Ask a Patient® Health News: July 11, 2023
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Nutrition & Diet A recent study suggests that unprocessed red meat and whole grains can be included or left out of a healthy diet. The study also found that diets with lots of fruit, vegetables, dairy (mainly whole-fat), nuts, legumes and fish were linked with a lower risk of cardiovascular disease (CVD) and premature death in all world regions. These are among the findings of a McMaster University-led study that is part of the PURE (Prospective Urban and Rural Epidemiological) project conducted in 80 countries.
“Low-fat foods have taken centre stage with the public, food industry and policymakers, with nutrition labels focused on reducing fat and saturated fat,” said study author Dr. Andrew Mente of the Population Health Research Institute, McMaster University. “Our findings suggest that the priority should be increasing protective foods such as nuts, fish and dairy, rather than restricting dairy (especially whole-fat) to very low amounts. Our results show that up to two servings a day of dairy, mainly whole-fat, can be included in a healthy diet. This is in keeping with modern nutrition science showing that dairy, particularly whole-fat, may protect against high blood pressure and metabolic syndrome.” The study was published in European Heart Journal. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Global-diet-study-challenges-advice-to-limit-high-fat-dairy-foods More about PURE: https://www.phri.ca/research/pure/
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Dr. Lucy McBride shares the case of one of her patients, in her mid-50s, who complained of severe afternoon fatigue, despite her efforts to eat a healthy diet and exercise more as she tried to lose weight. An assessment of her eating habits revealed that a lack of protein in her diet was most likely the culprit. "Protein is like premium gasoline: we need it for satiety (feeling of fullness), energy, weight management, maintenance of lean muscle mass, post-exercise recovery, immune function, focus, concentration, cognitive health , and mental health." How much protein should we consume a day? Dr. McBride advises that we eat 0.7 to 1.0 grams of protein per pound of body weight per day. Check out "The Major Food Group You Might Be Missing." https://lucymcbride.substack.com/p/the-major-food-group-you-might-be
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Rethinking "Overweight" BMI designations
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Could it be that the national standard for what is considered to be an ‘Overweight’ Body Mass Index(BMI) might be set too low? A large study by Rutgers Institute for Health has found that people with an ‘overweight’ body mass index actually lived longer than those within the ‘healthy’ range. The study, which began in 1999, tracked the survival of about 500,000 ethnically diverse U.S. adults of known height and weight, for up to 20 years.
Having a BMI between 25 and 27.4 carried a 5 per cent lower risk of death in this time period than a BMI within the healthy weight category of 22.5 to 24.9. A slightly higher BMI, of 27.5 to 29.9, seemed even better, linked with a 7 per cent lower risk of death. In June, the American Medical Association advised doctors that BMI shouldn’t be used in isolation to assess people’s weight, but should be considered alongside other factors such as waist circumference and other measures of health. https://www.newscientist.com/article/2381121-having-an-overweight-bmi-may-not-lead-to-an-earlier-death/
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Click here for a calculator that provides your body mass index (BMI) and the corresponding BMI weight status category (for adults 20 years and older).
https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
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City Tap Water has more "Forever Chemicals" than Rural Tap Water
U.S. Geological Survey (USGS) scientists collected tap water samples from the kitchen sinks at 716 residential locations representing a range of low (rural), medium, and high (urban) human-impacted areas.They estimate that almost half (at least 45%) of U.S. tap water contains one or more types of the chemicals known as per- and polyfluorinated alkyl substances, or PFAS, also known as "forever chemicals." There are more than 12,000 types of PFAS, not all of which can be detected with current tests; the USGS study tested for the presence of 32 types.
PFAS are a group of synthetic chemicals used in a wide variety of common applications, from the linings of fast-food boxes and non-stick cookware to fire-fighting foams and other purposes. High concentrations of some PFAS may lead to adverse health risks in people. Most of the exposure was observed near urban areas and potential PFAS sources. The study’s results are in line with previous research concluding that people in urban areas have a higher likelihood of PFAS exposure. USGS scientists estimate that the probability of PFAS not being observed in tap water is about 75% in rural areas and around 25% in urban areas. https://www.usgs.gov/news/national-news-release/tap-water-study-detects-pfas-forever-chemicals-across-us
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Map showing U.S. test locations and number of PFAS detections. Map source: USGS
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Women's Health: Infertility Trends & Research
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More women are having just one embryo transferred per cycle of fertility treatment to get pregnant, according to research presented at the 39th annual meeting of the European Society of Human Reproduction and Embryology (ESHRE). In 2020, 57% of embryo transfers were "singletons," while about a third transferred two, and only about 2% involved the transfer of three or more embryos. The ESHRE EIM report represents the largest data collection on medically assisted reproduction in Europe. Lead study author Dr. Jesper Smeenk said that preliminary findings show that live births resulting from fertility treatment in Europe continue to rise and that fertility treatments have become safer for mothers and babies without compromising success rates. https://www.eurekalert.org/news-releases/993396
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A small clinical study presented at the ESHRE compared couples with unexplained infertility trying to conceive naturally with couples where the woman used a vaginal progesterone treatment during the second half of her menstrual cycle. Progesterone naturally increases during a woman's cycle to prepare the lining of the uterus to receive a fertilized egg, and in this study, they found that the birth rate was twice as high among the women using progesterone therapy. https://www.cbsnews.com/boston/news/hormonal-therapy-progesterone-fertility-treatment-study/
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PCOS (Polycystic Ovary Syndrome)
Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility, affecting an estimated 5 million people in the U.S. In women with PCOS, hormone imbalances make it harder for ovaries to release mature eggs. Immature eggs develop into cysts on the ovaries. The risk of infertility, insulin resistance, and type 2 diabetes increases for people with PCOS. Check out Medshadow Foundation's seven-minute video to learn about the condition, diagnosis, and various medications and lifestyle modifications that can help treat symptoms of PCOS or help overcome fertility issues caused by PCOS. https://medshadow.org/videos/pcos-medical-animation-video/
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Medshadow also provides a full guide on PCOS with descriptions and side effects of medications frequently prescribed for PCOS. These include clomiphene (Clomid), letrozole (Femara), gonadotropins, metformin, birth control pills, and androgen blockers like spironolactone (Aldactone). https://medshadow.org/pcos-treatment-management-and-medications/
Check the Ask a Patient website for patient reviews for medications taken for various conditions or symptoms related to PCOS. (Note: this page is best viewed on a desktop computer or tablet.) https://www.askapatient.com/advancedsearchform.asp?Reason=pcos
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Medical Mystery: What was causing this retired doctor's violent abdominal pain? Retired surgical oncologist Thomas Trezona began having vague pain in his abdomen after returning from a rafting trip in the Grand Canyon in July of 2021. The pain came in waves, intensifying as the day wore on. Some days the pain was so overwhelming that he couldn't eat. Over a period of two months, he lost 21 pounds and underwent CT scans, doctor visits, and an endoscopy. At first he worried that his pain was caused by pancreatic cancer, the same disease that had killed his mother. Thankfully, that was ruled out, as was a parasitic infection or gastroenteritis. Ultimately, two months after his symptoms began, the detailed visualization from an MRI revealed a strange "artifact" in his upper abdomen. Read Sandra Boodman's latest medical mystery. https://www.washingtonpost.com/wellness/2023/07/08/medical-mystery-pain-grilled-meat/
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New Covid-19 and RSV Vaccines Coming Soon
The original or "ancestral" Covid virus variants and the Omicron variants BA.4 and BA.5 no longer are circulating in the U.S. Instead, a new, highly contagious Omicron variant called XBB and related spin-offs are rapidly spreading. In response, the FDA and CDC have asked the vaccine manufacturers to prepare a monovalent vaccine targeting XBB to be available this fall. It is not known yet who will be told to get this new shot. Many people are still catching Covid-19 but few are self-testing for it, so some instances of "summer colds" or sore throats might actually be mild cases of Covid-19 caused by the XBB variant. https://madison.com/fall-vaccine-update-likely/article_6ae057d2-3c8e-5e4e-bdc7-b5f48abbcea9.html
Almost everyone in the U.S. has caught Covid by now or been vaccinated or both. By the third quarter of 2022, an estimated 96.4% of approximately 143,000 blood donors in a nationwide, longitudinal cohort had SARS-CoV-2 antibodies from previous infection or vaccination or both, according to an analysis published in June in Morbidity and Mortality Weekly Report. https://jamanetwork.com/journals/jama/fullarticle/2807145
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Ask a Patient® Health Newsletter: July 11, 2023 Copyright, 2023
Visit us at www.askapatient.com
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