Medical Bulletin 29/ January/ 2025 - Video

A review article published in Canadian Medical Association Journal summarizes the considerable evidence supporting the important role physical activity plays in preventing or reducing the effects of diseases and discusses how to prescribe effective exercise for older adults.

A 2023 meta-analysis of several large studies found that 150 minutes of moderate physical activity every week reduced risk of death from all causes by 31%. Physical activity is essential for aging well and can help prevent or reduce disease in more than 30 chronic conditions, such as coronary artery disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, depression, dementia, and cancer.

Benefits of activity include the following:

Protection against risk of death from any cause

Falls prevention through increased muscle strength and better balance

Bone and joint health, including improved bone density and alleviation of some osteoarthritis symptoms

Improved cognitive function, and better mood and mental health

Ability to engage in daily activities and improved quality of life

The World Health Organization (WHO) recommends 150–300 minutes weekly of moderate-to-intense physical activity for adults, including older adults.

The WHO 5-step framework — called the “5As” — can provide clinicians with a roadmap to promote activity in their patients. The authors also suggest inputting physical activity in patient records as a vital sign to follow over time.

“Physical activity is underused as a health intervention both in the community and in the delivery of health care for older adults. Age, frailty, or existing functional impairments should not be viewed as absolute contraindications to physical activity but rather key reasons to prescribe it, considering the benefits of physical activity interventions for older adults. Older adults who become more physically active can potentially add years to their lives as well as higher quality of life to those years,” the authors conclude.

Reference: Move more, age well: prescribing physical activity for older adults

Jane S. Thornton, William N. Morley, Samir K. Sinha

CMAJ Jan 2025, 197 (3) E59-E67; DOI: 10.1503/cmaj.231336

A therapeutic vaccine targeting human papillomavirus type 16 (HPV16) induced regression in high-grade precancerous cervical lesions, according to the results from a phase II clinical trial published in Clinical Cancer Research, a journal of the American Association for Cancer Research.

The Vvax001 vaccine is a modified version of the Semliki Forest virus that cannot replicate and produces the oncogenic E6 and E7 proteins that are expressed exclusively by HPV16-infected cells.

In the phase II trial, 18 patients with HPV16-positive CIN3 received three doses of Vvax001 three weeks apart, and then were routinely monitored via colposcopy before a final colposcopy-guided biopsy at 19 weeks’ post-immunization.

Nine of the 18 patients experienced regression -- six to low-grade dysplasia and three with complete regressions and no signs of dysplasia. Lesion size was significantly reduced in all but one of the patients, and these reductions were evident within a month of finishing vaccination. The nine patients whose disease did not regress received loop excision surgery, though no residual disease was found in four of these patients, suggesting the additional time to surgery might have allowed for full lesion eradication, according to the authors.

Ten of the 16 patients evaluated cleared HPV16, including all nine of those whose disease regressed. Two patients whose disease did not regress also cleared HPV16; however, their lesions harbored other HPV strains. After a median follow-up of 20 months, none of the patients had recurrences.

"To the best of our knowledge, this response rate makes Vvax001 one of the most effective therapeutic vaccines for HPV16-associated CIN3 lesions reported to date," said Refika Yigit, MD, principal investigator and oncological gynecologist at University Medical Centre Groningen in the Netherlands. "If confirmed in a larger trial, our results could mean that at least half of the patients with CIN3 might be able to omit surgery and avoid all its possible side effects and complications."

Reference: https://www.aacr.org/about-the-aacr/newsroom/news-releases/a-therapeutic-hpv-vaccine-could-eliminate-precancerous-cervical-lesions/

Researchers have found that a newly developed diet inspired by the eating habits of non-industrialized societies can significantly reduce the risk of a number of chronic diseases -- and are to share recipes with the public.

A paper published in the scientific journal Cell shows that a newly developed diet that mimics eating habits in non-industrialized communities led to significant metabolic and immunological improvements in a human intervention study. In just three weeks the diet:

Promoted weight loss

decreased bad cholesterol by 17%

reduced blood sugar by 6%

reduced C-reactive Protein (a marker of inflammation and heart disease) by 14%

The study demonstrated that the new diet entitled NiMeTM (Non-industrialized Microbiome Restore) diet enhanced short-term persistence of L. reuteri in the gut.

However, it also improved microbiome features damaged by industrialization, such as reducing pro-inflammatory bacteria and bacterial genes that degrade the mucus layer in the gut. These changes were linked to improvements in cardio metabolic markers of chronic disease risk.

Although participants did not consume fewer calories on the NiMe diet, they lost weight, and the diet alone led to considerable cardio metabolic benefits.

The NiMeTM diet shares key characteristics of non-industrialized diets:

Plant-based focus, but not vegetarian: Primarily made up of vegetables, legumes, and other whole-plant foods. One small serving of animal protein per day (salmon, chicken, or pork).

No dairy, beef, or wheat: Excluded simply because they are not part of the traditional foods consumed by rural Papua New Guineans.

Very low in processed foods that are high in sugar and saturated fat.

Fibre-rich: Fiber content was 22 grams per 1,000 calories -- exceeding current dietary recommendations.

Commenting on this study, Prof. Paul Ross, Director of APC Microbiome Ireland, said: "This study shows that we can target the gut microbiome through specific diets to improve health and reduce disease risk. These findings could shape future dietary guidelines and inspire the development of new food products and ingredients, as well as therapeutics, which target the microbiome."

Reference: https://www.ucc.ie/en/news/2025/new-study-reveals-how-a-non-industrialised-style-diet-can-reduce-risk-of-chronic-disease.html

More than one in three parents say their child has faced issues like tooth decay, cavities, stained teeth, gum concerns or tooth pain over the past two years, a national poll suggests.

And these problems were linked to children’s oral care routine, more commonly experienced among those who skipped dental hygiene recommendations or followed them less often, according to the University of Michigan Health C.S. Mott Children’s Hospital National Poll on Children’s Health.

The nationally representative report is based on 1,801 responses from parents with at least one child aged 4-17 polled in August 2024.

Sixty-four percent of parents say their child brushes their teeth twice a day and roughly 60% say brushing lasts for at least two minutes.

But fewer parents say their child consistently follows other oral health recommendations.

In between brushing, rinsing the mouth with water after consuming sugary foods or beverages can help to prevent the sugar from adhering to the teeth; however, only 15% of parents report their child regularly uses this strategy.

Overall, just one in five parents say their child does at least four of the top six recommended oral health tasks on all or most days — with less consistency reported among boys than girls. Children who followed fewer practices and did them less frequently had more oral health challenges.

Over a third of parents polled have also noticed that their child has bad breath, which was more common among children who only followed one or less oral hygiene practices all or most days.

Most parents attribute their child’s bad breath to “morning breath” or lack of brushing or flossing while less than a quarter cited smelly food, mouth breathing or dental problems.

Most parents polled say their child’s most recent dentist visit was within the past year, but 7% said it was one to two years ago and 4% said it’s been more than two years. Parents reporting their child follows 0-1 oral hygiene recommendations all or most days are also more likely to say their child has not had a dental visit in over a year.

Reference: https://mottpoll.org/reports/oral-hygiene-key-healthy-smiles