Medical Bulletin 30/July/2025 - Video

A new report from The Lancet Commission reveals that over 60% of liver cancer cases globally could be prevented by addressing modifiable risk factors such as hepatitis infections, alcohol consumption, and metabolic liver diseases. The analysis, authored by an international team of researchers from The Hong Kong Cancer Institute, Fudan University, and institutions across China, South Korea, the US, and Europe, outlines a comprehensive global strategy to reduce the burden of this deadly disease.

Liver cancer ranks among the top three causes of cancer-related deaths in 46 countries, according to a 2022 study published in the Journal of Hepatology. The report predicts a sharp 35% increase in global liver cancer cases, primarily driven by metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease linked to obesity and type 2 diabetes.

The researchers warn that a growing global population, coupled with rising rates of obesity, alcohol use, and viral hepatitis, could lead to a 55% surge in liver cancer cases by 2040. First author Professor Stephen Chan, of The Chinese University of Hong Kong, emphasized that this presents a critical opportunity to act. “The Lancet Commission's findings present a huge opportunity for countries to target risk factors such as viral hepatitis, alcohol and obesity to prevent liver cancer and save lives,” he said.

The report calls for a multi-pronged public health approach. This includes intensifying vaccination and screening for hepatitis B and C, implementing stricter alcohol control policies, and investing in public awareness campaigns. It also highlights the importance of early detection, particularly among high-risk groups such as individuals with diabetes or obesity.

Importantly, the commission recommends integrating palliative care early in the treatment process, ensuring quality of life for patients diagnosed with advanced liver cancer. “We estimated that at least 60 per cent of liver cancers are preventable via control of modifiable risk factors,” the report states.

With a targeted global reduction in new liver cancer cases of 2–5% annually, the commission estimates up to 17 million cases and 15 million deaths could be prevented.

Reference: The Lancet Commission on addressing the global hepatocellular carcinoma burden: comprehensive strategies from prevention to treatment, Chan, Stephen Lam et al. The Lancet, Volume 0, Issue 0

High Body Fat, Not BMI, Linked to Increased Risk of Death and Heart Disease

A new study published in the Annals of Internal Medicine suggests that body fat percentage may be a far more accurate predictor of long-term health outcomes than the widely used body mass index (BMI). The research highlights the shortcomings of relying solely on BMI and supports a shift toward more precise body composition measurements in clinical practice.

Although BMI is a convenient tool for categorizing individuals based on weight relative to height, it does not distinguish between fat and lean mass. As a result, it may misclassify muscular individuals as overweight and overlook those with “normal-weight obesity” people who have a normal BMI but high body fat, which can still carry serious health risks.

In this study, researchers from the University of Florida analyzed data from 4,252 adults aged 20 to 49 who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004. All participants had complete technician-measured body composition data, including height, weight, and waist circumference, and their records were linked to the National Death Index through 2019. Body fat percentage was assessed using bioelectrical impedance analysis, a non-invasive method now becoming more feasible in clinical settings.

The results were striking: Adults with high body fat (defined as ≥27% in men and ≥44% in women) were 1.78 times more likely to die from any cause and 3.62 times more likely to die from heart disease compared to those with a healthy fat percentage. In contrast, individuals with a BMI in the overweight or obese range (≥25 kg/m²) did not show a significantly increased risk of death from any cause.

Additionally, a high waist circumference (over 40 inches in men and 35 inches in women) was associated with a 1.59-fold increased risk of all-cause mortality and a 4.01-fold higher risk of death from heart disease.

These findings support a reevaluation of how body composition is assessed in clinical care. “New bioelectrical impedance devices could make it feasible to move beyond BMI in routine health assessments,” the researchers noted. As obesity-related illnesses continue to rise, accurate screening tools could help identify at-risk individuals earlier and guide better preventive strategies.

Reference: Body Mass Index vs Body Fat Percentage as a Predictor of Mortality in Adults Aged 20-49 Years

Arch G. Mainous, Lu Yin, Velyn Wu, Pooja Sharma, Breana M. Jenkins, Aaron A. Saguil, Danielle S. Nelson, Frank A. Orlando

The Annals of Family Medicine Jul 2025, 23 (4) 337-343; DOI: 10.1370/afm.240330

Exercise, Diet and Brain Training Can Slow Mental Aging: Study Finds

A new large-scale study published in the Journal of the American Medical Association and presented at the Alzheimer’s Association International Conference has offered the strongest evidence yet that a structured combination of diet, exercise, brain training, and social activity can significantly improve cognitive function in older adults. Known as the POINTER study, it is the most comprehensive U.S.-based trial of its kind and suggests that brain aging may be delayed through targeted lifestyle changes.

Led by researchers at Wake Forest University School of Medicine, the POINTER study enrolled over 2,100 sedentary adults aged 60 to 79 who were at elevated risk for cognitive decline and Alzheimer’s disease. Participants had normal memory and thinking at the start but were selected based on having poor diet and low levels of physical activity.

Half of the participants were advised to improve their lifestyle on their own. The other half engaged in an intensive, two-year program involving four weekly aerobic exercise sessions, adherence to a Mediterranean-style heart-healthy diet, online cognitive training, required social engagement, and regular monitoring of blood sugar and blood pressure.

While both groups improved, those in the structured intervention group saw significantly greater gains in memory and thinking skills. “These people are obtaining cognitive function scores that are similar to people [like them who are] one to two years younger than they are,” said Dr. Laura Baker, principal investigator and professor of gerontology and geriatrics.

Importantly, the study focused on age-related brain changes rather than Alzheimer's disease directly. But experts believe that the improvements in cognitive function and “brain age” could eventually delay the onset of dementia. Additional findings from brain scans and biomarker analyses are expected later this year.

Experts say that with greater investment, physician engagement, and behavior-change tools, such approaches could become standard in dementia prevention.

Reference: Baker LD, Espeland MA, Whitmer RA, et al. Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA. Published online July 28, 2025. doi:10.1001/jama.2025.12923