Medical Bulletin 03/ July/ 2024

Here are the top medical news for the day:

New Research Links Fathers' Fish Oil Supplementation to Reduced Obesity in Offspring

A study conducted in mice, set to be presented at NUTRITION 2024, the flagship annual meeting of the American Society for Nutrition, has revealed a promising new approach to combat the growing problem of childhood obesity. The research indicated that a simple dietary adjustment, specifically fathers taking fish oil supplements, could help mitigate this significant health issue.

According to the World Health Organization, the number of young people aged 5 to 19 who are obese has skyrocketed from 31 million in 1990 to an alarming 160 million in 2022. This significant increase in obesity rates among youth poses severe health risks. Excess weight can lead to chronic conditions such as diabetes, high blood pressure, and high cholesterol, which may persist into adulthood.

Fish oil supplements, derived from the tissues of oily fish, are rich in omega-3 fatty acids, particularly EPA and DHA. These essential fats are known for their numerous health benefits, including supporting heart health, reducing inflammation, and improving brain function.

In this study, researchers explored whether a paternal diet could influence the health of offspring. Male mice were fed a high-fat diet, with or without the addition of fish oil supplements.

The study, which included nearly 150 mice, revealed that the offspring of males consuming fish oil had lower body weights and better metabolic health compared to those whose fathers did not receive fish oil. The male mice on these diets were then mated with female mice on a regular, healthy low-fat diet.

Results showed that the offspring, particularly those fed a low-fat healthy diet and fathered by males receiving fish oil, weighed less at 7 and 21 days old than those whose fathers did not consume fish oil. Additionally, female offspring of fish oil-supplemented males exhibited improved metabolic health, demonstrated by better glucose clearance and insulin sensitivity.

"This concept offers a significant potential to reshape our strategies in combating childhood obesity. Picture a future where pre-conception dietary guidance isn't solely directed at mothers, but also involves fathers, enabling them to play a more active role in promoting their children's well-being right from the start. While further human studies are needed, this discovery opens a new frontier in our understanding of how parents, beyond just genetics, influence their offspring's well-being. Fish oil, a readily available and safe supplement, could become a powerful weapon in our fight for a healthier next generation,” said Latha Ramalingam, PhD, Assistant Professor in Nutrition, Syracuse University.

Reference: Sarah Dellet; NUTRITION 2024, The flagship annual meeting of the American Society for Nutrition, Chicago; American Society for Nutrition

Physical Activity During Chemotherapy May Prevent Nerve Damage: JAMA Study

Cancer treatments often result in nerve damage, leading to long-lasting symptoms for patients. Traditional medications have proven largely ineffective in addressing this issue. However, a sports scientist at the University of Basel, collaborating with an interdisciplinary team from Germany, has demonstrated that simple physical exercises can effectively prevent nerve damage caused by chemotherapy.

The findings were published in the journal JAMA Internal Medicine.

Cancer treatments have significantly advanced over the years, shifting the focus from merely surviving the disease to ensuring a good quality of life after recovery.

Unfortunately, many cancer medications, including chemotherapy and modern immunotherapies, can damage nerves as well as tumour cells. Drugs like oxaliplatin or vinca alkaloids cause 70 to 90 percent of patients to experience pain, balance problems, or sensations of numbness, burning, or tingling. These symptoms can be very debilitating. While they may disappear after cancer treatment ends, about 50 percent of patients continue to suffer from these issues long-term. This condition is known as chemotherapy-induced peripheral neuropathy (CIPN).

In the study, 158 cancer patients, both male and female, undergoing treatment with either oxaliplatin or vinca-alkaloids were randomly divided into three groups. The first group, serving as the control, received standard care. The other two groups participated in exercise sessions twice a week during their chemotherapy, with each session lasting between 15 and 30 minutes. One exercise group focused on balancing on increasingly unstable surfaces, while the other trained on a vibration plate.

Regular examinations over the next five years revealed that the incidence of chemotherapy-induced peripheral neuropathy (CIPN) was approximately twice as high in the control group compared to the exercise groups. This means that the exercises performed alongside chemotherapy reduced the occurrence of nerve damage by 50 to 70 percent. Additionally, these exercises improved the patients' perceived quality of life, reduced the need to lower their chemotherapy doses, and decreased mortality rates in the five years following treatment.

Patients treated with vinca-alkaloids who participated in sensorimotor training experienced the greatest benefits.

“Significant investments have been made over the years to reduce the incidence of chemotherapy-induced peripheral neuropathy (CIPN). This side effect can directly impact clinical treatment, often requiring adjustments to chemotherapy cycles, dosages, or even leading to treatment termination. Despite these efforts, no effective pharmacological treatments have been found to prevent or reverse CIPN. In contrast, exercise has shown a proven positive effect on reducing nerve damage and is cost-effective. The potential of physical activity in mitigating CIPN is greatly underestimated. The recent study's findings highlight the need for more sports therapists in hospitals to fully harness this potential and improve patient outcomes,” said the authors.

Reference: Streckmann F, Elter T, Lehmann HC, et al. Preventive Effect of Neuromuscular Training on Chemotherapy-Induced Neuropathy: A Randomized Clinical Trial. JAMA Intern Med. Published online July 01, 2024. doi:10.1001/jamainternmed.2024.2354

New Genetic Research Links Early Puberty in Girls to Weight Gain

A Cambridge-led study has discovered that genes can indirectly influence the age at which girls experience their first period by accelerating childhood weight gain, a known risk factor for early puberty. Additionally, some genes can directly affect the timing of puberty, with significant impacts.

Published in the journal Nature Genetics, the research identified over 1,000 DNA variants that influence the age of first menstruation, with around 600 of these variants being newly observed.

Girls typically begin puberty and start menstruating between the ages of 10 and 15, though the average age has been decreasing in recent decades. The exact reasons for this remain unclear. Early puberty is associated with a higher risk of several diseases later in life, including type 2 diabetes, cardiovascular disease, and certain cancers. Conversely, later puberty is linked to better health in adulthood and a longer lifespan.

Just under half (45%) of the discovered genetic variants affected puberty indirectly, by increasing weight gain in early childhood.

In the study, researchers from Cambridge’s MRC Metabolic Diseases Unit discovered that a brain receptor known as MC3R detects the body's nutritional state and regulates the timing of puberty and growth rate in children. This finding explained how nutritional status can influence puberty. Additionally, other identified genes appear to act in the brain to control the release of reproductive hormones.

The scientists also examined rare genetic variants that, although carried by very few individuals, can significantly impact puberty timing. For instance, they found that one in 3,800 women carry variants in the gene ZNF483, causing these women to experience puberty on average 1.3 years later. The researchers developed a genetic score predicting the likelihood of a girl experiencing very early or very late puberty.

Girls in the highest 1% of this genetic score were 11 times more likely to have extremely delayed puberty, starting after age 15. Conversely, those in the lowest 1% were 14 times more likely to experience extremely early puberty, beginning before age 10.

“This is the first large-scale analysis of rare genetic variants, identifying six genes that significantly affect puberty timing. Although discovered in girls, these genes often impact boys similarly. The mechanisms we found could lead to interventions for early puberty and obesity. In the future, genetic scores could help predict very early or late puberty. The NHS is already trialling whole genome sequencing at birth, providing the necessary genetic information. Currently, children with early puberty– at age seven or eight – are offered blockers, but there's a need for additional interventions, such as oral medications or behavioural approaches, to support those who don’t meet this threshold, which could be crucial for their long-term health,” said the authors.

Reference: Kentistou, K.A., Kaisinger, L.R., Stankovic, S. et al. Understanding the genetic complexity of puberty timing across the allele frequency spectrum. Nat Genet (2024). https://doi.org/10.1038/s41588-024-01798-4