Conclusions
We observed a J-shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox.
via Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes — NEJM.
Safety Information > December 2013.
Memory permitting I will link to this FDA webpage on a regular basis. From my perspective the adverse reactions are the most interesting nuggets of information.
The FDA has approved dapagliflozin (Farxiga) for treatment of type 2 diabetes in adults, along with diet and exercise, the agency said in a statement.
The approval comes with strings, however: drugmakers Bristol-Myers Squibb and AstraZeneca must conduct six post-market studies, which include a cardiovascular outcomes trial in patients with baseline cardiovascular disease risks, a bladder cancer risk trial, an animal study looking at drug-induced urinary flow and bladder tumor promotion, two trials on risks in pediatric patients, and an enhanced pharmacovigilance program to study liver abnormalities and pregnancy outcomes.
Because radiation used in imaging tests is proven to cause cancer, they wrote, “cardiologists should make every effort to give ‘the right imaging exam, with the right dose, to the right patient.’
via Cardiologists Should Mind Radiation Doses, ESC Says.
We are seeing more applicant/patient initiated cardiac scans. I recently became aware of a life insurance application where the underwriter requested a repeat cardiac CT scan. The applicant’s cardiologist flatly rejected this course of action in an a asymptomatic patient with a correspondingly low CHD risk score.
Now you understand the cardiologist’s thinking.
Did I hear someone say “litigation risk”?
Compared with a control diet and a Mediterranean diet supplemented with mixed nuts, the olive oil-supplemented Mediterranean diet was associated with a 40% lower likelihood for new-onset diabetes (HR 0.60, 95% CI 0.43-0.85) , according to Jordi Salas-Salvado, MD, PhD, of the Universitat Rovira i Virgili in Reus, Spain, and colleagues.
Dieters who consumed a nut-supplemented Mediterranean diet did not see such protective benefits (HR 0.82, 95% CI 0.61-1.10), they wrote online in the Annals of Internal Medicine.
via Mediterranean Diet Cuts Risk of Diabetes.
Read the article and then the readers’ comments. The following are some excerpts:
The findings of this study identify inherent weaknesses in methodology. The low fat control group did not adhere to a low fat diet and the improbable risks of CVD were notably higher.
I wonder if the researchers would consider the benefits of asking their subjects to spread their food intake more evenly throughout the day rather than the the usual Spanish pattern of negligible breakfast, snack about 11, then large lunch mid-afternoon and a big, late evening meal. Also in my experience travelling in various parts of Spain, the diet includes plenty of pork.’Every bit of the pig but the eyes.’.
The olive oil group was probably using that in place of other vegetable oils for cooking and salad. Vegetable oils like soy and corn oil are high in pro-inflammatory omega-6, and are often partially hydrogenated (ie trans fats.) Avoidance of these in the olive group could have made a difference.
Be cautious in coming to conclusions based upon this study. The sample size was small. Perhaps too little attention was paid to what the participants did not consume. We all know less red meat is better for health. The Mediterranean style diet is clearly a healthy diet but I’m not quite ready to attribute all the wonderful benefits to the diet alone.
Think lifestyle. Despite the increase in US style fast food restaurants in Spain, the overall dietary preference continues to be a Mediterranean diet. So how much of the study’s effect come from fast food avoidance?
BTW, yesterday was a totally Mediterranean day for me. Veggie pizza for lunch and a Greek salad with grilled chicken for dinner.
CONCLUSIONS: Dairy consumption was associated with a significantly lower risk of type 2 diabetes and favorable changes of cardiometabolic traits in Chinese.
What about non-Chinese? Good news for me though.
Ice cream.
Top 10 Free Medical Apps | Physician’s Weekly.
I have one of the ten apps listed on my phone. At my age I consider this to be a little victory.
ISSUE: The FDA is advising consumers to immediately stop using a product called Mass Destruction, marketed as a dietary supplement for muscle growth. The product is labeled to contain at least one synthetic anabolic steroid and has been linked to at least one reported serious illness.
BACKGROUND: The FDA was alerted by the North Carolina Department of Health and Human Services of a serious injury associated with use of Mass Destruction. The report described a previously healthy 28-year-old male with liver failure requiring transplant after several weeks of product use. Mass Destruction is manufactured for Blunt Force Nutrition in Sims, N.C. and sold in retail stores, fitness gyms, and on the Internet. An investigation is underway to identify the product’s manufacturer.
Finally a product that lives up to its name.
Furthermore, data presented in early November at the American Association for the Study of Liver Diseases meeting found that liver failure caused by herbal supplements, especially those used in bodybuilding, increased almost three-fold from 2004 through 2012.
via Herbal supplements may be natural, but that doesn’t mean they’re safe.
An essential coenzyme of carbohydrate metabolism. Given to all patients with suspected chronic alcohol abuse.
lifeunderwriter.net 
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