Study finds boys with obesity at higher risk of becoming infertile men
Italian researchers have discovered a potential link between obesity in boys and reduced testicle size, which may increase the risk of infertility in these young men later in life.
The study included boys aged 2 to 18 who were recommended to the Pediatric Endocrinology Unit at the University of Catania in Sicily for weight management. The researchers observed that boys with normal insulin levels displayed up to double the testicular volume in comparison to boys with high insulin levels.
Boys who had overweight or obesity and displayed hyperinsulinemia, or insulin resistance, generally had smaller testicles than other boys, according to the researchers. This condition, referred to as “testicular hypotrophy,” is known to elevate the risk of infertility in males.
Dr. Alex Robles, a fertility specialist at the Columbia University Fertility Center in New York, explained to Medical News Today that testicular volume is directly linked to semen profiles and is generally a reliable indicator of hormonal function. He added that infertile men typically have a smaller testicular volume compared to fertile men. This is also seen in men who consume exogenous anabolic steroids, leading to a reduction in the production of endogenous testosterone, testicular size, and sperm production.
Co-author of the study, Rossella Cannarella, a research assistant at the University of Catania in Italy, noted that the impact of obesity and related metabolic disorders on testicular growth is not thoroughly understood, despite the global rise in childhood obesity. The study, published in the European Journal of Endocrinology, found that having overweight or obesity was associated with a decrease in testicular volume during peri-puberty. Additionally, obesity-related conditions like hyperinsulinemia and insulin resistance were found to affect testicular volume both before and after puberty.
Cannarella suggests that more careful management of body weight during childhood could be a preventive strategy for preserving testicular function in adulthood.
Male infertility is believed to contribute to approximately half of all cases of couple infertility, but the causes often remain unknown. Research has shown a decrease in sperm concentration and count over the past four decades, while childhood obesity rates have increased dramatically. It is estimated that by age 35, 60% of children aged 2 to 19 will have obesity.
Dr. Robles also highlighted the significant connection between obesity and fertility issues, particularly in women. Obesity can disrupt the hormonal balance needed for egg growth, development, and ovulation. Similarly, in men, obesity can interfere with the hormones that assist in testosterone production by the testicles. Low testosterone is linked to reduced sperm production and quality.
However, Dr. Jagdish Khubchandani, a professor of public health at New Mexico State University, warned that while the study showed promise in highlighting the connection between obesity, metabolism, and testicular volume, it had limitations. The study was cross-sectional with a small population, so it could not establish a cause-and-effect relationship between testicular size, obesity, and risk of infertility.
Dr. Khubchandani emphasised that although there is a correlation between the global rise in obesity and the decline in sperm count, it doesn’t necessarily mean the two are directly linked. Factors such as diet and environment could independently influence obesity, metabolism, and reproductive health.
Dr. Robles agreed that while the findings of the retrospective review are plausible given the known impacts of obesity on hormonal regulation and testosterone levels, more research is necessary to determine if weight loss is an effective treatment for improving testicular volume. Previous research suggests that weight loss can improve hormonal health in men with obesity by restoring natural testosterone levels, which can subsequently increase testicular volume and sperm production.
Dr. Khubchandani highlighted the importance of early childhood interventions to address many health issues linked to obesity, including those discussed in this study. He added that obesity is a global pandemic and a leading cause of numerous health problems worldwide.
Read MoreBariatric surgery associated with over 50% reduction in cancer risk for individuals with obesity
Bariatric surgery could considerably decrease the risk of cancers related to obesity, such as those of the breast, colon, liver, pancreas, ovaries, and thyroid, in patients with obesity.
“Bariatric surgery, which includes sleeve gastrectomy, gastric bypass, and gastric band procedures, is the principal method for significant weight loss in individuals with obesity,” stated Dr. Vibhu Chittajallu, a gastroenterology fellow at Case Western Reserve University and University Hospitals Cleveland Medical Center, during a Digestive Disease Week media briefing. He highlighted that these procedures offer benefits beyond weight loss, such as enhancements in patients’ mental and physical well-being.
Chittajallu further added, “Emerging evidence suggests that the substantial weight reduction linked with bariatric surgery may also provide a protective shield against the development of cancers associated with obesity. My team and I decided to delve deeper into this trend.”
Chittajallu and his team used TriNetX, a database involving 47 U.S. healthcare institutions and over 107 million patients, to conduct a retrospective study from 2002 to 2022. They singled out adults with a Body Mass Index (BMI) over 35 who underwent bariatric surgery, comparing them with patients with obesity who didn’t have the surgery. The study accounted for risk factors like smoking history, alcohol use, heart disease, hormone therapies, and cancer-screening tests, including 55,789 individuals in each group.
The researchers also used the International Agency for Research on Cancer to identify cancers with “sufficient” evidence of a connection to obesity. This included esophageal adenocarcinoma, multiple myeloma, and cancers of the kidney, colon, rectum, stomach, liver, gallbladder, pancreas, ovary, endometrium, breast, and thyroid.
The results revealed that after ten years, the cumulative occurrence of obesity-related cancer was 4% (n = 2,206) in the bariatric surgery group and 8.9% (n = 4,960) in the nonsurgical control group (HR = 0.482; 95% CI, 0.459-0.507).
Chittajallu pointed out that the bariatric surgery group consistently exhibited lower numbers of new cases for all types of obesity-related cancers, including those of the breast, colon, liver, pancreas, ovaries, and thyroid.
“Although more research is required to fully understand the impact of bariatric surgery on cancer risk,” Chittajallu concluded, “our findings indicate that bariatric surgery is a promising area to investigate.”
Read MoreHigh obesity-related cancer mortality linked to easy access to fast food
Obesity has been a significant contributor to various health issues, including cancer. A recent cross-sectional study published in JAMA Oncology highlights the role of food environments in obesity-related cancer mortality. Communities with easy access to fast food were found to be 77% more likely to have high levels of obesity-related cancer mortality.
Researchers led by Dr. Malcolm Seth Bevel from the Medical College of Georgia analysed food access and cancer mortality data from over 3,000 counties in the United States. The study aimed to understand the association between food deserts (areas with limited access to grocery stores and healthy food options) and food swamps (areas with easy access to convenience stores and fast food) and obesity-related cancer mortality rates.
Using data from the U.S. Department of Agriculture Food Environment Atlas and the Centers for Disease Control and Prevention, the researchers calculated food desert and food swamp scores for each county. A higher score indicated fewer healthy food resources in the area.
The primary outcome of the study was obesity-related cancer mortality, defined as either high or low (71.8 or higher per 100,000 individuals and less than 71.8 per 100,000 individuals, respectively). The results showed that counties with high food swamp scores (easy access to fast food) were 77% more likely to have high rates of obesity-related cancer mortality.
Further analysis revealed a positive dose-response relationship between food desert scores, food swamp scores, and obesity-related cancer mortality rates. Counties with high rates of obesity-related cancer mortality also had a higher percentage of non-Hispanic Black residents, higher percentage of adults older than 65 years, higher rates of adult obesity, and higher rates of adult diabetes.
The study demonstrates the significant impact of food environments on obesity-related cancer mortality rates. Communities with easy access to fast food have a considerably higher risk of obesity-related cancer deaths. The findings emphasise the importance of promoting healthier food environments and improving access to nutritious food options in order to reduce obesity and its associated health risks, including cancer.
Read MoreThe Healthcare Industry Goes Digital: The Impact of AI and Digital Health
The healthcare industry has undergone significant changes over the past century, with the proliferation of smartphones and digital media revolutionising the way patients access medical information. In recent years, applications of Artificial Intelligence (AI) and Machine Learning (ML) have further transformed the industry, enhancing the consumer experience, healthcare delivery, and healthcare in general.
The traditional doctor-patient connection is being replaced by a wave of digital health technologies, including telehealth services, AI, and ML. These advancements are reshaping an entirely new ecosystem for technology-driven global healthcare. The Indian digital healthcare industry, for example, was worth INR 524.97 Bn in 2021, and is anticipated to grow at a CAGR of 28.50%, or INR 2528.69 Bn by 2027, according to the research “Digital Healthcare Market in India 2022-2027.”
AI and digital health are rapidly transforming the global healthcare industry in several ways, including:
Improved diagnosis and treatment: By evaluating patient data including medical histories, test findings, and imaging scans, AI-powered systems can assist doctors in arriving at more accurate diagnoses and creating more effective treatment regimens. Additionally, the AI program can recognize trends and forecast which treatments will be more efficient and appropriate for patients, ultimately improving patient outcomes.
Remote patient monitoring: Digital health technology allows medical professionals to monitor their patients’ vital signs and health status remotely, lowering the risk of readmission to the hospital. Moreover, it broadens opportunities for pharmaceutical marketers to promote prescription drugs online.
Personalised medicine: AI algorithms can analyse a patient’s genetic and clinical data to create personalised treatment plans that take into account individual responses to medications and other treatments. The availability of AI-collected patient data can significantly enhance personalised diagnosis and outcomes.
Drug discovery: AI can accelerate drug discovery by analysing vast amounts of data to identify potential drug targets and predict how various compounds will interact with the human body. The Global Artificial Intelligence for Drug Discovery Market is expected to reach around US$ 8,149 Mn by 2026 and register a CAGR of above 42% over the forecast period 2019 to 2026 as the technology holds great potential.
Healthcare operations and management: By automating administrative processes, lowering expenses, and enhancing patient access to care, digital health technology can enhance healthcare operations. The adoption of AI and ML technologies offers significant potential for automating administrative tasks and lowering operating costs as a whole.
Overall, AI and digital health are improving patient outcomes, cost, and efficiency, rapidly changing the global healthcare sector. Moreover, the recent introduction of ChatGPT has generated buzz in the industry because it allows medical professionals to provide quicker, more accurate diagnoses and treatment plans, improving patient outcomes. It also enables medical professionals to access patient data easily, allowing the creation of customised treatment plans and the delivery of better medical services.
Read MoreMaking care smarter using predictive analytics
As more elderly and disabled individuals aim to live independently, monitoring apps designed for frail adults have become increasingly popular. These apps can also help family and caregivers distinguish between short-term problems and long-term declines. Falls, in particular, can be costly. The UK’s NHS estimates that unaddressed fall hazards in the home cost around £435 million per year, with fragility fractures costing £4.4 billion per year. Entrepreneurs have responded to the need for these apps by creating systems that can collect information for a better understanding of the individual’s daily functioning and factors that might be affecting it.
MySense, a predictive wellbeing analytics company, is one of these entrepreneurs. The founder and CEO, Lucie Glenday, created MySense after her sister was diagnosed with a rare form of motor neurone disease and died at age 23. She struggled to understand her sister’s symptoms and wanted to help others with complex needs. MySense uses eight devices, the majority of which are passive sensors, that pick up signs of daily activities. This data is then analysed to create a personalised digital portrait of what normal looks like for each person. The company’s sensors pick up on context around activity rather than the activity itself. MySense has been adopted by several NHS hospitals, including South Warwickshire NHS Foundation Trust, Leicestershire County Council, and Care Hub. The technology has reduced unplanned hospital admissions by 50% and moved 25% of people out of pathways for patients with fewer than 1,000 days to live.
Digital Social Care has created the Adult Social Care Technology Fund, which will provide funding for technology that increases care quality and safety, reduces avoidable hospital admissions, and increases support for independent living. AVERio, another initiative focused on falls prevention, has created non-intrusive sensors that detect falls using 4D radar technology to scan a room constantly. EIT Health, a European Union initiative, has also created a monitoring device, FFalls Predictor, which aims to provide early detection and prevention of falls.
Read MoreSamsung unveils new digital health platform
Technology giant Samsung has launched an open-source project called Samsung Health Stack 1.0 to aid digital health researchers. The tool is designed to allow researchers to build new digital health solutions on the Android and Wear OS operating systems. The stack includes a backend web portal that is intended to make digital health development more manageable, according to a news release from Samsung on April 19, 2023.
The Samsung Health Stack aims to make it simpler and safer to obtain digital health data, lowering the barriers between medical researchers and digital technology experts. It will serve as a foundation for innovation in the digital health industry, according to Yunsu Lee, Vice President and Head of the Data Intelligence Team at Samsung Electronics.
“By promoting the development of digital health services, we hope to ultimately improve the quality of life for people around the world,” Lee said. “We also hope that the Samsung Health Stack, being an open-source project, will be helpful to many people in the field, and we welcome the participation of interested developers and researchers.”
The Samsung Health Stack 1.0 will offer several features, including a customisable UI, user authentication and authorisation, and data storage and retrieval. Developers can use it to develop digital health solutions, such as remote patient monitoring tools, medical device control systems, and chronic disease management systems.
The tool has been launched as part of Samsung’s broader efforts to promote the use of digital health technology to improve health outcomes. The company has previously released several health-focused products, including the Galaxy Watch Active2, which features a range of health monitoring features such as electrocardiogram monitoring and blood pressure tracking.
The Samsung Health Stack 1.0 is an open-source project, meaning that developers can modify and distribute it freely. This makes it a flexible tool for building digital health solutions and should encourage collaboration and innovation in the field. As such, Samsung hopes that it will serve as a platform for advancing digital health research and ultimately improve healthcare outcomes for people around the world.
Read MorePersonalised Care Institute launches VR training for shared decision making
The Personalised Care Institute (PCI) has recently launched virtual reality training on shared decision-making (SDM) to help healthcare professionals fill gaps in their knowledge, which they have reported. This training, commissioned by NHS England, aims to explore key micro-skills around shared decision-making, including agenda setting, teach-back, exploring patient preferences, and reaching a shared decision. By practising these skills in a risk-free virtual environment, healthcare staff can improve and develop their skills for the benefit of their patients.
Shared decision-making has been shown to result in better patient outcomes, with increased adherence to treatment, fewer repeat appointments, and fewer regrets about decisions made over their health and care. However, 46% of healthcare professionals report gaps in their knowledge on the topic, according to The Patient Association, and 70% of them want to learn more.
The Personalised Care Institute developed a free, quality-assured eLearning tool called Virtual Patient Simulation: Test Your Personalised Care Conversations in conjunction with Keele University. This tool allows users to put their shared decision-making skills to the test through a series of life-like simulated patient consultations. It uses multiple-choice questions to provide a structured interaction with an on-screen animated patient character. Comprehensive feedback is delivered at the end of each exercise, allowing users to put what they’re learning to the test with repeated use.
Dr Emma Hyde, the clinical director of PCI, said that although research suggests only one in three healthcare professionals always practise shared decision-making fully, the perceived common barriers include lack of experience, confidence, and time. She believes that these could be quickly overcome with the opportunity to practise. “Not only will this training equip health and care professionals with the shared decision-making skills and knowledge needed to deliver the very best health outcomes for patients, but it will also address the growing desire among the general public for greater involvement in key decisions that inform their healthcare,” she added.
The use of simulations can help to encourage greater engagement and facilitate repetitive practice, and at the same time allows users to work at their own pace. Dr Priti Kadoo, a GP in frailty medicine and an ambassador for the PCI, said that the VR training helps professionals reflect on current practice and really think about personalised care and striking the right balance between imparting clinical information and considering how the patient feels and is likely to respond to what they tell or ask them.
The first scenarios launched are an in-person consultation based on an osteoarthritis discussion and a remote consultation by telephone with a father concerning his son’s sore throat. Two further scenarios – a referral for suspected bowel cancer and a discussion around the ongoing use of antidepressants – are due to be launched in the coming months.
The use of virtual reality to train healthcare professionals is becoming more widespread. Last year, Norfolk and Norwich University Hospitals NHS Foundation Trust introduced new virtual reality films for dementia education. The aim of the VR films was to help healthcare professionals gain a better understanding of the challenges patients living with dementia face when on a busy inpatient ward.
Read MoreUsing non-fungible tokens for secure health data management
SingHealth, a healthcare provider in Singapore, is exploring the use of non-fungible tokens (NFTs) as a potential solution for managing and exchanging health data in a secure and privacy-preserving manner.
NFTs, which are unique digital data units stored on the blockchain, offer features of uniqueness, transparency, and interoperability. Health data can be minted, exchanged and stored using blockchain technology, which would allow patients to own and exchange their personal health data with multiple stakeholders. Each patient can own, store and share their health data in the form of NFTs using a health wallet hosted on a secure web-based or smartphone application.
The use of NFTs shifts the onus of sharing individual patient data to each patient, thus fostering a closer relationship between the healthcare provider and the patient. Furthermore, sharing health data as NFTs ensures complete transparency and accuracy of healthcare research data, due to the traceable and unalterable nature of the blockchain.
SingHealth anticipates a growing need for privacy-preserving solutions to enhance the applications of data for medical research and clinical care purposes, and the use of NFTs will allow for a secure healthcare data exchange platform.
Read MoreChronic inflammation may explain why some mothers with obesity struggle with low milk production
A recent study published in The Journal of Nutrition has revealed that inflammation in lactating mothers who have obesity may interfere with the transfer of circulating fatty acids to the mammary gland, resulting in low milk production.
Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated enzymes have been shown to suppress the uptake of fatty acids from the blood by body tissues, leading to high blood lipid concentrations. Fatty acids are critical for supporting milk production in the mammary gland, and therefore, inflammation could negatively impact milk production through this pathway. To test this hypothesis, a team of researchers led by Rachel Walker, a USDA-funded post-doctoral fellow, analysed blood, milk fatty acid profiles, and inflammatory markers from lactating women. The study included 23 women with very low milk production despite frequent breast emptying, 20 with moderate milk production, and 18 exclusively breastfeeding controls.
The researchers found that mothers with very low milk production had significantly higher obesity and inflammatory biomarkers, lower proportions of long chain fatty acids in milk, and a disrupted association between blood and milk fatty acids, compared to those with moderate milk production and exclusively breastfeeding controls. While milk and blood fatty acids were strongly correlated in controls, this was not the case in the very low or moderate milk production groups. These findings support the hypothesis that inflammation and obesity disrupt the transfer of fatty acids from circulation to the mammary gland, potentially contributing to insufficient milk production in women with obesity.
The study suggests the need for further investigation into the transfer of fatty acids to milk and its relationship with milk volume. The findings are of significant importance as it has been known for decades that mothers with obesity are at an increased risk of shortened breastfeeding duration. This study provides important new evidence that physiological differences, such as chronic inflammation, may contribute to some mothers’ struggles with milk production.
Read MoreMen and women have different obesity drivers, pointing to the need for tailored interventions
A recent study conducted by researchers from UCLA has found sex-specific brain signals that may indicate why men and women develop obesity differently. Published in the journal Brain Communications, the study combined data from multiple modes of MRI imaging with clinical features and personal histories of patients to identify sex-specific mechanisms in the brain associated with obesity. The study aims to help tailor obesity interventions based on an individual’s sex.
The researchers analysed data from 183 participants aged between 18 and 55, which included 42 males with a non-obese BMI, 23 males with a high BMI, 63 females with a non-obese BMI, and 55 females with a high BMI. All participants completed a battery of self-report questionnaires that assessed various factors, including childhood trauma, anxiety and depression, visceral sensitivity, food addiction, bowel symptoms, and personality traits.
The researchers conducted three different brain MRIs to assess the structure, function, and connectivity of each participant’s brain. They then analysed the data sets from the three scans, along with clinical information, using an analytical tool to identify a limited number of variables from multiple data sets to predict an outcome.
The results of the study showed that specific network connectivity changes were associated with high BMI, regardless of sex. The researchers also found that in females, brain regions and networks had alterations associated with early life trauma, consistent with previous studies that showed that females with obesity may have greater anxiety, lower resilience, and difficulty integrating emotions with action-directed goal planning. The study also revealed that females may be more susceptible to the sight, smell, and taste of highly processed foods.
According to the researchers, the study’s results suggest that tailoring treatment plans for females with a high BMI should focus on emotional regulation techniques and vulnerability factors. However, they note that the study identified associations, not cause and effect. Future studies are needed to determine whether changes in the brain are a factor in the development of obesity or a result of the condition. The study builds on previous research that examined sex-related differences in the prominence and signalling of brain regions in obesity, which showed that women’s obesity was associated with emotion-related and compulsive eating, while men’s eating behaviour tended to be affected by a greater awareness of gut sensations and visceral responses.
Read MoreMediterranean diet linked to fewer signs of Alzheimer’s disease
According to a recent study, following a diet rich in leafy green vegetables, whole grains, nuts, and fish could result in fewer signs of Alzheimer’s disease. The study found that older adults who followed the MIND and Mediterranean diets had fewer amyloid plaques and tau tangles in their brains. While researchers are yet to establish a cause-and-effect relationship, the study showed that consuming specific foods can enhance brain health.
Individuals following the Mediterranean diet had levels of plaque and tangles in their brains similar to that of people 18 years younger than those who consumed the least brain-healthy foods. For those following the MIND diet, the figure was 12 years younger.
The Mediterranean diet contains food items from countries bordering the Mediterranean Sea, such as Italy, Greece, Cyprus, and Spain, including olive oil, dairy products, poultry, fish, fruits, vegetables, whole grains, legumes, nuts, and seeds.
The MIND diet, on the other hand, combines the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets. It promotes eating leafy green vegetables, berries, nuts, and whole grains. It is also recommended to consume at least one serving of fish per week.
The study involved 581 older adults who agreed to donate their brains for research after death. Before dying, 39% were diagnosed with dementia, and after death, 66% met the criteria for Alzheimer’s disease. Participants completed yearly questionnaires about their eating habits, which were analysed and scored based on the type and quality of the food they consumed.
One of the most noteworthy findings of the study was that consuming green leafy vegetables corresponded to a lower amount of plaque in the brain, almost 19 years younger than those who ate less. However, researchers could not establish a direct relationship between a healthy diet and fewer brain deposits of amyloid plaques, known as an indicator of Alzheimer’s disease.
Dr. Puja Agarwal, a study author, said that improvement in people’s diets in one area, such as eating green leafy vegetables or not consuming fried foods, was associated with fewer amyloid plaques in the brain, similar to being around four years younger. The study provides evidence for a real food approach to eating, which focuses on natural, unprocessed or minimally processed foods while reducing processed or ultra-processed foods.
Read MoreObesity in childhood and puberty linked to higher risk of blood clots in later life
According to a new study by the University of Gothenburg, being overweight during childhood and early adulthood increases the risk of developing blood clots in later years. The study analysed the health data of 37,000 men and their early body mass index (BMI) and any blood clots that developed as they got older. The researchers found that both overweight in childhood and overweight in young adulthood increased the risk of venous blood clots later in life, with overweight in young adulthood proving to be a more influential factor than childhood overweight. While most blood clots occur in the legs and are not dangerous, they can become life-threatening if they travel to the lungs and cause a pulmonary embolism.
The link between obesity and blood clots is already well known, but the impact of a higher BMI in childhood on the risk was unclear. The researchers examined the data of a large group of men in Sweden who were born between 1945 and 1961, looking at school records at age 8 and Armed Forces medical examinations at age 20 to establish BMI data. They then looked at blood clot data on the men up to an average age of 62.
The study found that BMI at both age 8 and age 20 can be linked to blood clots independently of each other. As adults, the researchers found that two groups were more at risk – those who had been overweight both as a child and in early adulthood, and those with a normal weight in childhood but who became overweight in early adulthood. In addition, the study found that carrying excess weight in both childhood and early adulthood increased a person’s risk of arterial thrombi, which are clots that result from constricted blood vessels with fatty deposits. However, the researchers noted that more research is needed in this area as they only found a small number of cases.
The study’s senior authors emphasised that obesity and overweight during puberty seem to have a marked impact on a person’s future risks of venous thrombi. The study has been published in the Journal of Internal Medicine.