OSA? Put Your Tongue on a Diet

“Most clinicians, and even experts in the sleep apnea world, have not typically focused on fat in the tongue for treating sleep apnea,” said Richard Schwab, MD, chief of Sleep Medicine. “Now that we know tongue fat is a risk factor and that sleep apnea improves when tongue fat is reduced, we have established a unique therapeutic target that we’ve never had before.”

https://www.sciencedaily.com/releases/2020/01/200110101035.htm

From the research article abstract:

Conclusions:

Weight loss reduced volumes of several UA soft tissues in persons with obesity and OSA. Improved AHI with weight loss was mediated by reductions in tongue fat. New treatments that reduce tongue fat should be considered for patients with OSA.

Journal Reference:

  1. Stephen H. Wang, Brendan T Keenan, Andrew Wiemken, Yinyin Zang, Bethany Staley, David B. Sarwer, Drew A. Torigian, Noel Williams, Allan I Pack, Richard J Schwab. Effect of Weight Loss on Upper Airway Anatomy and the Apnea Hypopnea Index: The Importance of Tongue Fat. American Journal of Respiratory and Critical Care Medicine, 2020; DOI: 10.1164/rccm.201903-0692OC

Wait for it.  A plethora of diet and weight loss books for your tongue.

Pass (on) the Chips

Eating Ultraprocessed Foods Tied to Diabetes Risk

Higher intake of ultraprocessed foods (for example, packaged snack foods) is associated with increased risk for type 2 diabetes, according to a prospective study in JAMA Internal Medicine.

Over 100,000 French adults completed a series of 24-hour dietary recall questionnaires over a 2-year period. During a median follow-up of 6 years, roughly 820 participants were diagnosed with type 2 diabetes.

After adjustment for body-mass index, physical activity, and other confounders, participants who ate more ultraprocessed foods were at higher risk for diabetes. In particular, the risk increased by 13% with each 10% increase in the proportion of diet comprising ultraprocessed foods.

The authors note that in previous studies, ultraprocessed foods have been linked to increased risks for cancer, cardiovascular disease, and mortality.

JAMA Internal Medicine article (Free abstract)

Background: Physician’s First Watch coverage of ultraprocessed foods & mortality (Free)

NEJM Journal Watch is produced by NEJM Group, a division of the Massachusetts Medical Society. Copyright © 2019 Massachusetts Medical Society. All rights reserved.

Junk food = bad.

Fake Burgers = also bad.

Got DM1? Don’t do Pot

Abstract

OBJECTIVE We examined the frequency of diabetic ketoacidosis (DKA) in cannabis users compared with nonusers in the T1D Exchange clinic registry (T1DX).

RESEARCH DESIGN AND METHODS The association between cannabis use by total substance score for cannabis (TSC) and DKA in the past 12 months was examined using a logistic regression model adjusted for potential confounders among adults in the T1DX.

RESULTS Of 932 adults with type 1 diabetes, 61 had a TSC >4, which classified them as moderate cannabis users. Adjusting for sex, age at study visit, and HbA1c, cannabis use was associated with a twofold increase in risk for DKA among adults with type 1 diabetes (odds ratio 2.5 [95% CI 1.0–5.9]).

CONCLUSIONS Cannabis use was associated with an increased risk for DKA among adults in the T1DX. Providers should inform their patients of the potential risk of DKA with cannabis use.

© 2019 by the American Diabetes Association.

Cannabis Use Is Associated With Increased Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Findings From the T1D Exchange Clinic Registry