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But you don't necessarily need a lot of time or effort to experience meaningful joy, a recent study reported.
The study, which researchers dubbed the Big Joy Project, enrolled more than 17,000 people across 169 countries to receive one daily joy-boosting activity for a week via email.
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Medscape
4 hours ago
- Medscape
Alcohol and Pancreatic Cancer: New Evidence About Risk
Does drinking alcohol increase the risk for pancreatic cancer? Researchers have long suspected it does, but the evidence has remained inconsistent. Now, a global study of more than two million people is firming up the case that a link exists. The study, which pooled data from 30 prospective cohorts, found that daily alcohol intake was associated with a 'modest' increased risk for pancreatic cancer in both women and men, regardless of smoking status. However, the extent of the risk depended somewhat on how the researchers modeled alcohol intake. One model, which mapped continuous increases in alcohol consumption, suggested there is no safe dose of alcohol — any amount can increase the risk for pancreatic cancer, though only by 3% for every additional 10 g of alcohol per day or about two thirds of a standard drink. The other model, which compared risk by alcohol volume categories, found that the risk does not become significant until a certain alcohol threshold — about two to three drinks per day for men and one to two for women. Still, overall, 'our findings provide new evidence that pancreatic cancer may be another cancer type associated with alcohol consumption, a connection that has been underestimated until now,' the study's senior author Pietro Ferrari, PhD, head of the Nutrition and Metabolism Branch at International Agency for Research on Cancer, said in a statement. The co-author Jeanine Genkinger, PhD, MHS, had a stronger take on the findings. 'I think this shows that alcohol use is a robust risk factor for pancreatic cancer,' said Genkinger, associate professor, epidemiology, Columbia University Mailman School of Public Health, New York City, noting that even more moderate drinking levels— no more than one drink for women and two for men — might be enough to boost pancreatic cancer risk. How Much of a Risk? The latest data, published in PLoS Medicine, come at a time of increased attention to the alcohol-cancer link. Earlier this year, then-US Surgeon General Vivek Murthy, MD, issued an advisory calling for cancer warnings to be added to alcohol labels. Major cancer organizations have determined alcohol to be an established risk factor for seven cancer types : those of the oral cavity, larynx, pharynx, esophagus, liver, breast, and colon/rectum. Despite the strong suspicion that drinking alcohol also contributes to pancreatic cancer risk, this aggressive cancer has not yet made the official list. The major reason is that the evidence surrounding an alcohol-pancreatic cancer link has been deemed 'inconsistent,' 'suggestive,' and 'inconclusive' by expert panels. Studies have been hampered by difficulties separating alcohol use from smoking — a known risk factor for pancreatic cancer — as well as varying findings by alcohol type and geographic location. In addition, certain studies highlighting a link have indicated that any association between alcohol and pancreatic cancer is driven only by more extreme drinking habits — more than four drinks a day, and sometimes as high as nine drinks. The latest analysis, Genkinger said, helps clarify uncertainty surrounding the alcohol-pancreatic cancer link, which is especially important for 'a disease where we don't have that many modifiable risk factors.' The findings are based on cohorts spanning four continents, all part of the Pooling Project of Prospective Studies of Diet and Cancer. Just under 2.5 million cancer-free participants were recruited between 1980 and 2013 (median age, 57 years), of whom 70% were alcohol drinkers, 47% were never-smokers, and 64% were alcohol drinkers and never smokers. Most study participants were from North America (60%), followed by Europe or Australia (32%) and Asia (8%). Alcohol intake was modeled in two ways: continuously for every 10 g/d increase and by volume threshold, using 0.1 to < 5 g/d as the reference for nondrinkers. For context, in the US, the amount of alcohol in a standard drink is defined as 14 g of pure alcohol — equivalent to a 12-ounce can of regular beer, a 5-ounce glass of wine, or a 1.5-ounce shot glass of distilled spirits. Over a median of 16 years, the researchers observed 10,067 incidents of pancreatic cancers. In the continuous model, the risk for pancreatic cancer rose by 3% for every additional 10 g of alcohol consumed per day (hazard ratio [HR],1.03; 95% CI, 1.02-1.04). This association remained consistent and significant among women and men (HR, 1.03 for both), current smokers (HR, 1.03), former smokers (HR, 1.02), and never-smokers (HR, 1.03), and across cohorts from Australia, Europe, and North America (HR, 1.03 for all), though not Asia (HR, 1.00). The research team also found evidence that the type of alcohol mattered: Alcohol from beer and liquor/spirits was associated with a significantly increased risk for pancreatic cancer (HR, 1.02 and 1.04, respectively) but alcohol from wine was not (HR, 1.00). This finding is in line with some previous studies suggesting that wine may have a different relationship with cancer risk compared with other alcoholic beverages. But Genkinger pointed out, this finding could 'reflect the ways in which people tend to drink different types of alcohol.' Wine, she noted, is often part of a meal, and people who favor wine may be less likely to binge drink than those who typically choose other types of alcohol. This study, however, did not survey participants about specific drinking patterns, including binge-drinking. In the threshold model, however, the increased risk only became significant once alcohol intake reached a certain level. For women, drinking one to two standard drinks per day raised their risk for pancreatic cancer by 12% compared with little to no drinking. For men, the threshold was a little higher: Consuming two to four drinks a day was associated with a 15% increase in risk, whereas drinking more than that was tied to a 36% greater risk. Overall, this research contributes to the growing body of evidence that pancreatic cancer should be added to the official alcohol-cancer risk list, according to Alison Klein, PhD, MHS, professor of oncology, pathology, and epidemiology, at Johns Hopkins School of Medicine, Baltimore, who was not involved in the research. Having the Conversation The recent Surgeon General's advisory encouraged clinicians to inform their patients that drinking is a cancer risk factor — something unknown to most Americans, according to recent survey findings. 'I think this study is a good reminder to all of us to talk to our patients about their alcohol use,' said Edward Thomas Lewis III, MD, an addiction psychiatrist and clinical assistant professor at the Medical University of South Carolina, Charleston, South Carolina. Providers can take opportunities for those discussions during routine care, such as when prescribing a medication that can interact with alcohol or when a patient's health condition, such as high blood pressure or heart disease, can be exacerbated by drinking. 'I think these are opportunities to really remind people about moderation,' Lewis said, 'and to talk about some of the individual risk factors that may cause someone to make changes related to their drinking.' It's also possible that drinking might interact with certain genetic variants to modify pancreatic cancer risk — an avenue Klein and colleagues are exploring. What's challenging, Lewis said, is advising patients on what level of drinking is 'Okay,' given that even lower levels of alcohol consumption — around one to two drinks per day — may carry some risk. 'There is no zero-risk alcohol use,' Lewis said. But, he added, people do not necessarily have to abstain to see benefits, either. 'So it may be that a patient, at the end of the day, is able to reduce their alcohol consumption by two or three standard drinks over a given week. That still has a positive net effect,' he said. Another challenge is patients often don't know what a 'standard drink' looks like and can underestimate how much they drink. Showing patients visual examples — such as these— can be an eye-opener, Lewis said. Given the associations between drinking alcohol and many health outcomes, Genkinger said, it's important for clinicians to discuss alcohol use, just as they would discuss physical activity and healthy body weight. 'These are all lifestyle factors that have an impact on numerous disease outcomes, not only pancreatic cancer,' she said.
Medscape
5 hours ago
- Medscape
More Sit-to-Stand Transitions Benefit Postmenopausal Women
TOPLINE: Reducing sedentary behavior with interventions such as increasing daily sit-to-stand transitions might help lower blood pressure in postmenopausal women with overweight or obesity. METHODOLOGY: Researchers conducted a randomized controlled trial to assess how different strategies to reduce time spent sitting affected the physiologic responses of postmenopausal women who led sedentary lives. The researchers included 407 women in the postmenopausal phase (mean age, 68 years; 92% White) who had overweight or obesity (average BMI, 32), had a sitting time of at least 7 hours a day, and performed no more than 70 sit-to-stand transitions daily. The women were randomly assigned to one of three study arms: healthy living (n = 135), sit less (n = 136), and increased sit-to-stand transitions (n = 136). All arms received seven sessions of individual health coaching over 12 weeks. Researchers assessed blood pressure and markers of glucose regulation using fasting blood samples. Readings from thigh- and hip-worn accelerometers for 7 days were used to evaluate posture, sedentary behavior, and physical activity. Primary outcomes were measurements of glucose regulation and resting blood pressure at baseline and 3 months. TAKEAWAY: A total of 388 women completed the trial, with no serious adverse events related to the study. Participants in the sit-less arm had a daily sitting time of approximately 58 minutes less than those in the healthy-living arm (P < .001), whereas those in the sit-to-stand arm had 26 more sit-to-stand transitions daily (P < .001). Diastolic blood pressure fell by 2.24 mm Hg in the sit-to-stand arm compared with the healthy living arm (P = .02); the decrease in systolic blood pressure did not reach a predefined significance level. Compared with the healthy-living arm, neither intervention produced significant changes in markers of glucose regulation. IN PRACTICE: 'Postmenopausal women are at high risk of engaging in large amounts of sitting time and cardiovascular diseases. The present randomized controlled trial adds to existing evidence by demonstrating that within just 3 months, increasing' sit-to-stand transitions can lower diastolic blood pressure, the researchers wrote. SOURCE: This study was led by Sheri J. Hartman, PhD, University of California, San Diego. It was published online on July 25, 2025, in Circulation. LIMITATIONS: The generalizability of findings was limited by the lack of ethnic and racial diversity. The 3-month intervention period may have been too brief to observe sizeable physiologic changes. Measurement of only fasting glucose parameters could not capture changes after meals. DISCLOSURES: This study received support from the National Institute of Aging. Additional support was provided by the Altman Clinical & Translational Research Institute at the University of California, San Diego, funded by the National Center for Advancing Translational Sciences. The authors did not report any conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
5 hours ago
- Medscape
Hydroxychloroquine Use May Be Beneficial in Lupus Nephritis
TOPLINE: Hydroxychloroquine exposure in patients with lupus nephritis was associated with a substantially lower risk for estimated glomerular filtration rate (eGFR) decline of ≥ 30%, particularly among those with chronic kidney disease (CKD) stage ≥ 3. METHODOLOGY: Researchers conducted a retrospective study involving 209 patients with biopsy-proven incident lupus nephritis (mean age at diagnosis, 38 years; 75% women) between 1994 and 2019 identified at a single center in Wisconsin to examine the effect of hydroxychloroquine on kidney function. Hydroxychloroquine exposure status (median dose, > 5 vs ≤ 5 mg/kg/d) was determined at each visit using electronic health records, with positive exposure ascertained by an active prescription for at least 3 months at each follow-up. The primary outcome was eGFR decline of ≥ 30% at a minimum of two follow-up visits compared with baseline eGFR, or the requirement of sustained renal replacement therapy, with a mean follow-up duration of 5.4 years. The secondary outcome included an eGFR decline of ≥ 40%, and the annual eGFR slope to assess kidney function decline over time. TAKEAWAY: Time-varying exposure to hydroxychloroquine was associated with a 59% lower risk for an eGFR decline of ≥ 30% (adjusted hazard ratio [aHR], 0.41; P = .007). Similarly, hydroxychloroquine exposure was associated with a 66% lower risk for an eGFR decline of ≥ 40% (aHR, 0.34; P = .004). In patients with CKD stage ≥ 3 at lupus nephritis diagnosis, hydroxychloroquine exposure was associated with a 77% lower risk for an eGFR decline of ≥ 30% (aHR, 0.23; P = .03). Exposure to hydroxychloroquine led to significant annual reductions in eGFR slope declines of 5.12 mL/min/1.73 m2 within 5 years of a lupus nephritis diagnosis and 3.17 mL/min/1.73 m2 within 10 years. IN PRACTICE: 'These findings emphasize the importance of starting early and continuing HCQ [hydroxychloroquine] therapy to preserve kidney health alongside overall disease control even if SLE [systemic lupus erythematosus] is limited to the kidneys [lupus nephritis],' the authors of the study wrote. SOURCE: This study was led by Shivani Garg, MD, PhD, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin. It was published online on July 20, 2025, in Arthritis Care & Research. LIMITATIONS: The single academic institution setting potentially affected population representation. Data on hydroxychloroquine blood levels were unavailable to assess adherence and absorption variability. Decline of eGFR may have been missed in patients lost to follow-up or those who died at outside institutions. DISCLOSURES: This study received support from the University of Wisconsin-Madison, Institute for Clinical and Translational Research and the Clinical and Translational Science Award program from the National Institutes of Health (NIH) National Center for Advancing Translational Sciences. One author reported receiving funding through the NIH and honoraria for presentation at a conference. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
