Patient Talk

Posted on Patient Talk

Eating high-processed foods impacts muscle quality

Axial T1-weighted bilateral thigh MR images

Caption

CreditRadiological Society of North Aurora (RSNA) and Zehra Akkaya, M.D.

A diet high in ultra-processed foods is associated with higher amounts of fat stored inside thigh muscles, regardless of the amount of calories consumed or level of physical activity, . Higher intramuscular fat in the thigh could also increase the risk for knee osteoarthritis.

The incorporation of natural and minimally processed ingredients in modern diets has declined, often being replaced by ingredients that are industrially processed, artificially flavoured, coloured, or chemically altered.

Foods such as breakfast cereals, margarine, spreads, packaged snacks, hot dogs, soft drinks, energy drinks, candies, desserts, frozen pizzas, ready-to-eat meals, and mass-produced packaged bread and buns are highly processed and contain synthesized ingredients.

These ultra-processed foods usually have longer shelf lives and are highly appealing. They are convenient and contain a combination of sugar, fat, salt, and carbohydrates that affect the brain’s reward system, making it hard to stop eating.

For the study, researchers assessed the association between ultra-processed food intake and intramuscular fat in the thigh.

“The novelty of this study is that it investigates the impact of diet quality, specifically the role of ultra-processed foods concerning intramuscular fat in the thigh muscles assessed by MRI,” said author Zehra Akkaya, M.D., researcher and former Fulbright Scholar in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. “This is the first imaging study looking into the relationship between MRI-based skeletal muscle quality and diet quality.”

For the study, researchers analyzed data from 666 individuals who participated in the Osteoarthritis Initiative but were not yet affected by osteoarthritis based on imaging. The Osteoarthritis Initiative is a nationwide research study sponsored by the National Institutes of Health that helps researchers better understand how to prevent and treat knee osteoarthritis.

“Research from our group and others has previously shown that quantitative and functional decline in thigh muscles is potentially associated with onset and progression of knee osteoarthritis,” Dr. Akkaya said. “On MRI images, this decline can be seen as fatty degeneration of the muscle, where streaks of fat replace muscle fibres.”

The average age of the 666 individuals (455 men, 211 women) was 60. On average, participants were overweight, with a body mass index (BMI) of 27. Approximately 40% of the foods they ate in the past year were ultra-processed.  

The researchers found that the more ultra-processed foods people consumed, the more intramuscular fat they had in their thigh muscles, regardless of energy (caloric) intake.

“In an adult population at risk for but without knee or hip osteoarthritis, consuming ultra-processed foods is linked to increased fat within the thigh muscles,” Dr Akkaya said. “These findings held regardless of dietary energy content, BMI, sociodemographic factors or physical activity levels.”

Dr. Akkaya noted that targeting modifiable lifestyle factors—mainly preventing obesity via a healthy, balanced diet and adequate exercise—has been the mainstay of initial management for knee osteoarthritis.

“Osteoarthritis is an increasingly prevalent and costly global health issue. It is the largest contributor to non-cancer related health care costs in the U.S. and around the world,” Dr. Akkaya said. “Since this condition is highly linked to obesity and unhealthy lifestyle choices, there are potential avenues for lifestyle modification and disease management.”

Posted on Patient Talk

Can podcasts create healthier habits?

Whether it’s ABC Listen’s Health Report or Mamamia’s But Are You Happy, podcasts have fast become a part of our everyday media consumption. In fact, the average person spends more than five hours a week listening to them. But could listening to podcasts lead to healthier habits?
Whether it’s ABC Listen’s Health Report or Mamamia’s But Are You Happy, podcasts have quickly become part of our everyday media consumption. The average person spends more than five hours a week listening to them. But could listening to podcasts lead to healthier habits?

In a groundbreaking study, researchers at the University of South Australia have discovered that podcasts can significantly enhance health knowledge, increase exercise frequency, and promote healthier eating habits.

After reviewing the results of 38 studies, researchers found that people’s engagement with health-related podcasts was generally high. This suggests that podcasts could serve as an effective medium for delivering health information and promoting behaviour change interventions.

Nielsen data indicates that podcast popularity has risen by 16% since last year, solidifying this on-demand media in the daily lives of 9.6 million Australians.

UniSA researcher Beth Robins says the findings highlight the potential of podcasts promoting positive health behaviours.

“Health and wellbeing podcasts have the unique ability to convey a wide range of health topics to a variety of listeners, but in a very accessible way,” Robins says.

“Not only are podcasts typically chatty and conversational – which makes them easy to listen to and understand – but they’re also available at the touch of a button, so they’re extremely convenient, portable, and can be listened to at any time of the day.”

The study found that the most common motivations for listening to a health podcast was to gain information, better understand mental health issues, and to seek entertainment.

UniSA researcher Dr Ben Singh says the high engagement with health podcasts presents an advantage over other health interventions for sharing important public health messages.

“Our study is the first to review the evidence about health podcasts for the general population,” Dr Singh says.

“From this study, we know that podcasts are highly valued for their authenticity and reliability and their impactful, experience-focussed, and narrative-driven content.

“They’re also valued for their ability to be consumed at the user’s pace and in a setting that suits them – whether that’s while relaxing at home or walking the dog – and this aligns with increasing consumer demand for health resources that are both informative and adaptable to individual lifestyles.

“While more research is warranted, podcasts are clearly a highly engaging, well-received resource that can positively impact health behaviours and outcomes. It’s certainly a watch this space.”

5 Comments Posted on Autism, Patient Talk

Autism and Unconscious vandalism. Please can you help my wife and I with some advice please?




Our son who has autism

Our son, who has autism

I’m not 100% sure how to explain exactly what my problem is. Perhaps the best way is to tell the story of yesterday’s incident and ask for your advice on how we can help our son (and ourselves) find a solution. I’ve included this as part of our ongoing series on autism and challenging behaviour.




As you may or may not know, we have a seven-year-old son (called John) who is on the autistic spectrum. As we know, people with autism show a wide variety of behaviours, and pretty much none show the same exact pattern. That being said, many readers may have had similar experiences and will be able to suggest some ways my wife and I can work with John to try and end what I have called in the title of this blog post “unconscious vandalism”.

One of the things our son likes to do is spend time alone watching videos on YouTube. He mainly likes to watch science programs and similar programs. However, in the last week, he has started to take an interest in voting systems, but that is another matter.

Over the last few weeks, he has taken to blocking the door to the room where we keep the computer with a chair. I can understand that, like a lot of people with autism, he likes to be on his own. That being said, it seems now not to be the only reason.




Yesterday I came into the computer room in to get him to go to the kitchen for his supper and discovered what he had been up to. In the brief time since we had last looked in on him he has used a chair to climb up to the top of the bookshelves. He then took down a set of Russian dolls of which I was and am very fond and, well, smashed them up. Interestingly he did not bother to hide the evidence but just left the detritus of his actions on the floor.

I have no idea why he did so, and on asking him, it seems that neither does he. Hence, I describe his actions as unconscious vandalism. I don’t think that he is taking revenge on us, but again, he does know it is wrong. He could certainly see that I was upset when I saw the results of his afternoon.

By the way the incident can only have taken about 10 minutes since the last time we looked in on him.

So what to do? I have to say I’m clueless.

Thus, I’m turning this over to you. What can my wife and I do to wean John off these behaviours? Have you experienced anything similar in your life?

We would appreciate it if you could use the comments section below to share your stories and any advice you may have for us.

Thanks very much in advance.

MANDY1967 Repetitive behaviour, anxiety, boredom, attention seeking, communication/ processing information confusion and destructive behaviour, self soothing/ stimulating behaviours are hard to work out the difference. If you haven’t observed the slightly different indicators It will make your work extra hard.
Write down little differences.
As you say it can look unconscious, but if your child is shrugging and saying I don’t know or I don’t remember or I didn’t do it.
Then giving them an emotional vocabulary is top priority.
seems extreme but so is the behaviour….Set up a camera that can’t be seen So you can observe the indicators if he is being secretive about the behaviour.
Often secretive can be an indicator of feeling guilty about the negative behaviour but not feeling safe to ask or not knowing that they need to ask for help if perfectionism is an issue…. “how can I fix my behaviour?”
Instead of saying no, no, no you can try diversion with explanation…… e.g. I think you are feeling tired, how about getting your blanket. (choose a blanket.that has threads similar to the destroyed material.)
Think creatively.
The destroyed babushka dolls. How do they fit together, maybe it was a sequencing issue. He was unable to get them to work. Frustration that they won’t work. Using too much force (this cause affect regulation gets worse as they get stronger…..how much force is needed to unscrew a lid, retighten a lid?…..how much force Is needed to make something fit without breaking it?)
Did he have a dream about them or see some on the internet? Ask questions.
Try to work on one issue at a time, isolate it from ALL the other behaviour. This appears to be the only way to see effective change.
Weariness of repeating ourselves is a vital change we need to work on in ourselves.
Repetition of simple explanations are imperative.
Explain it different ways. Ask him to repeat what you say.
For example “I’m feeling tired, Ill go get my blanket.
or he might say “I’m not tired.” Make him accountable.
Tease out an answer.
“What are you feeling then? Give him options….sad? Why?
Are you struggling with your visit to Nan’s the other day? What happened?”)
Accountability is often the perfect logical consequence. This way a lesson is learned until the behaviour becomes less and less.
A communication/ processing issue is not impossible. Just allow for processing time. You could say
Ill come.back in 10 minutes or it might work better if you just sit quietly.
Don’t get impatient. The more patient you are, the quicker your answer will be.
Know what you have struggles with yourself. Teach yourself.
Be accountable yourself to be able to support your son. Are you angry, disappointed etc. Tell your son, explain your feelings.”this is how I act when I’m disappointed. My mummy gave me the dolls and they were special. I could have shown you how to fit them together.”
We can’t really have private things with our little ones. But as they get older, it gets easier.
E.g.
The rules have to be the same for everyone though.
I have a special drawer. This drawer is inspected by each of my sons. Then it was closed and left alone to be mine.
Each son has a special box. Each boy respects that box.
With the oldest this was the hardest to teach.
The oldest shares EVERYTHING whether his or not.
Is it generosity?
Is it jealousy?
One emotion at a time. One behaviour at a time. Let the little things slip. You ll get to it later.
Don’t over stimulate.
Get him to analyse your moods.
This is all imperative learning.
Our job as parents is to teach our little ones emotional literacy.
Sensory self soothing is a vital part of a happy child.
Find what works for your child.
Ask “what is he getting out of this behaviour?”.
Attach a mood… use explanations.
Not just stopping at…why did you do that?
MamiAyo Have you tried a rewards system at all, my daughter is 4 1/2 and was diagnosed 1 month ago as being on the spectrum, however we were using the system before hand being assured by her previous Paed Specialist it was a behavioral issue, hence why she was diagnose at a late age…even with all the obvious symptoms and our detailed description of her unfamiliar behavior…..Delayed speech/sensory overload/public interaction..
Thankfully we are now in the care of another Specialist.
Sarah_Hills I am sorry to hear this, I also want to thank you for posting this. To know someone is going through the same things as you are takes a little bit of weight off the shoulders. The only thing that has helped with us is social stories, My little girl finds it hard to express her self and we find that’s when she starts to destroy things. So maybe do a story about him breaking something and how it makes you feel. I would also do a story of when I feel sad, Mad, Alone I can talk to mum or dad or hug a teddy. Doesn’t stop it completely but reduces and they start to understand what to do if you read them the social story every day.
ChantelleLeluda I feel for you , we too have the same issues , my partner and myself are into dragons and wizards , have always been , all our ornaments that we have left have ended up in a box put away for now , we don’t leave anything out that we don’t want our little man to damage , yes we do use the word no a frequently but have fond it does not work very well with our son , our modular lounge has been destroyed by our son , he will sit there and pull out the fine strands when we are busy cooking dinner , hanging out washing or even going to the toilet , we have holes on the lounge everywhere because of it , he has done the same with his mattress to his bed , he also like to pull out the fine threading on my bra’s and underwear , he has no respect for any of his toys or clothes as he will throw them around , smash and break them , we have tried everything to try stop him from doing all this , my son only just got diagnosed and is 4 so we finally have a speech pathologist and a occupation therapist assisting us but that is only over the past couple of weeks , we are yet to discuss with them how to stop this behaviour , once I find out more I will gladly post on here , hope what ever we do find out will assist 🙂
Bones235 i have absolutely no idea how to help… but i can say i have been there… DAILY…anything and everything i have cherished has been busted or ruined by my son.  he knows he has to hide or sneak to do it. but doesn’t understand that it’s wrong or hurtful.  he also breaks his own toys or those of his brothers. i love the little guy more than life and i want to create a world he can grow in.  it’s difficult.  i would love to know the answer.

Posted on Patient Talk

Standardized autism screening identified more children with high for autism diagnosis

Childhood disintegrative disorder

Recent research conducted by Drexel University’s A.J. Drexel Autism Institute has shown that implementing standardized autism screening during pediatric well-child visits allows for the identification of more children with a high likelihood of autism at an earlier age, including those who exhibit more subtle symptoms. This study is the first large-scale, randomized trial to evaluate the effectiveness of standardized autism screening in enhancing early detection of autism within pediatric primary care settings.

Usual care is generally a combination of non-standardized or low-fidelity screening (meaning that clinicians did not use the screening tool as intended) and clinical judgment to determine whether to refer a child for diagnostic evaluation and early intervention.

In the study, 31 pediatric practices across three sites near Philadelphia, Pennsylvania; Storrs, Connecticut; and Sacramento, California, were randomly assigned to an experimental condition involving training and supervision in the universal, standardized, high-fidelity use of M-CHAT-R/F or to usual care.

Pediatric practices in both groups referred toddlers who showed signs of autism during 18-month well-child visits to the research team for a diagnostic evaluation.

“We found that the practices randomly assigned to standardized screening — meaning the screener was administered and scored the same way for every child — identified children with a high likelihood of autism more frequently and more timely compared to practices in the usual care group,” said Giacomo Vivanti, PhD, an associate professor in the Autism Institute and lead author of the study. “This resulted in 186 children referred to a diagnostic evaluation — and their average age was 20.6 months, compared to 39 children with an average age of 23.6 months referred by practices in the usual care group.”

The research team found that most of the children who attended the evaluation in both conditions received a diagnosis of autism. Children referred by practices that used standardized autism screening had a wider range of clinical presentations, including milder manifestations in areas like language and cognition, compared to those referred from usual care practices – indicating that using the screening may counteract the tendency to refer only children with more apparent impairments.

The study results indicate that routine, standardized screening for all children at toddler well visits, coupled with immediate referrals for diagnosis for those showing the likelihood of autism during the screening, is superior to relying on non-standardized use of screeners or clinicians’ judgment for identifying children with autism.

“The earlier identification of autism allows for autism-specific early intervention at a younger age, which improves outcomes across the rest of their lives,” said Diana Robins, PhD, the director of the Autism Institute and creator of the M-CHAT-R/F, who was the principal investigator in the study.

The research team envisions that policies and guidelines align to support routine, standardized autism screening for all children at toddler well visits.

“Although the American Academy of Pediatrics has been recommending universal, standardized autism screening at 18- and 24-month well-child visits for nearly 20 years, it is clear that community implementation lags behind best practices,” said Vivanti and Robins.

They added that they hope these findings will emphasize the need to administer, score, and follow screeners’ recommended actions according to their instructions rather than using screeners in non-standardized ways or relying on clinical judgment to determine whether or not to refer toddlers for autism evaluations and early intervention, effectively overriding when a screener indicates that referrals are needed.

Posted on Multiple Sclerosis, Patient Talk

Multiple Sclerosis and Frozen Shoulder: Is there a Connection?

**Shoulder Pain with Multiple Sclerosis and Possible Relationship with Frozen Shoulder**In this video, I share my MRI scan results, the doctors’ opinions on the outcomes, and the next steps for treatment. This past week has been incredibly challenging due to chronic pain, making everyday tasks nearly impossible because of the loss of mobility in my arm. Unfortunately, this issue is also starting to develop in my right shoulder. I urgently need treatment to prevent the progression I’ve experienced in my left shoulder. I’ve researched the connections between frozen shoulder and autoimmune diseases, and there appears to be a link. I’m also curious about the potential relationships between shoulder pain and COVID-19 or the COVID vaccinations. Please don’t ignore your shoulder pain; seek professional help before it develops into something more severe and disabling.