Medical Bulletin 10/ December/ 2024

Here are the top medical news for the day:

Consuming Sugary Drinks May Significantly Increase Cardiovascular Disease Risk

Scientists studying the impact of sugar on the risk of cardiovascular disease have found that eating too much added sugar increases your risk of stroke or aneurysm, but eating a few treats is associated with a lower risk of cardiovascular diseases. Meanwhile, drinking sweetened beverages raises your risk of stroke, heart failure, and atrial fibrillation.

“The most striking finding from our study is the divergent relationship between different sources of added sugar and cardiovascular disease risk,” said Suzanne Janzi, PhD candidate at Lund University and corresponding author of the article in Frontiers in Public Health. “This surprising contrast highlights the importance of considering not just the amount of sugar consumed, but its source and context.”

Scientists collected data from two major cohort studies, the Swedish Mammography Cohort and the Cohort of Swedish Men. These studies had diet questionnaires administered in 1997 and 2009, allowing the scientists to monitor participants’ diets over time. The scientists looked at a sample of 69,705 participants. They looked at three classes of sugar consumption — toppings like honey, treats like a pastry, or sweetened beverages like fizzy drinks — and seven cardiovascular diseases: two different types of stroke, heart attacks, heart failure, aortic aneurysms, atrial fibrillation, and aortic stenosis. The participants were monitored until they died, were diagnosed with one of the cardiovascular diseases, or reached the end of the follow-up period in 2019. During this period, 25,739 participants were diagnosed with a cardiovascular disease.

They found that consuming sweet drinks was worse for your health than any other form of sugar: drinking more sweetened drinks significantly increased the risk of ischemic stroke, heart failure, atrial fibrillation and abdominal aortic aneurysm. However, the highest risks of a negative health outcome arose in the lowest intake category for treats. Consuming occasional treats was associated with better outcomes than no treats at all.

Reference: Janzi Suzanne , González-Padilla Esther , Ramne Stina , Bergwall Sara , Borné Yan , Sonestedt Emily, Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women, Frontiers in Public Health, VOLUME 12, 2024

DOI: 10.3389/fpubh.2024.1452085

New Guidelines on Diagnosis and Management of Premature Ovarian Insufficiency

New guidelines on the diagnosis and management of premature ovarian insufficiency (POI) – developed by the Centre for Research Excellence in Women’s Health in Reproductive Life (CRE-WHiRL) at Monash University, and key international women’s health organisations with an international team of experts including women with lived experience.

The guidelines were last updated in 2015 and the 2024 update of the premature ovarian insufficiency Guidelines of the European Society of Human Reproduction and Embryology (ESHRE).

The 2024 guidelines provide 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of premature ovarian insufficiency. The recommendations were developed using the best available evidence and graded according to the strength of that evidence. Topics to cover in the guideline were informed by an international survey of women and healthcare professionals. New information is provided about the genetic causes of premature ovarian insufficiency, the impact of premature ovarian insufficiency on muscle health, use of anti-mullerian hormone, non-hormonal therapies, lifestyle interventions and complementary therapies.

According to Co-Chair of the guideline development group, Associate Professor Amanda Vincent, from CRE-WHiRL, a key change of the updated 2024 guidelines is the recommendation regarding the diagnosis of premature ovarian insufficiency; only one elevated follicle stimulating hormone (FSH) level is needed combined with irregular or absent menstrual periods for at least four months. The FSH level only requires repeating if the diagnosis remains unclear. Women with lived experience provided recommendations on how to convey the diagnosis and care of women with premature ovarian insufficiency.

The updated guideline stresses the importance of personalised hormone therapy, unless contraindicated, for symptom relief and chronic disease prevention; with the need for prompt institution and continuation until the usual age of menopause.

Reference: Panay, N., Anderson, R. A., Bennie, A., Cedars, M., Davies, M., … Vincent, A. J. (2024). Evidence-based guideline: premature ovarian insufficiency†‡. Climacteric, 1–11. https://doi.org/10.1080/13697137.2024.2423213

Chronic Pain Relief May Be Just a Diet Change Away: Researchers

A research from the University of South Australia shows that adopting a healthy diet can reduce the severity of chronic pain, presenting an easy and accessible way for sufferers to better manage their condition. Exploring associations between body fat, diet, and pain, researchers found that a greater consumption of foods within the Australian Dietary Guidelines was directly associated with lower levels of body pain, particularly among women. Importantly, these findings were independent of a person’s weight, meaning that despite your body composition, a healthy diet can help reduce chronic pain.

Globally, about 30% of the population suffers from chronic pain. Women have higher rates of chronic pain, as do people who are overweight or obese. UniSA PhD researcher Sue Ward says the study shows how modifiable factors, such as diet, can help manage and relieve chronic pain. “It’s common knowledge that eating well is good for your health and wellbeing. But knowing that simple changes to your diet could offset chronic pain, could be lifechanging,” Ward says.

“In our study, higher consumption of core foods – which are your vegetables, fruits, grains, lean meats, dairy and alternatives – was related to less pain, and this was regardless of body weight.

“This is important because being overweight or obese is a known risk factor for chronic pain. “Knowing that food choices and the overall quality of a person’s diet will not only make a person healthier, but also help reduce their pain levels, is extremely valuable.”

Notably, the findings suggest that diet quality affects pain differently in men and women.

“Women with better diets, had lower pain levels and better physical function. But this effect was much weaker for men,” Ward says. “It’s possible that the anti-inflammatory and antioxidant properties of the healthier core food groups is what reduces pain, but we can’t yet determine whether poorer diet quality leads to more pain, or if pain leads to eating a poorer quality diet.

“A healthy, nutritious diet brings multiple benefits for health, wellbeing, and pain management. And while personalised pain management strategies should be adopted, a healthy diet is an accessible, affordable, and effective way to manage and even reduce pain.”

Reference: Ward, S. J., Coates, A. M., Baldock, K. L., Stanford, T. E., & Hill, A. M. (2024). Better diet quality is associated with reduced body pain in adults regardless of adiposity: Findings from the Whyalla Intergenerational Study of Health. Nutrition Research, 130, 22-33.

Heatwaves Are Harming the Young More Than the Elderly: Study Finds

Many recent studies assume that elderly people are at particular risk of dying from extreme heat as the planet warms. A new study of mortality in Mexico turns this assumption on its head: it shows that 75% of heat-related deaths are occurring among people under 35 -- a large percentage of them ages 18 to 35, or the very group that one might expect to be most resistant to heat.

The analysis found that from 1998 to 2019, the country suffered about 3,300 heat-related deaths per year. Of these, nearly a third occurred in people ages 18 to 35 -- a figure far out of proportion with the numbers in that age bracket. Also highly vulnerable: children under 5, especially infants. Surprisingly, people 50 to 70 suffered the least amount of heat-related mortality.

The researchers say several factors may be at work. Young adults are more likely to be engaged in outdoor labor including farming and construction, and thus more exposed to dehydration and heat stroke. The same goes for indoor manufacturing in spaces that lack air conditioning. Young adults are also more likely to participate in strenuous outdoor sports; the researchers point out.

Wet bulb temperatures are often converted by popular media into "real-feel" heat indexes on the Fahrenheit scale, where numbers can vary depending on the exact combination of heat and humidity. According to the study, wet-bulb temperatures of around 13 C are ideal for young people; in this range, they suffer minimum mortality. This study found that the largest number of deaths occurred at wet-bulb temperatures of just 23 or 24 C, in part because those temperatures occurred far more frequently than higher ones, and thus cumulatively exposed more people to dangerous conditions.

Using the same daily temperature and mortality data, the researchers found that elderly people died predominantly not from heat, but rather modest cold. Among other things, older people tend to have lower core temperatures, making them more sensitive to cold. In response, they may be prone to staying indoors, where infectious diseases spread more easily.

Reference: https://news.climate.columbia.edu/2024/12/06/high-heat-is-preferentially-killing-the-young-not-the-old-new-research-finds/