Medical Bulletin 18/Jul/2025 - Video

Findings from a newly published randomized controlled trial in the Journal of Nutrition reveal that snacking on avocado before bed may help improve triglyceride metabolism the next morning, a key factor in cardiovascular health. The study highlights the benefits of eating avocado as a nighttime snack, particularly for adults with prediabetes a condition affecting one in three adults and linked to increased heart disease risk.

The research is based on the “second-meal effect,” which suggests that the nutritional content of a previous meal can impact the body’s response to the next one. This study investigated how different nighttime snacks influenced metabolic markers in adults with prediabetes, with a particular focus on triglycerides the most common type of fat in the body and a known indicator of insulin resistance.

The trial involved 27 adults with prediabetes, who were given three different calorie-matched snacks on separate evenings: one whole avocado (rich in fiber and unsaturated fats), a low-fat, low-fiber snack, and a processed snack engineered to match the avocado’s fat and fiber content. Participants consumed the snacks between 8:00 and 9:00 p.m., then fasted overnight. The next morning, after a standardized breakfast, blood samples were collected to measure triglycerides, glucose, insulin, and inflammation markers.

The results showed that avocado aled to slightly lower triglyceride levels before breakfast and significantly lower levels three hours after eating, compared to the other snacks. No notable differences were observed in glucose, insulin, or inflammatory markers.

“Our findings suggest that avocado’s unique nutrient package its whole-food matrix may further support heart health by encouraging healthier triglyceride metabolism,” said Britt Burton-Freeman, study author and professor and chair of the Department of Food Science and Nutrition at Illinois Institute of Technology. “While the good fats and fiber in avocados already make them a satisfying snack, this research is making us think about how snacks before bed something 84% of people consume regularly can influence how the body handles food later. “It’s really intriguing to find a positive outcome when the snack is avocado given the concerns about late-night eating contributing to increased risk of obesity and cardiometabolic conditions.”

While more long-term studies are needed, especially to understand the impact on other health markers, this research offers promising insight into how avocado as a nighttime snack may support better heart health in those at risk.

Reference: Using the Avocado as an Evening Snack to Investigate Whole Food Matrix and Macronutrient Composition on Morning Metabolic Indices in Adults With Prediabetes, Preiss, Chelsea et al., Current Developments in Nutrition, Volume 9, Issue 7, 107486

14 Extra Steps a Minute Could Improve Mobility in Seniors: Study

A pair of new studies from the University of Chicago Medicine, published in PLOS ONE and Digital Biomarkers, reveal that modestly increasing walking pace by just 14 steps per minute can significantly improve physical function in frail or prefrail older adults. The researchers also developed a user-friendly smartphone app, “Walk Test,” to accurately track walking cadence, making this simple health intervention more accessible for daily use.

Walking pace, or cadence, is a practical way to gauge walking intensity and is particularly relevant for older adults, many of whom face mobility challenges. Daniel Rubin, MD, an anesthesiologist at UChicago Medicine, was inspired to explore walking cadence as a clinical tool after observing the limitations of questionnaires used to assess surgical risks in elderly patients.

In one study, Rubin and his colleagues conducted a secondary analysis of a randomized controlled trial involving frail and prefrail seniors participating in structured walking programs in retirement communities. Participants were assigned to either walk at their usual pace or “as fast as safely possible.” Cadence was measured using a sensor placed on their thigh.

The results were clear: individuals who increased their pace by just 14 steps per minute reaching about 100 steps per minute saw measurable gains in their ability to walk longer distances during standardized tests. “People who haven’t experienced frailty can't imagine how big a difference it makes to be able to not get tired going to the grocery store or not need to sit down while they're out,” Rubin said.

To make this health intervention more practical, Rubin’s team also created the “Walk Test” app. Unlike standard smartphone step counters, the app uses a novel open-source algorithm and brief, deliberate walking tests to ensure high accuracy in cadence measurement. “We wanted to make it as low-barrier as possible so it’s easy for older adults to use without additional equipment,” Rubin explained. “The people who need the most help are usually the least well-equipped to get started.”

The studies suggest that even small adjustments in walking habits can significantly benefit older adults' health, helping them stay more independent. Rubin added, “Even casual walking had positive effects on our study participants.”

Reference: Rubin DS, Hung A, Yamamoto E, Hedeker D, Conroy DE, Huisingh-Scheetz M, et al. (2025) Walking cadence as a measure of activity intensity and impact on functional capacity for prefrail and frail older adults. PLoS One 20(7): e0323759. https://doi.org/10.1371/journal.pone.0323759

Music Therapy May Ease Distress for Dementia Patients

A new study published in Frontiers in Psychiatry reveals that music therapy could offer a low-cost and compassionate alternative to psychotropic medications for dementia patients in NHS mental health wards. The research uses a structured music therapy tool known as MELODIC to help reduce patient distress.

Dementia patients in inpatient wards often experience high levels of confusion and emotional agitation, placing immense pressure on care staff. Current treatment methods often rely on psychotropic medications, which can come with side effects. To address this, researchers embedded a music therapist in two NHS dementia wards, delivering clinical music sessions and creating personalised music care plans for patients.

Music therapy sessions included singing, listening to music, and playing instruments, with therapists identifying musical strategies that families and staff could incorporate into daily care. The pilot study showed slight improvements in patients’ quality-of-life scores and reductions in the severity of distress symptoms and disruptiveness. While agitation scores rose slightly, there were no related adverse events or increases in incidents reported on the wards.

“People with dementia on inpatient mental health wards are often experiencing very high levels of distress, and staff are under immense pressure to manage this in ways that are safe and compassionate,” said lead author Naomi Thompson of ARU’s Cambridge Institute for Music Therapy Research. “Our study yielded promising results and importantly showed that the MELODIC tool can be used effectively in these highly complex settings, giving an alternative option to current ways of managing severe distress, such as psychotropic medication.”

The MELODIC approach was shaped through interviews with 49 healthcare professionals, patients, and family members to understand their experiences managing distress and using music in care. The intervention represents a scalable and affordable model for NHS wards.

Reference: Thompson Naomi , Odell-Miller Helen et al, Music therapy embedded in the life of dementia inpatient care to help prevent and manage distress: a feasibility study to inform a future trial, Frontiers in Psychiatry, Volume 16 – 2025.

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1618324

DOI=10.3389/fpsyt.2025.1618324

Intermittent Fasting Outperforms Other Diets for Diabetes Control: Study Finds

A new study presented at ENDO 2025 reveals that while all three popular dietary strategies intermittent energy restriction, time-restricted eating, and continuous energy restriction can aid in blood sugar control and weight loss for people with obesity and type 2 diabetes, intermittent energy restriction stands out for offering the greatest metabolic benefits and adherence.

"This study is the first to compare the effects of three different dietary interventions intermittent energy restriction, time-restricted eating, and continuous energy restriction in managing type 2 diabetes with obesity," said Haohao Zhang, Ph.D., chief physician at The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China. "The research fills a gap in directly comparing 5:2 intermittent energy restriction with a 10-hour time-restricted eating in patients with obesity and type 2 diabetes. The findings provide scientific evidence for clinicians to choose appropriate dietary strategies when treating such patients."

The study was a single-center, randomized, parallel-controlled trial conducted between November 2021 and November 2024. Ninety patients were randomly assigned to one of three groups intermittent energy restriction, time-restricted eating, or continuous energy restriction with equal caloric intake across all groups. Participants underwent a 16-week intervention supervised by a team of nutritionists.

Sixty-three participants completed the trial. While all three dietary approaches led to improvements in HbA1c and body weight, the intermittent energy restriction group experienced the greatest reductions. Additionally, intermittent energy restriction significantly lowered fasting blood glucose and triglyceride levels and improved whole-body insulin sensitivity, measured by the Matsuda index.

Adverse events were mild, with a few cases of hypoglycemia reported across all groups. The intermittent energy restriction group also showed the highest adherence rate at 85%, compared to 84% in the continuous energy restriction group and 78% in the time-restricted eating group.

Zhang said these findings highlight the feasibility and effectiveness of dietary interventions for people who have obesity and type 2 diabetes.

Reference: https://www.endocrine.org/