Shining a light on World Aids Day
While HIV/AIDS isn’t often in the headlines these days, it’s still a global public health concern, claiming over 44 million lives to date, with 40.8 million people living with the condition today.
The UN has a stated goal of eliminating the disease by 2030, with the global Fast-Track programme established in 2016, predicting a return of US$6.44 of economic benefits for every $1 invested in prevention and management – The economic returns of ending the AIDS epidemic as a public health threat.
Ten years on, while there is significant progress, with a fall of 34% in AIDS-related deaths in Western and Central Europe and America since 2010, pressure on funding and the stigma attached to the condition, compounded by the difficulty maintaining continuity of care in populations on the move, means that we’re a long way from meeting that goal. People from marginalised communities are at the greatest risk of infection, compounding the disparities that cost us all dearly in lost economic growth and cultural diversity – The Fight for an AIDS-Free World: Confronting the Stigma, Reaching the Marginalized. Annals of Global Health.
What’s that got to do with light?
HIV, or Human Immunodeficiency Virus, targets the white blood cells, reducing the ability of the immune system to fight off everyday attacks like common colds, which can then escalate to influenza and pneumonia.
There’s a direct link between the circadian cycle and immune response, as this review explains – Circadian rhythms in adaptive immunity and vaccination.
Interestingly, HIV is associated with decrease in circadian amplitude and dysregulation of melatonin regulation – The Circadian Clock and Viral Infections.
That means that patterns of light exposure that support the body clock can not only boost immune response, it can optimise the timing of vaccination and other treatment protocols.
This paper is one of a series from a research team that installed dynamic lighting in a care home in Wetzikon near Zurich in Sweden. Here, they focused on the potential for lighting to boost markers of immune response in older adults living with dementia following a ‘flu vaccination.
They found significantly higher levels of the specific antibodies in higher average mean light exposure group (>395 lux) compared to those in the low mean light exposure group (<395 lux). They also noted increased amplitude and intra-daily stability of rest-activity cycles in the higher light group – Preliminary evidence that daily light exposure enhances the antibody response to influenza vaccination in patients with dementia.
The body clock also affects the efficacy of vaccination, with morning administration associated with a higher immune response compared to afternoon and evening – A Narrative Review on How Timing Matters: Circadian and Sleep Influences on Influenza Vaccine Induced Immunity.
Finally, the broad spectrum of wavelengths delivered by daylight, including ultraviolet and infrared, offer a range of other anti-viral benefits, including disinfection and increased metabolic function.
So, while we wait for governments and the global health industry to invest in the diagnostic and management infrastructure, new antiretroviral drugs and support strategies that actively engage those who are at highest risk, the best thing we can all do is to shine a light on this hidden pandemic: talk openly about this life-changing condition hiding in plain sight, get outside and make sure that healthcare environments give everyone a diet of light that helps their immune system to fight back.
Walking to smile
It’s dark when you get to work – and it’s dark when you head home.
If you’re finding it hard to be productive when it’s cold and gloomy outside, you’re not alone. An estimated one in five Brits struggles with energy levels and motivation during the winter months, while a subset of around 2% suffer from the clinical condition known as Seasonal Affective Disorder – a sub-type of major depressive disorder and bipolar disorder – Seasonal Affective Disorder.
So what can you do?
- Hold a walking meeting – Aim to get outside at least once during daylight hours for an hour every day if you can. Even on a gloomy day, it’s likely to be several times brighter out there than in the average home or office. A walking meeting could be a good solution. Johnson and Johnson tried it for six months and found it increased levels of employee energy, focus and engagement – 7 Powerful Reasons to Take Your Next Meeting for a Walk. Research shows it can improve creativity and connection, too. This guide from UCL is a great place to start – Walking Meetings.
- Embrace the dark – Your brain is looking for a clear difference in light levels between day and night. So when you don’t get much light during the day, it’s even more important to make sure it’s quiet and dark at night. Light pollution from street lamps and cars outside, and electronic devices inside, will blur the boundaries between wake and sleep. Switch off appliances at the wall and add thick curtains or black-out blinds to reduce symptoms of insomnia, and improve cognitive function during the day – Effects mediated by melatonin and cortisol of artificial light and noise, alone and in combination, on sleep and health.
- Respect the rhythm of the seasons – Awareness of how the seasons affect our physical and mental health is not new. The Yellow Emperor’s Classic of Medicine, written in 260 BC, describes winter as a time of storage, as a seed prepares for the spring. ‘Early to bed, late to rise. (You) must await the daylight’, going on to warn that opposing these principles injures the kidneys.(Consequently) spring will bring paralysis and fainting(and) there will be little to offer (your) sprouting. More recent research has identified significant seasonal changes in blood composition and inflammatory markers as well as levels of Vitamin D, linked to mood and memory – Seasonal Variations of Complete Blood Count and Inflammatory Biomarkers in the US Population – Analysis of NHANES Data. So use this time to rest and lay down seeds for the brighter days to come.
Dawn Chorus
One of the few compensations of darker mornings is that you may see the sunrise and enjoy one of my favourite sounds – the dawn chorus. The robins are the first to start singing in the morning and the last to pipe down at night. The robins in my allotment are incredibly tame. Here’s one keeping me company while I work – The Winter Dawn Chorus.