The COVID-19 pandemic may be over, but our immune systems are still feeling the impact. After years of battling constant viral threats, from COVID-19 to seasonal flu and other infections, our body’s defense system is exhausted. Many people continue to experience lingering inflammation, frequent illnesses, and slower recovery times. This extended state of immune stress has compromised us further to chronic illness, including autoimmune diseases and even neurodegenerative diseases such as Parkinson's. So why is our immune system still in trouble? And how do we give it its power back? Understanding immune exhaustion is the beginning of rebuilding our body's natural immunity.
A weakened immune system makes people more susceptible to disease, mental illnesses, and even sleep disorders. Now, new research indicates that immune system depletion may play an important role in the onset of Parkinson's disease, a degenerative neurologic disorder that compromises movement and cognition.
Dysfunctional immune response is a leading cause of long-standing inflammation within the body, that has been found to contribute towards a multitude of conditions, including cardiovascular conditions, diabetes, depression, and neurodegenerative diseases such as Alzheimer's.
As people age, their immune system naturally becomes less effective. This deterioration, referred to as immune exhaustion, may be a key contributor to the onset and progression of Parkinson’s disease. Rebecca Wallings, a Parkinson’s Foundation Launch Award grant recipient and senior postdoctoral fellow at the University of Florida, believes that an accumulation of exhausted immune cells could be driving neurodegeneration in Parkinson’s patients.
Parkinson's disease is most commonly linked with the degeneration and loss of dopaminergic neurons—motor nerve cells that produce dopamine, an essential neurotransmitter for movement. While researchers have long suspected inflammation is involved in this neurodegeneration, the mechanisms are not yet well understood.
Wallings' study is on immune cell exhaustion, a process by which aging immune cells fail to control immune responses effectively. Her research indicates that instead of dampening inflammation in Parkinson's patients, attempts should be made to rejuvenate the immune system to regain its functionality.
One of the major findings of Wallings' work is the function of mitochondrial impairment in immune cell exhaustion. Mitochondria are commonly called the powerhouses of cells, as they are vital for generating energy. As mitochondria age and become inefficient, immune cells fail to function well, potentially accelerating neurodegeneration in Parkinson's disease.
Wallings has found that mutations in the LRRK2 gene, a recognized genetic risk factor for Parkinson's disease, are linked with defective mitochondrial function and immune cell exhaustion. Her current work includes testing various therapeutic approaches to restore mitochondrial function in immune cells with the potential to enhance the immune system and potentially prevent or treat Parkinson's disease.
For decades, the standard practice in treating Parkinson's has been to suppress brain inflammation. Yet Wallings' work indicates that instead of slowing down immune responses, restoring the immune system could be a more successful strategy. By addressing mitochondrial impairment and immune resilience, researchers can potentially reverse or slow down Parkinson's disease.
Wallings is now looking into how to rejuvenate immune cells by fixing mitochondria. She studies immune cells from patients with Parkinson's as well as from healthy subjects and performs experiments on animal models to determine if rejuvenation of the immune system could result in improved disease outcomes.
While there is no cure for Parkinson's disease, some lifestyle adjustments may decrease the chances of developing the illness. Since neurodegenerative diseases are associated with chronic inflammation and immune dysfunction, developing habits that enhance immune function might prove helpful.
Diet: There is evidence to suggest that eating in accordance with the Mediterranean or MIND diets, both high in antioxidants, healthy fats, and anti-inflammatory foods, can encourage brain wellness and reduce Parkinson's risk.
Avoiding Dangerous Substances: Restricting alcohol and nicotine use can maintain a robust immune system and suppress inflammation.
Reducing Stress: Chronic stress weakens immune function, so methods such as meditation, exercise, and sufficient sleep can lead to improved overall well-being.
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The menstrual cycle is more than a monthly reproductive event. It is a complex physiological process involving fluctuations in hormones such as oestrogen and progesterone, which can influence appetite, energy balance, mood and digestion, raising the question: does a woman need to eat differently during different phases of her menstrual cycle?
Current research suggests that nutritional needs do not dramatically change from one week of the cycle to another for most healthy women. However, appetite, food intake and certain symptoms can change across the cycle. Understanding these changes can help women make practical dietary choices without turning nutrition into a complicated four-phase diet.
The menstrual cycle can broadly be divided into the menstrual, follicular, ovulatory and luteal phases.
During menstruation, oestrogen and progesterone levels are relatively low, and the uterine lining is shed. The follicular phase begins with menstruation and continues until ovulation. Oestrogen generally rises during this period and reaches a peak around ovulation.
After ovulation, the body enters the luteal phase. Progesterone rises, along with another increase in oestrogen, before both hormones decline if pregnancy does not occur. These hormonal changes can influence appetite and food preferences.
Research has found that energy intake tends to be somewhat higher during the luteal phase than during the follicular phase.
Some studies suggest that resting metabolic rate may increase slightly during the luteal phase, although the estimated change is relatively small and varies between individuals and studies.
This is important because it means that feeling hungrier before a period is not necessarily a failure of willpower. It may partly reflect normal biological changes.
The goal should not be to follow a completely different diet every week. Instead, nutrition should provide the body with adequate energy, protein, fibre, vitamins, minerals and fluids throughout the entire cycle.
For women who experience premenstrual syndrome (PMS), dietary habits may be particularly relevant. PMS can include bloating, breast tenderness, headaches, fatigue, appetite changes, food cravings and mood changes.
Calcium is one nutrient that has attracted considerable attention. The American College of Obstetricians and Gynecologists recommends including calcium-rich foods such as yoghurt and leafy green vegetables as part of dietary strategies for PMS.
Iron is another important consideration, particularly for women with heavy menstrual bleeding. The recommended dietary allowance for iron is 18 mg per day for women aged 19–50 years. Good sources include lentils, beans, spinach, meat, poultry, seafood, fortified cereals and nuts. Vitamin C-rich foods can improve absorption of plant-based non-haem iron.
1. During menstruation: focus on iron, protein and hydration
If menstrual bleeding is moderate to heavy, prioritising iron-containing foods is sensible.
Include:
· Lentils, rajma, chickpeas and soy
· Green leafy vegetables
· Eggs, poultry or lean meat
· Sesame and pumpkin seeds
· Iron-fortified cereals
· Vitamin C-rich fruits such as oranges, guava, amla and kiwi
Pairing plant-based iron sources with vitamin C can improve iron absorption.
Adequate fluid intake can help maintain hydration, particularly if you experience symptoms such as bloating or headaches.
2. During the follicular phase: maintain a balanced eating pattern
There is no need for a special “follicular-phase diet”. This can be a good time to establish consistent meals containing whole grains, vegetables, fruits, pulses, dairy or alternatives, nuts and seeds.
Protein should be distributed throughout the day rather than concentrated in one meal.
For example, breakfast could include eggs or paneer with whole-grain toast; lunch could contain dal, vegetables and roti; and dinner could include tofu, paneer, fish or another protein source.
3. Around ovulation: focus on overall dietary quality
Focus on a diet rich in colourful vegetables and fruits, whole grains, legumes, nuts, seeds and adequate protein. These foods provide fibre and a broad range of micronutrients and plant compounds.
4. During the luteal phase: plan for appetite and cravings
This is perhaps where nutrition can be adapted most practically.
Since appetite may increase during the luteal phase, trying to rigidly maintain the same food intake every day may backfire for some women. A better approach is to choose satisfying foods.
Combine protein + fibre + healthy fats in meals and snacks. For example:
ACOG also recommends complex carbohydrate-rich foods and reducing excessive intake of salt, sugar and high-fat foods when managing PMS symptoms.
Keep a symptom and food diary. Tracking your cycle for two or three months can help identify personal patterns in appetite, cravings, bloating, bowel habits, headaches and mood.
Do not compensate for increased appetite through extreme dietary restriction. A modest increase in hunger during the luteal phase can be a normal physiological response.
Build meals around protein and fibre. These can improve satiety and help make meals more filling.
Stay consistent with calcium-rich foods. Milk, yoghurt, paneer, ragi, sesame and calcium-fortified alternatives can contribute to calcium intake.
Be cautious with supplements. More is not necessarily better. Evidence for nutrients such as magnesium and vitamin B6 in PMS is mixed, and supplementation should be individualised. High-dose vitamin B6 taken for prolonged periods can cause neurological problems.
Myth: Every woman needs a different diet for each menstrual phase.
Fact: There is currently no strong evidence that healthy women require four completely different diets. A nutrient-dense dietary pattern should remain the foundation throughout the cycle.
Myth: Eating certain seeds during each phase can balance hormones.
Fact: Seeds such as flax, sesame, pumpkin and sunflower seeds are nutritious foods, but there is insufficient clinical evidence that consuming particular seeds at specific cycle phases “balances” reproductive hormones.
Myth: Weight gain before a period always means fat gain.
Fact: Changes in body weight around menstruation can reflect fluid retention, gastrointestinal changes and altered food intake. These changes should not automatically be interpreted as an increase in body fat.
Myth: Increased premenstrual hunger means a lack of self-control.
Fact: Research indicates that energy intake can increase during the luteal phase. Individual responses vary, but increased appetite can have a physiological component.
Myth: Supplements are necessary to manage PMS.
Fact: Some nutrients, particularly calcium, have evidence supporting a role in symptom management, but dietary supplements are not automatically necessary for everyone. ACOG recommends discussing PMS products and supplements with a healthcare professional because some products have limited evidence or may interact with medications.
So, does the body need different foods at different times of the menstrual cycle? Not in the way social media often suggests.
The evidence does indicate that hormonal fluctuations can influence appetite, energy intake and possibly energy expenditure. For some women, these changes are noticeable, particularly during the luteal phase. Nutritional priorities such as iron, calcium, protein, fibre, hydration and overall dietary quality remain important throughout the month.
The most useful approach is therefore not strict “cycle syncing”, but cycle-aware nutrition: understand your own symptoms, respond to changes in hunger, maintain adequate nutrient intake and avoid unnecessary dietary restrictions.
Nutrition should work with the menstrual cycle, not become another source of stress.
(By Neha Kanodia, Senior Executive Nutritionist, Cloudnine Hospital,Faridabad)
Credit: AI
The biological age of ovaries may be influenced by the environment surrounding the organs, rather than being an entirely irreversible process. A new experiment done on mice found that older ovaries became biologically younger after being transplanted into younger animals, restoring and extending their ability to support pregnancy.
The research, led by scientists at Harvard Medical School, body's environment may influence how quickly the ovaries age. The findings could help researchers investigate treatments aimed at preserving ovarian function and fertility for longer in women.
The researchers transplanted ovaries from 13-month-old mice into younger mice that were four months old. The older donor mice had crossed their reproductive age.
Four to five months after transplantation, the younger recipients gave birth to healthy offspring, even though the transplanted ovaries were 17 to 18 months of age.
The same effect was not observed when older ovaries were transplanted into older recipients. This suggested that the recipient's biological environment, rather than the age of the ovaries alone, affected their reproductive function.
The team also performed the reverse experiment. When young ovaries were transplanted into older mice, the ovaries showed signs of accelerated ageing.
The researchers developed an ovarian ageing clock called OvaAge to observe the changes. The clock uses patterns of gene activity to ascertain an ovary's molecular age.
The results showed that the molecular age of older ovaries dropped when they were placed in younger animals. Conversely, young ovaries in older recipients aged faster.
The researchers also observed that older ovaries in younger hosts showed reduced inflammatory activity, while young ovaries in older hosts showed increased inflammation.
The study also explored whether the ovaries affect ageing elsewhere in the body. When young ovaries were transplanted into older mice, researchers observed that the molecular ages of the brain, liver and uterus also dropped. The findings suggest that the ovaries may also influence other organs through hormones or other signals.
The researchers also identified changes in gene activity and cellular processes linked to inflammation, metabolism and tissue maintenance. Understanding these signals could help scientists investigate whether some effects of ovarian ageing can be targeted without an organ transplant.
Ovarian ageing refers to a decline in both the number and quality of eggs. This reduces women's fertility as they grow older. The ovaries also produce hormones, including oestrogen, that affect overall health.
The new findings spark the possibility that the environment surrounding the ovaries could be a target for future treatments to preserve ovarian function.
If researchers can identify the signals that allowed older ovaries to function in younger mice, they may eventually be able to investigate ways to reproduce those effects without transplantation. But substantial research is still needed to move ahead.
The study was based mice, and ovarian biology, reproductive ageing and fertility outcomes differ significantly between mice and humans.
Credit: iStock
Stroke is a medical emergency, but in some patients, it may also be the first sign of an undiagnosed cancer, said top Neurologist Dr. Vinit Suri on World Stroke Day.
In an exclusive interview with HealthandMe for World Stroke Day, Dr. Suri, Senior Consultant Neurologist and Academic Coordinator at Indraprastha Apollo Hospital, New Delhi, explains the link between cancer and stroke, the warning signs that need urgent attention, and how patients can reduce their risk.
He noted that cancer and its treatment can also increase stroke risk, while a stroke may sometimes prompt doctors to investigate an underlying malignancy.
The noted expert also highlighted warning signs which may point to an underlying malignancy, and how cancer patients can reduce their risk and manage recovery.
Dr Suri said cancer and stroke can overlap in three ways: cancer patients may have conventional risk factors such as hypertension and diabetes; cancer itself can increase blood clotting; and certain treatments can raise stroke risk.
“Cancer patients have double the risk of having a stroke compared to their age-matched individuals,” Dr Suri said.
He estimated that 10% to 15% of stroke patients may have cancer or cancer treatment as the underlying cause. Sometimes, a stroke is the first sign of an undiagnosed malignancy, known as a sentinel stroke. Thus, identifying the cause is important to prevent recurrent strokes.
Dr. Suri said doctors should consider investigating an underlying malignancy in patients with:
Investigations may include D-dimer testing, tumor markers such as prostate-specific antigen (PSA), other cancer biomarkers and whole-body PET-CT, said the noted neurologist.
A stroke may reveal cancer even without obvious cancer-related symptoms. Emergency stroke treatment must take priority, followed by investigations to identify the cause and prevent recurrence, he added.
Read More: World Stroke Day: What Is BE FAST? Stroke Warning Signs To Watch For
Dr Suri said sudden neurological symptoms in cancer patients require urgent assessment because stroke and brain metastases can present similarly. Brain metastases may also cause seizures and one-sided weakness.
He recommended BE FAST to recognize possible stroke symptoms:
Anyone experiencing these symptoms should seek emergency care, the expert said.
“Time is brain,” he said. Clot-dissolving drugs may be given within four and a half hours in eligible patients, while clot-removal procedures may be possible within six to 24 hours, depending on the patient.
CT scans may be sufficient in many cases, but MRI may help distinguish a stroke from brain metastases.
Dr Suri said that some chemotherapy drugs and hormonal therapies for breast and prostate cancers can increase blood clotting.
Radiation to the neck may cause narrowing, scarring and fibrosis in the carotid arteries, potentially contributing to strokes years later.
READ: 1 in 7 Stroke Patients In India Are Under 45; Hypertension Leads Risk Factors: ICMR Study
Dr Suri advised people to control blood pressure, diabetes, abnormal cholesterol and obesity through physical activity and by avoiding a sedentary lifestyle.
Age, male sex and family history are the non-modifiable risks, while other risk factors include heart disease, smoking, alcohol use, chewing tobacco and drug abuse, which can contribute to strokes even in young people.
Dr Suri described hypertension as the most important modifiable risk factor and a major cause of ischemic and hemorrhagic strokes. He recommended regular blood pressure checks, reducing salt intake, walking and taking prescribed medication. He also stressed diabetes management and identifying atrial fibrillation, which can cause strokes affecting multiple brain blood vessel territories in older adults.
Oncologists should consider stroke risk when choosing treatments, particularly for patients with pancreatic or lung cancer and other adenocarcinomas associated with increased clotting risk, he said.
Treatment may involve addressing the underlying cancer through chemotherapy or surgery and preventing further clots. Warfarin may not work in some cases, and doctors may consider direct oral anticoagulants (DOACs) or low-molecular-weight heparin.
Dr Suri said having both conditions can worsen prognosis because stroke can cause death or long-term disability, while cancer may reduce life expectancy.
“When these two double whammies are happening together, the outlook becomes much, much graver,” he said, adding neurologists and oncologists must work together to adjust treatment.
“Both of them have to be involved together as a team to plan and modify both the cancer therapy as well as the stroke therapy,” he said.
Some medicines that increase stroke risk may need to be withdrawn. Blood thinners must be selected with the oncologist because certain chemotherapy drugs can rapidly lower platelet and white blood cell counts.
Cancer does not automatically prevent stroke rehabilitation, Suri said, although severe weakness or frailty may limit participation.
“Cancer is not likely to interfere with the rehabilitative processes unless and until it has made the patient very weak and frail,” he said.
Yes, Dr Suri said. Both can occur at any age, although their causes and cancer types may differ across age groups.
“Stroke can occur even in very young children,” he said, noting that infants may have strokes due to arteriopathies and other conditions. Both conditions become more common with age, but neither has a lower age limit.
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