What’s the best way for children to lose weight?

23Jun
2017

Hormone therapy position statement of The North American Menopause Society

21Jun
2017

Screening for Obesity in Children and Adolescents

21Jun
2017

Taxing sugary drinks would boost productivity, not just health

21Jun
2017

Your vitamin D tests and supplements are probably a waste of money

21Jun
2017

Your vitamin D tests and supplements are probably a waste of money – VOX (free)

Related: Why Are So Many People Popping Vitamin D? – The New York Times (10 articles per month are free)

“Screening for vitamin D has exploded — with no good evidence that it helps people.”

 

Glucose targets for preventing diabetic kidney disease and its progression

20Jun
2017

Glucose targets for preventing diabetic kidney disease and its progression – Cochrane Library (link to summary – $ for full review)

Sources: EvidenceAlerts and @anupam1623

Intensive glycemic control had no effect on risks of kidney failure, death and major cardiovascular events. “The clinical impact of targeting an HbA1c < 7% or blood glucose < 6.6 mmol/L (120 mg/dL) is unclear and the potential harms of this treatment approach are largely unmeasured.

 

ACR Thyroid Imaging and Reporting

20Jun
2017

Incretin based treatments and mortality in patients with type 2 diabetes

20Jun
2017

Incretin based treatments and mortality in patients with type 2 diabetes: systematic review and meta-analysis – The BMJ (free)

“The current evidence provides no support for the hypothesis that incretin based treatment increases all-cause mortality in patients with type 2 diabetes”

 

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association

19Jun
2017

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association (free PDF)

Invited Commentary: Trimming the Fat on Diet Recommendations for a Healthy Heart: Emphasis on Eating Patterns over Dietary Restrictions (free)

Top Ten Things to Know: Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the American Heart Association (free PDF)

AHA News: Advisory: Replacing saturated fat with healthier fat could lower cardiovascular risks (free)

News release: Replacing saturated fat with healthier fat may lower cholesterol as well as drugs in context of a healthy diet (free)

AHA no longer recommends decreasing total fat, but to replace saturated fats with polyunsaturated or monounsaturated fats. “Replacing saturated fat with healthier fat in the diet lowers cardiovascular disease risk as much as cholesterol-lowering statin drugs”

 

Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels

19Jun
2017

Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Glycation of Hemoglobin Differs by Race – Physician’s Briefing (free) AND Hemoglobin A1c Overestimates Average Glucose in Blacks – Medscape (free registration required) AND Why a key diabetes test may work differently depending on your race – CNN (free)

In this study with 104 black patients and 104 white patients with type 1 diabetes, HbA1c values in black persons were 0.4 percentage points higher than those in white persons for a given mean glucose concentration.

 

Evolocumab for Treatment of High Cholesterol: Clinical Effectiveness

19Jun
2017

Guidelines for gastro-entero-pancreatic neuroendocrine neoplasms

19Jun
2017

Primary hyperparathyroidism in pregnancy

19Jun
2017

Risk of major congenital malformations in relation to maternal overweight and obesity severity

16Jun
2017

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes

14Jun
2017

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes – New England Journal of Medicine (free)

Commentary: CANVAS: Canagliflozin Reduces CV Events, but at Cost of Amputations – Medscape (free registration required)

Patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation and fractures. The benefits and harms were likely small. See interesting commentaries on the trade-offs by @AnilMakam, see Tweet 1Tweet 2Tweet 3Tweet 4Tweet 5Tweet 6Tweet 7Tweet 8; and Tweet 9.

 

Health Effects of Overweight and Obesity in 195 Countries over 25 Years

13Jun
2017

Is the finger-stick blood test necessary for type 2 diabetes treatment?

12Jun
2017

Lower Risk of Heart Failure and Death in Patients Initiated on SGLT-2 Inhibitors?

12Jun
2017

Canagliflozin will receive new boxed warning about amputation risks

12Jun
2017

Prevention and Treatment of Glucocorticoid-Induced Osteoporosis

9Jun
2017

Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor

9Jun
2017

Serum uric acid levels and multiple health outcomes

8Jun
2017

Serum uric acid levels and multiple health outcomes: umbrella review of evidence from observational studies, randomised controlled trials, and Mendelian randomisation studies – The BMJ (free)

Observational studies suggest that high serum uric acid levels are associated with multiple health outcomes, including cardiovascular and metabolic diseases. This review findings suggest there is a clear association only for gout and nephrolithiasis.

 

Prebiotic for Overweight or Obesity Children?

7Jun
2017

Prebiotic Reduces Body Fat and Alters Intestinal Microbiota in Children With Overweight or Obesity (free PDF)

Commentary: Prebiotics reduce body fat in overweight children – American Gastroenterological Association, via EurekAlert (free)

Small randomized trial (42 patients) suggests prebiotics might be useful for overweight and obese children.

 

Television in the bedroom and body fatness

4Jun
2017

DASH diet and risk of gout

4Jun
2017

Metformin is linked to reduced mortality in type 2 diabetes with comorbid CKD and CHF

4Jun
2017

Diabetes – Injection and Infusion Technique Recommendations

1Jun
2017

Current guidelines on prevention with a focus on dyslipidemias

30May
2017

Review: Current guidelines on prevention with a focus on dyslipidemias – Cardiovascular Diagnosis & Therapy (free)

Review comparing current recommendations for the treatment of dyslipidemia.

 

Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk

30May
2017

Type 2 diabetes in adults: management – NICE Guideline

29May
2017

The Weight Loss Trap: Why Your Diet Isn’t Working

29May
2017

The Weight Loss Trap: Why Your Diet Isn’t Working – Time (cover story) (free)

“The challenges of weight loss and obesity – really well addressed” (RT @EricTopol see Tweet)

 

Eating disorders: recognition and treatment

26May
2017

The lap band for weight loss is a tale of medicine gone wrong

25May
2017

Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease

25May
2017

Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study – BMJ (free)

Recommended: New QRISK-3 2017 Calculator (free)

QRISK-3 risk prediction model was developed with data from 7.89 million patients in the derivation cohort and 2.67 million patients in the validation cohort. QRISK-3 includes more factors than QRISK2 to help enable doctors to identify those at most risk of heart disease and stroke. New risk factors include: 1) Chronic kidney disease, which now includes stage 3 CKD; 2) Migraine; 3) Use of corticosteroids; 4) Systemic lupus erythematosus (SLE); 5) Use of atypical antipsychotics; 6) Severe mental illness; 7) Erectile dysfunction; 8) and Systolic blood pressure variability.

 

Trans-fat – The Worst Fat in the Food Supply

24May
2017

The Worst Fat in the Food Supply – The New York Times (10 articles per month are free)

See also a recent study and commentaries on the effects of trans-fat bans in our April 23rd issue (see #1)

Trans-fat bans seem to be reducing cardiovascular deaths.

 

Effect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults

23May
2017

Effect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults: The ALLHAT-LLT Randomized Clinical Trial – JAMA Internal Medicine (free) (RT @EricTopol see Tweet)

Editorial: Risks of Statin Therapy in Older Adults (free)

Commentaries: Older adults may not benefit from taking statins to prevent heart disease – Medical News Today (free) AND Pravastatin Doesn’t Improve Clinical Outcomes in Seniors – Physician’s First Watch (free)

Patients > 65 years with moderate hyperlipidemia and hypertension had no benefit from pravastatin for primary prevention. “A nonsignificant direction toward increased all-cause mortality with pravastatin was observed among adults 75 years and older” (HR 1.34; 95% CI, 0.98-1.84; P = .07).

 

Reoperation and Medicare Expenditures After Laparoscopic Gastric Band Surgery

23May
2017

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults

19May
2017

How to rein in the widening disease definitions that label more healthy people as sick

17May
2017

Menopausal Hormone Therapy for Prevention of Chronic Conditions

17May
2017

Draft Recommendation Statement: Menopausal Hormone Therapy: Primary Prevention of Chronic Conditions – U.S. Preventive Services Task Force (free)

Source: USPSTF Recommendation Against HRT for Chronic Conditions Stands – Medscape (free registration required)

“The USPSTF recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women”.

 

Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs

16May
2017

Prevalence of Elevated Cardiovascular Risks in Young Adults

16May
2017

Prevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys – Annals of Internal Medicine (link to abstract – $ for full-text)

Source: Study Assesses ASCVD Risk in Non-Diabetic Adults – American College of Cardiology, Latest in Cardiology (free)

In the absence of diabetes, smoking or hypertension, most adult men younger than 40 years and adult women younger than 50 years are at low risk of cardiovascular disease (defined as < 5% in 10 years, usually not eligible for statin therapy) and may not benefit from cholesterol screening.

 

Treatment Deintensification Is Uncommon in Adults With Type 2 Diabetes Mellitus

15May
2017

Mortality from different causes associated with meat, heme iron, nitrates, and nitrites

10May
2017

Meta-analysis: Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study – The BMJ (free)

High intakes of red and processed meat are associated with increased risks of all-cause mortality and death due to nine different causes.

 

Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality

10May
2017

Type 2 diabetes in adults: management – NICE Guideline

9May
2017

Weight management programmes of extended duration

5May
2017

Randomized controlled trial: Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial – The Lancet (free)

Invited commentary: Weight management programmes of extended duration – The Lancet (free)

Commentary: Give overweight patients a year of weight-loss classes, say researchers – The Guardian (free)

In this trial with 1,267 overweight or obese participants an extended weight loss program (1 year) was more effective for weight loss and seems cost-effective in the longer term.

PCSK9 inhibitors for prevention of cardiovascular disease – Cochrane Library

3May
2017

Systematic review: PCSK9 inhibitors for prevention of cardiovascular disease – Cochrane Library (free summary – $ for full-text))

The evidence so far suggests that PCSK9 inhibitor use probably leads to little or no difference in mortality and leads to a modest absolute risk reduction (often less than 1%) in cardiovascular events in high-risk patients.

 

Alternate-day fasting does not seem to lead to greater weight loss

3May
2017

UK guideline for the prevention and treatment of osteoporosis

1May
2017

Normal-Weight Central Obesity and Risk for Mortality

28Apr
2017

Guidelines For Management Of Dyslipidemia And Prevention Of Cardiovascular Disease

27Apr
2017

Prevention and Management of Cardiovascular Disease Risk in Primary Care

26Apr
2017

Hormone Therapy in Primary Ovarian Insufficiency

25Apr
2017

Effect of Weight Reduction on Hemoglobin A1c

24Apr
2017

Systematic review: Effect of Weight Reduction on Hemoglobin A1c in weight loss trials of Type 2 Diabetes Patients – Diabetes, Obesity and Metabolism (link to abstract – $ for full-text)

“Each 1kg reduction in weight loss trials associated with 0.1% reduction in HbA1c” (RT @kamleshkhunti see Tweet)

 

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes

21Apr
2017

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes – New England Journal of Medicine (link to abstract – $ for full-text)

See also: Researchers Propose Extending Diabetic Retinopathy Screening Interval – Physician’s First Watch (free) AND Research from long-term study advocates individualized eye screenings in type 1 diabetes – Diabetes.co.uk (free)

In patients who have had type 1 diabetes for 5 years, annual retinal examinations are currently recommended. Based on their findings, the authors suggest an individualized screening schedule, with less frequent screening for patients at low risk and more frequent screening for patients at higher risk, leading to decreased cost without delaying the diagnosis of clinically significant disease.

 

Association between active commuting and incident cardiovascular disease, cancer, and mortality

21Apr
2017

ACC/AHA vs. USPSTF statin guidelines

19Apr
2017

Comparison of Recommended Eligibility for Primary Prevention Statin Therapy Based on the US Preventive Services Task Force Recommendations vs the ACC/AHA Guidelines – JAMA (link to abstract – $ for full-text)

See also: ACC/AHA vs. USPSTF statin guidelines – Cardiology News (free)

Although recommended by most guidelines for individuals at high risk, there is still some controversy over prescribing statins for primary prevention and over what patients benefit the most – see related commentary: Cholesterol-lowering statin therapy for healthy people is not as simple as ‘yes’ or ‘no’ – The Pharmaceutical Journal (free)

Adherence to the 2016 USPSTF recommendations for statin therapy, compared with the 2013 ACC/AHA guidelines, could lead to a lower number of individuals (an estimated difference of 9.3 million individuals in the U.S. population) recommended for primary prevention statin therapy.

 

Insulin pump didn’t improve glycemic control compared to training on injections

18Apr
2017

Amsterdam’s solution to the obesity crisis: no fruit juice and enough sleep

17Apr
2017

Amsterdam’s solution to the obesity crisis: no fruit juice and enough sleep – The Guardian (free) (RT @DrAseemMalhotra see Tweet)

“The city is successfully fighting fat by promoting tap water in its schools, along with healthy cooking classes and a ban on fast food sponsorship”

 

Screening for Endocrine Hypertension

14Apr
2017

Screening for Endocrine Hypertension: An Endocrine Society Scientific Statement (free)

Source: Screen for Endocrine Hypertension, Endocrine Society Says – Medscape (free registration required)

“The statement provides guidance on screening for 15 hormonal disorders that present with hypertension and that can be potentially cured with surgery or treated with medication” (from Medscape commentary above).

 

Banning trans fats in New York prevented thousands of heart attacks

13Apr
2017

Why Are So Many People Popping Vitamin D?

11Apr
2017

Why Are So Many People Popping Vitamin D? – The New York Times (10 articles per month are free)

“Labs performing these tests are reporting perfectly normal levels of vitamin D — 20 to 30 nanograms per milliliter of blood — as “insufficient.” As a consequence, millions of healthy people think they have a deficiency”

Note: Some organizations still think appropriate levels would be above 30 nanograms per milliliter of blood, more details in the text.

 

No TV during meals may lower obesity risk

10Apr
2017

With same training, insulin pumps no better than injections

7Apr
2017

Singapore Ministry of Health Clinical Practice Guidelines: Lipids

7Apr
2017

Inhaled Corticosteroids May Raise Women’s Risk of the Metabolic Syndrome

6Apr
2017

Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism

5Apr
2017

Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups

5Apr
2017

Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups in the United States: A Cross-sectional Analysis of Two Cohort Studies – Annals of Internal Medicine (link to abstract – $ required for full-text)

Sources: Certain Racial/Ethnic Groups More Likely to Have Cardiometabolic Abnormalities at Normal Weight – Physician’s First Watch (free) AND Cardiovascular Risk High Among Some Normal Weight Minorities – Medscape (free registration required)

Compared with whites, all racial/ethnic minority groups had higher prevalence of metabolic abnormalities, with a high prevalence even in persons with normal weight. The prevalence of metabolic abnormalities in whites with a BMI of 25 kg/m2 corresponded to the prevalence in BMI values of 22.9 kg/m2 in African Americans, 21.5 kg/m2 in Hispanics, 20.9 kg/m2 in Chinese Americans, and 19.6 kg/m2 in South Asians.

 

The wound/burn guidelines – Japanese Dermatological Association

5Apr
2017

American College of Radiology (ACR) Appropriateness Criteria Adds Topics

4Apr
2017

ACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)

Browse Appropriateness Criteria Topics (free)

Source: Newswise

This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.

 

Management of Inpatient Hyperglycemia and Diabetes in Older Adults

4Apr
2017

Intensive glucose control and microvascular outcomes

3Apr
2017

Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials – The Lancet Diabetes & Endocrinology (RT @EricTopol see Tweet with interest discussion) (link to abstract – $ required for full-text)

Contradicting the analysis above, a recent report found no significant impact of tight glycemic control on the risk of dialysis / transplantation / renal death, blindness, or neuropathy: Glycemic Control for Patients With Type 2 Diabetes Mellitus: Our Evolving Faith in the Face of Evidence – Circulation (free)

Benefits of intensive glucose control on microvascular outcomes in patients with type 2 diabetes remains controversial.

 

Cognitive Dysfunction in Older Adults With Diabetes

3Apr
2017

Cognitive Dysfunction in Older Adults With Diabetes: What a Clinician Needs to Know – Diabetes Care (free)

Source: Management of Older Adults With Diabetes and Cognitive Dysfunction – PracticeUpdate (free registration required)

“Recommendations include the need for simplified medication regimens, avoidance of glucose-lowering drugs with a high risk of hypoglycemia, periodic reassessment of glycemic goals, and repeated education of the patient and caregiver” (from PracticeUpdate commentary above)

 

Functional Hypothalamic Amenorrhea Guideline

3Apr
2017

Dairy consumption and risk of hypertension

23Mar
2017

Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study – The BMJ (free)

Contradicting evidence from previous observational studies, dairy consumption was not associated with lower blood pressure.

 

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