Medical Bulletin 02/ April/ 2024

A recent study published in The Journal of Nutrition, Health and Aging explored how meat consumption influences the risk of death in frail populations.

Frailty, a clinical syndrome affecting almost 10% of the elderly, undermines their ability to handle stress. Nutrition plays a key role in frailty development, with protein supplements often used to boost strength and physical function in frail older adults. Meat, as a food category, includes red meat, fish, and poultry. Rich in proteins and micronutrients, meat is important for building and maintaining muscle strength, enhancing physical strength, and minimizing the incidence of malnutrition in the elderly. Although meat is a rich protein source, its impact on the health of frail individuals remains under-researched.

In the study, around 20,000 participants, with a mean age of 58 years were enrolled. About 38% and 12% ate red meat and processed meat, respectively. Higher processed meat consumption, particularly more than 4 times a week, increased all-cause mortality by 20% and deaths from cardiovascular disease (CVD) by 25%. Red meat intake showed a U-shaped relationship with mortality, with lower death rates from all causes, cancer, and CVD observed among those consuming red meat up to 2 times a week. Compared to those consuming red meat less than once a week, the risk of all-cause deaths was 14% lower in this group. Additionally, for every additional 25 g of red meat consumed, there was a 7% increase in all-cause mortality and a 16% increase in deaths from CVD among the frail. Overall meat consumption did not show the same impact on mortality.

The findings suggested that a higher processed meat intake was associated with an increased risk of all-cause and cardiovascular mortality among frail individuals. Moderate intake of unprocessed red meat and higher intake of unprocessed substitutes such as poultry was associated with a decreased risk of all-cause, cancer, and cardiovascular mortality. Replacing processed meat or unprocessed red meat with fish or unprocessed poultry may be encouraged to reduce mortality and prolong life expectancy.

Reference: Jie Chen a, Weihao Xu, Lintao Dan, Junhan Tang b, Jirong Yue e, Emiel O. Hoogendijk f, and Chenkai Wu (2024). Associations between meat consumption and all-cause and cause-specific mortality in middle-aged and older adults with frailty. The Journal of Nutrition, Health and Aging. doi: http://dx.doi.org/10.1016/j.jnha.2024.100191.

A new research to be presented at this year’s European Congress on Obesity, from 12-15 May, suggested that children and teenagers living with overweight or obesity are more likely to have high blood pressure as adults (aged 50-64 years), suggesting the processes behind the condition could begin as early as childhood.

Hypertension is a major global health concern, affecting 1.28 billion adults aged 30-79 years worldwide. It significantly increases the risk of cardiovascular diseases like heart attacks, strokes, and chronic kidney disease. Poor diet, lack of exercise, and obesity are modifiable risk factors. High BMI in adults is strongly linked to high blood pressure, but the impact of elevated BMI during childhood and puberty on midlife blood pressure remains unclear.

In the study, researchers examined 1,683 individuals from two population-based cohorts to investigate the relationship between BMI during development and blood pressure in midlife (50-64 years old). They utilized data from the BMI Epidemiology Study Gothenburg (BEST) cohort and the Swedish Cardio-Pulmonary bio-Image Study (SCAPIS). Developmental BMI was assessed using school health records and military enrolment examinations for young adults. Blood pressure measurements in midlife were obtained from SCAPIS participants not taking medication for high blood pressure. All analyses were adjusted for birth year.

The results revealed that in men, both childhood BMI and pubertal BMI change independently contributed to increased systolic and diastolic blood pressure in middle age. For each one unit increase in childhood BMI, there was a 1.30 mmHg increase in systolic blood pressure and a 0.75 mmHg increase in diastolic blood pressure. In women, only pubertal BMI change was significantly associated with increased blood pressure in midlife, with a 0.96 mmHg increase in systolic blood pressure and a 0.77 mmHg increase in diastolic blood pressure. Childhood BMI did not show a significant association with blood pressure in midlife for women.

“Although the differences in blood pressure are not very large, if blood pressure is slightly elevated over many years, it can damage blood vessels and lead to cardiovascular and kidney disease. Our findings indicate that high blood pressure may originate in early life. Excessive fat mass induces chronic low-grade inflammation and endothelial dysfunction [impaired functioning of the lining of the blood vessels] already in childhood. Higher amounts of visceral abdominal fat increase the risk of developing hypertension in adults. And we have previously shown that a large pubertal BMI change in men is associated with visceral obesity [fat around the internal organs] at a young adult age. So enlarged visceral fat mass might, in individuals with a high BMI increase during puberty, be a possible mechanism contributing to higher blood pressure.” explained co-author Dr Jenny Kindblom from Sahlgrenska University Hospital, Sweden.

Reference: Study suggests high blood pressure could begin in childhood; EUROPEAN ASSOCIATION FOR THE STUDY OF OBESITY; MEETING: European Congress on Obesity (ECO2024)

A population-wide observational study to be presented at this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024) showed an association between tuberculosis (TB) and cancer, with those with current or previous TB more likely to have a diagnosis of a variety of cancers, including lung, blood, gynaecological and colorectal cancers.

Despite a successful cure of TB being possible, complications can occur at various anatomical sites due to structural or vascular damage, metabolic abnormalities and host inflammatory response. These complications may include an increased risk of cancer, which may be influenced by host tissue and DNA damage, and/or interruption of normal gene repair processes and growth factors present in the blood. In this study, the authors investigated the association between cancer incidence and TB compared with the general population.

In the study, researchers analyzed data from 72,542 TB patients and matched controls from South Korea's National Health Insurance Service-National Health Information Database (2010-2017). TB patients, identified by disease codes or treatment, were compared to controls matched for various factors. The study investigated cancer incidence post-TB diagnosis and identified associated risk factors.

The results revealed that compared with the general population, the incidence of cancer was significantly higher in TB patients: 80% higher for all cancers combined; 3.6 times higher for lung cancer, 2.4 times higher for blood cancer; 2.2 times higher for gynaecological cancer; 57% higher for colorectal cancer; 56% higher for thyroid cancer and 55% higher for oesophagus and stomach cancer. After adjustment, current smoking (40% increased risk versus non-smokers), heavy alcohol consumption (15% increased risk versus regular alcohol consumption) chronic liver disease (42% increased risk versus no liver diseases) and chronic obstructive pulmonary disease (COPD) (8% increased risk) were also identified as independent risk factors for cancer in people with TB.

“TB is an independent risk factor for cancer, not only lung cancer, but also various site-specific cancers, after adjusting for confounders. Screening and management for cancer should be warranted in patients with TB,” said the authors of the study.

Reference: Study finds association between TB infection and increased risk of various cancers; EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES; MEETING; The European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024)