, such as confusion
  • abnormal serum sodium levels
  • fluid retention
  • muscle weakness

In some cases, a potassium deficiency can lead to a coma or death.

Doctors can identify people at risk for refeeding syndrome, but it is impossible to know whether a person will develop it. Attempting to prevent the syndrome from developing is vital.

Risk factors

bottle of alcohol on its side with man slumped on table
A history of alcohol use disorder can put a person at risk for refeeding syndrome.

People who have experienced recent starvation have the highest risk of developing refeeding syndrome.

The risk is high when a person has an extremely low body mass index.

People who have recently lost weight quickly, or who have had minimal or no food before starting the refeeding process are also at significant risk.

Other people at risk include:

  • children or adolescents with severely restricted calorie intakes, when this occurs with vomiting or laxative misuse
  • children or adolescents with a history of refeeding syndrome
  • frail individuals with multiple medical problems

Regardless of age, a person is at high risk if they have:

  • a BMI of less than 16
  • lost more than 15 percent of their body weight unintentionally in the past 3–6 months
  • consumed minimal food over the past 10 consecutive days or more
  • low levels of serum phosphate, potassium, or magnesium

Two or more of the following issues also increases the risk of developing refeeding syndrome:

  • a BMI of less than 18.5
  • unintentionally losing 10 percent of body weight in the past 3–6 months
  • consuming little or no food in the past 5 consecutive days or more
  • a history of alcoholism or drug abuse
  • receiving some treatments, such as insulin, diuretics, chemotherapy drugs, radiation therapy, and antacids

Anyone who suspects that they have refeeding syndrome should seek immediate medical care.

What are the treatment options?

People with refeeding syndrome need to regain normal levels of electrolytes. Doctors can achieve this by replacing electrolytes, usually intravenously.

Replacing vitamins, such as thiamine, can also help to treat certain symptoms. A person will need continued vitamin and electrolyte replacement until levels stabilize.

Doctors may also slow the refeeding process, to help a person to adjust and recover.

The person will require continual observation in a hospital. Doctors will monitor electrolyte levels and bodily functions with tests, including urine and blood analyses.

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Recovery times vary, depending on the extent of illness and malnourishment.

Treatment will continue for up to 10 days, and monitoring may continue afterward.

If a person has complications or underlying medical problems, treatment for these may lead to longer recovery time.

Can it be prevented?

health professionals discussing patients diagnosis
It is important for healthcare professionals to look out for warning signs and treat at-risk patients.

Prevention is the most effective way to combat refeeding syndrome.

Healthcare professionals that are aware of warning signs and risk factors are better able to treat malnourished patients.

In 2013, researchers found that in a large sample of people being fed intravenously in the UK, 4 percent had refeeding syndrome. The authors noted that doctors only recognized the risk in half of the at-risk patients.

Healthcare professionals can prevent refeeding syndrome by:

  • quickly identifying those at risk
  • adapting refeeding programs
  • monitoring patients continuously once treatment has begun

Malnourishment can result when food intake is severely limited. This may occur in people with:

  • depression
  • dysphagia
  • alcoholism and drug use
  • anorexia nervosa
  • uncontrolled diabetes

Surgery and illnesses such as cancer can result in increased metabolic demands, leading to malnourishment.

Malnourishment can also occur when the body no longer absorbs nutrients as it should. This can result from conditions such as celiac disease and inflammatory bowel disease.

Patients at high risk of malnourishment and refeeding syndrome must be identified and treated. Guidelines state that doctors should consider a person’s alcohol intake, nutrition, weight changes, and psychological state before refeeding.


Refeeding syndrome can occur when food is reintroduced too quickly after a period of starvation or malnourishment. This can lead to electrolyte imbalances and severe complications that can be fatal.

The best way to combat refeeding syndrome is to identify and treat at-risk people. People with the syndrome can recover if they receive treatment early. Education and increased awareness of the condition can help.

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Medical News Today: Smoking and diabetes ‘risk factors’ for calcium buildup in brain

New dementia research from the Netherlands has revealed that smoking and diabetes are associated with calcium buildup in a part of the brain that is important for memory.
woman holding a cigarette
Both smoking and diabetes are found to be linked to calcium buildup in the brain.

In a report published in the journal Radiology, the study investigators describe how they analyzed brain CT scans of patients with memory problems.

According to lead study author Dr. Esther J.M. de Brouwer, from the Department of Geriatrics at the University Medical Center in Utrecht, in the Netherlands, “We know that calcifications in the hippocampus are common, especially with increasing age.”

She and her colleagues found that, in addition to advancing age, diabetes and smoking were also linked to calcium deposits, or calcifications, in the hippocampus.

Dementia and the hippocampus

Because the hippocampus is a structure in the brain important for short- and long-term memory, it is the subject of much research on dementia, a disease that affects some 50 million people worldwide.

This research has shown, for example, that the hippocampus is “especially vulnerable to damage” during the early development of Alzheimer’s disease, which is the main cause of dementia.

Other causes of dementia include damage to the blood supply to the brain, buildup of abnormal proteins called Lewy bodies, and inflammation.

However, Dr. de Brouwer and team note that current dementia research on the hippocampus tends to focus on degeneration of brain cells and tissues as opposed to abnormalities in the blood supply, or vascular system, that feeds them.

The scientists’ findings could be significant because they support the idea that the “calcifications may be of vascular origin.”

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New type of CT scan

A distinguishing feature of the study is that it was able to take advantage of a new type of scan known as a “multiplanar brain CT scan.”

This type of CT scan lets radiologists differentiate between calcium buildup in the hippocampus and that in neighboring structures such as the choroid plexus.

Dr. de Brouwer explains that this scan type also “makes it possible to see the hippocampus in different anatomical planes; for example, from top to bottom, right to left, and front to back.”

The team examined the multiplanar brain CT scans of around 2,000 people who had attended a hospital memory clinic in the Netherlands during 2009–2015. The age of the patients ranged between 45 and 96 years. Their average age was 78.

The CT scans had all been performed as part of diagnostic tests that also included assessment of cognitive function.

The researchers had two goals in mind for their study. One was to investigate any links between risk factors known to cause vascular problems — such as smoking, diabetes, and high blood pressure — and hippocampal calcifications.

The other goal of the study was to discover whether calcium buildup in the hippocampus has an effect on cognitive function.

Smoking and diabetes ‘likely risk factors’

When they analyzed the CT scans, the scientists found that 19 percent of all the study participants had calcifications in their hippocampus.

They also discovered that “older age,” smoking, and diabetes “were associated with the presence of hippocampal calcifications.”

The study design did not permit the scientists to be sure that smoking and diabetes actually raise the risk of hippocampal calcifications.

However, Dr. de Brouwer says that they “do think that smoking and diabetes are risk factors.”

There is evidence to suggest that hippocampal calcifications are a hallmark of vascular disease and “[i]t is well-known that smoking and diabetes are risk factors for cardiovascular disease,” she adds.

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No link to cognitive function

The team was puzzled that the study found no links between calcium buildup in the hippocampus and cognitive function.

Dr. de Brouwer suggests that this could have been due to some of the limitations of their methods and design.

One limitation, for example, was the fact that there was no “control group” of healthy subjects; all the participants were patients at a memory clinic and had disorders ranging from cognitive impairment to vascular dementia and Alzheimer’s disease.

Another explanation might lie in the fact that there are several layers in the hippocampus, “and it is possible that the calcifications [found in the study] did not damage the hippocampal structure that is important for memory storage,” notes Dr. de Brouwer.

She and her colleagues are now expanding the research to include other groups in a bid to better understand how calcium buildup in the hippocampus might impact cognitive function.

It is […] likely that smoking and diabetes are risk factors for hippocampal calcifications.”

Dr. Esther J. M. de Brouwer

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Medical News Today: Metabolic risk tied to both too much and too little sleep

Do you often struggle because you don’t get enough sleep on a nightly basis? Or perhaps you sleep in as much as you can each day, since your schedule permits it? Neither of these is good for you, a new study suggests, and you may be at risk of metabolic problems.
person snoozing alarm
How might sleep duration influence the risk of metabolic syndrome?

We already know that too little sleep can impact our health in myriad ways, but to what extent does too much sleep effect our well-being?

A study recently conducted by researchers from Seoul National University College of Medicine in South Korea has discovered that both of these extremes are liable to increase the risk of metabolic syndrome.

This refers to a cluster of metabolic conditions, including low glucose tolerance, hypertension, and obesity.

Lead study author Claire E. Kim and her team analyzed data sourced through the Health Examinees (HEXA) study, a large population study investigating the interaction of genetic and environmental factors in the context of chronic disease incidence in South Korea.

Their results — which have been reported in the journal BMC Public Health — not only indicate a correlation between extremes of sleep and metabolic syndrome, but also suggest that the risks may be different depending on a person’s sex.

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Sleep duration and metabolic syndrome

Kim and team analyzed the medical data of 133,608 men and women aged 40–69. The participants also self-reported how much sleep they got every day, including both night-time sleep and any daytime naps.

The HEXA study included information on the participants’ medical histories, use of medication, modifying lifestyle factors, and family medical history.

All of the volunteers also provided samples of plasma, serum, blood cells, urine, and chromosomal DNA, among other things.

Analyses of the participants’ collected data — including the self-reported information on sleep hygiene — revealed that both fewer than 6 and more than 10 hours of sleep on a daily basis were linked to the presence of metabolic syndrome.

Individuals were deemed to have metabolic syndrome if they presented at least three of these tell-tale symptoms: excess fat around the waist; high triglyceride levels; low levels of high-density lipoprotein (HDL), or “good,” cholesterol; high fasting blood glucose; and hypertension.

Just over 29 percent of the male participants had metabolic syndrome, and 24.5 percent of the women showed signs of this condition. The team noted certain differences in risk patterns.

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‘Potential gender difference’ observed

So, women who slept little — for fewer than 6 hours per day — were likelier to have a higher waist circumference, indicative of excessive belly fat, than women who slept for 6–7 hours per day.

Men who slept for under 6 hours were more likely to have not just a higher waist circumference, but also metabolic syndrome.

As for oversleeping — defined as more than 10 hours of sleep each day — it was tied to raised triglyceride levels, as well as metabolic syndrome, in men.

But in women, it was linked with even more negative health outcomes: not just metabolic syndrome and high triglyceride levels, but also high blood sugar, low HDL cholesterol, and higher waist circumference.

Of the participants, about 13 percent of the women and 11 percent of the men slept too little, and 1.7 percent of the women and 1.5 percent of the men slept for over 10 hours every day.

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“This is the largest study examining a dose-response association between sleep duration and metabolic syndrome and its components separately for men and women,” Kim explains.

We observed a potential gender difference between sleep duration and metabolic syndrome, with an association between metabolic syndrome and long sleep in women and metabolic syndrome and short sleep in men.”

Claire E. Kim

It is not clear how sleep patterns might influence the development of metabolic syndrome, but the researchers note that sleep duration could impact the production of key hormones that regulate appetite and how much energy our bodies produce and consume.

Kim and colleagues also note that, although this study’s findings may be compelling, the research observed an association that may not necessarily speak of a cause and effect relationship.

The authors acknowledge some limitations to their study, including the fact that the information on sleep duration was self-reported, so there were no objective measurements in this regard, as well as the fact that the analysis amalgamated night-time sleep and daytime naps.

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Medical News Today: Is it bronchitis or asthma?

Asthma and bronchitis are respiratory conditions that can cause airway irritation, inflammation, and coughing. Sometimes, people mistake bronchitis for asthma and vice versa.

Knowing how the two conditions can present themselves is essential, as the treatments people may need are different.

Symptoms of asthma vs. bronchitis

Woman with cough wondering if it's caused by asthma or bronchitis
A cough and shortness of breath are symptoms of both asthma and bronchitis.

Asthma and bronchitis both have a cough as one of the most common symptoms.

Therefore, a doctor will often look for other symptoms of each condition when trying to decide the one a person may have.

Bronchitis symptoms include:

  • a chill
  • general malaise
  • a headache
  • a productive cough with mucus that is white, green, or yellow
  • shortness of breath
  • soreness or tightness in the chest

Sometimes, people who have symptoms that include coughing, wheezing, and shortness of breath think they are having a bout of bronchitis when they actually have asthma.

Asthma causes the airways to become inflamed and narrower than usual. People often find they cannot breathe because asthma narrows the airways.

The most common asthma symptoms include:

  • coughing
  • shortness of breath
  • wheezing

People will usually notice symptoms are worse at night or first thing in the morning. People may also notice their asthma symptoms are especially bad after they have experienced certain triggers, such as cigarette smoke, exercise, or pollen.

Can you have asthma and bronchitis at the same time?

People with asthma can also have acute bronchitis. They may notice their asthma symptoms become worse as a consequence. They may experience:

  • shortness of breath
  • wheezing
  • pain and discomfort when breathing

Sometimes, people with severe bronchitis and asthma may have to go to the hospital because mucus has clogged the airways into their lungs so much.

How is each condition diagnosed?

spirometry test
Doctors can use a spirometry test to diagnose asthma.

Doctors can diagnose asthma by taking a health history and asking about a person’s symptoms, such as when they become worse or better.

Doctors can then conduct breathing tests to see if someone is likely to have asthma.

Several different tests exist, but a common one is known as spirometry.

Spirometry involves a person blowing into a sensor that measures how fast and hard they are exhaling their breath.

How forcefully a person can exhale is usually reduced if they have asthma.

A doctor may consider asthma over bronchitis if someone has had a cough that goes away but keeps returning.

An exception is when a person has chronic bronchitis, often because they smoke. Asthma is also often unresponsive to cough medications.

A doctor will diagnose bronchitis by:

  • taking a medical history
  • listening to the lungs
  • considering symptoms

A doctor may also order a chest X-ray to ensure symptoms are not related to pneumonia. They may consider a further round of testing for asthma if the symptoms do not improve in 1 or 2 weeks.

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What are the causes of each?

Viruses, such as those that cause the common cold, can cause bronchitis as well.

People coming in contact with viruses is how these germs are spread. This can happen when someone else coughs nearby or if they touch an infected person’s hands.

People who also have gastroesophageal reflux disease (GERD) can get acute bronchitis if stomach acid refluxes up and into their airways.

Doctors do not know exactly why people develop asthma. They do know that people with a family history of asthma or allergies are more likely to have the condition.

Being exposed at an early age to viruses that cause respiratory infections may also contribute.

What are the treatment options?

woman holding out a glass of water
People with bronchitis should drink plenty of fluids.

There is no cure for bronchitis because a virus is the cause of the condition.

A person should instead engage in actions and behaviors that will support their immune system and give it time to fight off the virus.

Methods to treat bronchitis include:

  • drinking plenty of fluids
  • getting plenty of rest
  • taking over-the-counter (OTC) cough medicines

A doctor may sometimes prescribe an inhaler with a medication designed to help the airways open more if a person is experiencing significant wheezing related to their bronchitis.

An example of this treatment is an albuterol inhaler. This is the same medication doctors also use to treat asthma.

Doctors have several medications they can prescribe to reduce asthma symptoms and incidence, although they do not have a cure. Examples include inhalers that are both quick and long acting to alleviate breathing problems.

Avoiding asthma triggers, such as smoke, allergens, or other irritants, can also help.


People can prevent bronchitis by being careful to avoid the ways that viruses spread. The main way to achieve this is through hand-washing.

A person should always wash their hands before and after eating and frequently throughout the day to prevent the spread of germs.

People cannot prevent asthma, unfortunately. They can, however, avoid asthma triggers that are known to worsen their condition. Examples of triggers include cigarette smoke, pet dander, and seasonal allergies.

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What is the outlook?

Bronchitis is a temporary condition that should resolve itself with at-home care. There are, however, some who are more likely to have complications. These include the elderly, young children, and those who are immunocompromised, such as people with cancer or diabetes.

Taking medications and avoiding asthma triggers can help people avoid more acute asthma attacks if they have the condition.

People should not refrain from physical activity, even though exercise can trigger asthma attacks in some. A doctor may, instead, suggest they carry a rescue or short-acting inhaler to prevent more acute attacks.

A doctor may also recommend that the individual uses a short-acting inhaler 30 minutes before they begin to exercise.


Both acute bronchitis and asthma can cause symptoms, especially coughing and wheezing. If a cough lingers more than a few weeks, people should see their doctor in case asthma is causing the condition.

There are treatments that can help reduce the symptoms of both conditions, whenever possible, although there is no cure for either one.

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