Medical Bulletin 05/ December/ 2024 - Video

Gastric balloons — silicone balloons filled with air or saline and placed in the stomach — can help people lose weight by making them feel too full to overeat. However, this effect eventually can wear off as the stomach becomes used to the sensation of fullness.

MIT engineers have designed a new type of gastric balloon that can be inflated and deflated as needed. In an animal study, they showed that inflating the balloon before a meal caused the animals to reduce their food intake by 60 percent. This type of intervention could offer an alternative for people who don’t want to undergo more invasive treatments such as gastric bypass surgery, or people who don’t respond well to weight-loss drugs, the researchers say.

The researchers created two prototypes: One is a traditional balloon that inflates and deflates, and the other is a mechanical device with four arms that expand outward, pushing out an elastic polymer shell that presses on the stomach wall. In animal tests, the researchers found that the mechanical-arm device could effectively expand to fill the stomach, but they ended up deciding to pursue the balloon option instead.

The researchers’ new balloon is similar to a traditional gastric balloon, but it is inserted into the stomach through an incision in the abdominal wall. The balloon is connected to an external controller that can be attached to the skin and contains a pump that inflates and deflates the balloon when needed. Inserting this device would be similar to the procedure used to place a feeding tube into a patient’s stomach, which is commonly done for people who are unable to eat or drink. In tests in animals, the researchers found that inflating the balloon before meals led to a 60% reduction in the amount of food consumed.

Reference: OSIRIS: Oscillating satiety induction and regulation intragastric system, Jia, Neil Zixun et al. Device, Volume 0, Issue 0, 100624

A study by Baycrest found that high blood sugar may impair brain health even in people without diabetes.

“Our results show that even if someone does not have a diabetes diagnosis, their blood sugar may already be high enough to be negatively impacting their brain health,” said Dr. Jean Chen, senior author on the study and Senior Scientist at the Rotman Research Institute, part of the Baycrest Academy for Research and Education (BARE). “Blood sugar exists on a spectrum – it isn’t a black and white categorization of healthy or unhealthy.”

The study, titled “The associations among glycemic control, heart variability, and autonomic brain function in healthy individuals: Age- and sex-related differences,” was recently published in the journal Neurobiology of Aging and examined 146 healthy adults aged 18 and older. For each individual, researchers analyzed blood sugar, brain activity using magnetic resonance imaging (MRI) scans and heart rate variability through electrocardiogram (ECG) readings.

Main study findings were:

Higher blood sugar was associated with decreased connection in brain networks. These networks play a crucial role in all aspects of cognition including memory, attention and emotion regulation.

The effect was stronger in older adults, but it was present across all ages; older adults generally had higher blood sugar than younger adults.

The effect was also stronger in women than in men.

In addition, there was a link between higher blood sugar and lower heart rate variability – that is, the beat-to-beat change in an individual’s heart rate. Previous research indicates that higher heart-rate variability is associated with better brain health.

Reference: Jeffrey, X. Y., Hussein, A., Mah, L., & Chen, J. J. (2024). The associations among glycemic control, heart variability, and autonomic brain function in healthy individuals: Age-and sex-related differences. Neurobiology of Aging, 142, 41-51.

An average of four minutes of incidental vigorous physical activity a day could almost halve the risk of major cardiovascular events, such as heart attacks, for middle-aged women who do not engage in structured exercise, according to new research from the University of Sydney, published in the British Journal of Sports Medicine.

“We found that a minimum of 1.5 minutes to an average of 4 minutes of daily vigorous physical activity, completed in short bursts lasting up to 1 minute, were associated with improved cardiovascular health outcomes in middle-aged women who do no structured exercise,” said lead author Professor Emmanuel Stamatakis, Director of the Mackenzie Wearable Hub at the Charles Perkins Centre and the Faculty of Medicine and Health.

High-intensity physical activity that forms part of a daily routine is known as “vigorous intermittent lifestyle physical activity” (VILPA). Longer sessions of VILPA are linked to significantly lower cardiovascular disease risk.

The study drew on data from 22,368 participants aged 40–79 who reported they did not engage in regular structured exercise. The data was collected from the UK Biobank, whose participants wore physical activity trackers for almost 24 hours a day for 7 days between 2013 and 2015.

Cardiovascular health was monitored through hospital and mortality records, tracking major adverse cardiovascular events (MACE), such as heart attack, stroke, and heart failure, until November 2022.

The researchers found that women who averaged 3.4 minutes of VILPA daily were 45% less likely to experience a major cardiovascular event. They were also 51% less likely to have a heart attack and 67% less likely to develop heart failure than women who did no VILPA.

Even when amounts of daily VILPA were lower than 3.4 minutes they were still linked to lower cardiovascular event risk. A minimum of 1.2 to 1.6 minutes of VILPA per day was associated with a 30 percent lower risk of total major cardiovascular events, a 33 percent lower risk of heart attack, and a 40 percent lower risk of heart failure.

However, men reaped fewer benefits from tiny bursts of VILPA. Those who averaged 5.6 minutes daily were only 16 percent less likely to experience a major cardiovascular event compared with men who did none.

Reference: Stamatakis, E., Ahmadi, M., Biswas, R. K., del Pozo Cruz, B., Thøgersen-Ntoumani, C., Murphy, M. H., ... & Hamer, M. (2024). Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences. British Journal of Sports Medicine.

People who use both vapes and cigarettes are less likely to quit compared to people who only smoke or only vape, according to a study published in ERJ Open Research. Instead, the research suggests that over time, most of these ‘dual users’ tend to revert to only smoking cigarettes. The researchers say their findings suggest that taking up vaping while continuing to smoke will probably not help people to stop smoking.

The review brings together 16 individual studies looking at whether groups of dual users went on to quit smoking, switch to vaping only, switch to smoking only or continue dual use over time. The analyses incorporate data on up to 9,337 people including 2,432 dual users. When researchers compared dual users with people who only smoked cigarettes or only vaped, they found that dual users were less likely to quit completely. Over time, the analysis showed that the majority of dual users reverted to smoking conventional cigarettes.

Over a period of four to eight months, 30% of dual users switched to cigarettes only. Between eight and 16 months, 47% of dual users switched to cigarettes only. Between 16 and 24 months, the proportion was 58% and after 24 to 48 months, the proportion was 55%. Most dual users continued to use cigarettes across the time periods. Combining those who continued dual use with those who transitioned to smoking only, the total proportion using cigarettes ranged from 90% to 63%. The researchers also point out that over the medium term (eight to 16 months), 38% of dual users were still using both vapes and cigarettes.

Reference: Hamoud, J., Hanewinkel, R., & Andreas, S. (2024). A systematic review investigating the impact of dual use of e-cigarettes and conventional cigarettes on smoking cessation. ERJ Open Research, 2024, 00902-2024. https://doi.org/10.1183/23120541.00902-2024