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Tag: Heart Disease

  • Some mosquitoes like it hot

    Some mosquitoes like it hot

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    Newswise — Certain populations of mosquitoes are more heat tolerant and better equipped to survive heat waves than others, according to new research from Washington University in St. Louis.

    This is bad news in a world where vector-borne diseases are an increasingly global health concern. Most models that scientists use to estimate vector-borne disease risk currently assume that mosquito heat tolerances do not vary. As a result, these models may underestimate mosquitoes’ ability to spread diseases in a warming world.

    Researchers led by Katie M. Westby, a senior scientist at Tyson Research Center, Washington University’s environmental field station, conducted a new study that measured the critical thermal maximum (CTmax), an organism’s upper thermal tolerance limit, of eight populations of the globally invasive tiger mosquito, Aedes albopictus. The tiger mosquito is a known vector for many viruses including West Nile, chikungunya and dengue.

    “We found significant differences across populations for both adults and larvae, and these differences were more pronounced for adults,” Westby said. The new study is published Jan. 8 in Frontiers in Ecology and Evolution.

    Westby’s team sampled mosquitoes from eight different populations spanning four climate zones across the eastern United States, including mosquitoes from locations in New Orleans; St. Augustine, Fla.; Huntsville, Ala.; Stillwater, Okla.; St. Louis; Urbana, Ill.; College Park, Md.; and Allegheny County, Pa.

    The scientists collected eggs in the wild and raised larvae from the different geographic locations to adult stages in the lab, tending the mosquito populations separately as they continued to breed and grow. The scientists then used adults and larvae from subsequent generations of these captive-raised mosquitoes in trials to determine CTmax values, ramping up air and water temperatures at a rate of 1 degree Celsius per minute using established research protocols.

    The team then tested the relationship between climatic variables measured near each population source and the CTmax of adults and larvae. The scientists found significant differences among the mosquito populations.

    The differences did not appear to follow a simple latitudinal or temperature-dependent pattern, but there were some important trends. Mosquito populations from locations with higher precipitation had higher CTmax values. Overall, the results reveal that mean and maximum seasonal temperatures, relative humidity and annual precipitation may all be important climatic factors in determining CTmax.

    “Larvae had significantly higher thermal limits than adults, and this likely results from different selection pressures for terrestrial adults and aquatic larvae,” said Benjamin Orlinick, first author of the paper and a former undergraduate research fellow at Tyson Research Center. “It appears that adult Ae. albopictus are experiencing temperatures closer to their CTmax than larvae, possibly explaining why there are more differences among adult populations.”

    “The overall trend is for increased heat tolerance with increasing precipitation,” Westby said. “It could be that wetter climates allow mosquitoes to endure hotter temperatures due to decreases in desiccation, as humidity and temperature are known to interact and influence mosquito survival.”

    Little is known about how different vector populations, like those of this kind of mosquito, are adapted to their local climate, nor the potential for vectors to adapt to a rapidly changing climate. This study is one of the few to consider the upper limits of survivability in high temperatures — akin to heat waves — as opposed to the limits imposed by cold winters.

    “Standing genetic variation in heat tolerance is necessary for organisms to adapt to higher temperatures,” Westby said. “That’s why it was important for us to experimentally determine if this mosquito exhibits variation before we can begin to test how, or if, it will adapt to a warmer world.”

    Future research in the lab aims to determine the upper limits that mosquitoes will seek out hosts for blood meals in the field, where they spend the hottest parts of the day when temperatures get above those thresholds, and if they are already adapting to higher temperatures. “Determining this is key to understanding how climate change will impact disease transmission in the real world,” Westby said. “Mosquitoes in the wild experience fluctuating daily temperatures and humidity that we cannot fully replicate in the lab.”

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    Washington University in St. Louis

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  • Keto Diets and Diabetes  | NutritionFacts.org

    Keto Diets and Diabetes  | NutritionFacts.org

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    Ketogenic diets are put to the test for diabetes reversal. 
     
    As you can see at the start of my video Does a Ketogenic Diet Help Diabetes or Make It Worse?, ketogenic diets can lower blood sugars better than conventional diets. So much so, in fact, that there is a keto product company that claims ketogenic diets can “reverse” diabetes. However, they are confusing the symptom (high blood sugars) with the disease (carbohydrate intolerance). People with diabetes can’t properly handle carbohydrates, and this manifests as high blood sugars. Clearly, if you stick to eating mostly fat, your blood sugars will stay low, but you may be actually making the underlying disease worse at the same time. 
     
    We’ve known for nearly a century that if you put people on a ketogenic diet, their carbohydrate intolerance can skyrocket within just two days. Below and at 0:46 in my video, you can see a graph from the study showing the blood sugar response two days after eating sugar. On a high-carb diet, blood sugar response is about 90 mg/dL. But, the blood sugar response to the same amount of sugar after a high-fat diet is about 190 mg/dL, nearly double. The intolerance to carbohydrates skyrocketed on a high-fat diet. 

    After one week on an 80 percent fat diet, you can quintuple your blood sugar spike in reaction to the same carb load compared to a week on a low-fat diet, as you can see in the graph below and at 1:12 in my video. 

    Even a single day of excessive dietary fat intake can do it, as you can see in the graph below and at 1:26 in my video. If you’re going in for a diabetes test, having a fatty dinner the night before can adversely affect your results. Just one meal high in saturated fat can make carbohydrate intolerance, the cause of diabetes, worse within four hours. 


    Given enough weight loss by any means, whether from cholera or bariatric surgery, type 2 diabetes can be reversed, but a keto diet for diabetes may not just be papering over the cracks, but actively throwing fuel on the fire. 
     
    I’ve been trying to think of a good metaphor. It’s easy to come up with things that just treat the symptoms without helping the underlying disease, like giving someone with pneumonia aspirin for their fever instead of antibiotics. However, a keto diet for diabetes is worse than that because it may treat the symptoms while actively worsening the disease. It may be more like curing the fever by throwing that pneumonia patient out into a snow bank or “curing” your amputated finger by amputating your hand. One of the co-founders of masteringdiabetes.org suggested it’s like a CEO who makes their bad bottom line look better by borrowing tons of cash. The outward numbers look better, but on the inside, the company is just digging itself into a bigger hole. 
     
    Do you remember The Club, that popular car anti-theft device that attaches to the steering wheel and locks it in place so the steering column can only turn a few inches? Imagine you’re in a car at the top of a hill with the steering wheel locked. Then, the car starts rolling down the hill. What do you do? Imagine there’s also something stuck under your brake pedal. The keto-diet equivalent response to this situation is who cares if you’re barreling down into traffic with a locked steering wheel and no brakes—just stick to really straight deserted roads without any stop signs or traffic lights. If you do that, problem solved! The longer you go, the more speed you’ll pick up. If you should hit a dietary bump in the road or start to veer off the path, the consequences could get more and more disastrous over time. However, if you stick to the keto straight and narrow, you’ll be a-okay! In contrast, the non-keto response would be to just unlock the steering wheel and dislodge whatever’s under your brake. In other words, fix the underlying problem instead of just whistling past—and then into—the graveyard. 
     
    The reason keto proponents claim they can “reverse” diabetes is they can successfully wean type 2 diabetics off their insulin. That’s like faith-healing someone out of the need for a wheelchair by making them stay in bed the rest of their life. No need for a wheelchair if you never move. Their carbohydrate intolerance isn’t gone. Their diabetes isn’t gone. In fact, it could be just as bad or even worse. Type 2 diabetes is reversed when you are weaned off insulin while eating a normal diet like everyone else. Then and only then do you not have diabetes anymore. A true diabetes reversal diet, as you can see below and at 4:58 in my video, is practically the opposite of a ketogenic diet: getting diabetics off their insulin within a matter of weeks by eating more than 300 grams of carbs a day! 
    The irony doesn’t stop there. One of the reasons people with diabetes suffer such nerve and artery damage is due to an inflammatory metabolic toxin known as methylglyoxal, which forms at high blood sugar levels. Methylglyoxal is the most potent creator of advanced glycation end products (AGEs), which are implicated in degenerative diseases—from Alzheimer’s and cataracts to kidney disease and strokes, as you can see below and at 5:31 in my video. 

    You get AGEs in your body from two sources: You can eat them preformed in your diet or make them internally from methylglyoxal if you have high blood sugar levels. On a keto diet, one would expect high exposure to preformed AGEs, since they’re found concentrated in animal-derived foods high in fat and protein, but we would expect less internal, new formation due to presumably low levels of methylglyoxal, given lower blood sugars from not eating carbs. Dartmouth researchers were surprised to find more methylglyoxal! As shown in the graph below and at 6:11 in my video, a few weeks on the Atkins diet led to a significant increase in methylglyoxal levels. Those in active ketosis did even worse, doubling the level of this glycotoxin in their bloodstream. 

    It turns out that high sugars may not be the only way to create this toxin, as you can see below and at 6:24 in my video. One of the ketones you make on a ketogenic diet is acetone (known for its starring role in nail polish remover). Acetone does more than just make keto dieters fail breathalyzer tests, “feel queasy and light-headed, and develop what’s been described as ‘rotten apple breath.’” Acetone can oxidize in the blood to form acetol, which may be a precursor for methylglyoxal.

    That may be why keto dieters can end up with levels of this glycotoxin as high as those with out-of-control diabetes, which can cause the nerve damage and blood vessel damage you see in diabetics. That’s another way keto dieters can end up with a heart attack. The irony of treating diabetes with a ketogenic diet may extend beyond just making the underlying diabetes worse, but by mimicking some of the disease’s dire consequences. 

    This is part of a seven-video series on keto, which you can find in related videos below.

    I also recently tackled diabetes.

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    Michael Greger M.D. FACLM

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  • Muscle Shrinkage and Bone Loss on Keto Diets?  | NutritionFacts.org

    Muscle Shrinkage and Bone Loss on Keto Diets?  | NutritionFacts.org

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    Ketogenic diets have been found to undermine exercise efforts and lead to muscle shrinkage and bone loss. 
     
    An official International Society of Sports Nutrition position paper covering keto diets notes the “ergolytic effect” of keto diets on both high- and low-intensity workouts. Ergolytic is the opposite of ergogenic. Ergogenic means performance-boosting, whereas ergolytic means performance-impairing. 
     
    For nonathletes, ketosis may also undermine exercise efforts. Ketosis was correlated with increased feelings of “perceived exercise effort” and “also significantly correlated to feelings of ‘fatigue’ and to ‘total mood disturbance,’” during physical activity. “Together, these data suggest that the ability and desire to maintain sustained exercise might be adversely impacted in individuals adhering to ketogenic diets for weight loss.” 
     
    You may recall that I’ve previously discussed that shrinkage of measured muscle mass among CrossFit trainees has been reported. So, a ketogenic diet may not just blunt the performance of endurance athletes, but their strength training as well. As I discuss in my video Keto Diets: Muscle Growth and Bone Density, study participants performed eight weeks of the battery of standard upper and lower body training protocols, like bench presses, pull-ups, squats, and deadlifts, and there was no surprise. You boost muscle mass—unless you’re on a keto diet, in which case there was no significant change in muscle mass after all that effort. Those randomized to a non-ketogenic diet added about three pounds of muscle mass, whereas the same amount of weight lifting on the keto diet tended to subtract muscle mass by about 3.5 ounces on average. How else could you do eight weeks of weight training and not gain a single ounce of muscle on a ketogenic diet? Even keto diet advocates call bodybuilding on a ketogenic diet an “oxymoron.” 
     
    What about bone loss? Sadly, bone fractures are one of the side effects that disproportionately plague children placed on ketogenic diets, along with slowed growth and kidney stones. Ketogenic diets may cause a steady rate of bone loss as measured in the spine, presumed to be because ketones are acidic, so keto diets can put people in what’s called a “chronic acidotic state.” 
     
    Some of the case reports of children on keto diets are truly heart-wrenching. One nine-year-old girl seemed to get it all, including osteoporosis, bone fractures, and kidney stones, then she got pancreatitis and died. Pancreatitis can be triggered by having too much fat in your blood. As you can see in the graph below and at 2:48 in my video, a single high-fat meal can cause a quintupling of the spike in triglycerides in your bloodstream within hours of consumption, which can put you at risk for inflammation of the pancreas.  

    The young girl had a rare genetic disorder called glucose transporter deficiency syndrome. She was born with a defect in ferrying blood sugar into her brain. That can result in daily seizures starting in infancy, but a ketogenic diet can be used as a way to sneak fuel into the brain, which makes a keto diet a godsend for the 1 in 90,000 families stricken with this disorder.

    As with anything in medicine, it’s all about risks versus benefits. As many as 30 percent of patients with epilepsy don’t respond to anti-seizure drugs. Unfortunately, the alternatives aren’t pretty and can include brain surgery that implants deep electrodes through the skull or even removes a lobe of your brain. This can obviously lead to serious side effects, but so can having seizures every day. If a ketogenic diet can help with seizures, the pros can far outweigh the cons. For those just choosing a diet to lose weight, though, the cost-benefit analysis would really seem to go the other way. Thankfully, you don’t need to mortgage your long-term health for short-term weight loss. We can get the best of both worlds by choosing a healthy diet, as I discussed in my video Flashback Friday: The Weight Loss Program That Got Better with Time.
     
    Remember the study that showed the weight loss was nearly identical in those who had been told to eat the low-carb Atkins diet for a year and those told to eat the low-fat Ornish diet, as seen below and at 4:18 in my video? The authors concluded, “This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.” That seems like terrible advice. 

    There are regimens out there like “The Last Chance Diet which consisted of a low-calorie liquid formula made from leftover byproducts from a slaughterhouse [that] was linked to approximately 60 deaths from cardiovascular-related events.” An ensuing failed lawsuit from one widower laid the precedent for the First Amendment protection for those who produce deadly diet books. 

    It’s possible to construct a healthy low-carb diet or an unhealthy low-fat one—a diet of cotton candy would be zero fat—but the health effects of a typical low-carb ketogenic diet like Atkins are vastly different from a low-fat plant-based diet like Ornish’s. As you can see in the graph below and at 5:26 in my video, they would have diametrically opposed effects on cardiovascular risk factors in theory, based on the fiber, saturated fat, and cholesterol contents of their representative meal plans. 

    And when actually put to the test, low-carb diets were found to impair artery function. Over time, blood flow to the heart muscle itself is improved on an Ornish-style diet and diminished on a low-carb one, as shown below and at 5:44 in my video. Heart disease tends to progress on typical weight-loss diets and actively worsens on low-carb diets, but it may be reversed by an Ornish-style diet. Given that heart disease is the number one killer of men and women, “recommending any diet that a patient will adhere to in order to lose weight” seems irresponsible. Why not tell people to smoke? Cigarettes can cause weight loss, too, as can tuberculosis and a meth habit. The goal of weight loss is not to lighten the load for your pallbearers. 

     
    For more on keto diets, see my videos on the topic. Interested in enhancing athletic performance? Check out the related videos below. 

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    Michael Greger M.D. FACLM

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  • USC's Bronny James returns to full-contact practice for 1st time since cardiac arrest

    USC's Bronny James returns to full-contact practice for 1st time since cardiac arrest

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    Bronny James has returned to full-contact practice for the first time since suffering cardiac arrest in July, paving the way for the son of Los Angeles Lakers superstar LeBron James to make his college debut for Southern California

    ByBETH HARRIS AP sports writer

    December 7, 2023, 7:21 PM

    Southern California guard Bronny James warms up before an NCAA college basketball game against Gonzaga Saturday, Dec. 2, 2023, in Las Vegas. (AP Photo/Sam Morris)

    The Associated Press

    LOS ANGELES — Bronny James returned to full-contact basketball practice on Thursday for the first time since suffering cardiac arrest in July, paving the way for the son of Los Angeles Lakers superstar LeBron James to make his college debut with Southern California.

    The Trojans host Long Beach State on Sunday.

    “It’ll be a determination how he feels personally and our doctors and trainers and our strength coach, but all indication is he feels great and he looks good,” USC coach Andy Enfield said after practice.

    James would come off the bench and be on a minutes restriction in his debut, Enfield said.

    The elder James has said he would attend his son’s first game regardless of whether the Lakers were playing the same day. The Lakers are off Sunday.

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    Get poll alerts and updates on AP Top 25 basketball throughout the season. Sign up here

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    AP college basketball: https://apnews.com/hub/ap-top-25-college-basketball-poll and https://apnews.com/hub/college-basketball

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  • The Safety of Keto Diets  | NutritionFacts.org

    The Safety of Keto Diets  | NutritionFacts.org

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    What are the effects of ketogenic diets on nutrient sufficiency, gut flora, and heart disease risk? 

    Given the decades of experience using ketogenic diets to treat certain cases of pediatric epilepsy, a body of safety data has accumulated. Nutrient deficiencies would seem to be the obvious issue. Inadequate intake of 17 micronutrients, vitamins, and minerals has been documented in those on strict ketogenic diets, as you can see in the graph below and at 0:14 in my video Are Keto Diets Safe?. 

    Dieting is a particularly important time to make sure you’re meeting all of your essential nutrient requirements, since you may be taking in less food. Ketogenic diets tend to be so nutritionally vacuous that one assessment estimated that you’d have to eat more than 37,000 calories a day to get a sufficient daily intake of all essential vitamins and minerals, as you can see in the graph below and at 0:39 in my video. 


    That is one of the advantages of more plant-based approaches. As the editor-in-chief of the Journal of the American Dietetic Association put it, “What could be more nutrient-dense than a vegetarian diet?” Choosing a healthy diet may be easier than eating more than 37,000 daily calories, which is like putting 50 sticks of butter in your morning coffee. 
     
    We aren’t just talking about not reaching your daily allowances either. Children have gotten scurvy on ketogenic diets, and some have even died from selenium deficiency, which can cause sudden cardiac death. The vitamin and mineral deficiencies can be solved with supplements, but what about the paucity of prebiotics, the dozens of types of fiber, and resistant starches found concentrated in whole grains and beans that you’d miss out on? 
     
    Not surprisingly, constipation is very common on keto diets. As I’ve reviewed before, starving our microbial self of prebiotics can have a whole array of negative consequences. Ketogenic diets have been shown to “reduce the species richness and diversity of intestinal microbiota,” our gut flora. Microbiome changes can be detected within 24 hours of switching to a high-fat, low-fiber diet. A lack of fiber starves our good gut bacteria. We used to think that dietary fat itself was nearly all absorbed in the small intestine, but based on studies using radioactive tracers, we now know that about 7 percent of the saturated fat in a fat-rich meal can make it down to the colon. This may result in “detrimental changes” in our gut microbiome, as well as weight gain, increased leaky gut, and pro-inflammatory changes. For example, there may be a drop in beneficial Bifidobacteria and a decrease in overall short-chain fatty acid production, both of which would be expected to increase the risk of gastrointestinal disorders. 
     
    Striking at the heart of the matter, what might all of that saturated fat be doing to our heart? If you look at low-carbohydrate diets and all-cause mortality, those who eat lower-carb diets suffer “a significantly higher risk of all-cause mortality,” meaning they live, on average, significantly shorter lives. However, from a heart-disease perspective, it matters if it’s animal fat or plant fat. Based on the famous Harvard cohorts, eating more of an animal-based, low-carb diet was associated with higher death rates from cardiovascular disease and a 50 percent higher risk of dying from a heart attack or stroke, but no such association was found for lower-carb diets based on plant sources.  
     
    And it wasn’t just Harvard. Other researchers have also found that “low-carbohydrate dietary patterns favoring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favored plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain bread, were associated with lower mortality…” 
     
    Cholesterol production in the body is directly correlated to body weight, as you can see in the graph below and at 3:50 in my video. 

    Every pound of weight loss by nearly any means is associated with about a one-point drop in cholesterol levels in the blood. But if we put people on very-low-carb ketogenic diets, the beneficial effect on LDL bad cholesterol is blunted or even completely neutralized. Counterbalancing changes in LDL or HDL (what we used to think of as good cholesterol) are not considered sufficient to offset this risk. You don’t have to wait until cholesterol builds up in your arteries to have adverse effects either; within three hours of eating a meal high in saturated fat, you can see a significant impairment of artery function. Even with a dozen pounds of weight loss, artery function worsens on a ketogenic diet instead of getting better, which appears to be the case with low-carb diets in general.  

    For more on keto diets, check out my video series here. 

    And, to learn more about your microbiome, see the related videos below.

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    Michael Greger M.D. FACLM

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  • USC's Bronny James cleared by doctors for return to basketball 4 months after cardiac arrest

    USC's Bronny James cleared by doctors for return to basketball 4 months after cardiac arrest

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    LOS ANGELES — LOS ANGELES (AP) — Bronny James has been cleared by doctors for a full return to basketball four months after suffering a cardiac arrest, and the Southern California freshman is expected to make his collegiate debut soon — with his father saying he wouldn’t miss it.

    A James family spokesperson said in a statement Thursday that the 19-year-old will have a final evaluation with USC staff this week and resume practice next week. He will be able to play in games “soon after,” it said.

    “The heart specialists have cleared him, which is great,” coach Andy Enfield said Thursday after practice, “and now it’s a matter of getting him back on the court next week hopefully to begin working out with the team full contact.”

    LeBron James said after the Los Angeles Lakers’ game Thursday night at Oklahoma City that he’d skip a game to attend his son’s college debut

    “I already told my teammates that if they play on the same day we’re playing, I’m going to have to catch them the next game,” James said. “Family over everything. Definitely got to see Bronny’s first game whenever he’s cleared and ready to go.”

    LeBron said Bronny handled rehab well.

    “We had great doctors along the way the whole time telling us that they believe things will work out for us in our favor, so Bronny took care of his business,” LeBron said. “He did everything and didn’t have any setbacks. Didn’t try to rush the process of his rehab. He took every step accordingly to plan.”

    Bronny didn’t participate in pregame warmups Wednesday night and he didn’t join his teammates on the bench until late in the first half of their 106-78 rout of Eastern Washington. He joked and smiled with the other reserves and he stood at the rear of the huddles during timeouts.

    The Trojans (5-2) play No. 11 Gonzaga in Las Vegas on Saturday. Their next home game is Dec. 10 against Long Beach State, a day the Lakers are off, which could allow LeBron to watch his namesake son’s debut. After that, the Trojans hit the road for four straight games.

    “That’s not my decision and it’s probably too early to speculate,” Enfield said. “He’s been out of basketball for quite a few months, so we’ll be patient with him and once we get the green light we’ll get him into games.”

    USC fell out of the AP Top 25 poll this week after a two-point loss to Oklahoma last week.

    “We’re excited, but we’ll be even more excited when he’s actually out there with us playing,” leading scorer Boogie Ellis said. “That’s definitely a piece that we’re missing.”

    While Bronny will be a welcome addition to USC’s rotation, he’ll need time to acclimate to game action. He has been on the court for pregame warmups twice in recent weeks, doing some rebounding and taking shots but also watching his teammates. He’s also been at practices.

    “We’re all ready to have him back,” said forward Kijani Wright, who played in high school with Bronny. “It’ll just be another guard component that we have, add more fire.”

    Bronny need look no further than teammate Vincent Iwuchukwu for inspiration. The 7-foot-1 sophomore suffered a cardiac arrest in July 2022. He began limited practice last December and made his debut in January. He played in 14 games last season, averaging 5.4 points and 2.5 rebounds.

    Iwuchukwu was the top player off the bench Wednesday night, with 13 points, six rebounds and two blocks.

    Bronny was found to have a congenital heart defect that was treatable. He suffered a cardiac arrest in July during a workout at Galen Center.

    “When you go through something like this, it puts everything in perspective and truly understood that nothing else matters besides your loved ones at that moment,” LeBron said. “Just stop everything that you’re doing and it’s literally, ‘How do we help him or help your loved one get better?’”

    Bronny was a McDonald’s All-American just like his father. The 6-foot-3 guard played at Sierra Canyon School in the Chatsworth section of Los Angeles and chose to stay close to home in picking USC.

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    AP Sports Writer Cliff Brunt in Oklahoma City contributed to this report.

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    AP college basketball: https://apnews.com/hub/ap-top-25-college-basketball-poll and https://apnews.com/hub/college-basketball

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  • One of the world’s fattest men found dead in home he’d been trapped for years

    One of the world’s fattest men found dead in home he’d been trapped for years

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    A MAN who weighed more than three baby elephants and lived on his sofa has been found dead after he vowed to shed pounds.

    Leonid Andreev had been a prisoner in his own home for five years weighing 44 stone but he had just started to turn his life around.

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    Leonid Andreev spend five years living on the sofa and being cared for by neighboursCredit: Newsflash

    Only a day before Andreev died he had told local media how he was planning a new life of losing weight and moving to a city apartment.

    The 60-year-old revealed that he had started a new diet with just a cup of light soup for lunch.

    He said: “I tried to lose at least a little weight – I ate less and did not indulge in flour products.”

    Andreev’s body was discovered in his village home in Armizonskoye, Russia, on November 17 after he suffered a heart attack.

    Andreev had shocked reporters when he told them that he once used to be an athlete, weighing in at just 11 stone.

    Ten years ago, he was a hunter, ran his own farm, and took part in harvesting the crops.

    He said his weight problems began when he left a career in the army.

    In just three months, his weight nearly doubled to 16 stone and it never stopped rising.

    Doctors apparently told him that his weight gain was caused by a metabolic disorder.

    Five years ago Andreev’s size had ballooned so much he had to quit work and he began his reclusive life on the sofa.

    In an ongoing health crisis, his blood pressure soared so high he called for an ambulance but after controlling his symptoms paramedics refused further aid because of Andreev’s weight.

    Andreev described a miserable existence and said for five years he lived and slept on his sofa watching TV all day while neighbours helped clean and take care of his house.

    He shared his monotonous daily routine, “In the morning, I get up, cook food, eat a little, watch TV. Tried to move here, move there.

    “I used to have porridge – the heaviest, well, and buns, potatoes, bread. That’s how I got fat, probably,” he said.

    Andreev was married and divorced twice and had no children.

    Doctors had warned him he had to lose at least seven stone to be able to live normally again, but he waited too late to act.

    Despite Andreev’s astonishing mass there are others even heavier.

    The fattest man who ever lived, Jon Brower Minnoch, weighed 100 stone.

    Despite Andreev’s astonishing mass, there are others who have surpassed his huge size.

    The fattest man who ever lived weighed a whopping 100 stone while the fattest man alive today weighed an astonishing 93 stone.

    He was recently found dead in his home despite declaring he wanted to be healthier

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    He was recently found dead in his home despite declaring he wanted to be healthierCredit: Newsflash

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    Olivia Allhusen

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  • ¿Quiénes se benefician de la administración de estatinas?

    ¿Quiénes se benefician de la administración de estatinas?

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    Newswise — ROCHESTER, Minnesota—Si usted corre el riesgo de enfermedad cardíaca, el equipo de atención médica podría utilizar la herramienta de la ecuación de cohorte agrupada para determinar su riesgo a largo plazo y si la administración de estatinas (medicamentos para reducir el colesterol) es una buena opción.

    El Dr. Francisco Lopez-Jimenez, cardiólogo de Mayo Clinic de Rochester, Minnesota, afirma que es importante saber quiénes se benefician más de la administración de estatinas.

    Las estatinas son medicamentos que reducen la cantidad de colesterol que produce el hígado.

    “El colesterol se forma en las placas que se acumulan y crecen en el interior de las arterias, a veces hasta el punto de que esas arterias se obstruyen”, explica el Dr. López-Jiménez.

    Y esa obstrucción puede derivar en una enfermedad cardíaca. Sin embargo, ¿se pueden administrar las estatinas a todas las personas? 

    “Los pacientes que más se beneficiarán de la administración de estatinas serán las personas con antecedentes de ataques cardíacos, accidentes cerebrovasculares y otras afecciones que se sabe que se producen por las placas de colesterol”, afirma.

    La alimentación también desempeña un papel importante. El Dr. Lopez-Jimenez recomienda comer menos carne procesada y más cereales, frutas y verduras.

    “Los cambios de mayor impacto que las personas pueden hacer para reducir el colesterol incluyen consumir menos productos de origen animal que no sean pescado y consumir menos grasas saturadas”, afirma.

    ¿Qué ocurre si el equipo de atención médica recomienda medicamentos además de cambios en el estilo de vida?

    “Tome los medicamentos indicados, verifique las cantidades, asegúrese de que todos esos factores estén bien controlados”, afirma el Dr. Lopez-Jimenez.

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    Información sobre Mayo Clinic

    Mayo Clinic es una organización sin fines de lucro, dedicada a innovar la práctica clínica, la educación y la investigación, así como a ofrecer pericia, compasión y respuestas a todos los que necesitan recobrar la salud. Visite la Red Informativa de Mayo Clinic para leer más noticias sobre Mayo Clinic.

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  • من الذي يستفيد من تناول أدوية خافِضة للكوليسترول؟

    من الذي يستفيد من تناول أدوية خافِضة للكوليسترول؟

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    Newswise — مدينة روتشستر، ولاية مينيسوتا—إذا كنت مهددًا بخطرالإصابة بمرض القلب فقد يستخدم فريق الرعاية الصحية أداة معادلة تقييم المخاطر المُشتركة بين الفئات العمرية(PCE)  لتحديد خطر إصابتك على المدى الطويل وما إذا كان تناول أدوية خافِضة للكوليسترول — أدوية خفض الكوليستيرول، خيار مناسب لك أم لا.

    يقول الدكتور فرانسيسكو لوبيز جيمينيز،طبيب القلب لدى مايو كلينك في مدينة روتشستر، ولاية مينيسوتا إنه من المهم أن نفهم من هم الأكثر استفادةً من تناول أدوية خافِضة للكوليسترول.

    أدوية خافِضة للكوليسترول هي أدوية تعمل على خفض مقدار الكوليستيرول الذي يصنعه الكبد.

    يقول الدكتور لوبيز جيمينيز: “الكوليستيرول يتراكم في اللويحات التي تتجمع وتنمو داخل الشرايين، ويصل الأمر أحيانًا إلى انسداد هذه الشرايين.”

    والشرايين المسدودة تؤدي إلى مرض القلب التاجي. ولكن هل تناول أدوية خافِضة للكوليسترول مناسبة للجميع؟ 

    يقول الدكتور جيمينيز: “المرضى الأكثر استفادةً من تناول أدوية خافِضة للكوليسترول هم الأشخاص الذين لديهم تاريخ الإصابة بالنوبات القلبية والسكتات الدماغية وغير ذلك من الحالات المعروف أنها تنشأ عن لويحات الكوليستيرول.”

    كما أن الحمية الغذائية لها دور مهم. يقول الدكتور لوبيز جيمينيز إنه يجب الإقلال من أكل اللحوم المُصنَّعة والإكثار من الحبوب والفاكهة والخضروات.

    ويقول أيضًا: “التغييرات الأكثر تأثيرًا التي يجب على الناس إجراؤها للحد من الكوليستيرول تشمل الإقلال من أكل المُنتجات الحيوانية بخلاف الأسماك والإقلال من تناول الدهون المُشبَّعة.

    وماذا إذا أوصاك فريق الرعاية الصحية بالأدوية إلى جانب تغييرات نمط الحياة؟

    يقول الدكتور لوبيز جيمينيز: “خُذ الأدوية، وافحص مستويات الكوليسترول لديك، وتأكد أن كل العوامل تحت السيطرة.”

    ###

    نبذة عن مايو كلينك

    مايو كلينك هي مؤسسة غير ربحية تلتزم بالابتكار في الممارسات السريرية والتعليم والبحث وتوفير التعاطف والخبرة لكل مَن يحتاج إلى الاستشفاء والرد على استفساراته. لمعرفة المزيد من أخبار مايو كلينك، تفضَّل بزيارة شبكة مايو كلينك الإخبارية.

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  • Quem se beneficia com a administração de estatinas?

    Quem se beneficia com a administração de estatinas?

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    Newswise — ROCHESTER, Minnesota—Se você está sob o risco de ter uma doença cardíaca, a equipe de cuidados médicos pode usar a ferramenta de equação de coorte agrupada (PCE) para determinar o seu risco de longo prazo, e se a administração de estatinas (medicamentos para reduzir o colesterol) é uma boa opção.

    O Dr. Francisco Lopez-Jimenez, cardiologista da Mayo Clinic em Rochester, Minnesota, explica que é importante entender quem mais se beneficia com a administração de estatinas.

    As estatinas são medicamentos que reduzem a quantidade de colesterol produzida pelo fígado.

    “O colesterol se forma nas placas que acumulam e crescem dentro das artérias. Às vezes, o acúmulo chega ao ponto de as artérias ficarem bloqueadas”, explica o Dr. Lopez-Jimenez.

    E artérias bloqueadas podem ocasionar o surgimento de doença cardíaca. Mas, as estatinas podem ser usadas por todas as pessoas? 

    “Os pacientes que mais serão beneficiados com a administração de estatinas são aqueles com um histórico de ataques cardíacos, acidentes vasculares cerebrais e outras condições conhecidas decorrentes das placas de colesterol”, ele explica.

    A dieta também tem um papel importante. O Dr. Lopez-Jimenez recomenda consumir menos carne processada e mais grãos, frutas e vegetais.

    “As mudanças mais impactantes que as pessoas podem fazer para reduzir o colesterol incluem consumir menos produtos de origem animal, exceto peixes, e menos gordura saturada”, explica o Dr. Lopez-Jimenez.

    E se a equipe de cuidados médicos recomendar o uso de medicamentos além das mudanças do estilo de vida?

    “Tome os medicamentos, verifique as suas taxas e tenha a certeza de que todos os fatores estarão sob controle”, ele explica.

    ###

    Sobre a Mayo Clinic

    A Mayo Clinic é uma organização sem fins lucrativos comprometida com a inovação na prática clínica, educação e pesquisa, fornecendo compaixão, conhecimento e respostas para todos que precisam de cura. Visite a Rede de Notícias da Mayo Clinic para obter outras notícias da Mayo Clinic.

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  • Alcohol can increase blood pressure, study shows

    Alcohol can increase blood pressure, study shows

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    Alcohol can increase blood pressure, study shows – CBS News


    Watch CBS News



    A recent from the American Heart Association found that drinking just one alcoholic beverage a day can increase blood pressure, even for those who don’t have hypertension. Adriana Diaz takes a look at some of the other benefits of cutting back on drinking.

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  • Adolescent fitness may not provide as much future cardiovascular health benefit as believed.

    Adolescent fitness may not provide as much future cardiovascular health benefit as believed.

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    Newswise — There is a well-known relationship between good physical fitness at a young age and a lower risk of cardiovascular disease later in life. However, when researchers adjusted for familial factors by means of sibling analysis, they found a weaker association, although the link between high body mass index (BMI) and cardiovascular disease remained strong. The study, which was conducted by researchers from Karolinska Institutet and other universities, is published in JAMA Network Open.

    “This does not mean that fitness is irrelevant,” says the study’s last author Viktor Ahlqvist, doctoral student at the Department of Global Public Health, Karolinska Institutet. “We could still see an association, although it was weaker after taking into account factors shared by full siblings. We also think that adolescence is an important time in life for establishing good habits such as exercising and having a healthy diet.”

    Challenging to prove causal associations

    Many observational studies have previously demonstrated links between various risk factors at a young age and cardiovascular disease in adulthood. However, whether the associations are causal is challenging to prove because of the potential influence of unaccounted genetic and environmental factors. A collaborative team including researchers from Karolinska Institutet in Sweden has therefore tried to examine if a large proportion of cardiovascular diseases in adulthood could indeed be prevented with a lower BMI, lower blood pressure, improved physical fitness or improved muscle strength in adolescence.

    Sourcing data from the Swedish Military Conscription Register and other Swedish registries, the researchers identified over a million 18-year-old males and followed them for 60 years. Almost half of them were full brothers.

    “The strength of our study, which makes it more reliable than many other conventional observational studies, is that we have used sibling analyses,” says the study’s first author Marcel Ballin, researcher at Uppsala University and analyst at Region Stockholm’s Centre for Epidemiology and Community Medicine. “By doing so we could examine how the relationship changes when controlling for all shared sibling factors. This includes environmental factors such as childhood environment and half of the genetics.”

    High BMI is a strong risk factor

    The results show that a high BMI in late adolescence was strongly associated with future cardiovascular disease, even after the researchers had controlled for shared familial factors. However, the association between physical fitness and cardiovascular disease was considerably weaker in the sibling analysis, suggesting that many previous observational studies might have overestimated the relevance of adolescent fitness to cardiovascular health later in life.

    “Our conclusion is that of the risk factors studied, high BMI is the strongest individual risk factor for cardiovascular disease, and that efforts to tackle the obesity epidemic should continue to be given high priority,” says co-author Daniel Berglind, docent at the Department of Global Public Health, Karolinska Institutet. “A good level of fitness and muscle strength in adolescence doesn’t seem as crucial, but physical activity still remains important for public health, as it can bring other health benefits.”

    Several limitations

    The study examined the association between risk factors at a young age and future cardiovascular disease; other disease outcomes were not investigated. The researchers had no data on whether the participants’ risk factors varied later in life, and they only studied men, which makes it difficult to extend their findings to women. The Military Conscription Register also lacks details on certain risk factors for future cardiovascular disease, such as diet, alcohol consumption, smoking, blood lipids and blood glucose.

    The researchers received no specific grant for this study. Co-author Martin Neovius is on the advisory panels for Ethicon, Johnson & Johnson and Itrim and has been a consultant for the Swedish armed forces outside the scope of this study. No other conflicts of interest have been reported.

    Publication: “Genetic and environmental factors and cardiovascular disease risk in adolescents”, Marcel Ballin, Martin Neovius, Francisco B. Ortega, Pontus Henriksson, Anna Nordström, Daniel Berglind, Peter Nordström, Viktor H. Ahlqvist, JAMA Network Open, online 17 November 2023, doi: 10.1001/jamanetworkopen.2023.43947.

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  • The Future of Obesity Drugs Just Got Way More Real

    The Future of Obesity Drugs Just Got Way More Real

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    A wild idea recently circulated about the future of aviation: If passengers lose weight via obesity drugs, airlines could potentially cut down on fuel costs. In September, analysts at Jefferies Bank estimated that in the “slimmer society” obesity drugs will create, United Airlines could save up to $80 million in jet fuel annually.

    In the past year, as more Americans have learned about semaglutide, which is sold for diabetes under the brand name Ozempic and for obesity under the name Wegovy, hype has become completely divorced from reality. For all the grand predictions, just a fraction of Americans who qualify for obesity drugs are on them. With a list price of roughly $1,350 a month, Wegovy is far too expensive, under-covered by insurance, and in limited supply to be a routine part of health care.

    But that possibility is beginning to seem very real. The results of a highly anticipated study published on Saturday indicate that Wegovy can have profound effects on heart health, which potentially opens up the drug to even more patients. A few days earlier, the FDA approved Zepbound, an obesity drug that is a bit cheaper and appears more potent than Wegovy. If there was any doubt before, now it is undeniable: Obesity drugs “are here to stay,” Kyla Lara-Breitinger, a cardiologist at the Mayo Clinic, told me. “There’s only going to be more and more of them.” They are now poised to become deeply entrenched in American health care, perhaps eventually even joining the ranks of commonly used drugs such as statins and metformin.

    Considering that obesity is linked to all sorts of major heart ailments, it is no big surprise that a weekly shot for weight loss might have some cardiovascular benefits. But because this class of obesity drugs, known as GLP-1 agonists for the hunger hormone they target, is so new, doctors did not know that for sure. Starting in 2018, Novo Nordisk, the company that manufactures semaglutide, began to look for answers in a study of more than 17,600 people with obesity and cardiovascular disease. In this group, results of a trial named SELECT show that Wegovy reduced the risk of major cardiac events—stroke, heart attack, death—by 20 percent. Even compared with studies on common heart medications such as Praluent and Repatha, the Wegovy results are “impressive,” Eugene Yang, a cardiologist and professor of medicine at the University of Washington, told me.

    How exactly the drug prevents major cardiac events isn’t fully understood. Some of the effects can likely be chalked up to weight loss itself, which is associated with improvements in metrics that influence heart health, such as blood pressure, Yang said. But mechanisms independent of weight loss may also be at work. In the trial, lower rates of cardiovascular events began showing up before participants lost weight. One explanation is the drug’s impact on inflammation, which is associated with heart disease: C-reactive protein, a rough proxy for inflammation, dropped by nearly 40 percent in study participants.

    Regardless of how Wegovy works, Yang said, “it has the potential benefit of being very significant” as a new line of treatment for heart disease, the leading cause of death nationwide. Novo Nordisk has already applied for expanded FDA approval and anticipates receiving it within six months. Approval would also show that Wegovy has a medical benefit beyond weight loss, pressuring insurers to cover it. Right now, for instance, Medicare does not, in part because obesity has long been viewed as a cosmetic issue, not a medical one. Even with private coverage, the drug is still frequently out of reach. The SELECT trial makes it “unequivocally clear” that obesity is a health condition that can be treated with drugs, Ted Kyle, an obesity-policy expert, told me. Still, the study leaves room for pushback: The absolute risk reduction of cardiovascular events was 1.5 percent, which is, by some reckonings, quite small. A higher risk reduction would have “put more pressure” on insurers and manufacturers to make the drugs more affordable for Americans, Lara-Breitinger said.

    Still, the findings are robust enough that it seems likely that the heart benefits of obesity drugs will lead more Americans to take them—if not immediately, then eventually. The approval of a new drug could do the same. Tirzepatide, which Eli Lilly has sold as a diabetes drug under the name Mounjaro, will be marketed as Zepbound for obesity—and it is coming for Wegovy’s throne. In one study, people on tirzepatide lost an average of 18 percent of their body weight; for comparison, in another study patients on Wegovy lost an average of 15 percent. At a little over $1,000 a month, Zepbound is not cheap, but its list price is hundreds of dollars lower than that of Wegovy. (The manufacturers of both drugs have said that most insured patients pay far less than that.)

    Zepbound’s approval is just the beginning. Unlike semaglutide, which targets only one hormone, GLP-1, to exert its effects on appetite and fullness, tirzepatide targets two. Other drugs that target two or even three hormones are in the works, as are versions that come in a more appealing pill format rather than as an injection. Generic versions of these drugs, likely beginning with liraglutide, a predecessor to semaglutide sold as Saxenda, could become available soon, Yang said. This competition will help bring down costs, but it will go only so far. Drug pricing is “a little bit screwy,” Kyle said, complicated by the wide gap between the list price and the net price created by manufactures, insurers, and intermediaries between them.

    Each new competitor and new study is a step toward a future in which a substantial proportion of Americans with obesity are routinely prescribed these drugs. In a single week, obesity drugs leapt a new era—one in which they are about to become significantly more mainstream. No doubt that future is a bright one for millions of people who might benefit from treatment. Still, many questions about the drugs remain unanswered, such as their long-term safety and endless supply shortages.

    But the potential for obesity drugs to truly change America has never felt closer—with all of the dizzying questions this creates about what “a slimming society” might mean for exercise, the food industry, and apparently even airline jet fuel.

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  • Is It Safe to Take Weight-Loss Pills?  | NutritionFacts.org

    Is It Safe to Take Weight-Loss Pills?  | NutritionFacts.org

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    Why don’t more people take the weight-loss medications currently on the market? 

    Despite the myriad menus of FDA-approved medications for weight loss, they’ve only been prescribed for about 1 in 50 patients with obesity. We tend to worship medical magic bullets in the United States, so what gives? As I discuss in my video Friday Favorites: Are Weight-Loss Supplements Safe and Effective?, one of the reasons anti-obesity drugs are so “highly stigmatized” is that, historically, they’ve been anything but magical and the bullets have been blanks—or worse. 

    To date, most weight-loss drugs that were initially approved as safe have since been pulled from the market for unforeseen side effects that turned them into a “threat to public health.” As you may remember from my video Brown Fat: Losing Weight Through Thermogenesis, it all started with DNP, a pesticide with a promise to safely melt away fat that melted away people’s eyesight instead. (That actually helped lead to the passage of the landmark Food, Drug, and Cosmetic Act in 1938.) Thanks to the internet, DNP has made a comeback with “predictably lethal results.” 

    Then came the amphetamines. Currently, more than half a million Americans may be addicted to amphetamines like crystal meth, but the “original amphetamine epidemic was generated by the pharmaceutical industry and medical profession.” By the 1960s, drug companies were churning out about 80,000 kilos of amphetamines a year, which is nearly enough for a weekly dose for every man, woman, and child in the United States. Billions of doses a year were prescribed for weight loss, and weight-loss clinics were raking in huge profits. A dispensing diet doctor could buy 100,000 amphetamine tablets for less than $100, then turn around and sell them to patients for $12,000.  

    At a 1970 Senate Hearing, Senator Thomas Dodd (father of “Dodd-Frank” Senator Chris Dodd) suggested that America’s speed freak problem “was no by means an ‘accidental development’: ‘Multihundred million dollar advertising budgets, frequently the most costly ingredient in the price of a pill, have, pill by pill, led, coaxed and seduced post-World War II generations into the ‘freaked-out’ drug culture…’” I’ll leave drawing the Big Pharma parallels to the current opioid crisis as an exercise for the viewer.  

    Aminorex was a widely-prescribed appetite suppressant before it was pulled for causing lung damage. Eighteen million Americans were on fen-phen before it was pulled from the market for causing severe damage to heart valves. Meridia was pulled for heart attacks and strokes, Acomplia was pulled for psychiatric side effects, including suicide, and the list goes on, as you can see below and at 2:51 in my video. 

    The fen-phen debacle resulted in “some of the largest litigation pay-outs ever seen in the pharmaceutical industry, with individual amounts of up to US$200,000 and a total value of ~US$14 billion,” but that’s all baked into the formula. If you read the journal PharmacoEconomics (and who doesn’t!), you may be aware that a new weight-loss drug may injure and kill so many that “expected litigation cost” could exceed $80 million, but Big Pharma consultants estimate that if it’s successful, the drug could bring in more than $100 million, so do the math. 

    What does work for weight loss? I dive deep into that and more in How Not to Diet.  For more of my videos on weight loss, check out the related videos below. 

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    Michael Greger M.D. FACLM

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  • A ‘game-changing’ study backs Wegovy use to cut heart attacks and strokes: ‘This is not just about weight and appearance’

    A ‘game-changing’ study backs Wegovy use to cut heart attacks and strokes: ‘This is not just about weight and appearance’

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    Novo Nordisk A/S unveiled details from a closely watched study that support use of Wegovy, its blockbuster weight-loss drug, to cut heart attacks and strokes in obesity patients with a history of cardiovascular disease.

    People taking the highest dose of Wegovy saw a drop in blood sugar levels and inflammation — two harbingers of heart disease — that help explain the 20% reduction in cardiovascular events that Novo reported in August. While none of the patients had diabetes, two-thirds started the study with blood sugar levels in the prediabetic range, which is associated with a higher risk of heart disease and death. Patients also saw significant reductions in blood pressure.

    Three-quarters of patients had suffered heart attacks before the study began and a quarter had heart failure. In this highly vulnerable population, the results help cement the argument for using Novo’s drug as a heart treatment alongside statins and blood pressure therapies. Patients on Wegovy also lost weight in the trial.

    The results, presented on Saturday at the American Heart Association’s annual conference in Philadelphia, are “game-changing,” Eugene Yang, the chair of the American College of Cardiology’s prevention section, said in an interview. The room at the city’s Convention Center erupted into several rounds of applause when the data were presented.

    Heart disease is the number one killer in the US and accounts for about a third of deaths globally. While obesity is known to raise the risk for such ailments, Novo’s trial was designed to show whether Wegovy could ward off future heart attacks and strokes in people with established cardiovascular disease.

    Novo said it will seek expanded US approval for reducing risk of major adverse cardiovascular events in adults with a body mass index, or BMI, of 27 or higher and established cardiovascular disease.

    Read More: All About the New Obesity Drugs Causing a Big Stir

    “Increasingly, physicians are understanding that this is not just about weight and appearance,” Lars Fruergaard Jorgensen, Novo’s chief executive officer, said in an interview on Friday before the details were released. “It’s about real health benefits.”

    Weight-loss drugs such as Wegovy, which increased sales more than 700% last quarter, have become a phenomenon this year. Celebrities are touting their benefits, while investors handicap how much they will disrupt a wide swath of sectors that includes apparel companies, restaurants and packaged food producers. Novo is already struggling to keep up with demand. And competition is increasing with Eli Lilly & Co. just receiving approval for its weight-loss drug, Zepbound.

    However, the drugs are expensive. Zepbound will cost about $1,050 for a month’s supply, which is cheaper than Wegovy’s monthly list price of roughly $1,350. The cost is a barrier to widespread access, Yang said. Based on the trial results, to prevent one heart attack or cardiovascular death, 67 people will need to be treated with Wegovy for almost three years and four months, according to a Bloomberg analysis. At list prices, this would cost $3.8 million.

    Along with reducing weight, blood sugar control and anti-inflammatory effects are likely what’s driving the benefit for heart disease shown in the study, Martin Holst Lange, Novo’s development chief, said in an interview. In the trial of more than 17,600 overweight and obese adults who were 45 and older, taking Wegovy lowered body weight by an average of 9.4% over two years, compared to a less than 1% loss in the placebo group. The treatment group also saw reduced weight circumference and blood pressure that’s often associated with shedding pounds.

    At the same time, blood sugar fell into a healthy range in two-thirds of those treated. That was enough to ward off diabetes in about 70% of patients. C-reactive protein, a liver product that’s linked to inflammation, fell about 40% among those taking Wegovy.

    Only 28% of the patients in the trial were women and just 4% were Black, meaning the results may not translate to those populations, according to the ACC’s Yang. About 17% of the patients in the trial stopped taking Wegovy due to side effects. The most common cause was gastrointestinal issues, which were responsible for most of the discontinuations.

    — With assistance from Robert Langreth

    Subscribe to Well Adjusted, our newsletter full of simple strategies to work smarter and live better, from the Fortune Well team. Sign up for free today.

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  • Traditional Chinese medicine proves effective in modern clinical trial

    Traditional Chinese medicine proves effective in modern clinical trial

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    A traditional Chinese medicine has been shown to be effective at reducing complications following a heart attack after a large-scale, clinical trial.

    The medicine, known as tongxinluo, is made of extracts derived from seven herbs and various animals—including cockroaches, scorpions, cicadas and leeches. The compound, whose name means “to open the network of the heart,” has long been used as a traditional Chinese treatment for patients who have had heart attacks and/or strokes.

    Based on promising results in cellular and animal models, the State Food and Drug Administration of China approved its use for the treatment of stroke and angina pectoris—a heart condition characterized by reoccurring chest pain—in 1996.

    But the medicine had never been evaluated in a randomized, double-blind, placebo-controlled clinical trial—the gold standard of drug testing that is usually required to approve treatments in the United States and Europe.

    The latest study, which has been published in JAMA (formerly The Journal of the American Medical Association), represents one of the first times that a traditional Chinese medicine has been tested in a large-scale, Western-style clinical trial.

    The authors of the study, who include researchers from several Chinese universities and hospitals, in collaboration with experts from the University of Texas Southwestern Medical Center (UTSW)—found that tongxinluo reduced the risk of heart attacks (known as myocardial infarctions), deaths and other major cardiovascular complications for at least a year after a first heart attack.

    Matthew Saybolt, a cardiologist with the Hackensack Meridian Jersey Shore University Medical Center who was not involved in the latest study, told Newsweek that he found the latest research “compelling” after reviewing the paper.

    “I am not aware of any other large, well-run trials like this studying traditional Chinese medicine. This is a rarely run type of study, and I congratulate the authors for their work and publication in such a prestigious medical journal,” Saybolt said.

    The study involved 3,777 patients at 124 clinical centers in China who had suffered the most severe form of heart attack—known as ST-segment elevation myocardial infarction, or STEMI. This condition involves a blood clot that completely blocks a major vessel supplying the heart. The patients were enrolled from May 2019 to December 2020, with the last date of follow-up occurring in December 2021.

    The patients were treated within hours of symptom onset by surgical or chemical removal of the clot. While they received standard treatments over the next year—such as taking a daily aspirin or medications including beta blockers—half of the individuals were randomly selected to receive tongxinluo as well. The other half were given a placebo—designed to match the look, smell and taste of the traditional Chinese medicine—instead.

    Over the next year, the patients were followed to track the incidence of major adverse cardiac and cerebrovascular events (MACCEs), an umbrella term that covers cardiac death, repeat heart attacks (myocardial reinfarctions), stroke and emergency procedures to restore blood flow to the heart.

    The results showed that the incidence of MACCEs was around 30 percent lower in the group that took tongxinluo, compared with those participants taking the placebo at 30 days of follow-up. These benefits persisted for one year after discharge, and no major side effects were recorded, indicating that the medicine was safe to use, the authors found.

    A stock image shows a doctor prescribing medicine. A traditional Chinese medicine has been shown to be effective at reducing complications from a heart attack after a large-scale, clinical trial.
    iStock

    “Many drugs have failed to achieve effects as impressive as this traditional Chinese medicine,” Dr. Ying Xian, an author of the study who is at UTSW, said in a press release.

    Saybolt said the study was “well conducted,” with a large sample size that was “well powered” to measure the outcomes.

    “In this trial, there is clearly a benefit to patients treated with this Chinese medicine compound compared to placebo,” he said.

    He went on: “A reduction in death, reinfarction or complications after a STEMI is a very exciting finding. We have for some time been trying to bend the curve and improve mortality and complications after STEMI. Any new therapy, if safe, that can accomplish this would be very appealing to patients and physicians alike.”

    Saybolt said he also observed some weaknesses in the way the study was conducted, one of which was that the participants were entirely Chinese citizens and predominantly male.

    “Thus the findings may not be generalizable throughout the world or to women,” he said. “Furthermore, the patients were less frequently—compared to the United States, for example—treated with traditional proven medicine after their myocardial infarctions. Therefore, the effect of the Chinese medicine may have been augmented by the lack of patient exposure to proven therapies.

    “However, there was equivalent low utilization of these traditional medications in both groups,” he continued. “Furthermore, the study drug Chinese medicine compound was composed of multiple plant and insect products. Thus, we do not know which component or combination of components were the active ingredients and what is the correct dose.”

    Further research will be needed to address these matters, and the benefits shown in this study would need to be duplicated in other populations before the treatment could get approved by the U.S. Food and Drug Administration.

    Saybolt said he would be “very interested” to see another study of its kind in a broader population outside China. “We must also isolate the compound into its individual components and determine which of the components is the therapeutic ingredient.”

    Traditional Chinese medicines are seldom tested in large, randomized, placebo-controlled, blinded trials, he said.

    “The gap in research is due to a combination of bias in research towards traditional pharmaceuticals and due to funding. Large trials such as this require funding from federal agencies, grants or industry sponsorship. A generic medicine or nutritional/herbal/animal/insect compound has little financial backing in many cases,” he said.

    Eric Peterson, a senior author of the study who is at UTSW, advised and collaborated with the Chinese researchers. He told Newsweek: “Is the medicine ready for the West? No. Does it show interesting promise? Absolutely. And we should not discount it. We have shown that traditional Chinese medicines can be tested.”

    He continued: “There’s a little bit of disbelief when you just look at the ingredients that are in it. People in the West…we have our doubts. We felt similarly about some of the drugs that we had to treat malaria until we found that they were actually pretty powerful medicines. So I think there are a lot of natural cures that actually are based on some believable and truthful benefits.”