Conclusion: The study was inconclusive with respect to potential differences in progression of individual radiographic features after surgical and non-surgical treatment for degenerative meniscal tear. Further, we found no strong evidence in support of differences in development of incident radiographic knee osteoarthritis or patient-reported outcomes between exercise therapy and arthroscopic partial meniscectomy.
Objective: To evaluate progression of individual radiographic features 5 years following exercise therapy or arthroscopic partial meniscectomy as treatment for degenerative meniscal tear.
Design: Randomized controlled trial including 140 adults, aged 35-60 years, with a magnetic resonance image verified degenerative meniscal tear, and 96% without definite radiographic knee osteoarthritis. Participants were randomized to either 12-weeks of supervised exercise therapy or arthroscopic partial meniscectomy. The primary outcome was between-group difference in progression of tibiofemoral joint space narrowing and marginal osteophytes at 5 years, assessed semi-quantitatively by the OARSI atlas. Secondary outcomes included incidence of radiographic knee osteoarthritis and symptomatic knee osteoarthritis, medial tibiofemoral fixed joint space width (quantitatively assessed), and patient-reported outcome measures. Statistical analyses were performed using a full analysis set. Per protocol and as treated analysis were also performed.
Results: The risk ratios (95% CI) for progression of semi-quantitatively assessed joint space narrowing and medial and lateral osteophytes for the surgery group were 0.89 (0.55-1.44), 1.15 (0.79-1.68) and 0.77 (0.42-1.42), respectively, compared to the exercise therapy group. In secondary outcomes (full-set analysis) no statistically significant between-group differences were found.
From a MedPage Today online article (April 2, 2020):
This relationship between higher glucose levels and poorer cognitive functioning extended beyond just CASI z-score, as well, Cukierman-Yaffe noted. Higher HbA1c levels were also tied to significantly poorer performance in other psychological tests, including the clock making test of executive functioning, test of discriminative ability, and for the test of verbal fluency.
Poorer glycemic control was tied to cognitive decline following a lacunar stroke in a prospective cohort study.
Among 942 individuals with type 2 diabetes who had a lacunar stroke, every 1% higher HbA1c was tied to a 0.06 drop in cognitive function at baseline measured by Cognitive Assessment Screening Instrument (CASI) z-score (95% CI -0.101 to -0.018), reported Tali Cukierman-Yaffe, MD, MSc, of Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University in Israel.
The major finding of this study is that the timing of feeding over the day leads to significant differences in the metabolism of an equivalent 24-h nutritional intake. Daily timing of nutrient availability coupled with daily/circadian control of metabolism drives a switch in substrate preference such that the late-evening Snack Session resulted in significantly lower LO compared to the Breakfast Session.
Developed countries are experiencing an epidemic of obesity that leads to many serious health problems, foremost among which are increasing rates of type 2 diabetes, metabolic syndrome, cardiovascular disease, and cancer. While weight gain and obesity are primarily determined by diet and exercise, there is tremendous interest in the possibility that the daily timing of eating might have a significant impact upon weight management [1–3]. Many physiological processes display day/night rhythms, including feeding behavior, lipid and carbohydrate metabolism, body temperature, and sleep.
These daily oscillations are controlled by the circadian clock, which is composed of an autoregulatory biochemical mechanism that is expressed in tissues throughout the body and is coordinated by a master pacemaker located in the suprachiasmatic nuclei of the brain (aka the SCN [1,4]). The circadian system globally controls gene expression patterns so that metabolic pathways are differentially regulated over the day, including switching between carbohydrate and lipid catabolism [1,3,5–9]. Therefore, ingestion of the same food at different times of day could lead to differential metabolic outcomes, e.g., lipid oxidation (LO) versus accumulation; however, whether this is true or not is unclear.
From a New York Times online article (March 16, 2020):
“Maintaining weight loss can get easier over time. Over time, less intentional effort, though not no effort, is needed to be successful. After about two years, healthy eating habits become part of the routine. Healthy choices become more automatic the longer people continue to make them. They feel weird when they don’t.”
Among the useful strategies identified in the new study is to keep lower calorie foods like fruits and vegetables more accessible. “We eat what we see,” Dr. Phelan noted. The corollary is equally important: keep high-calorie, less nourishing foods relatively inaccessible and out of sight if not out of the house entirely.
The new study led by Dr. Phelan, professor of kinesiology and public health at California Polytechnic State University, identified habits and strategies that can be keys to success for millions. Yes, like most sensible weight-loss plans, they involve healthful eating and regular physical activity. But they also include important self-monitoring practices and nonpunitive coping measures that can be the crucial to long-term weight management.
From a BMJ Open Heart online study (March 8, 2020):
Overall, the evidence in the literature suggests that spirulina improves several well-established CVD risk factors including hyperlipidaemia and seems to provide benefits around weight loss.
Although caloric restriction and exercise are the mainstay treatments for obesity, spirulina has shown significant benefits in aiding weight loss. The phycocyanin in spirulina contains a light-harvesting chromophore called phycocyanobilin, which is capable of inhibiting nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) oxidase, a significant source of oxidative stress in adipocytes playing a key role in inducing insulin resistance and shifting adipokine and cytokine production in hypertrophied adipocytes. Thus, by suppressing adipocyte oxidative stress, spirulina may lead to systemic anti-inflammatory and insulin-sensitising effects.
Spirulina is both a salt and fresh water blue-green algae, which is being increasingly studied recently. Spirulina was initially classified under the plant kingdom due to its rich plant pigments and its ability to photosynthesize, but was later placed into bacterial kingdom (cyanobacteria) due to its genetic, physiological and biochemical makeup. Spirulina grows naturally in high salt alkaline water reservoirs in subtropical and tropical areas of America, Mexico, Asia and Central Africa.
From a The Guardian online article (Feb 12, 2020):
What characterizes ultra-processed foods is that they are so altered that it can be hard to recognize the underlying ingredients. These are concoctions of concoctions, engineered from ingredients that are already highly refined, such as cheap vegetable oils, flours, whey proteins and sugars, which are then whipped up into something more appetizing with the help of industrial additives such as emulsifiers.
From a MedPage Today online article (March 7, 2020):
The top ultra-processed foods by calorie intake were breads, beverages, cakes, cookies and pies, salty snacks, frozen and shelf-stable dishes, pizza, and breakfast cereals.
Altogether, ultra-processed foods accounted for 58% of all calories in the U.S. diet and nearly 90% of all added sugars.
They divided foods into four categories:
Unprocessed or minimally processed foods: Fresh, dry, or frozen fruits or vegetables, grains, legumes, meat, fish, and milk
Processed culinary ingredients: Table sugar, oils, fats, salt, and other substances extracted from foods or from nature and used in kitchens to make culinary preparations
Processed foods: Foods manufactured with the addition of salt, sugar, or other substances of culinary use to unprocessed or minimally-processed foods, such as canned food, simple breads, and cheese
Ultra-processed foods: Formulations of several ingredients that — besides salt, sugar, oils, and fats — include food substances not used in culinary preparations, in particular, flavors, colors, sweeteners, emulsifiers, and other additives used to imitate sensory qualities of unprocessed or minimally-processed foods and their culinary preparations or to disguise undesirable qualities of the final product