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Anxiety is seen as an obstacle to success. It is a thought that always lingers in your mind before you start to do something. If you are doing something new or trying to do something that you have already done it in your life and have bad memories with. This thought creeps in. This thought that sometimes sends chills down your spine, makes you shiver, or that makes you feel like you cannot breathe, as if someone has put a huge rock on your heart is what defines anxiety. However, emerging research suggests that it can in fact, serve as a valuable tool for focus, motivation and problem solving. Studies on performance and stress, including the widely known Yerkes-Dodson curve, indicate that moderate levels of anxiety can enhance productivity, while both excessive and insufficient anxiety can hinder it.
The Yerkes-Dodson curve demonstrates that when anxiety is too high, it can become paralyzing, preventing individuals from taking action. On the other hand, very low anxiety can lead to complacency, reducing motivation and attention to detail. The ideal state falls somewhere in the middle, where anxiety signals importance, sharpens focus, and encourages preparation.
This perspective challenges the common belief that anxiety should always be suppressed. Instead, researchers argue that learning to harness anxiety can be beneficial. Studies have shown that people experiencing moderate anxiety often generate more creative solutions to problems compared to those who remain entirely calm.
Anxiety can serve as a sort of increased awareness, motivating people to take action in critical situations. Medical decision-making research show that concerned people are more likely to follow up on health issues, stick to treatment plans, and aggressively seek medical help. For example, studies on heart transplant patients show that people with moderate levels of anxiety are more likely to seek adequate care, which leads to improved survival rates.
The same strategy is used to address everyday difficulties. Anxiety tells the brain that something is important and requires effort. Anxiety can encourage you to be prepared and attentive, whether you're preparing for a presentation, making a critical life decision, or dealing with an uncertain situation.
Despite its potential benefits, anxiety can become debilitating when it causes what researchers term “functional impairment.” This occurs when excessive worry prevents individuals from fulfilling their daily responsibilities, whether in work, relationships, or personal well-being.
One method for distinguishing between helpful and harmful anxiety is cognitive reframing—shifting the perspective on stressors. Studies suggest that those who reframe anxiety as a performance-enhancing tool rather than a hindrance experience less distress and greater effectiveness in high-pressure situations. By viewing anxiety as a source of energy rather than a threat, individuals can improve their ability to navigate challenges.
Research on stress resilience indicates that experiencing a moderate amount of adversity in life can lead to stronger coping skills. Longitudinal studies on both humans and animals suggest that those who have faced and overcome moderate difficulties—such as personal loss or professional setbacks—tend to develop greater mental fortitude.
One study found that individuals who had endured a small number of adverse events exhibited better overall mental health than those who had either faced extreme hardship or had led relatively stress-free lives. This pattern aligns with the concept of "stress inoculation," where manageable levels of stress act as a form of psychological training, making individuals more resilient to future challenges.
Rather than attempting to eliminate anxiety, researchers suggest acknowledging it as a natural response that can be channeled productively. Psychological studies indicate that when people view their physiological responses—such as increased heart rate and adrenaline surges—as performance enhancers, their actual outcomes improve.
For instance, in high-stakes situations like public speaking or athletic competitions, individuals who interpret nervousness as a sign of readiness rather than fear tend to perform better. Physiologically, the body's response to excitement and fear is similar; the key difference lies in perception.
Research suggests that those who embrace a mindset of "anxiety as fuel" experience improved cognitive and physical performance. This approach aligns with studies showing that moderate stress prompts the release of hormones that enhance alertness and problem-solving ability, whereas overwhelming stress triggers a flood of cortisol, which can impair decision-making.
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The liver and heart are two of the most vital organs of the body, and although they perform very different functions, they are closely connected. When the liver is not functioning properly, it can place significant stress on the heart and circulatory system of the body.
Liver disease not only affects the digestion process, metabolism, and detoxification but can also trigger serious cardiovascular changes that may go unnoticed in the early stages. Understanding this particular connection is significant for timely diagnosis and better overall care.
The liver helps to regulate the flow of blood, fluid balance, cholesterol metabolism, and inflammation as well. When liver disease develops—whether due to fatty liver, hepatitis, cirrhosis, or alcohol-related damage—all these processes become disturbed.
As a result of the same, the heart may have to work harder to maintain circulation, while blood vessels may also undergo certain changes that impact blood pressure and delivery of oxygen as well.
In well-advanced liver disease, especially cirrhosis, the flow of blood through the liver becomes restricted. This can also increase pressure in the portal vein, a condition known as portal hypertension. At the same point in time, blood vessels in the rest of the body may also widen, causing a drop in effective blood pressure.
To compensate, the heart pumps faster and harder. With the passage of time, this constant strain can weaken cardiac function and even lead to a condition sometimes referred to as cirrhotic cardiomyopathy, where the heart does not respond normally under stress.
Liver disease often causes the body to retain both salt and water. This can also lead to swelling in the legs, abdomen, and surrounding tissues as well. Extra fluid in the body increases the workload on the heart, making it more difficult for it to pump blood in an efficient way. In severe cases, this may also contribute to shortness of breath, fatigue, and worsening cardiovascular strain.
Some of the conditions, such as non-alcoholic fatty liver disease, are also linked with diabetes, obesity, high levels of cholesterol, and high blood pressure – all of which are the major risk factors for heart disease. Chronic inflammation, well-associated with liver damage, may further increase the risk of atherosclerosis and other cardiac complications.
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GLP-1 receptor agonist drugs such as Ozempic and Wegovy have shown significant benefits for people with diabetes and obesity. However, not everyone experiences the same results.
Now, a study suggests that this variation may be due to genetic resistance, which means that some people are biologically less responsive to these medications, making these drugs less effective.
The new study by scientists at Stanford University in the US showed that about 10 per cent of the general population carry genetic variants that lead to what the researchers called “GLP-1 resistance”.
The GLP-1- receptor agonist drugs typically work by mimicking the hormone GLP-1 (glucagon-like peptide-1), which naturally helps regulate blood sugar by stimulating insulin release. The process slows the emptying of the stomach and reduces appetite.
However, in individuals with certain genetic variants, the team found that higher levels of GLP-1 did not regulate blood sugar better.
The researchers noted that the findings, published in the journal Genome Medicine, may be key to developing new therapies for people with GLP-1 resistance.
“There are a whole class of medications that are insulin sensitizers, so perhaps we can develop medications that will allow people to be sensitized to GLP-1s or find formulations of GLP-1, like the longer-acting versions, that avoid the GLP-1 resistance,” said Anna Gloyn, professor of pediatrics and of genetics at Stanford Medicine.
Also read: Foundayo: US FDA Approves Eli Lilly’s GLP-1 Weight Loss Pill
To zero in on the gene resistant to GLP-1 drugs, the team conducted experiments in humans. They traced this resistance to a PAM variant known as p.S539W.
PAM (peptidyl-glycine alpha-amidating monooxygenase) is an enzyme that is uniquely capable of activating many hormones in the body, including GLP-1.
While the researchers suspected that people with the PAM variant would have lower levels of GLP-1 in their blood, it actually increased levels of GLP-1. Although the exact mechanism is still unclear, experiments in both humans and mice confirmed signs of reduced response to GLP-1.
Analyzing diabetes drug trial data, they found that individuals with these variants were less able to lower their blood sugar levels even after six months of treatment. This suggests that despite having more circulating GLP-1, their bodies are less responsive to it.
“When I treat patients in the diabetes clinic, I see a huge variation in response to these GLP-1-based medications and it is difficult to predict this response clinically,” said Mahesh Umapathysivam, an endocrinologist and clinical researcher at Adelaide University in Australia.
“This is the first step in being able to use someone’s genetic make-up to help us improve that decision-making process,” he added.
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Importantly, participants with the PAM variants did not respond differently to other common diabetes treatments, including sulfonylureas, metformin, and DPP-4i.
The finding may help develop precision medicine, the researchers said. Knowing ahead of time who is likely to respond would help patients get on the right drugs faster, Gloyn said.
Ozempic is primarily indicated for type 2 diabetes management. But some doctors may prescribe it for weight loss in appropriate patients without diabetes.
Previous research has shown that medical conditions such as sleep apnea, along with certain common medications, such as antidepressants, steroids, and contraceptives, can hamper the process of shedding extra pounds.
Another major reason that can hamper weight loss is the side-effects of these drugs that can prompt a person to halt their prescription mid-way.
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Once widely known as non-alcoholic fatty liver disease (NAFLD), the common and dangerous fatty liver condition was rephrased as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) due to its strong link to metabolic health issues like obesity and diabetes.
MASLD now includes patients with fatty liver disease linked to metabolic risk factors such as obesity, diabetes, and hypertension.
Globally, it was observed that all patients who have non-alcoholic fatty liver disease also have some associated form of metabolic dysfunction. The patients reported having either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.
And all these problems eventually lead to significant comorbidities later, like some people developed heart disease, while others developed complications of diabetes.
In view of these, a global consensus process in 2023 involving hundreds of experts from different countries adopted MASLD as it better reflected these underlying causes of the condition.
Also read: Lancet Study Shows Metabolic Liver Disease To Rise Over 38% By 2050: What’s Behind The Surge
MASLD is an umbrella term for liver conditions that develop in the presence of 1 or more cardiometabolic risk factors—including high blood sugar, elevated body mass index (BMI), and hypertension—but in the absence of other causes of liver fat accumulation.
The condition can be defined by excess liver fat accumulation (more than 5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake.
It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.
“Initially, it was thought that having fatty liver disease without alcohol was a benign condition, but now it is recognized that, since it is associated with lots of metabolic comorbidities, it's no longer benign,” Dr. Ashish Kumar, Professor of gastroenterology and hepatology at Sir Ganga Ram Hospital in New Delhi, told HealthandMe.
He stated that whenever a diagnosis of fatty liver is present, "we should actually include other comorbidities, like obesity, dyslipidemia, which means cholesterol problem, diabetes, sugar problem, pre-diabetes, and hypertension. At least 50–70–80 percent of these patients will have one or more of these comorbidities".
Although alcohol has remained the number one risk for liver disease, MASLD seems to be rising globally, including among people who do not drink. Why?
The reasons include:
a sedentary lifestyle,
increased consumption of fast and processed food,
lack of exercise,
lack of sleep,
stressful life.
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The experts noted that food, especially the increasingly accessible junk food or processed food, is a major culprit.
“So even if the person is not drinking alcohol, people are developing addiction to processed food, and this is causing an epidemic level of obesity and diabetes. Consequently, MASLD is also increasing, and now it is becoming the number one cause of liver disease,” Dr Kumar said.
According to Dr. Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, Gurugram, prevention must focus on following a healthy lifestyle like maintaining a healthy BMI, engaging in regular physical activity, and eating a balanced diet.
Controlling diabetes, cholesterol, and blood pressure is also important to prevent the risk of MASLD.
Dr Siddharth Badola, Manipal Hospital, Ghaziabad, suggested sustainable lifestyle changes such as:
Maintaining an adequate body weight: Even slight weight loss (5–10 percent) has been shown to significantly reduce liver fat and inflammation.
Follow a balanced and nutrient-rich diet: People should focus on consuming whole grains, fresh fruits and vegetables, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods.
Avoid foods with added sugar: Excess consumption of fructose, commonly found in packaged foods and sugary beverages, is a key contributor to fat accumulation in the liver.
Engage in regular physical activity: At least 150 minutes of moderate-intensity exercise per week is recommended to improve insulin sensitivity and liver health.
Manage associated metabolic conditions: Effective control of diabetes, hypertension, and dyslipidemia is essential in reducing the risk of MASLD progression.
Ensure adequate sleep and stress management: Poor sleep quality and chronic stress can negatively impact metabolic balance and liver function.
Keep your body hydrated with ample water intake and follow structured meal timings.
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