Medical Bulletin 05/ March/ 2024

A study published in the Journal Nature revealed that consumption of a Flavonol-rich diet is linked with healthy blood vessels, balanced cholesterol levels, reduced inflammation and lowered risk of heart disease.

Flavonols, a type of flavonoid, is a potent bioactive compound found in a majority of plant-based foods. They are known for their antioxidant properties, which help protect cells from damage caused by free radicals. Additionally, flavonols have been associated with several health benefits, including improved heart health, brain function, and reduced risk of chronic diseases such as cardiovascular disease and certain cancers.

The new cohort study examined the relationship between dietary flavonol intake (isorhamnetin, kaempferol, myricetin, and quercetin) and all-cause and disease-specific mortality risk in adults. Data from three NHANES cycles (2007-2019) on 11,679 participants were analysed. Flavonol intake was calculated using USDA data, and mortality risk was assessed using the National Death Index, categorised by causes such as cancer and cardiovascular diseases. Participants were followed until death or December 2019.

The study findings revealed significant associations between total and specific flavonol intake and mortality risks. High dietary flavonol intake reduced cancer-related mortality by 55%, cardiovascular disease mortality by 33%, and death risk from other causes by 36%.

Certain flavonols, like myricetin, showed substantial reductions in Alzheimer's disease-specific mortality risk (66%). No significant correlation was found between flavonol intake and diabetes-related mortality. Flavonol-rich diets also had a stronger protective effect against all-cause mortality in adults over 40.

The findings suggest that flavonol intake can help predict disease survival and that dietary modifications can be used to manage health risks. In particular, flavonol intake may positively impact overall mortality rates and mortality rates specific to cancer, Alzheimer’s disease, and cardiovascular disease, reflecting flavonols' potent anti-tumour, anti-inflammatory, and antioxidant effects.

Reference: Zhiqiang Zong, Xiang Cheng, Yang Yang, Jianchao Qiao, Jiqing Hao & Fanfan Li; Journal: Nature

According to a large study published in CMAJ (Canadian Medical Association Journal), Obesity is a risk factor for stillbirth, and the risk increases as pregnancy advances to later stages.

The global overall risk of stillbirth in pregnancy is approximately 2.6%. Although the link between obesity and stillbirth is well-known, little research was done on the association between obesity and stillbirth risk by gestational age, or on the impact of higher classes of obesity.

For the study, researchers examined data from the Better Outcomes Registry and Network on 681,178 singleton births from 2012 to 2018, including 1,956 stillbirths and accounted for other risk factors such as diabetes and high blood pressure when analyzing the data.

The findings revealed that people with class I obesity (BMI 30–34.9 kg/m2) had double the risk of stillbirth at 39 weeks gestation compared to those with normal BMI (18.5–24.9 kg/m2). For those in obesity classes II and III (BMI 35–39.9 kg/m2 and BMI 40 kg/m2 and higher, respectively), stillbirth risk at 36 weeks was 2 to 2.5 times that of people with normal BMI. This risk further increased with gestational age, with a more than fourfold risk at 40 weeks.

The authors also explored whether stillbirths occurred before or during delivery and found a higher risk of stillbirths occurring before delivery in people with class I and II obesity.

"Our findings suggest that an earlier delivery date may help reduce the risk of stillbirth for pregnant people with obesity," says lead author Dr. Naila Ramji, a high-risk pregnancy specialist and assistant professor at Dalhousie University, with coauthors at The Ottawa Hospital. "For other medical conditions that increase the risk of stillbirth, there are guidelines that recommend delivery at 38 or 39 weeks. Interestingly, the risk thresholds for those conditions are lower than the risks we found associated with obesity. We worry that implicit biases against people with obesity may be causing the medical community to take the risks they face less seriously.”

"Pregnant people with obesity, especially those with additional risk factors may benefit from timely referral and greater surveillance closer to term, and the presence of additional risk factors may warrant earlier delivery," concluded Dr. Ramji.

Reference: Journal: Canadian Medical Association Journal; DOI: 10.1503/cmaj.221450

According to a preliminary study released on March 3, 2024, people who experience sleep apnea may be more likely to also have memory or thinking problems. The findings will be presented at the American Academy of Neurology’s 76th Annual Meeting in April 2024.

Sleep apnea, a sleep disorder, is when people stop and restart breathing repeatedly during sleep which can lower oxygen levels in the blood. Symptoms, known as apnea, include snorting, gasping, breathing pauses, loud snoring, excessive daytime sleepiness, and difficulty concentrating. People with the disorder may also experience morning headaches or have trouble focusing on tasks. If left untreated, sleep apnea can lead to serious health complications such as hypertension, heart disease, stroke, and cognitive impairment.

“Sleep apnea is a common disorder that is often underdiagnosed, yet treatments are available,” said study author Dominique Low, MD, MPH, of Boston Medical Center in Massachusetts, and a member of the American Academy of Neurology. “Our study found that participants who had sleep apnea symptoms had greater odds of having memory or thinking problems.”

For the study, researchers included 4,257 participants who completed a questionnaire on sleep quality, memory, and thinking. For sleep, participants were asked about snorting, gasping or breathing pauses in their sleep. For memory and thinking, participants were asked questions related to difficulty remembering, periods of confusion, difficulty concentrating or problems with decision-making.

The findings revealed that among individuals with sleep apnea symptoms (1,079 participants), 33% reported memory or thinking issues, compared to 20% of those without symptoms (628 participants). After adjusting for factors like age, race, gender, and education, researchers observed that those with sleep apnea symptoms were approximately 50% more likely to experience memory or thinking problems compared to those without such symptoms.

“These findings highlight the importance of early screening for sleep apnea,” said Low. “Effective treatments like continuous positive airway pressure (CPAP) machines are readily available. Quality sleep, along with eating a healthy diet, regular exercise, social engagement and cognitive stimulation, may ultimately reduce a person’s risk of thinking and memory problems, improving their quality of life.”

Reference: Source: American Academy of Neurology