Tag Archives: New England Journal Of Medicine

Health Studies: High Milk & Dairy Consumption Not Related To Lower Heart Disease, Diabetes (NEJM)

From the New England Journal of Medicine (February 13, 2020):

Milk and Dairy Product Health NEJMIn our opinion, the current recommendation to greatly increase consumption of dairy foods to 3 or more servings per day does not appear to be justified…When consumption of milk is low, the two nutrients of primary concern, calcium and vitamin D (which is of particular concern at higher latitudes), be obtained from other foods or supplements without the potential negative consequences of dairy foods.

For calcium, alternative dietary sources include kale, broccoli, tofu, nuts, beans, and fortified orange juice for vitamin D, supplements can provide adequate intake at far lower cost than fortified milk. Pending additional research, guidelines for milk and equivalent dairy foods ideally should designate an acceptable intake (such as 0 to 2 servings per day for adults), deemphasize reduced-fat milk as preferable to whole milk, and discourage consumption of sugar-sweetened dairy foods in populations with high rates of overweight and obesity.

For adults, the overall evidence does not support high dairy consumption for reduction of fractures, which has been a primary justification for current U.S. recommendations. Moreover, total dairy consumption has not been clearly related to weight control or to risks of diabetes and cardiovascular disease. High consumption of dairy foods is likely to increase the risks of prostate cancer and possibly endometrial cancer but reduce the risk of colorectal cancer.

Read full article

Podcast: “Intermittent Fasting” Study Author Mark P. Mattson MD On Diet’s Health Benefits

NEJM Journal WatchIntermittent fasting has salutary effects. Listen how Dr. Mark P. Mattson, co-author of a recent NEJM review on the topic, assesses the practice — and how he’s managed to skip breakfast for the past 30 years or so.

Evidence is accumulating that eating in a 6-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-based energy, with increased stress resistance, increased longevity, and a decreased incidence of diseases, including cancer and obesity.

Inline image

Read article on study

Top Medical Podcasts: Lung-Cancer Screenings, Placebo Effects (NEJM)

Lung-Cancer Mortality with Volume CT Screening NEJM February 2020Featuring articles on lung-cancer screening in the NELSON trial, ribociclib and fulvestrant in metastatic breast cancer, vitamin D in pregnancy and asthma, treatment thresholds for neonatal hypoglycemia, and CAR-NK cells in anti-CD19 lymphoid tumors; a review article on placebo and nocebo effects; a Clinical Problem-Solving describing a rapid change in pressure; and Perspective articles on altruism in Extremis, on abuses of FDA regulatory procedures, and on joining forces against delirium.

The New England Journal of Medicine logo

Medical Podcasts: The Time Physicians Spend On Patient’s Electronic Health Records (NEJM)

New England Journal of Medicine Podcast logoListen to a chat with Julia Adler-Milstein, the author of an editorial that comments on a recent Annals of Internal Medicine study detailing the amount of time clinicians typically spend hunched over their EHRs during a patient visit.

Why aren’t you able to navigate your electronic health record (EHR) as easily as you can find a recipe on, say, Google?

And, what about those requirements for documenting everything?

Links:

Annals of Internal Medicine editorial

Annals paper on the time clinicians spend

Running time: 17 minutes

Aortic Stenosis: Early Aortic-Valve Replacement Surgery Lowers Mortality

Early Surgery or Conservative Care for Aortic Stenosis New England Journal of Medicine January 8 2020 Infographic

CONCLUSIONS

Among asymptomatic patients with very severe aortic stenosis, the incidence of the composite of operative mortality or death from cardiovascular causes during the follow-up period was significantly lower among those who underwent early aortic-valve replacement surgery than among those who received conservative care.

Read study

Heart Studies: Alcohol Abstinence For Atrial Fibrillation Reduces Arrhythmia (NEJM)

Alcohol Abstinence for Atrial Fibrillation New England Journal of Medicine January 1 2020

Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. 

New England Journal of Medicine

January 2, 2020 Atrial fibrillation is the most common sustained arrhythmia,1 and alcohol is consumed by a majority of U.S. adults.2 The current study showed that among regular drinkers, a substantial reduction in alcohol consumption by patients with symptomatic atrial fibrillation was associated with a reduction in recurrence of atrial fibrillation and a reduced proportion of time spent in atrial fibrillation. Earlier meta-analyses showed that alcohol was associated with a dose-related increased risk of incident atrial fibrillation, with increased risk observed even among drinkers who consumed as few as 7 drinks per week.8 Current trends show a rise in alcohol consumption among adults older than 60 years of age,2coupled with greater prevalence of atrial fibrillation in this age group. The present study, with participants having an average intake of approximately 17 drinks per week at baseline, suggests that consumption at these levels may contribute to atrial fibrillation.

Read article

New Studies: Beneficial Effects Of “18-Hour Intermittent Fasting” On Health And Aging (NEJM)

From a New England Journal of Medicine online release:

In humans, intermittent-fasting interventions ameliorate obesity, insulin resistance, dyslipidemia, hypertension, and inflammation. Intermittent fasting seems to confer health benefits to a greater extent than can be attributed just to a reduction in caloric intake.

Evidence is accumulating that eating in a 6-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-based energy, with increased stress resistance, increased longevity, and a decreased incidence of diseases, including cancer and obesity.

The New England Journal of Medicine Logo

Preclinical studies and clinical trials have shown that intermittent fasting has broad-spectrum benefits for many health conditions, such as obesity, diabetes mellitus, cardiovascular disease, cancers, and neurologic disorders. Animal models show that intermittent fasting improves health throughout the life span, whereas clinical studies have mainly involved relatively short-term interventions, over a period of months.

Effects of Intermittent Fasting on Health, Aging, and Disease New England Journal of Medicine December 26 2019

BOOMERS-DAILY.COM “18-HOUR INTERMITTENT FASTING DIET” STUDY

How much of the benefit of intermittent fasting is due to metabolic switching and how much is due to weight loss? Many studies have indicated that several of the benefits of intermittent fasting are dissociated from its effects on weight loss. These benefits include improvements in glucose regulation, blood pressure, and heart rate; the efficacy of endurance training; and abdominal fat loss.

To read more

Inline image