Medical Bulletin 26/September/2025

Despite national guidelines established in 2011 by the National Heart, Lung, and Blood Institute (NHLBI) and the American Academy of Pediatrics (AAP), the prevalence of pediatric universal lipid screening remains low, leaving the majority of affected children at high risk of heart disease decades earlier.

The research highlights strategies that could lead to improved universal guideline-recommended screening implementation.

Previous data published in the Journal of the American Medical Association and in Pediatrics indicate that only 11% of youth in the U.S. between the ages of 9 and 21 had documented lipid screening, and 30 to 60% of youth with dyslipidemia may be missed by targeted screening alone compared to universal lipid screening.

Many times, families do not understand that the cardiovascular disease that runs through their family for generations can be managed with early diagnosis. The publication in the Journal of Pediatrics lays out concrete actions that can be taken, and on which we have formed partnerships to support families and improve care for children.

Therefore, the goal of LEAD is to significantly impact missed opportunities to save hundreds of thousands of young lives from being cut short or burdened by early cardiovascular disease. The tools created by a working group representing patient, families, clinicians, and health systems as part of the Family Heart Foundation’s LEAD initiative and outlined in the Journal of Pediatrics will increase understanding among clinicians and parents about the importance of universal screening.

Ref: Accelerating Guideline Recommended Universal Pediatric Lipid Screening: Launch of the LEAD Pediatric Initiative Flyer, Jonathan N. et al. The Journal of Pediatrics, Volume 0, Issue 0, 114804. 10.1016/j.jpeds.2025.114804

UH Study Finds Gut Microbes Influence Gene Activation and Silencing Mechanisms

The trillions of microbes that live in the human gut may play a bigger role in health than previously thought, according to a new research by the University of Hawaiʻi at Mānoa. The article, published in September 2025 in the International Journal of Molecular Sciences, explores how gut bacteria interact with human genes in ways that could shape disease risk, aging and even future medical treatments.

The review highlights how the gut microbiome (the collection of bacteria, viruses and fungi that live in the digestive system) can affect epigenetics, the process that turns genes on or off without changing the DNA itself. These changes happen through chemical tags such as DNA or RNA methylation, which control when and how genes are expressed.

Everyday factors—such as diet, stress, medications and aging—can influence these microbial interactions. For example, gut bacteria produce short-chain fatty acids, nutrients and other chemical signals that may reprogram gene activity linked to immunity, metabolism or brain health. In turn, a person’s lifestyle and genetic makeup can shape which microbes thrive in the gut, creating a feedback loop between humans and their microbes.

The researchers point to future possibilities where understanding this loop could help doctors design personalized treatments. Potential applications include using microbial biomarkers (biological signals that indicate health or disease), developing “live biotherapeutics” (beneficial bacteria given like medicine) or refining fecal microbiota transplants, which transfer gut microbes from healthy donors to patients. Advances in artificial intelligence and single-cell analysis are helping scientists model these complex relationships at an unprecedented scale.

By mapping out how gut microbes communicate with human genes, the review underscores both the promise and responsibility of this emerging science. The insights could open the door to precision health strategies that tailor prevention and treatment to each individual’s unique microbial and epigenetic makeup.

Ref: Rubas, N.C.; Torres, A.; Maunakea, A.K. The Gut Microbiome and Epigenomic Reprogramming: Mechanisms, Interactions, and Implications for Human Health and Disease. Int. J. Mol. Sci. 2025, 26, 8658. https://doi.org/10.3390/ijms26178658

Study Suggests Body Fat Distribution May Play Key Role in Cancer Risk

How fat is distributed in people’s bodies could make a difference to their risk of certain cancers, according to new research led by the University of Bristol. The international study is published in the Journal of the National Cancer Institute (JNCI).

Scientists have already shown that having obesity increases a person’s risk of developing certain cancers. Obesity is usually measured using body mass index (BMI), but growing evidence – particularly from heart health research – suggests that BMI alone doesn't capture the full picture when it comes to obesity-related health risks. However, the role of fat distribution in cancer risk has been relatively unexplored.

Researchers investigated whether body fat at different locations across the body influences the risks of 12 obesity-related cancers - endometrial, ovarian, breast, colorectal, pancreas, multiple myeloma, liver, kidney (renal cell), thyroid, gallbladder, oesophageal adenocarcinoma, and meningioma.

They used a technique, which uses statistics, computing and the natural variations in people’s genetics to identify patterns in large health data sets.

The team found that fat distribution appears to influence cancer risk – but the relationship varies by cancer type. For some cancers, where fat is stored in the body seems more important than how much is stored; for others, the reverse is true; and, for some, both matter. In cancers where distribution is important, the specific locations of body fat driving this seem to differ by cancer, meaning the overall picture is quite complex.

The paper’s findings fit with recent calls for change, including the 2024 European Association for the Study of Obesity framework and the Lancet Commission on the future of obesity, which have emphasised that BMI is a flawed diagnostic tool and that fat distribution matters.

In the future, a better understanding of how fat distribution across the body affects cancer risk could help identify those most at risk and guide more personalised approaches to obesity treatment and cancer prevention.

Ref: Distribution of fat could influence cancer risk, study suggests; University of Bristol; JNCI: World Cancer Research Fund, Cancer Research UK, Medical Research Council

Study Finds Exercise Rewires Left and Right Heart Nerves in Distinct Ways

Frequent exercise doesn’t just strengthen the heart – it also changes the nerves that control it, according to new research which could guide more targeted and effective care for common heart problems.

The study, led by the University of Bristol (UK), shows for the first time that moderate aerobic training reshapes nerves that drive the heart, and affects them on each side of the heart differently. The research is published in the journal Autonomic Neuroscience.

Findings highlighting this marked left-right split could ultimately be used to treat more effectively a range of conditions, including irregular heartbeats, chest pain, angina pain, and ‘broken-heart’ syndrome.

Study lead author Dr Augusto Coppi, Senior Lecturer in Veterinary Anatomy at the University of Bristol, said: “The discovery points to a previously hidden left–right pattern in the body’s ‘autopilot’ system that helps run the heart.

“These nerve clusters act like the heart’s dimmer switch and we’ve shown that regular, moderate exercise remodels that switch in a side-specific way. This could help explain why some treatments work better on one side than the other and, in future, help doctors target therapies more precisely and effectively.”

The research used advanced 3D quantitative imaging analysis methods called stereology. Findings showed that trained rats over a 10-week period had around four times more nerves – called neurons – in the cardiovascular cluster on the right-hand side of the body than the left compared to untrained rats. Conversely, the neurons on the left nearly doubled in size while those on the right slightly shrunk.

Dr Coppi added: “Understanding these left-right differences could help us personalise treatments for heart rhythm disorders and angina. Our next step is to test how these structural changes map onto function and whether similar patterns appear in larger animals and humans.”

Ref: Asymmetric neuroplasticity in stellate ganglia: Unveiling side-specific adaptations to aerobic exercise; Ladd, Fernando Vagner Lobo et al. Autonomic Neuroscience: Basic and Clinical, Volume 0, Issue 0, 103338. Doi: 10.1016/j.autneu.2025.103338