New machine learning approach transforms behavioural health medication practices
At the recent AMCP Nexus 2023 conference in Orlando, Florida (16th-19th of October), presenters showcased a groundbreaking machine learning program designed to address medication-related issues in individuals with behavioural health conditions. This program has shown promising results in reducing polypharmacy, enhancing medication adherence, and decreasing healthcare costs.
Behavioural health conditions pose a significant challenge to healthcare systems. A 2020 Milliman study examining commercial healthcare claims data from 2017, which encompassed 21 million people, revealed that although only 27% had a behavioural health condition, they accounted for over half of the total healthcare expenditures. In this context, machine learning offers a potential solution for better managing these conditions.
The presenters highlighted the issue of polypharmacy, a common concern in behavioural health where 60% of adults with a condition are prescribed two or more psychotropic medications. Polypharmacy not only increases the risk of drug interactions and adverse events but also contributes to soaring healthcare costs. Dr. Caroline Carney, Chief Medical Officer at Magellan Health, underscored the tendency for medication overlap and overprescription in treating conditions like depression and anxiety, often leading to unnecessary medication layers.
Another issue in managing behavioural health medications is the multiple prescribers involved, including primary care doctors, specialists, and inpatient clinicians, often resulting in uncoordinated treatment. This lack of coordination can leave patients confused and overwhelmed with their medication regimens.
To combat these challenges, Magellan Health collaborated with Arine, a medication management tech startup, to create inforMED (formerly known as Navigate Whole Health). This AI-driven program identifies prescribers who can potentially optimise patient care, generating comprehensive care plans with treatment recommendations and patient education. The program’s effectiveness is continuously improved by incorporating new clinical outcome data.
Dr. Carney elaborated on the program’s approach, which considers hundreds of parameters, providing prescribers not just with medication change suggestions but also with reasons, implications, and evidence-based support for the recommended changes.
Yoona Kim, PharmD, PhD, co-founder and CEO of Arine, explained that machine learning algorithms are utilised to target prescribers based on their prescribing patterns and the presence of prescribing outliers in their patient panels. The program also considers social determinants of health, using ZIP code data to assess potential barriers to healthcare access, such as low income or lack of vehicle access.
The results of this program have been significant. Dr. Kim reported a reduction in behavioural health polypharmacy by 45% to 55%, a 20% increase in medication adherence, a 20% reduction in average daily morphine milligram equivalents, and a savings of $360 to $840 in pharmaceutical costs per enrolled member annually.
Dr. Carney emphasised the program’s success in providing actionable data and guidance to healthcare providers, leading to improved patient outcomes and stronger, longer-lasting professional relationships. This innovative approach signifies a major step forward in the management of medication for behavioural health conditions.
Read MoreVietnam and Australia join forces to accelerate digital health transformation
A pivotal conference in Hanoi, sponsored by the government, has recently brought together health authorities and experts from Vietnam and Australia. This gathering focused on exploring collaborative opportunities to enhance Vietnam’s digital healthcare infrastructure and capabilities.
The conference saw participation from the Vietnam Military–Civil Medicine Association, the Health Strategy and Policy Institute under the Vietnamese Ministry of Health, and the Iverson Health Innovation Research Institute at Swinburne University of Technology in Australia.
The significance of this event lies in addressing the urgent need for Vietnam’s health sector to secure resources for its digital transformation. Deputy Minister of Health, Dr Tran Van Thuan, emphasised the importance of such advancements in improving patient access to medical services. He highlighted the potential role of international cooperation and assistance in achieving these goals.
Vietnam currently faces several challenges in its journey towards healthcare digitalisation, notably its underdeveloped IT infrastructure, which hampers the support for Electronic Medical Records (EMR). Additionally, there is a notable scarcity of funding to integrate new health technologies in medical facilities across the country.
Dr Tran Quy Tuong, chairman of the Vietnam Health Informatics Association, pointed out further obstacles, such as the shortage of IT skills and manpower and the lack of standardised protocols and guidelines for integrating data across various medical information systems.
The Iverson Health Innovation Research Institute from Swinburne University of Technology, which participated in the conference, is actively engaging in collaborations with governments and industry stakeholders. Their focus includes the management of patient health records among other digital health areas. However, there has been no formal announcement regarding a partnership between the research institution and the Vietnamese government.
In the broader context, Vietnam is aiming to establish smart healthcare by 2025 as part of its National Digital Transformation Programme. This initiative encompasses three key areas: smart disease prevention, smart medical examination and treatment, and smart health administration.
Vietnam commenced its healthcare digitalisation foundation in 2019 with the nationwide implementation of Electronic Health Records (EHRs). While all public hospitals have adopted Health Information Systems (HIS), there is still progress to be made in integrating PACS, RIS, and LIS systems.
International collaborations have been crucial in introducing advanced technologies in Vietnamese healthcare. Earlier this year, IT giant Microsoft entered its first technology partnership in Vietnam, teaming up with VinBrain, a local AI healthcare company supported by Vietnam’s leading conglomerate Vingroup. Their collaboration focuses on three primary AI healthcare areas: data sharing, cross-product validation, and research and development.
Read MoreUS panel of health experts advocate early interventions for childhood obesity from age 6
A panel of U.S. health experts has put forth a draft recommendation advocating for children with obesity to begin receiving comprehensive counselling aimed at fostering healthy eating and exercise habits, starting at the age of 6. This guidance, issued by the U.S. Preventive Services Task Force (USPSTF), builds upon their 2017 recommendation which suggested that obesity screening should commence from the same age.
Recent research underscores the value of intensive behavioural interventions, defined as a minimum of 26 hours of counselling with one or more health professionals, in aiding children and adolescents to achieve and maintain a healthy weight and enhance their overall quality of life. However, the recommendation does not set a specific timeframe for these interventions.
The USPSTF’s updated advice does not delve into the use of weight-loss medications like Novo Nordisk’s Wegovy, approved for use in children aged 12 and above, nor does it address surgical options. The Task Force reviewed evidence surrounding weight-loss medications but noted that further research is needed to fully grasp the long-term health impacts of such treatments.
According to Dr. Katrina Donahue from the University of North Carolina School of Medicine and a member of the Task Force, the proposed behavioural interventions encompass a combination of physical activity, behaviour change support, and education on healthy eating. Recognising that available resources vary by location, Donahue acknowledged that the implementation of these interventions might differ across cities.
The recommendation is backed by data from 58 randomised controlled trials involving over 10,000 children, which demonstrated the effectiveness of these interventions when a child engages in at least 26 hours of professional contact. The evidence for these intensive interventions received a “grade B” from the USPSTF, indicating high certainty of at least moderate benefit. The children in these trials lost an average of 4 to 6.5 pounds (approximately 2 to 3 kilograms), with the reductions being sustained for at least a year.
Childhood and adolescent obesity, through the age of 19, is defined as having a body mass index (BMI) – a weight-to-height ratio – higher than that of 95% of peers of the same age and gender. Nearly one in five U.S. children and teenagers are categorised as having obesity, based on data from the U.S. Centers for Disease Control and Prevention (CDC).
The American Academy of Pediatrics (AAP) guidelines also endorse lifestyle support, including over 26 hours of face-to-face, family-based, multicomponent treatment spanning 3 to 12 months. Additionally, the AAP recommends paediatricians consider weight-loss drugs for children with obesity aged 12 and over and to refer adolescents aged 13 and older with severe obesity for metabolic and bariatric surgery evaluation.
The USPSTF’s draft recommendation is open for public comment until the 16th of January 2023, inviting a wider discourse on the proposed approach to tackle childhood obesity.
Read MoreUS study uncovers key gut metabolite’s role in combating obesity
Vanderbilt University researchers have made a groundbreaking discovery about the role of gut microbiota in obesity prevention. Published in the journal Cell Host & Microbe, their study reveals that bacteria in the small intestines produce a compound crucial for guarding against obesity. This finding sheds light on how disruptions in the microbiota, such as those caused by early-life antibiotic exposure, can increase childhood obesity risks.
One of the study’s key insights is the potential for probiotic bacteria, or the compounds they produce, to serve as preventive measures against antibiotic-associated childhood obesity. “Previous studies have indicated that either antibiotics or a high-fat diet can lead to obesity later in life by disturbing the microbiota,” explained Mariana Byndloss, DVM, PhD, assistant professor of Pathology, Microbiology and Immunology at Vanderbilt. “Our aim was to investigate the combined effect of these risk factors, which children often face simultaneously.”
Under the guidance of graduate student Catherine Shelton, who is the first author of the paper, the research team developed a model using young mice exposed both to antibiotics and a high-fat diet. This dual exposure led to increased weight gain, adiposity, and metabolic dysfunction in the mice.
The team’s investigation pinpointed a disruption in the small intestine microbiota caused by the combination of antibiotics and a high-fat diet. This disruption led to decreased levels of beneficial Lactobacillus bacteria and a corresponding reduction in a metabolite they produce, known as phenyllactic acid. The researchers identified phenyllactic acid as a regulator of a fat metabolism pathway in intestinal epithelial cells — the cells lining the intestines.
Byndloss noted, “The absence of this specific microbe and its metabolite changes how intestinal epithelial cells process fat, leading to increased fat in the bloodstream. Normally, phenyllactic acid instructs these cells to limit fat packaging and secretion. When this microbial signal is lost, the cells behave differently, resulting in increased obesity in mice.”
This discovery opens up the possibility of using phenyllactic acid or Lactobacillus bacteria as interventions for obesity, particularly in children undergoing antibiotic treatment. Lactobacillus is commonly found in probiotic supplements and in fermented foods like kombucha, kimchi, and probiotic milk products popular in Asia.
“Some cultures already have a practice of giving children fermented milk, which might be inadvertently providing this protective compound,” added Byndloss.
In the study’s mouse model, exposure to antibiotics alone did not lead to weight gain; it was the combination of antibiotics and a high-fat diet that heightened obesity risk. Byndloss suggests a healthy diet with limited excess dietary fats as a way to mitigate the negative impact of antibiotics on the microbiota.
Surprisingly, the researchers found that intestinal epithelial cells play a significant role in weight gain. “We usually associate obesity with adipose tissue and the liver, not intestinal cells. It was unexpected that a single metabolite acting on these cells could have such a profound effect in preventing weight gain,” Byndloss remarked.
Ongoing studies by Byndloss and her colleagues are exploring the role of Lactobacillus and phenyllactic acid in early life, particularly during breastfeeding. Given the high fat content in breast milk, the team is investigating whether this pathway offers protective benefits against obesity from a very early age.
Read MoreNHS England’s controversial £330m data deal with Palantir draws mixed reactions
NHS England’s recent decision to award the £330 million Federated Data Platform (FDP) contract to US data analytics firm Palantir, in collaboration with Accenture, PwC, NECS, and Carnall Farrar, has elicited a spectrum of reactions. This announcement marks a significant step in NHS’s digital transformation efforts, with the FDP designed to connect and streamline access to healthcare data across the NHS.
Matthew Taylor, CEO of the NHS Confederation, acknowledged the FDP’s potential in enhancing care delivery by freeing up clinical time and fostering efficient, safer patient care. However, he emphasised the need for substantial efforts to garner public support for the initiative.
Contrasting opinions emerged from within the NHS. Paul Jones, Chair of the Digital Health Networks CIO Advisory Panel, expressed disappointment at NHS England’s decision to proceed despite reservations from trust digital teams and the financial constraints on other NHS digital budgets.
Nick Wilson, CEO at System C, recognised the wealth of experience within the NHS and technology companies in digital transformation but voiced disappointment over the contract not being awarded to a British consortium. He also highlighted concerns about the exclusion of GP data from the FDP, stressing the complexities of interoperability in health and social care and urging Palantir and Accenture to learn from past challenges.
The decision faced criticism from those who had campaigned against Palantir’s involvement. The Good Law Project, a not-for-profit campaign organisation, is preparing legal challenges to ensure proper handling of sensitive NHS data, focusing on maintaining privacy.
Cori Crider, Director of Foxglove, a legal advocacy organisation, raised questions about the FDP’s effectiveness, citing unsuccessful hospital trials of Palantir’s technology. Dr David Nicholl, spokesperson for Doctors’ Association UK, echoed these concerns, questioning the scrutiny around the deal and the preliminary results of NHS trials with Palantir’s technology.
David Davis, MP for Haltemprice and Howden, expressed reservations about Palantir’s suitability for handling sensitive data, citing their background in espionage and concerns about data protection.
In response to these varied perspectives, NHS England has garnered support from several organisations, including the NHS Confederation, National Voices, and the Academy of Royal Medical Colleges. National Voices CEO Jacob Lant and Dr Jeanette Dickson, Chair of the Academy of Medical Royal Colleges, acknowledged the FDP’s potential in driving digital innovation and enhancing data connectivity in the NHS.
To address public concerns, NHS England is developing an engagement portal for the public to learn more about the FDP and submit queries. Additionally, Dr Nicola Byrne, National Data Guardian, and Dr Nicola Perrin of the Association of Medical Research Charities have joined the independent Check and Challenge Group for the FDP, overseen by NHS England.
Furthermore, NHS England has assured that data sharing under the FDP will not commence until new ‘Privacy Enhancing Technologies’ (PET) are developed and implemented, expected by April 2024. Details on these technologies, being developed by a separate supplier, are anticipated to be released later in the year.
Read MoreUK’s obesity challenge: Learning from Japan’s effective approach
In Japan, a unique festive tradition involving Colonel Sanders statues dressed as Santa Claus outside KFC branches marks the start of the Christmas season. This tradition, a result of a marketing strategy from the 1970s, has become a cultural phenomenon, with millions participating in the “KFC Special Christmas Dinner”. This period is significant for KFC Japan, contributing to a substantial portion of their annual sales.
This contrasts sharply with the UK, where traditional home-cooked Christmas dinners are preferred. However, the issue for the UK lies in the dietary habits adopted for the rest of the year. The British tendency towards unhealthy eating has led to an escalating obesity crisis, now costing the economy almost £100 billion annually and impacting productivity far more than previously estimated.
The report by the Tony Blair Institute indicates a worrying trend: two-thirds of the UK’s population are either overweight or have obesity, a figure that has risen by around 11% since 1993. The economic impact of obesity, including healthcare costs and reduced productivity, is projected to increase by an additional £10 billion in the next 15 years. Henry Dimbleby, the government’s former food advisor, highlights the dire consequences of this trend. He points out that by 2035, the costs of treating Type 2 diabetes alone could surpass the current expenditure on all cancer treatments within the NHS.
Comparatively, Japan stands out with one of the lowest obesity rates among developed nations, a mere 4%. This has not always been the case. In the 1960s, Japan was considered one of the least healthy countries in the G7, with a diet heavily reliant on cheap US food imports post-World War II. However, over the following decades, Japan underwent a dramatic cultural shift concerning food, resulting in the world’s highest life expectancy. This transformation demonstrates that obesity is an addressable issue, requiring a change in cultural attitudes towards food rather than reliance on medication.
In Japan, the “bukatsudō” programme plays a pivotal role in promoting physical activity among schoolchildren. This initiative, coupled with the provision of healthier school meals, has contributed to Japan’s low obesity rates among children. In contrast, recent NHS figures show concerning trends in the UK, with significant percentages of children categorised as having overweight or obesity from a young age.
The traditional Japanese diet, which includes fresh fish, small portions of meat, tofu, and vegetables, is inherently healthier than typical Western diets. Andrew Kojima, a celebrity chef, suggests that the UK could benefit from adopting Japanese dining philosophies such as eating until only 80% full and ensuring a variety of colours and types of food in meals.
In Japan, there is a lesser emphasis on snacking and takeaway food compared to the UK. The quality of institutional food in Japan is also notably healthier. Dimbleby recalls a stay in a Tokyo hospital, where meals included healthy options such as pickles, rice porridge, grilled fish, miso soup, and steamed vegetables. He argues that such changes are feasible in the UK without significantly increasing budgets.
Dimbleby’s charity, Chefs in Schools, aims to improve the quality of school meals across England and advocates for an inspection regime similar to Ofsted for school dinners. Another potential strategy is adapting Japan’s “metabo” law, which mandates waistline measurements for citizens aged 40 to 74, with counselling and incentives for those who do not meet the standards. This approach could be implemented in the UK through voluntary annual health checks in workplaces.
Despite the need for action, the UK government has shown reluctance to intervene effectively. The National Food Strategy’s recommendations have been largely overlooked, and proposed anti-obesity measures like junk food deal bans and advertising restrictions have been delayed. Campaigners are calling for the sugar tax on soft drinks to be extended, but there is little movement from the government.
The lack of government intervention and the influence of corporations promoting high-calorie foods mean the UK continues to struggle with an obesity crisis. As the report highlights, Britain urgently needs to adopt successful strategies like those in Japan to address both the public health and economic challenges posed by obesity.
Read MoreSingapore forges ahead with digital health initiatives to address healthcare workforce shortages
In Singapore, healthcare leaders and young professionals are uniting under a common goal: to create a more integrated and sustainable healthcare system, leveraging digital technologies. This ambition aligns with findings from the Future Health Index 2023 report by Royal Philips, highlighting Singapore’s dedicated efforts in digital health transformation. These findings reflect broader trends observed across the Asia-Pacific region.
A critical driving force behind this digital push is the projected need for an additional 24,000 allied health professionals and support care staff by 2030, as forecasted by Singapore’s Ministry of Health. This need arises from the growing demands of the nation’s ageing population.
A survey involving 200 senior healthcare executives and young clinicians in Singapore revealed that 75% are either already utilising or planning to adopt digital health technology. This strategic move aims to mitigate the impact of the looming workforce shortage in healthcare. Technologies such as cloud-based solutions, out-of-hospital care innovations, and workflow technologies like digital health records and patient flow automation are at the forefront of this digital transition.
Artificial Intelligence (AI) is recognised as a key area of opportunity, with a quarter of respondents currently investing in AI technologies. Over the next three years, a significant 84% have pledged investment in health AI, particularly favouring applications in outcome prediction and clinical decision support.
For young healthcare professionals, the prospect of working in an AI-enabled institution is highly attractive. Furthermore, about half of the healthcare leaders surveyed are investing in virtual care, acknowledged for its substantial role in enhancing patient care.
Singaporean healthcare leaders are also adapting to technology-driven distributed models of care, with about two-thirds of respondents considering themselves well-prepared to work effectively within these new frameworks. These models are anticipated to bring improved work-life balance and job satisfaction for healthcare professionals. They are expected to boost patient compliance with treatment, create additional revenue opportunities, and enhance efficiency and convenience for patients.
In the broader context, Singapore’s commitment to integrating AI in healthcare is further evidenced by the recent memorandum of understanding between Synapxe, its national health technology agency, and Microsoft. This collaboration aims to use generative AI to increase clinical productivity, among other initiatives to modernise public healthcare IT in the country.
Additionally, the Agency for Science, Technology and Research, Singapore’s leading research and development agency, has launched a joint AI lab with health tech company EVYD Technology. This lab is designed to foster multi-institutional and cross-border collaborations in digital health, underpinning Singapore’s robust approach towards embracing digital solutions in healthcare.
Read MoreOxford study shows doctors’ communication style crucial for patient weight loss success
A groundbreaking study from the University of Oxford, recently published in the Annals of Internal Medicine, has revealed that the manner in which doctors communicate with patients about obesity plays a pivotal role in their weight loss success. This innovative research delves into the nuances of communication, showing that not only do the words doctors use matter, but also their tone and delivery have a profound impact over both short and long-term patient outcomes in a medical setting.
Conducted by the Nuffield Department of Primary Care Health Sciences, the study analysed 246 recordings of consultations and discovered that even subtle elements like the choice of words and vocal tone significantly affect patient responses. The findings have emerged amidst obesity treatment guidelines urging doctors to initiate weight loss discussions and suggest weight loss services. However, effective communication on this front occurs for only about 5% of those affected annually, indicating a significant gap between policy and practice.
Many doctors express reluctance to broach sensitive topics like obesity due to fears of offending patients or feeling uncertain about handling such discussions. From the patients’ perspective, negative experiences stemming from certain tones or word choices can inadvertently harm the doctor-patient relationship.
This research, funded by the National Institute for Health and Care Research School for Primary Care Research and Foundation for the Sociology of Health and Illness, utilised conversation analysis techniques on audio recordings from the BWel trial. In this trial, doctors offered patients referrals to a 12-week weight loss programme, and the researchers observed how different communicative approaches – categorised as ‘good news’, ‘bad news’, or neutral – influenced patient engagement and satisfaction.
Statistical analysis revealed that patients were more likely to enrol in, attend, and lose more weight in programmes when the referral was framed as ‘good news’. Specifically, 83% of patients offered programmes in a positive light attended, compared to only 50% for neutrally framed offers. Those who received ‘good news’ also lost about half a stone (3.6kg) more compared to the ‘neutral’ or ‘bad’ news groups.
Dr Charlotte Albury, the study’s lead author, emphasised that framing weight loss conversations positively encourages patients to participate more actively in programmes, yielding better weight loss outcomes. She noted that while both ‘neutral’ and ‘negative’ framings led to similar levels of programme acceptance and weight loss, the ‘good news’ approach stood out for its effectiveness.
The study identified specific characteristics of ‘good’ and ‘bad’ news delivery. In the ‘good news’ approach, doctors focused on the benefits of weight loss in an optimistic manner, confidently shared advantages, and communicated fluently and cheerfully. In contrast, the ‘bad news’ framing centred on health issues related to overweight and emphasised patient effort, often marked by slower delivery and hesitations. The neutral approach maintained a steady tone without leaning towards either benefits or issues.
Dr Albury highlighted the importance of these findings for medical professionals, suggesting that adopting a ‘good news’ approach could significantly enhance patient motivation and success in weight management. By transforming discussions into positive and empowering dialogues, doctors can effectively encourage patients to adopt healthier lifestyles.
Read MoreSwiss pharmaceutical giant Roche enters obesity drug race with $2.7 billion Carmot deal
Swiss pharmaceutical giant, Roche, has announced a significant strategic move in the obesity treatment market with its $2.7 billion acquisition of Carmot Therapeutics, a U.S.-based obesity drug developer. This places Roche among leading contenders like Novo Nordisk and Eli Lilly in the weight-loss drug sector. Carmot’s flagship product, CT-388, a once-a-week dual GLP-1/GIP receptor agonist injection similar to Lilly’s Mounjaro, has shown promise in Phase I trials and is poised for Phase II testing. Its market introduction is anticipated in the 2030s.
The move has generated optimism, reflected in a 2.4% rise in Roche shares, as the weight-loss drug market, potentially worth $100 billion, appears to have room for multiple players. Roche’s Teresa Graham, head of the pharmaceuticals division, expressed ambitions beyond merely competing on price, envisioning CT-388 as a leading obesity drug in its class.
This acquisition marks Roche’s re-entry into the GLP-1 field, following a previous exit in 2018 when subsidiary Chugai sold experimental drug rights to Lilly. The Carmot deal, expected to conclude in early 2024, includes additional payments of up to $400 million subject to achievement of certain milestones.
The deal is part of Roche’s broader strategy, under new CEO Thomas Schinecker, to diversify its therapeutic fields and rejuvenate its development pipeline, especially after setbacks in Alzheimer’s and cancer immunotherapy. Besides the Carmot acquisition, Roche recently committed $7.1 billion for rights to a new drug for inflammatory bowel disease.
Carmot, founded in 2008, has a portfolio of various gut-hormone drug candidates, in both pill and injectable forms, designed to treat obesity in patients with and without diabetes. This acquisition underlines Roche’s commitment to expanding its presence in the evolving field of obesity treatment.
Read MoreUK’s obesity epidemic costs economy almost £100 billion per year
Britain is grappling with an obesity crisis that is inflicting a staggering economic toll of nearly £100 billion annually, as per a comprehensive report by the Tony Blair Institute. This figure, highlighted in a report published by The Times, indicates that the impact of obesity on national productivity is far more severe than previously estimated, being ninefold higher.
The financial implications are forecasted to escalate by an additional £10 billion over the coming 15 years. This total cost, inclusive of the £63 billion attributed to shorter life spans and compromised health due to obesity, equates to roughly 4% of the nation’s GDP.
Henry Dimbleby, the former government advisor on food, is advocating for stringent measures akin to those applied to tobacco, targeting junk food. He warns that without decisive action, Britain risks becoming a nation burdened by illness and economic decline. Dimbleby is poised to highlight these concerns in a speech at a Royal Society conference, stressing the potential strain on the NHS and consequent economic stagnation.
Amid these warnings, the government has postponed initiatives like the 9pm junk food advertising watershed and restrictions on promotional deals for unhealthy food products until 2025. Health Secretary Victoria Atkins has expressed a desire to offer health guidance in a non-patronising manner.
A Department of Health spokesperson reiterated the government’s commitment to tackling obesity, pointing to initiatives like food-labelling standards, investment in school sports, and healthy food vouchers for underprivileged families.
Hermione Dace from the Tony Blair Institute underscored the critical link between the nation’s health and its economic prosperity, calling for a revamped approach to promote healthier food options and discourage the profitability of ultra-processed and junk food.
The obesity epidemic has intensified, with two-thirds of British adults now classified as having overweight or obesity, a significant rise from half a generation ago. Notably, the average weights of British men and women have increased by 6kg and 5kg, respectively, since 1993.
Read MorePomegranate proves potent in metabolic health management
A comprehensive study featured in Nutrients journal has cast a spotlight on pomegranate (Punica granatum l., PG) and its polyphenolic compounds, scrutinising their potential to modulate metabolic irregularities. Historically embraced for its therapeutic properties against bacterial infections, diabetes, and various metabolic syndromes, pomegranate’s efficacy is being re-evaluated amidst concerns over the side effects of conventional pharmacological treatments.
The review delves into pomegranate’s pharmacokinetic profiles, safety, and bioavailability, particularly focusing on its capacity to combat metabolic disorders such as type 2 diabetes, obesity, dyslipidemia, and cardiovascular diseases. It outlines how PG’s consumption could attenuate insulin resistance, inflammatory cytokines, redox gene expression, blood pressure elevation, vascular damage, and lipoprotein oxidation.
In animal models, pomegranate seed oil has been found to reduce fat mass and enhance insulin sensitivity, corroborating previous research indicating significant reductions in lipid levels. The study further explains how enzymes and nuclear receptors involved in lipid metabolism are positively influenced by PG’s floral components.
Despite some contradictory findings regarding PG’s impact on food intake and weight gain, the review suggests genetic differences may account for varied physiological reactions to phytochemicals. PG polyphenols are also being explored for their anti-diabetic properties through diverse mechanisms, including modulation of PPAR-γ activity and adiponectin gene expression.
The review also evaluates the pharmacodynamics and safety of PG’s ellagitannin compounds, noting individual differences in urolithin production and absorption, which are influenced by factors such as gut microbiota composition and pH. Although high doses of PG have shown cellular and nuclear alterations in toxicological studies, conventional uses of PG and its compounds appear safe, with adverse effects only predicted at dosages exceeding those traditionally used in ethnomedicine.
In conclusion, the research indicates that PG could play a beneficial role in preventing metabolic disorders. However, the outcomes of clinical and pharmacokinetic studies remain variable, attributed to factors like plant part selection, cultivar differences, environmental conditions, bioavailability, organ accessibility, and individual genetic profiles. Despite these discrepancies, the therapeutic potential of PG in addressing components of metabolic syndrome highlights the need for integrated treatment strategies.
Read MoreJapan’s healthcare system to include new obesity treatment in insurance coverage
Japan’s healthcare system is set to introduce a novel obesity treatment covered by public medical insurance starting Wednesday (22nd of November, 2023), marking the first such inclusion in thirty years. Wegovy, produced by the Danish firm Novo Nordisk, will be accessible under the national health insurance following its approval for manufacture and sale in March.
The treatment contains semaglutide, a GLP-1 receptor agonist that not only enhances insulin production and lowers blood sugar but also suppresses appetite by inducing satiety and curbing cravings.
Coverage is specifically tailored for patients who are significantly overweight or have weight-related health complications such as high blood pressure, hyperlipidemia, and Type 2 diabetes, and who have not seen results from lifestyle changes alone. Criteria for eligibility include having a Body Mass Index (BMI) of 35 or above, or a BMI of 27 with associated comorbidities.
Wegovy is administered weekly through self-injection, with a monthly supply consisting of four pens. The cost varies according to the dose, from ¥1,876 (£9.99) for the smallest dose to ¥10,740 (£57.19) for the highest.
The drug joins Ozempic, also a GLP-1 receptor agonist with semaglutide by Novo Nordisk, on the market. While Ozempic targets Type 2 diabetes at lower doses, Wegovy is dosed higher specifically for weight loss.
Despite its medical purposes, there’s growing concern over Wegovy’s use for aesthetic weight loss, leading to potential drug shortages for those in medical need. This has prompted Japanese medical bodies to warn against such misuse, especially with the trend of “medical diets” offered by clinics to individuals without obesity or diabetes.
Research has pointed out the risk of severe gastrointestinal issues with these medications, a concern highlighted in the Journal of the American Medical Association. Yet, Novo Nordisk has cited an August report claiming Wegovy can cut the risk of major adverse cardiovascular events by 20% in adult individuals with overweight or obesity.
Previously, Japan’s insured treatment for obesity was limited to Mazindol, introduced in 1992, designated for severe obesity and capped at three months of use due to addiction risks.
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