Medical Bulletin 04/November/2025

Impaired fasting glucose, marked by elevated blood sugar levels not yet meeting diabetes criteria, affects millions worldwide and increases the likelihood of developing type 2 diabetes and heart disease. While lifestyle changes remain primary treatment, adherence challenges have prompted researchers to explore nutritional supplements that may offer complementary benefits.

The study enrolled 62 Italian adults aged 18-75 with impaired fasting glucose (blood glucose 100–125 mg/dL), randomly assigning them to receive either the supplement or placebo. The supplement delivered 250 µg chromium and 560 mg total flavonoids—extracted from Citrus limon (lemon), Vitis vinifera (red grape), and Citrus sinensis (orange)—alongside dietary counseling for an isocaloric DASH diet. Blood samples were taken at baseline, 3 months, and 6 months to measure glucose metabolism, insulin resistance (HOMA-IR), and lipid profiles.

The supplemented group normalized fasting blood glucose as early as 3 months, maintaining levels within the normal range at 6 months, while the placebo group remained in the prediabetic range. LDL cholesterol decreased significantly from 114 to 73 mg/dL, HDL cholesterol increased markedly, and triglycerides declined, contrasting with increased triglycerides in the control group. HbA1c improved only in the supplemented group, though insulin and HOMA-IR showed no significant treatment effect. Safety markers, including liver and kidney function tests, indicated excellent tolerability.

The combination supplement works through multiple mechanisms: chromium enhances insulin receptor signaling and glucose uptake, while flavonoids like hesperidin modulate insulin-dependent pathways and reduce inflammation.

Lead researchers highlight this multi-ingredient approach as a valuable adjunct to lifestyle interventions, potentially offering safe and effective management of early impaired glucose metabolism while mitigating cardiovascular risk. Further larger-scale and longer-term studies are warranted to confirm and extend these findings.

REFERENCE: Di Minno, A., Morone, M. V., Buccato, D. G., De Lellis, L. F., Ullah, H., Borromeo, L., Cerqua, A., Piccinocchi, R., Greco, A., Santonastaso, S., Larsen, D. S., El-Seedi, H., Riccioni, C. V., Baldi, A., Piccinocchi, G., Xiao, X., Sacchi, R., & Daglia, M. (2025). Impact of a food supplement containing Citrus limon L. Osbeck and Vitis vinifera L. extracts, hesperidin and chromium in combination with an isocaloric diet on glucose and lipid metabolism in subjects with impaired fasting blood glucose, a single-center, controlled, randomized, parallel-arm, double-blind clinical trial. Frontiers in Nutrition, 12. DOI: 10.3389/fnut.2025.1671102.

Study Finds Simple Neck Measurement Could Help Detect Hidden Heart Risks

Your neck circumference, an often-overlooked measurement, can serve as a powerful indicator of hidden health risks, including cardiovascular and metabolic diseases. Recent research highlights how a thicker neck is linked to increased risk for heart conditions, type 2 diabetes, and sleep disorders, offering an accessible tool to complement traditional metrics like BMI.

Neck circumference reflects the accumulation of upper-body fat, which plays an active metabolic role by releasing fatty acids into the bloodstream. This fat distribution can interfere with cholesterol regulation, blood sugar control, and heart rhythm, particularly increasing risks for hypertension, atrial fibrillation, heart failure, and coronary heart disease. Atrial fibrillation—an irregular heartbeat—raises stroke risk through erratic blood flow and clot formation that can strain the heart over time.

Recent large-scale studies measured neck circumference in adults and correlated it with detailed cardiovascular and metabolic health assessments. Anthropometric measurements were combined with blood pressure, cholesterol profiles, glucose levels, and clinical histories to assess associations. Statistical analyses adjusted for confounders such as age, sex, BMI, and lifestyle factors to isolate neck size’s predictive value.

Individuals with neck circumferences exceeding approximately 17 inches (43 cm) for men and 14 inches (35.5 cm) for women showed significantly heightened risks for cardiovascular events and metabolic disorders, even when BMI was normal. For each additional centimeter above these thresholds, risks of hospitalization and premature death increased. Thick neck size also strongly correlated with obstructive sleep apnea, characterized by repeated breathing interruptions during sleep, which worsens daytime fatigue and cardiovascular stress.

Lead researchers underscore that neck circumference is a simple, non-invasive measurement that adds substantial insight to cardiovascular and metabolic risk assessments. While not replacing standard tests, neck size checks can encourage earlier interventions and personalized lifestyle changes. Regular exercise, nutritious diets rich in whole foods, and good sleep hygiene remain critical in reducing upper-body fat and associated health risks.

REFERENCE: The Conversation. "This simple neck measurement might reveal hidden heart risks." ScienceDaily. ScienceDaily, 20 October 2025.

Study Shows Fitness Apps, Wearables Partly Boost Children’s Health

Scientists have demonstrated that electronic health (eHealth) and mobile health (mHealth) interventions can modestly but meaningfully improve physical activity, diet, and weight-related outcomes in children and adolescents. A comprehensive umbrella review published in the Journal of Medical Internet Research synthesized evidence from 25 systematic reviews, covering 440 randomized trials with over 130,000 young participants.

The study aimed to evaluate the effectiveness of digital tools—including apps, websites, wearables, and text messaging—in promoting critical lifestyle behaviors among youth. These behaviors, such as moderate to vigorous physical activity (MVPA), fruit and vegetable intake, and reducing sedentary time, profoundly impact immediate and long-term health outcomes, including obesity and chronic disease risk.

Researchers conducted a pre-registered review using PRISMA guidelines, systematically assessing meta-analyses of randomized controlled trials targeting children and adolescents under 18 years. Interventions included a range of digital platforms offering personalized coaching, goal setting, feedback, gamification, and social support. The effects on physical activity, diet, sleep, sedentary behavior, BMI, and body weight were pooled using random-effects models. Subgroup analyses investigated age, intervention duration, delivery mode, and study quality.

Digital health interventions yielded small but consistent benefits in increasing MVPA (SMD 0.18) and total physical activity (SMD 0.24). Dietary improvements included reduced fat intake and increased fruit and vegetable consumption. Weight outcomes showed decreased BMI (SMD −0.19) and body weight (SMD −0.15), alongside reductions in body fat percentage. Wearable devices produced the most significant reductions in sedentary behavior, while app-based programs achieved the largest BMI improvements, likely through interactive self-monitoring and gamified goal-setting. Sleep outcomes remained largely unchanged, and sedentary behavior effects were mixed.

Shorter interventions (<8 weeks) were more effective at increasing physical activity, whereas longer ones (>12 weeks) better aided weight loss. Despite some variability, these modest effect sizes suggest that digital interventions can complement traditional health promotion, especially when integrated into schools and pediatric care.

Lead researchers advocate for expanded, high-quality trials focused on long-term engagement strategies, equitable access, and tailored digital health solutions to amplify benefits for youth.

REFERENCE: Singh, B., Ahmed, M., Staiano, A., Vasiloglou, M., Gough, C., Petersen, J., Yin, Z., Vandelanotte, C., Kracht, C., Fiedler, J., Timm, I., Dallinga, J., Sivakumar, B., Baumann, H., Huong, C., Wunsch, K., Suárez-Reyes, M., Schoeppe, S., Button, A., Spring, K., & Maher, C. (2025). Lifestyle eHealth and mHealth Interventions for Children and Adolescents: Systematic Umbrella Review and Meta–Meta-Analysis. J Med Internet Res, 27. DOI: 10.2196/69065, https://www.jmir.org/2025/1/e69065