Medical Bulletin 20/ April/ 2024

A recent study published in Frontiers in Nutrition discussed the role of yoghurt as a nutritious food in preventing and managing diabetes and obesity.

Yoghurt, a low-calorie fermented dairy product, offers a balanced mix of proteins, essential nutrients, and beneficial bacteria. Studies have linked yoghurt consumption to lower risks of obesity, diabetes, osteoporosis, and heart disease while improving gut health and boosting immune function. According to an economic model for yoghurt use in diabetes risk reduction, the consumption of 100 grams of yogurt each day by adults can lead to 388,000 fewer people developing diabetes in the next 25 years.

In the study, researchers analyzed yogurt consumption data in the Argentine population, revealing an average annual intake of four kilograms per person. Over the past decade, both full-fat and skim yogurt consumption has declined by 44%. In 2019, diabetes prevalence was estimated at 13%.

Low-fat yogurt's anti-diabetic properties stem from its low glycemic load and nutrient content, including proteins, calcium, magnesium, and vitamin D. Certain saturated fatty acids in yogurt are linked to reduced diabetes risk, with daily consumption of 50 grams associated with a 7% lower risk.Yogurt's beneficial bacteria improve blood lipid profiles, lower cholesterol, and boost antioxidant status in diabetic patients. Additionally, yogurt's organic acids, like lactic acid, reduce postprandial blood glucose and insulin levels.

Gut microbiota imbalance is a key factor in obesity, causing changes like increased fat deposition and metabolic dysfunction. Yoghurt, with its nutritious elements and beneficial bacteria, can mitigate obesity risk by replacing unhealthy foods. It also influences appetite regulation, energy balance, and body mass index (BMI).

The findings of the study indicated that yogurt consumption could be beneficial for the prevention and management of both diabetes and obesity. The rising prevalence of these chronic diseases throughout the world emphasizes the importance of encouraging people to incorporate yogurt as part of their healthy diet to improve public health.

Reference: Britos, S., Gonzalez, A. F., Marco, F. F., et al. (2024). Yogurt, in the context of a healthy diet, for the prevention and management of diabetes and obesity: a perspective from Argentina. Frontiers in Nutrition. doi:10.3389/fnut.2024.1373551.

Researchers at the University of Michigan Rogel Cancer Center have developed a new urine-based test that addresses a major problem in prostate cancer.

The study was published in the journal JAMA Oncology.

Prostate cancer is a prevalent and deadly malignancy globally. Screening trials like the European Randomized Study of Screening for Prostate cancer and Göteborg Randomized Prostate Cancer Screening trial have demonstrated reduced cancer mortality with PSA-based screening. Current guidelines suggest men with high PSA levels undergo risk stratification via multiparametric magnetic resonance imaging or biomarker testing before biopsy.

The test, called MyProstateScore2.0, or MPS2, looks at 18 different genes linked to high-grade prostate cancer. In multiple tests using urine and tissue samples from men with prostate cancer, it successfully identified cancers classified as Grade Group 2, or higher. These cancers are more likely to grow and spread compared to Grade Group 1 prostate cancers, which are unlikely to spread or cause other impact.

In the study, multiple biomarker tests were assessed, including serum PSA alone, the Prostate Cancer Prevention Trial risk calculator, and the Prostate Health Index (PHI) and the 18-gene MPS2 models. Under a testing approach with 95% sensitivity for Prostate cancer of Grade group 2 or greater, measures of diagnostic accuracy and clinical consequences of testing were calculated. Cancers of GG 3 or greater were assessed secondarily.

Of 761 men included in the study, 151 had high-grade Prostate cancer on biopsy. Area under the graph showed 0.74 using the original MPS model compared with 0.81 using the MPS2 model and 0.82 using the MPS2+ model. Across pertinent subgroups, the MPS2 models had negative predictive values of 95% to 99% for cancers of Grade group 2 or greater and of 99% for cancers of Grade group 3 or greater.

The findings suggested that the use of this test would meaningfully reduce unnecessary biopsies performed while maintaining highly sensitive detection of high-grade cancers. The data supported use of this new Prostate cancer biomarker test in patients with elevated PSA levels to reduce the potential harms of prostate cancer screening while preserving its long-term benefits.

Reference: Jeffrey J. Tosoian, MD, MPH; Yuping Zhang, PhD; Lanbo Xiao, PhD; et al; Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer; Journal: JAMA Oncology; doi:10.1001/jamaoncol.2024.0455

According to a study conducted at the University of Gothenburg, dietary treatment is more effective than medications in irritable bowel syndrome (IBS). With dietary adjustments, more than seven out of ten patients had significantly reduced symptoms.

The study, published in The Lancet Gastroenterology & Hepatology, compared three treatments: two dietary and one based on use of medications.

Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain, gas, bloating, diarrhea, and constipation. Treatment typically involves dietary changes like eating small, frequent meals and avoiding triggers such as coffee and alcohol. Medications may also be prescribed to alleviate symptoms like gas, constipation, diarrhea, and bloating. In some cases, antidepressants are used to manage IBS symptoms.

In the study, participants with severe or moderate IBS symptoms at Sahlgrenska University Hospital in Gothenburg were divided into three treatment groups. One group received traditional dietary advice focusing on low-FODMAP foods, another received a low-carbohydrate, high-protein and high-fat diet, and the third group was treated with medication tailored to their specific symptoms. Treatment lasted for four weeks, and the participants' responses were assessed using an IBS symptom scoring scale.

The results showed that of those who received traditional IBS dietary advice and low content of FODMAPs, 76% had significantly reduced symptoms. In the group receiving low carbohydrates and high protein and fat, the proportion was 71%, and in the medication group 58%. All groups reported significantly better quality of life, less physical symptoms and less symptoms of anxiety and depression.

“With this study, we can show that diet plays a central role in the treatment of IBS, but that there are several alternative treatments that are effective. We need more knowledge about how to best personalize the treatment of IBS in the future and we will further investigate whether there are certain factors that can predict whether individuals will respond better to different treatment options,” said Sanna Nybacka, lead author of the study.

Reference: Sanna Nybacka, PhD, et al; A low FODMAP diet plus traditional dietary advice versus a low-carbohydrate diet versus pharmacological treatment in irritable bowel syndrome (CARBIS): a single-centre, single-blind, randomised controlled trial; Journal: The Lancet Gastroenterology & Hepatology; DOI:https://doi.org/10.1016/S2468-1253(24)00045-1