Medical Bulletin 22/December/2025 - Video

Here are the top medical news for today:

ACC/AHA release updated guidelines for managing adult congenital heart disease

More people than ever before are living long, full lives with congenital heart disease—but adulthood brings new challenges. To guide physicians and patients through this growing frontier, the American College of Cardiology (ACC) and the American Heart Association (AHA) have released updated clinical guidelines for managing congenital heart disease in adults (ACHD). The guideline, jointly published in JACC and Circulation, incorporates the latest evidence from 2017–2024, updating recommendations last issued in 2018.

Congenital heart disease (CHD)—structural defects present at birth—is the most common birth defect, affecting about 1% of newborns in the U.S. thanks to decades of advances in pediatric cardiology and surgery, over 90% now survive into adulthood. But this success has created a new reality: a rapidly growing population of adults with CHD who remain at risk for complications such as arrhythmias, heart failure, and pregnancy-related challenges later in life.

The new guideline expands on several key areas. First, it underscores the critical need for lifelong, specialized care. Many patients lose connection with CHD experts after childhood due to geographic, financial, or awareness barriers. The ACC and AHA now recommend that adults with congenital heart disease be regularly evaluated by, or in consultation with, certified ACHD specialists—especially those with moderate or complex defects.

Another major addition is the guideline’s renewed focus on mental health, cognitive well-being, and exercise. Research has shown that anxiety, depression, and neurocognitive issues are common but underdiagnosed in ACHD patients. Clinicians are encouraged to routinely screen for mental health symptoms and ensure timely referrals. On physical activity, the authors promote personalized exercise testing—not restriction. “We’re now saying adults with CHD are not only allowed but encouraged to be active,” noted Dr. Michelle Gurvitz, chair of the writing committee.

As Dr. Gurvitz explained, “Our most complex patients are our fastest-growing group. These guidelines help ensure that as they live longer, they also live better.” The new framework marks a vital step toward continuous, comprehensive, and compassionate care for adults born with heart disease—a population once deemed untreatable, now thriving well into old age.

REFERENCE: Gurvitz, Michelle, et al.; 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines; Circulation; American Heart Association; doi: 10.1161/CIR.0000000000001402; https://doi.org/10.1161/CIR.0000000000001402

Cutting carbs better than fat for controlling appetite in women, Study finds

For many women with lipedema—a painful fat accumulation disorder often mistaken for obesity—controlling appetite and cravings can feel like a losing battle. But a new study published in Frontiers in Nutrition suggests that low carbohydrate diets may be far more effective than low fat diets in curbing food cravings and improving emotional eating patterns. The findings offer new insights into how diet influences “hedonic hunger,” the desire to eat for pleasure rather than true energy needs.

Lipedema primarily affects women and typically emerges during hormonal transitions such as puberty, pregnancy, or menopause. Unlike typical obesity, it involves abnormal fat storage in the lower limbs, inflammation, and damaged blood vessels—all of which may alter how the brain regulates appetite. Many women with lipedema face both physical discomfort and emotional distress, contributing to overeating or difficulty maintaining healthy eating behaviors.

To test how macronutrient composition affects appetite, researchers analyzed data from a randomized clinical trial comparing low carbohydrate and low fat diets over eight weeks. Seventy women with lipedema or obesity were randomly assigned to consume either 75 grams of carbohydrates per day (low carb) or 180 grams of carbohydrates with 27 grams of fat (low fat). Both groups received the same daily energy (1,200 kcal) and protein (60 g) intake. The team used validated questionnaires—including the Power of Food Scale and emotional eating assessments—to measure hedonic hunger before and after the intervention.

The results were clear: participants following the low carbohydrate diet showed significant reductions in food cue responsiveness—particularly in the Food Present category, which measures the urge to eat when exposed to appetizing food, even if not hungry. They also exhibited declines in emotional eating, suggesting better control over eating triggered by stress or negative mood. Meanwhile, the low fat group showed no such improvements; in fact, they reported higher levels of restrained eating, reflecting greater cognitive effort to control intake.

Researchers believe these differences stem from the impact of carbohydrate restriction on hunger hormones such as insulin and ghrelin, which interact with brain reward pathways. Lower carbohydrate intake may stabilize these hormones, dampening dopamine driven cravings that fuel overeating.

By tuning hormonal and reward based hunger signals, low carb diets might help restore a healthier relationship with food, improving both emotional well being and adherence to lifestyle management.

REFERENCE: Lundanes J. (2025). Hedonic hunger and eating behavior after low-carbohydrate versus low-fat diets in females with lipedema and obesity. Frontiers in Nutrition. https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1716592/full

Study reveals how foods modulate oxidative stress after high-intensity training

Pushing your limits in the gym can do wonders for fitness—but it also floods the body with reactive oxygen species (ROS), the unstable molecules responsible for exercise induced oxidative stress. Too much ROS can impair recovery, weaken muscles, and even accelerate aging. Now, a study by University of Vienna researchers, published in Antioxidants, offers new insight into how different foods help the body handle this stress. They found that carbohydrate rich foods protect muscles during exercise, while polyphenol rich foods like berries and pomegranate juice aid recovery after intense workouts—especially in fasted, high intensity conditions.

Oxidative stress occurs when ROS production outpaces the body’s antioxidant defenses. While low levels of ROS help strengthen cells and enhance performance, excess amounts damage tissues and slow recovery. Athletes often turn to foods or supplements rich in antioxidants to balance this effect, but the real world efficacy of such strategies remains debated. To explore this further, the team conducted a randomized controlled trial assessing how carbohydrate and polyphenol rich foods influence ROS generation and antioxidant capacity during exercise.

The researchers enrolled 45 healthy, sedentary women aged 19–33, with 30 completing the full protocol. Participants engaged in resistance circuit high intensity interval training (HIIT) after a 12 hour fast. They were randomly assigned to consume either polyphenol rich foods (blueberries or pomegranate juice) or carbohydrate rich foods (whole grain bread or bread rolls) before training, with water as a control. Blood samples were collected before, during, and after exercise to measure ROS levels and total antioxidant capacity (using FRAP assays).

The results revealed that carbohydrate intake significantly reduced markers of oxidative stress during exercise, stabilizing ROS levels compared to water or polyphenol intake. Carbohydrates appeared to act not by trapping radicals directly, but by reducing the body’s reliance on fat metabolism—thereby limiting mitochondrial ROS production. In contrast, polyphenol rich foods showed their greatest effect during recovery, helping normalize ROS levels faster than carbohydrates. This suggests that while carbohydrates are better for preventing acute oxidative damage, polyphenols support post exercise repair and resilience.

Eating the right food at the right stage of training could optimize both performance and recovery. In practical terms, a balanced strategy—carbs before, polyphenols after—might give athletes the best of both worlds.

REFERENCE: Gassner, M., Bragagna, L., Dasht Bayaz, H. H., Schlosser, L., Lemberg, J., Brem, J., Pignitter, M., Strauss, M., Wagner, K., & König, D. (2025). Acute Impact of Polyphenol-Rich vs. Carbohydrate-Rich Foods and Beverages on Exercise-Induced ROS and FRAP in Healthy Sedentary Female Adults - A Randomized Controlled Trial. Antioxidants, 14(12), 1481. DOI: 10.3390/antiox14121481, https://www.mdpi.com/2076-3921/14/12/1481