NICE approves digital health therapies for psychosis treatment in the NHS
The National Institute for Health and Care Excellence (NICE) has officially approved three innovative digital therapies for incorporation into the treatment of psychosis within the NHS, pending further investigation into their benefits. This provisional approval, part of an early value assessment, encompasses AVATAR Therapy, SlowMo, and CareLoop, each targeting different aspects of psychosis management.
AVATAR Therapy utilises sophisticated software to create a digital representation or avatar of the distressing voices often heard by individuals suffering from psychosis. This digital approach involves patients in therapeutic dialogues spanning six to twelve sessions, wherein a mental health professional animates the avatar. This interaction is designed to facilitate a tripartite conversation, aiming to reduce the impact of auditory hallucinations.
SlowMo, on the other hand, emerges from a collaboration between the Psychosis Research Partnership at King’s College London and the Helen Hamlyn Centre for Design at the Royal College of Art. This therapy employs a web application linked to a smart device to help individuals recognise and moderate the rapid thought processes associated with psychosis, particularly paranoia. By slowing down these thoughts, the therapy aims to lessen the distress they cause.
The third therapy, CareLoop, is an application focused on preventing relapses. It enables patients to document their symptoms, thoughts, and feelings through a journaling feature and structured questionnaires. An underlying algorithm analyses these entries to detect early signs of potential relapse, allowing healthcare teams to intervene promptly.
These three digital health technologies are now available for use within NHS care teams on the condition that they actively collect and share data on their effectiveness over a three-year period, providing annual reports to NICE.
Furthermore, a separate assessment by NICE has recognised the potential of gameChangeVR, a virtual reality technology, for treating severe agoraphobic avoidance in individuals with psychosis, marking another step forward in digital health solutions for mental health.
NICE’s reports underline several advantages these digital therapies may offer, including improved accessibility to mental health services—which are currently under high demand and unevenly distributed across the NHS. These technologies not only provide an alternative treatment option for those unable to access traditional psychological interventions but also require no specialised training in cognitive behavioural therapy for psychosis (CBTp), potentially broadening the pool of mental health professionals who can deliver these services. Additionally, when integrated with standard care, these digital solutions could decrease the frequency of therapy sessions needed.
Earlier in the year, NICE also supported the use of Brainomix’s stroke management software, further demonstrating its commitment to integrating digital health technologies into healthcare provision.
Read MoreMelatonin offers new hope for obesity prevention according to recent studies
Recent collaborative research spearheaded by the University of Granada (UGR) has unveiled significant findings regarding the use of melatonin in the prevention of obesity. This research, conducted by a team comprising experts from UGR’s Department of Pharmacology, the Federico Olóriz Neurosciences Institute, the Biosanitary Institute of Granada, and the University of Qatar, has shown promising results in mitigating the risks associated with visceral obesity. This type of obesity is especially concerning as it involves fat accumulation deep within the abdomen, surrounding vital organs, thus posing heightened health risks.
The studies, which were led by Professor Ahmad Agil of UGR and published in the well-regarded journals Antioxidants and Biomedicine & Pharmacotherapy, employed a methodical approach to their experimentation. Using adult rats with obesity and diabetes of both sexes, the research demonstrated that chronic administration of melatonin at a dosage of 10 mg/kg of body weight per day over three months is significantly more effective in preventing obesity compared to short-term treatments. Notably, the treatment resulted in a reduction of visceral fat by approximately 3%. Moreover, the studies highlighted melatonin’s ability to alleviate muscle-fibre atrophy associated with obesity, transform muscle fibre types into a more oxidative and slower phenotype, and increase mitochondrial activity and content—factors which collectively contribute to the observed reduction in weight gain among the treated rats.
An intriguing aspect of the research involved combining melatonin treatment with exposure to slightly cold water, around 17°C, which simulates the average sea temperature. This combination was found to further enhance weight loss, suggesting a potential new approach to managing obesity in humans.
Professor Agil underscored the growing prevalence of obesity, overweight, and type 2 diabetes across both developed and developing nations. He attributed these conditions to poor adaptation of the human genome to current environmental factors that include sedentary lifestyles, consumption of hypercaloric diets, and exposure to persistent artificial light which disrupts natural circadian rhythms and reduces endogenous melatonin levels.
To counter these challenges, Professor Agil recommends several lifestyle adjustments based on individual circadian rhythms. During the day, he suggests exposure to natural light, engaging in physical activity, opting for low-calorie, unprocessed diets, and incorporating thermogenic spices in meals while avoiding snacks between meals and reducing the use of insulating clothing and heating in homes. At night, recommendations include sleeping in complete darkness, avoiding blue light-emitting devices before bedtime, and practising fasting to boost melatonin levels naturally. For older adults and those suffering from obesity, Professor Agil advises the administration of melatonin under medical supervision.
The overarching goal of these studies is to integrate strategies like melatonin administration and intermittent fasting into medical practices to address the complex challenges posed by ‘diabesity’—a confluence of diabetes and obesity—and its associated complications, such as hepatic steatosis, hypertension, and lipid disorders. The research builds on 13 years of prior studies which have consistently shown that pharmacological use of melatonin can serve as a viable strategy in treating central obesity and its related complications. Moreover, melatonin has been found to activate brown fat and enhance the conversion of subcutaneous fat to a more metabolically active form, thus promoting the formation of beige fat cells from mesenchymal stem cells in humans.
These findings not only reaffirm the potential of melatonin in treating visceral obesity but also highlight the necessity for further clinical trials to confirm its efficacy in human subjects. Encouraging results from existing human trials support the progression to more extensive studies focusing on melatonin’s role in maintaining mitochondrial homeostasis and potentially slowing or halting the progression of obesity and its complications through prolonged pharmacological use.
The research has received funding from the SAF2016-79794-R project of the Ministry of Science, Innovation and Universities and is also supported by the European Regional Development Fund (ERDF).
Read MoreAI enhances physician-patient communication, study reveals
UC San Diego Health, as one of the initial health institutions in the United States to integrate generative artificial intelligence (GenAI) into the Epic Systems electronic health record system, is at the forefront of digital health innovation. This integration facilitates the drafting of replies to patient inquiries, marking a significant step forward in medical communication.
The findings from a recent study conducted by the University of California San Diego School of Medicine, published in the Journal of the American Medical Association’s Network Open on April 15, 2024, reveal that while AI-generated drafts did not shorten the time physicians took to respond, they significantly reduced the mental effort required by doctors by providing an initial empathetic draft. This allows physicians to refine the message rather than composing one from scratch.
This pioneering study represents the first randomised prospective evaluation focused on AI-drafted messages within physician-patient communication, highlighting its potential to alleviate some of the cognitive demands on healthcare providers.
Christopher Longhurst, MD, the senior author of the study and a leading figure at UC San Diego Health, emphasised the utility of AI in addressing challenges within health systems, notably the surge in patient communications contributing to physician burnout. He pointed out that the lengthier AI-drafted messages suggest enhanced quality and that physicians have expressed appreciation for the assistance, which lessens their cognitive load.
The research underscores the role of GenAI in improving the quality, efficiency, and engagement of digital healthcare interactions. By reducing the workload on physicians, AI allows them to concentrate on the more intricate aspects of patient care, thereby aiming to mitigate burnout.
Ming Tai-Seale, PhD, MPH, the lead author and a professor at UC San Diego School of Medicine, described generative AI as a collaborative tool that assists physicians, who may receive around 200 messages per week, in overcoming writer’s block by providing a foundation for crafting empathetic responses to patients.
The enduring high demand for digital communication between patients and physicians, amplified by the COVID-19 pandemic, has led to the widespread use of patient portals like MyUCSDChart. These systems facilitate direct emails to doctors but also increase the pressure for timely responses, a demand that many physicians struggle to meet efficiently.
In response, UC San Diego Health initiated a pilot program with Epic Systems in April 2023 to employ GenAI for drafting responses to non-urgent patient queries. The AI-generated drafts include a disclaimer to inform patients of the AI’s involvement before the messages are reviewed and personalised by the responding physician.
Despite not reducing response times, the AI helps compose more detailed and compassionate replies, which are valued by patients. According to Marlene Millen, MD, another co-author and chief medical information officer for ambulatory care at UC San Diego Health, the AI’s ability to maintain consistent performance, regardless of the time of day, provides significant support in drafting empathetic messages that integrate relevant patient information.
While the study did not find time savings in message drafting, the qualitative benefits suggest a potential shift in healthcare communication practices. Further research is needed to evaluate patient perceptions of the enhanced empathy and detail in AI-assisted replies.
Since May 2023, UC San Diego Health and the Jacobs Center for Health Innovation have been rigorously testing GenAI models, exploring their safe and innovative applications in healthcare settings, thereby paving the way for future advancements in the field.
Read MoreTwenty years of research validates mediterranean diet’s role in lowering hypertension risk
A landmark study published in the European Journal of Clinical Nutrition has shed light on the enduring benefits of the Mediterranean diet in preventing hypertension (HTN) over an extensive 20-year period. Conducted among a group of initially non-hypertensive adults, this research marks a significant step in understanding long-term dietary impacts on health.
Hypertension remains a critical challenge globally, significantly influencing the onset of heart diseases and strokes, predominantly in low- and middle-income nations. Despite advancements in medication that stabilise blood pressure, approximately 30% of adults still suffer from HTN, which escalates both the healthcare costs and mortality associated with cardiovascular diseases (CVD). Lifestyle changes such as adopting balanced diets, regular physical activity, and smoking cessation are crucial for managing and preventing HTN. Official health guidelines recommend diets rich in plant-based foods, healthy fats, and lean proteins while being low in sodium and alcohol. The Mediterranean diet, celebrated since the 1960s for its role in preventing chronic conditions and reducing CVD mortality, has lacked long-term concrete evidence of its efficacy in managing blood pressure, prompting further investigation.
The study in question, known as the ATTICA study, complies with the Declaration of Helsinki and explores CVD incidence among Greek adults. Beginning in 2001-2002 with 4,056 individuals from the Attica region invited to participate, 3,042 agreed, embarking on a two-decade-long health journey. Initial assessments involved detailed face-to-face interviews at homes or workplaces by trained health professionals, who collected extensive socio-demographic, clinical, and biochemical data. Key health measures included fasting blood samples for glucose, insulin, total cholesterol, and high sensitivity C-reactive protein levels, among others. Participants also underwent physical examinations to ensure no pre-existing CVD and to measure blood pressure. Lifestyle factors including diet, exercise, and smoking habits were meticulously recorded, using a validated food frequency questionnaire to evaluate adherence to the Mediterranean diet through the MedDietScore.
Throughout the 20-year study period, participant engagement was maintained through regular follow-ups, with the latest in 2022 assessing 2,169 of the original cohort. This follow-up re-evaluated their health outcomes, including HTN, diabetes, and CVD development, corroborating data through family reports and medical records for deceased participants.
Statistical analyses utilised advanced software to contrast initial and 10-year dietary patterns, identifying four distinct adherence trajectories to the Mediterranean diet. Techniques such as correlation coefficients, chi-squared tests, and logistic regression models were employed to ascertain the connection between dietary adherence and HTN risk, accounting for variables like age, sex, body mass index, lifestyle habits, and initial health status.
Findings revealed that at the start, participants averaged 41 years of age with a near-equal gender distribution and showed moderate adherence to the Mediterranean diet, scoring an average MedDietScore of 27.1. Physically, 63.1% were minimally active, and about half were classified as having overweight or obesity. Early medical evaluations noted a 35.3% prevalence of hypercholesterolemia and a 3.9% incidence of diabetes.
Analysis of initial data highlighted a strong negative correlation between adherence to the Mediterranean diet and both systolic and diastolic blood pressures, indicating that higher dietary adherence correlated with lower blood pressure levels. Over the study’s duration, 314 individuals developed hypertension, representing a 22.2% incidence rate. Those who developed HTN typically were older, predominantly male, had higher obesity rates, poorer cardiometabolic profiles, and greater tobacco use compared to those who remained free from HTN.
In-depth analysis demonstrated that participants with low initial MedDietScore faced significantly higher HTN development rates than those with medium or high adherence levels. Statistical evaluation confirmed that each point increase in MedDietScore at baseline correlated with a 7% decrease in HTN risk over 20 years, a relationship that persisted even after adjusting for demographic and lifestyle factors.
The study also examined changes in diet adherence from the start to the 10-year point, revealing varied patterns. Notably, participants consistently adherent to the Mediterranean diet showed a remarkably lower incidence of HTN, with a 46.5% reduced risk in the fully adjusted model, underscoring the diet’s protective effect against HTN when sustained over time.
Read MoreEli Lilly’s Tirzepatide shows up to 66% reduction in sleep apnea severity in adults with obesity
In a recent development, Eli Lilly & Co. announced that its weight-loss medication, Tirzepatide, has shown promising results in alleviating symptoms of obstructive sleep apnea, a disorder primarily associated with obesity. This revelation emerged from two advanced clinical trials, wherein Tirzepatide significantly reduced the incidences of diminished or halted breathing during sleep by up to 63%, surpassing the anticipations of Jefferies analysts who had projected a reduction range of 50% to 55%.
During these year-long studies, participants experienced a substantial decrease in body weight, with losses nearing 20%, as reported by Lilly. The pharmaceutical giant intends to present the comprehensive findings from these studies at the upcoming American Diabetes Association conference in June. Subsequently, plans are underway to submit these results to the U.S. Food and Drug Administration and other international regulatory bodies starting mid-year.
The potential approval of Tirzepatide for treating sleep apnea could significantly broaden patient access to the drug through insurance coverage. Currently, weight loss medications like Tirzepatide do not receive coverage under Medicare, the U.S. federal health programme for the elderly and certain individuals on long-term disability. Such approval would not only facilitate greater competition with Novo Nordisk A/S—whose leading weight-loss drug, Wegovy, has recently gained insurance coverage for some Medicare beneficiaries with cardiac conditions—but also position Lilly at the forefront of addressing the underlying causes of sleep apnea.
Jeff Emmick, Lilly’s senior vice president of product development, emphasised the transformative potential of Tirzepatide, highlighting its capacity as the inaugural pharmaceutical intervention targeting the fundamental aspects of the disease. Given the correlation between weight loss and improvements in sleep apnea symptoms, widespread insurance coverage for Tirzepatide could potentially prevent up to 5.6 million cases of this sleep disorder by 2030, as estimated by analytics firm Airfinity.
Nevertheless, despite these advances, analysts from Airfinity caution that while GLP-1 drugs like Tirzepatide will significantly reduce sleep apnea incidences, they are unlikely to eradicate the disorder entirely.
The study enrolled 469 participants suffering from obesity and sleep apnea, with some receiving Tirzepatide alone and others receiving both the drug and using breathing devices. Results indicated a more pronounced average reduction in the apnea-hypopnea index (AHI)—a diagnostic measure quantifying the severity of sleep apnea based on the number of breathing disruptions per hour of sleep—for those utilising both the medication and breathing devices compared to those solely on medication.
The approval of Tirzepatide for sleep apnea treatment could also influence the market for respiratory support devices. Companies like ResMed Inc. and Inspire Medical Systems Inc., which manufacture such equipment, may see a reduction in demand, with Airfinity projecting a potential market contraction of over 11% in the coming years due to the increased use of weight loss drugs as a therapeutic alternative.
Read MorePioneering AI tool developed by NHS teams to transform patient care
A ground-breaking artificial intelligence (AI) tool, designed to forecast patient health trajectories, has been developed by a collaboration of healthcare researchers within the NHS. Dubbed “Foresight,” this innovative tool is poised to revolutionise clinical decision-making processes, enhance monitoring in healthcare environments, and bolster clinical trials.
The development team is composed of specialists from two NHS foundation trusts in London—King’s College Hospital and Guy’s and St Thomas’—as well as academic experts from King’s College and University College London. Utilising the Cogstack platform, which is renowned for its capability in information retrieval and extraction, Foresight leverages natural language processing to efficiently mine data from NHS electronic health records. This allows the tool to be trained on vast amounts of healthcare data, employing a deep learning methodology to identify intricate patterns within both structured and unstructured data sources.
A critical evaluation published in The Lancet Digital Health illustrates Foresight’s effectiveness: the tool successfully predicted the next ten possible health disorders in a patient’s timeline with impressive accuracy rates—68% at King’s College Hospital, 76% at Maudsley NHS Foundation Trust, and an outstanding 88% with the US-based MIMIC-III dataset.
The tool’s utility was further underscored through a practical test where five clinicians created 34 hypothetical patient timelines based on simulated scenarios. An impressive 93% of the predictions made by Foresight were deemed clinically relevant, affirming their practical applicability in real-world settings.
According to a report from the NIHR Maudsley Biomedical Research Centre, Foresight’s capabilities are not limited to forecasting; it can also emulate clinical trials, facilitate longitudinal research, generate synthetic datasets, and simulate interventions to study disease progression. Professor Richard Dobson, a leading figure in medical informatics at King’s College London and the senior author of the study, expressed enthusiasm about the multitude of applications for Foresight. He highlighted its potential in creating digital health twins and advancing medical education, among other uses.
Professor Dobson emphasised the importance of employing high-quality data to refine AI models and expressed a vision for expanded collaboration. His aim is to involve more hospitals in the development of “Foresight 2,” an iteration that promises even greater accuracy through enhanced language models.
This initiative has garnered substantial support, receiving funding from the NHS AI Lab, the National Institute for Health and Care Research, and Health Data Research UK (HDRUK). Professor Andrew Morris, director of HDRUK, noted that the success of such innovations hinges on the quality and representativeness of the data used. He advocated for continued investment in the UK’s data infrastructure to ensure these advancements can be realised in a manner that is both secure and respectful of patient privacy.
Read MoreDigital health platform reduces hospital stay for surgery patients
A recent study has highlighted the significant benefits of a digital health platform named Pip Care in enhancing the postoperative recovery process for patients undergoing surgery. The research, published in the Journal of Medical Internet Research, demonstrates the platform’s ability to reduce hospital stays through effective engagement with patients and integration of personalised recovery strategies.
Pip Care is designed to support patients throughout their perioperative journey by offering personalised care plans and connecting them with certified health coaches. These coaches collaborate with the patients’ surgical teams to provide tailored guidance and daily recovery tasks. The platform’s objective is to foster patient adherence to recovery plans, thus improving surgical outcomes.
The study was conducted in collaboration between UPMC and the University of Pittsburgh School of Medicine. Researchers invited patients scheduled for elective surgeries at an academic medical centre over a period from November 22, 2022, to March 27, 2023, to participate in the platform from approximately two to four weeks pre-surgery to four weeks post-surgery. Out of 283 patients approached, 172 (60.8%) enrolled in the study. A notable 83.1% of these participants engaged in one or more health coaching sessions, with 97.2% proceeding to surgery, surpassing the industry’s typical 90% to 93% surgical adherence rates. Post-surgery, 70.3% continued to engage with the platform.
The platform maintained an impressive 82% weekly engagement rate, with patients frequently attending multiple health coaching sessions. Feedback gathered from 95 survey submissions revealed high levels of satisfaction, with many patients affirming that the coaching significantly aided their perioperative experience.
A comparative analysis between 128 patients using the Pip Care platform and 268 non-users undergoing the same procedures at the same hospital showed that platform users experienced a 24% reduction in postoperative hospital stay. Specifically, the average stay for Pip Care users was 2.4 days compared to 3.1 days for those not using the service. However, both groups recorded similar rates of return to emergency departments within 30 days post-operation.
Dr. Aman Mahajan, MD, PhD, Peter and Eva Safar Professor and Chair of the Department of Anesthesiology and Perioperative Medicine at the University of Pittsburgh School of Medicine, emphasised the challenge of ensuring adherence to perioperative care plans. He noted, “Ensuring that patients follow through with their prescribed perioperative care plans is crucial for their health and recovery outcomes, but achieving this adherence is often challenging.” Dr. Mahajan hailed the integration of this hybrid digital-telemedicine platform as a significant advancement in clinical care, offering ease of use for both patients and clinicians while enhancing patient outcomes and satisfaction with surgical procedures.
This study contributes to the growing body of evidence supporting digital healthcare’s role in improving the continuity of care in surgery. For instance, a 2022 study from the University of Alabama Birmingham indicated that telehealth interventions had substantially reduced no-show rates among surgical patients. The American College of Surgeons has endorsed telehealth, recognising its potential to enhance access to surgical care, especially for patients in remote or underserved areas, and to empower patients in their health care journeys by facilitating active participation in virtual consultations.
Read MoreEuropean regulators find no evidence of link between new obesity medication and suicidal thoughts
Following an extensive nine-month investigation, European medical regulators have concluded that there is no evidence to suggest that GLP-1 receptor agonists, such as Ozempic and Wegovy, contribute to suicidal ideation or behaviours. This conclusion by the European Medicines Agency (EMA) aligns with a similar assessment conducted by the U.S. Food and Drug Administration (FDA) earlier in January, which also found no causal connection between these widely used medications for weight loss and diabetes and the risk of suicidal thoughts.
The investigation by the EMA began in July, 2023, after anecdotal instances were reported where patients exhibited self-harm thoughts while being treated with GLP-1 receptor agonists, specifically liraglutide (marketed as Saxenda by Novo Nordisk) and semaglutide (known commercially as Ozempic and Wegovy, also by Novo Nordisk). The concern prompted the EMA’s Pharmacovigilance Risk Assessment Committee to demand further information from the manufacturers of these medications in November.
Throughout the investigation, the committee meticulously analysed various sources including medical records, clinical trial data, post-marketing surveillance reports, and other academic studies. Notably, a study published in Nature Medicine indicated that the risk of suicidal ideation was actually lower in patients using GLP-1 drugs compared to those treated with other medications for obesity and diabetes. Ultimately, the EMA committee concluded that the evidence does not support a causal link between the use of GLP-1 receptor agonists and increased suicidal risk.
Despite these findings, the EMA has mandated continuous monitoring by manufacturers of GLP-1 based medications for any future incidents of suicidal thoughts or actions. This ongoing vigilance reflects a cautious approach, particularly given the historical context where earlier obesity treatments, such as rimonabant, were withdrawn from the European market in 2008 due to their association with increased suicidal ideation risks.
GLP-1 based treatments, including Ozempic, Wegovy, Eli Lilly’s Mounjaro, and Zepbound, have seen a surge in popularity recently. However, this increase in usage has coincided with sporadic anecdotal reports linking the drugs to suicidal thoughts, thus prompting these detailed investigations.
The FDA, in its preliminary review statement in January, mentioned that while a definitive exclusion of any risk is challenging, it is committed to further investigation to clarify this potential link. It is important to note that while the FDA’s approvals for Wegovy and Zepbound for obesity management include advisories for physicians to monitor for signs of suicidal thoughts, similar advisories are not included on the labels of Ozempic and Mounjaro, which are approved for managing type 2 diabetes.
This comprehensive review by regulatory bodies underscores a significant step in ensuring the safety and efficacy of GLP-1 medications, reaffirming their use in clinical practice amidst growing concerns over possible psychiatric side effects.
Read MoreHeightened risk of iron deficiency in children with overweight and obesity
A comprehensive study conducted by the University of Leeds’ nutritional scientists has revealed a significant correlation between overweight and obesity in children and young people and an increased risk of iron deficiency. The research, spearheaded by the School of Food Science and Nutrition, involved a meticulous analysis of numerous medical studies across 44 countries, focusing on individuals under 25 years old. These studies assessed levels of essential vitamins and minerals, including iron, in relation to body weight.
The findings indicated that iron deficiency is prevalent among both underweight and overweight youths. Professor Bernadette Moore of the School of Food Science and Nutrition highlighted the broader implications of these findings, suggesting that “Iron status may be the canary in the coalmine, signalling deeper health issues like prolonged inflammation, which is linked to serious conditions including heart disease, diabetes, and fatty liver.”
Unlike deficiencies in zinc and vitamin A, which were primarily found in undernourished children, iron deficiency in overweight children appears to stem from inflammation that disrupts iron absorption. This research, funded by the UK Biotechnology and Biological Sciences Research Council and published in the ‘BMJ Global Health’ journal on 10 May 2024, marks a significant advancement in understanding the nutritional challenges faced by children with obesity.
The impact of iron deficiency on cognitive functions such as attention, concentration, and memory is well-documented, with potential links to conditions like autism and ADHD. This study is pioneering in its focus on the association of iron deficiency with childhood obesity, an area previously unexplored.
Xiaomian Tan, a doctoral researcher at the University, emphasised the importance of this study, stating, “While the link between undernutrition and deficiency of crucial micronutrients in children’s growth is established, the risks posed by obesity—leading to what can be described as a hidden form of malnutrition—are less understood.”
The study also addresses the broader socio-economic implications. Historically, nutrient deficiencies have been associated with hunger, especially in lower- and middle-income countries where they contribute significantly to child mortality. However, the phenomenon of ‘hidden hunger’—nutrient deficiencies in the context of an energy-dense but nutrient-poor diet—is becoming more prevalent in both affluent and developing nations. This is often linked to diets dominated by ultra-processed foods in wealthier countries and limited dietary variety in poorer regions.
The dual burden of malnutrition and overnutrition is particularly pressing in regions like Africa and Asia, which are undergoing rapid economic changes and dietary shifts towards Western high-sugar, high-fat foods. Between 2000 and 2017, the number of overweight children under five years old rose significantly in these continents, alongside an increase in stunting.
Professor Moore also pointed out the alarming trend in the UK, where one in three children by age 11 have overweight or obesity, which compounds the risk of inflammation-driven iron deficiencies. She advocates for increased physical activity and dietary improvements to mitigate these risks.
The call for further research is clear, with an emphasis on the need for more comprehensive studies that address micronutrient deficiencies within the context of the growing global epidemic of obesity, particularly in regions currently lacking detailed data.
Read MoreNew research debunks perceived benefits of overweight/obesity in lung cancer patients
In Buffalo, New York, the widely held belief that having overweight or obesity could have protective benefits for lung cancer patients has been critically re-examined by researchers at the Roswell Park Comprehensive Cancer Center. Despite obesity being linked to an increased risk and poorer prognosis in at least thirteen different cancer types, lung cancer has been noted as a striking exception. Previous studies suggested that patients with a higher Body Mass Index (BMI) faced a reduced risk of disease recurrence and enjoyed longer survival rates post-surgery, a phenomenon dubbed “the obesity paradox”. This has raised questions about the paradoxical role of obesity in lung cancer outcomes compared to its universally acknowledged negative impact on other cancer types.
Sai Yendamuri, MD, MBA, FACS, the Chair of Thoracic Surgery at Roswell Park, spearheaded a research initiative that has shed light on crucial “confounding factors” that distorted earlier conclusions, suggesting a beneficial link between overweight conditions and lung cancer patient prognoses. Dr. Yendamuri, along with a distinguished team including Santosh Patnaik, MD, PhD, Assistant Professor of Oncology in the Department of Thoracic Surgery, and Joseph Barbi, PhD, Assistant Professor of Oncology in the Department of Immunology, presented their groundbreaking findings at the annual American Association for Cancer Research (AACR) symposium held in San Diego, California, from April 5 to 10, 2024.
The research illuminated the inadequacy of BMI as a reliable measure of obesity, pinpointing it as one of the key factors leading to the misinterpretation of previous studies’ results. BMI, a simple calculation based on height and weight, fails to accurately represent the body’s fat percentage, its distribution, or differentiate between fat types. Through a meticulous case-control study utilising CT imaging, the team discovered that early-stage lung cancer patients exhibited a greater fat content without necessarily having a higher BMI, compared to high-risk individuals without lung cancer.
Moreover, the study revealed a heightened risk of disease recurrence in surgically treated lung cancer patients with substantial volumes of visceral fat—the dangerous type lodged between abdominal organs—regardless of their BMI status. Laboratory findings complemented these observations, suggesting that the rapid growth of lung tumours might be facilitated by an obesity-induced increase in suppressor leukocytes, which dampen the immune system’s ability to fight cancer.
Further investigations into patients categorised as having obesity through CT imaging rather than BMI calculations confirmed the suppression of the immune response within the lung microenvironment, allowing for unchecked cancer cell proliferation. These insights underscore the urgency for developing more precise obesity measurement methods to better understand its impact on lung cancer patients and tailor treatment approaches accordingly.
Dr. Yendamuri advocated for the exploration of blood-based testing as a future direction for accurately assessing obesity, circumventing the limitations of CT scans not typically conducted for all cancer patients. Identifying blood-based biomarkers correlating with imaging-derived fat measurements could revolutionise how obesity is gauged, facilitating more informed treatment decisions.
Another aspect of the study addressed the observed effects of certain medications, like metformin used for diabetes management, which appeared to offer additional anticancer benefits exclusively to patients with obesity. Laboratory and retrospective analyses supported the notion that in individuals with obesity, metformin could enhance the vulnerability of lung carcinoma tumours to immunotherapy, particularly immune checkpoint inhibitors (ICIs), promoting a more effective antitumor immune response.
Reflecting on the broader implications of their work, Dr. Yendamuri highlighted the necessity of re-evaluating the design of future studies to account for the limitations of BMI as an obesity measure and the distinct effects of medications in patients with obesity. Addressing the “obesity paradox” can pave the way for clearer, more beneficial patient recommendations, thereby potentially enhancing patient outcomes significantly. The team’s research, backed by both public and private funding, including support from the Roswell Park Alliance Foundation and National Institutes of Health agencies, marks a significant step forward in demystifying the complex interplay between obesity and lung cancer.
Read MoreObesity and high-fat diets linked to swift vascular ageing in the brain
A new study conducted in mice traces how obesity and a high-fat diet may accelerate ageing in the blood vessels that supply blood to the brain. The work is being presented this week at the American Physiology Summit, the flagship annual meeting of the American Physiological Society (APS), in Long Beach, California.
The findings suggest that obesity and a poor diet can cause damage to accumulate in the blood vessels, reducing the supply of oxygen to parts of the brain and ultimately leading to cognitive decline. The study could help scientists find ways to intervene and preserve brain function in people with obesity, which is estimated to affect about 42% of U.S. adults.
“This project highlights the critical roles of vascular components and cellular ageing in cognitive deterioration, pinpointing novel potential therapeutic targets for dementia prevention and treatment,” said Sharon Negri, PhD, the study’s first author and a postdoctoral research fellow in the laboratory of Stefano Tarantini, PhD, in the Department of Neurosurgery at the University of Oklahoma Health Sciences Center.
Previous research has found strong links between mid-life obesity and an increased risk of cognitive decline and dementia later in life. The scientists sought to uncover the mechanisms behind this association, with a particular focus on the role of diet and vascular health.
To do this, the researchers studied the impact of a high-fat diet on blood flow to the brain and memory performance in aged mice with obesity. By using a special mouse model, they were also able to measure cellular senescence, a process when cells stop dividing and making new cells. Cellular senescence increases with ageing and contributes to a variety of ageing-associated diseases.
“Obesity may cause the cells in blood vessels in the brain to age faster and reach senescence. If a link between obesity and cellular senescence is established, it could open up new lines of investigation aimed at exploring therapeutic avenues to prevent or slow down the progression of senescence, with the potential to mitigate obesity-related health issues, including cognitive decline.” – Sharon Negri, PhD, study’s first author
The results showed that after three months, mice fed a high-fat diet had increased cellular senescence and reduced density of healthy blood vessels in the brain, as well as evidence of impaired learning in a maze test, compared with normal-weight mice fed a standard diet. In addition, the scientists found that removing the senescent cells using Navitoclax, an investigational cancer drug that selectively kills senescent cells, improved features of the brain vasculature.
If further experiments confirm that it is possible to reverse the detrimental effects of senescence, Negri and Tarantini next plan to evaluate whether various lifestyle interventions could help to prevent or reduce obesity-induced cognitive impairment.
Read MoreNvidia collaborates with hippocratic AI to pioneer AI healthcare ‘agents’ surpassing nurse efficiency at reduced costs
In an ambitious move to revolutionise healthcare delivery, Nvidia, renowned for its advanced chip technology, has joined forces with the artificial intelligence healthcare innovator, Hippocratic AI, to introduce cutting-edge generative AI “agents.” These agents, designed to offer empathetic healthcare interactions, significantly outstrip the capabilities of human nurses in video call engagements while being markedly more economical.
Announced recently, this partnership focuses on the creation of “empathetic healthcare agents” that leverage Nvidia’s robust computing power, combined with training from Hippocratic’s specialised healthcare-focused large language models (LLMs). These agents are engineered to establish a deeper human connection with patients through highly responsive, super-low latency conversational dynamics.
The efficacy of Hippocratic’s AI agents has been rigorously evaluated through tests involving over 1,000 registered nurses and 100 licensed physicians across the United States. Additionally, numerous healthcare providers are currently experimenting with these AI bots for a variety of non-diagnostic tasks within their operations.
The results from these evaluations are compelling, demonstrating the AI’s superior performance not only against leading AI rivals, such as OpenAI’s GPT-4 and the LLaMA 2 70B Chat, but also surpassing human nurses in every tested category. The AI’s Constellation model demonstrated remarkable proficiency, outperforming human nurses by significant margins in several key areas. These include identifying the effects of medications on lab values (79% versus 63%), pinpointing condition-specific contraindications for over-the-counter medications (88% to 45%), accurately comparing lab values against reference ranges (96% to 93%), and detecting toxic dosages of over-the-counter drugs (81% to 57%).
This collaboration between Nvidia and Hippocratic AI is presented as a strategic solution to alleviate the pressing shortage of healthcare workers in the U.S. Munjal Shah, co-founder and CEO of Hippocratic AI, emphasised the dual objectives of refining their technology to address staffing shortages while simultaneously improving access, equity, and patient outcomes in healthcare.
Kimberly Powell, Nvidia’s vice president of healthcare, highlighted the transformative potential of voice-based digital agents powered by generative AI, positing that such technology can herald a new era of abundance in healthcare, provided it can interact with patients with human-like responsiveness.
An added advantage of these AI-powered agents is their cost-effectiveness. Operating at a mere $9 per hour, these agents represent a fraction of the cost associated with employing human nurses, who, according to the Bureau of Labor Statistics, commanded a median hourly wage of $39.05 in 2022. This cost efficiency, coupled with their superior performance, positions Nvidia and Hippocratic AI’s generative AI agents as a promising advancement in the field of healthcare.
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