What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss

“we examine real-world data from a cohort based in a UK primary care clinic offering a low-carbohydrate approach to people with T2D [type 2 diabetes] from 2013 to 2021. The physiological mechanisms behind remission induced by dietary weight loss were first demonstrated in 2011. Since then the idea of drug-free T2D remission has gained international momentum. [..] Advice on lowering dietary carbohydrate was offered routinely by our team of nine specially trained GPs and three practice nurses to patients with T2D (defined as HbA1c >48 mmol/mol on two occasions) starting in March 2013. Our protocol includes important information around the deprescribing of … Read More

Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality

“[Introduction] According to the Global Burden of Disease Study 2017, unhealthy diet is estimated as one of the leading causes of death globally. [..] using 2 large prospective cohorts with data on repeated measures of dietary habits, we derived dietary scores for 4 healthy dietary patterns, including the Healthy Eating Index 2015 (HEI-2015), Alternate Mediterranean Diet (AMED) score, Healthful Plant-based Diet Index (HPDI), and Alternate Healthy Eating Index (AHEI). We then examined their associations with total and cause-specific mortality. We also specifically examined these associations stratified by race and ethnicity and other potential risk factors. [Methods] This cohort study used … Read More

Athletic Greens as More Wellness Nonsense

Excerpt – For a company that’s been around for more than a decade, it seems to have appeared out of nowhere. Athletic Greens aggressively advertises (and sells) only one product: AG1, a moss-toned powder that costs $99 for a 30-serving bag and claims to be “all you really need, really.” But it isn’t a meal replacement nor is it a pre- or post-workout drink, as the brand’s name implies. AG1 promises “75 vitamins, minerals, whole-food sourced superfoods, probiotics and adaptogens” in one scoop. The ingredient list is biblically long and rife with parentheses, its components categorized by wellness buzzwords: “Alkaline, … Read More

The Biden Administration Killed America’s Collective Pandemic Approach

“Coronavirus case numbers are in free fall; vaccines and, to a lesser degree, viral infections have built up a wall of immunity that can blunt the virus’s impact overall. Several experts stressed that certain aspects of the CDC’s new guidelines are genuinely improving on the framework the country was using before. “The timing feels right to make some kind of change,” Whitney Robinson, an epidemiologist at Duke University, told me. But protection against SARS-CoV-2 isn’t spread equally. Millions of kids under 5 are still ineligible for shots. Vaccine effectiveness declines faster in older individuals and is patchy to begin with … Read More

Assessment of Parental Choice Predisposition for Tonsillectomy in Children

“[Introduction] Shared decision-making is a strategy to improve communication and health care delivery by reducing unwarranted variation and improving quality of treatment decisions, particularly for conditions where evidence supports multiple treatment choices without a single superior option. In such “preference-sensitive” treatment scenarios, shared decision-making promotes a collaborative decision that is consistent with evidence-based practices and patient preferences and values. Obstructive sleep-disordered breathing (OSDB) is a common condition in children for which decisions for surgery with tonsillectomy are often dependent on family preferences. The treatment decisions are considered preference sensitive because of a lack of definitive evidence for a single best … Read More

UPMC Partnership Expands Chronic Disease Medication Adherence

“UPMC Health Plan and Sempre Health’s medication adherence collaboration has expanded its chronic disease management benefits to include diabetes medicines for members of UPMC’s employer-sponsored health plans. Since the program’s launch in 2017, members have collectively saved over $500,000 on cardiovascular medications, with the average member saving $33 per prescription refill through SMS message discounts. [..] In the first year of the partnership, the program successfully enrolled more than one-third of eligible members. Improvements in cardiovascular medication adherence for these members was significant when compared to a control group. Now, UPMC is expanding the program to diabetic members in order … Read More

Weight-Focused Public Health Interventions—No Benefit, Some Harm

“findings in these articles are consistent with literature on the adverse impact of weight stigma, which may be exacerbated by the increased focus on weight. Specifically, health promotion approaches that focus on obesity and target the individual perpetuate weight stigma and fail to address the profound inequities that drive disparities in health and weight. For example, BMI report cards, a widely used school-based childhood obesity intervention, inform parents of their child’s weight status and increase parents’ weight-related anxiety but provide little guidance about evidence-based health promotion strategies and offer no structural support for behavior change. Furthermore, weight-focused health promotion approaches … Read More

How might a mask mandate play out? Look to the battle over seat belt laws

“If public health officials want to get people to wear masks to curb the spread of Covid-19, they might take a lesson what is now a widely accepted aspect of American life: buckling up. [..] Fred Rivara, an injuries expert and professor of pediatrics at the University of Washington, remembers an unsubstantiated claim that any positive effects would be cancelled out by people dying when they couldn’t escape fiery cars. [..] After years of pressure, President Johnson signed legislation in 1966 that required seat belts in all passenger vehicles and created a national traffic safety agency. Rivara credits science for … Read More

A Moment with Duke’s Dori Steinberg: On Nutrition Beyond Calories and Health at Every Size

“[Question] What are you working on right now that you’re excited about? [Steinberg] Our team is developing a behavioral intervention focused on improving intuitive eating and diet quality using digital health tools (apps, video coaching, APIs) to improve blood pressure. Most notably, we were purposeful in not focusing on calories or changing one’s weight in this project. I am excited to offer people something that can improve health independent of changing body size or weight. Reducing weight stigma is something I aim to work on more in future projects. [Question] Who’s doing something that you admire in healthcare today, and … Read More

A Moment with Gina Merchant: On Shiny Objects and Technology’s Path to Meaningful Behavior Change

“[Question] What’s the biggest barrier to getting things done in your line of work? [Merchant] The biggest barrier I face, and observe others facing, is being asked to play by a set of rules and a culture handed down by the tech industry, which does not transfer well to the health tech industry. For example, product timelines are often too short to bring an effective product to market (and despite lip service to iteration, products often remain unchanged year over year). Also, the right combination of experts and leaders are often missing seats at the table; there isn’t enough investment … Read More