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MedicalResearch.com Interview with: Dr. Ogino Shuji Ogino, MD, PhD, MS (HSPH / BWH / HMS/ Broad Institute) Professor of Pathology, Harvard Medical School; Brigham and Women's Hospital Department of Pathology Professor, Department of Epidemiology Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Evidence indicates that the incidence of early-onset cancers (diagnosed before age 50) in various organs has been rising in adults Read the full article

MedicalResearch.com Interview with: Dr Irene Papanicolas PhD Associate Professor of Health Economics Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: The background to this study has been the recent debate around Health care reform in the US and whether moving to a Medicare for all model would bring down U.S. health care costs. One of the key arguments to this debate is that moving to a Medicare for all model would save the US money on the premise that health care provision for the over 65 population is more efficient as compared to the population under 65.   MedicalResearch.com: What are the main findings?  Response: The data from our comparison of the 65+ population shows that while per capita spending across the over 65 population is not uniformly distributed, for most age groups it is still higher in the U.S. relative to comparators. More specifically, the U.S. spends almost twice as much as the other seven countries for the groups aged 65-80, approximately 1.5 times as much for those aged 80-90, and less than average for those aged 90+. MedicalResearch.com: What should readers take away from your report? Response: These findings suggest that despite having a more similar health care structure to other high spending health care systems, the U.S. Read the full article

MedicalResearch.com Interview with: Mingyang Song, MD, ScD. Division of Gastroenterology Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School Department of Nutrition and Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Recent studies showed a presence of dysbiotic oral microbiome in patients with esophageal and gastric cancer, suggesting a link between oral health and these cancers. However, how periodontal disease and tooth loss may influence the risk of these cancers has been inconsistent.  MedicalResearch.com: What are the main findings? Response: Our findings support a possible role of oral health in the development of upper GI cancer. Individuals with periodontal disease and tooth loss are at higher risk of developing esophageal and gastric adenocarcinoma. The risk is particularly high for individuals with both periodontal disease and tooth loss.  MedicalResearch.com: What should readers take away from your report? Response: Based on our findings, people with periodontal disease and tooth loss should be encouraged to modify their lifestyle, for example, quit smoking and lower alcohol intake, in order to reduce their cancer risk. Also, these people may benefit from early cancer screening, although this requires further investigation.  MedicalResearch.com: Read the full article

This shows the 5-minute image of the standard eye mask and the filtered eye mask, which demonstrated how a mask without a filter can really get fogged up. MedicalResearch.com: What should readers take away from your report? Response: The biggest takeaway is that improvements in eye protection have the potential to both increase usage and prevent COVID-19 transmission, especially to health care workers. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: I would recommend that filtered eye masks be manufactured and tested. If proven effective, filtered eye masks can be disseminated to health care workers and other at risk populations. MedicalResearch.com: Is there anything else you would like to add?  Response: Yes, I think that individuals with prolonged exposures to crowded environments with poor air circulation, such as subways, would especially benefit from usage of filtered eye masks. On a broader sense, this could help increase protection against COVID-19 as our country and the world go back to work. Preventing airborne spread of COVID-19 is a big deal. So, I would like to leave the reader with a mental picture of how airborne spread might occur. Imagine looking at rays sunlight passing through your living room in the early morning. One can see dust particles floating and twirling in the air currents. So too can airborne viruses spread. Any disclosures? Yes, I am a co-author of two patents pending on eye protection where I have improved the filtered eye mask design many times over. I would gladly share my designs with any and all parties who might be interested in collaborative research to combat COVID-19.  Citation: Addressing the corona virus outbreak: will a novel filtered eye mask help? Douglas, David et al. International Journal of Infectious Diseases, Volume 0, Issue 0 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

MedicalResearch.com Interview with: Dr. Baden Megu Baden, MD, PhD Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA02115  MedicalResearch.com: What is the background for this study? Would you give an example of healthful vs non-healthful plantbased diet? Response: Plant-based diets are recommended for health and recently also for their environmental benefits. However, most previous studies defined it as either vegetarian or non-vegetarian, and importantly, without differentiation for the quality of plant foods. As you know, not all plant foods are equally good to our health. Therefore, to capture the quality of plant-based diets, we established overall, healthful and unhealthful plant-based diet indices. A higher score on the overall plant based diet index indicates greater intake of all types of plant foods and less of animal foods. A higher score on the healthful plant based diet index indicates greater intake of only healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee), and less of less healthy plant foods (fruit juices, refined grains, potatoes, sugar-sweetened beverages, sweets/desserts) and animal foods. A higher score on the unhealthful plant based diet index indicates greater intake of only less healthy plant foods, and less of healthy plant foods and animal foods. In this study, we used these plant-based diet indices and investigated the associations between 12-year changes in plant-based diet quality and subsequent total and cause-specific mortality in two large US cohorts. MedicalResearch.com: What are the main findings? Response: Improving plant-based diet quality over a 12-year period was associated with subsequent lower risk of total and cardiovascular disease mortality, whereas increased consumption of an unhealthful plant-based diet was associated with a higher risk of total and cardiovascular disease mortality.  MedicalResearch.com: What should readers take away from your report? Response: Increasing intakes of healthy plant foods and decreasing intakes of less healthy and/or animal foods can lower the future risk of mortality. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: It would be important to replicate our findings in other large cohorts. Also, we would like to integrate the recent omics technology, such as metabolomics and gut microbiome, and investigate to examine the mechanisms underlying the association between improved plant-based diet quality and lower mortality risk.  Any disclosures? Dr. Li and Dr. Hu reported receiving research support from California Walnut Commission. Dr. Satija is currently employed at Analysis Group, Inc. All other authors have no conflict of interest to disclose.   Citation: Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality Megu Y. Baden,Gang Liu, Ambika Satija, Yanping Li, Qi Sun, Teresa T. Fung, Eric B. Rimm, Walter C. Willett, Frank B. Hu, and Shilpa N. Bhupathiraju Originally published12 Aug 2019 https://doi.org/10.1161/CIRCULATIONAHA.119.041014 Circulation. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.041014   Last Modified:   The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Tori Cowger Tori Cowger, MPH Ph.D Student | Population Health Sciences Department of Epidemiology Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Globally, approximately one million cases of tuberculosis disease (TB) and 233,000 TB-related deaths occurred among children aged younger than 15 years during 2018. TB in children and adolescents is clinically and epidemiologically heterogeneous, making diagnosis, care, and prevention challenging. Understanding this heterogeneity can inform TB care and prevention efforts, and efforts to eliminate disparities in TB incidence and mortality in these groups. In this study, we describe the epidemiology of TB among children and adolescents in the United States, and report TB incidence rates for US territories and freely associated states and by parental country of birth, which have not been previously described. MedicalResearch.com: What are the main findings? Response: Overall, we found that TB incidence among children and adolescents during 2007–17 was low – 1·0 case per 100 000 person-years – and decreased substantially (48%) during this period. However, these results were not uniform – TB burden and trends varied substantially across geographies and sociodemographic groups. We observed disproportionately high rates of TB among children and adolescents of all non-white racial or ethnic groups examined, children and adolescents living in US-affiliated islands, and children born in or with parents from TB-endemic countries. MedicalResearch.com: What should readers take away from your report? Response: Our results show that overall TB incidence among children and adolescents in the United States is low and steadily declining. However, we also observed wide-ranging and pervasive disparities by race or ethnicity, geography, and place of birth. These disparities probably reflect structural inequalities that give rise to disproportionate exposure, vulnerability to infection and disease, and unequal access to prompt diagnosis and treatment. Our findings suggest that TB care and prevention strategies in the USA are succeeding in reducing overall TB burden among children and adolescents, but that more attention and possibly new approaches are needed to address the disparities in TB incidence and mortality in these age groups. Citation: DOI:https://doi.org/10.1016/S2468-2667(19)30134-3 Epidemiology of tuberculosis among children and adolescents in the USA, 2007–17: an analysis of national surveillance data  Last Modified: The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Frank Qian Frank Qian, MPH Department of Nutrition Harvard T. H. Chan School of Public Health Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Plant-based diets have really grown in popularity in the last several years, particularly among the younger generation in the United States, many of whom are adopting a plant-based or vegetarian/vegan diet. However, the quality of such a diet can vary drastically. While many prior studies have demonstrated beneficial associations for risk of type 2 diabetes with healthful plant-based foods such as fruits, vegetables, nuts/seeds, whole grains, and legumes, the opposite is true for less healthful plant-based foods such as potatoes and refined grains such as white rice. In addition, some animal-based foods, such as dairy and fish, have shown protective associations against the development of type 2 diabetes, so strict vegetarian diets which exclude these foods may miss out on the potential benefits. Given these divergent findings, we sought to pool all the available data from prior cohort studies to analyze whether the overall association of a diet which emphasizes plant-based foods (both healthful and unhealthful) are related to risk of type 2 diabetes. MedicalResearch.com: What are the main findings? Response: The main findings of our study suggest that following a diet which emphasizes plant-based foods, particularly the healthful ones I alluded to above, is associated with a substantial reduction in risk of type 2 diabetes. In addition, this effect seems to be operating independently of body weight, because we continued to observe a beneficial association even after accounting for an individual's body mass index. In addition, we found a linear dose-response relationship between higher adherence to a plant-based diet and risk of type 2 diabetes. MedicalResearch.com: What should readers take away from your report?  Response: Our findings suggest that following a healthful plant-based diet over the long-term may be beneficial for the prevention of type 2 diabetes, and the higher the adherence, the greater the potential benefit. While our study doesn't address whether being a strict vegetarian and excluding all animal-based foods may produce greater reductions in risk, it is likely prudent to reduce or minimize red and processed meats, which have consistently demonstrated harmful associations with risk ofdiabetes. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future studies should seek to better understand the mechanism underlying the associations we found in this study, particularly the potential interactions between a plant-based diet and the gut microbiome, which has not been well-elucidated. Our study only included cohorts from high-income countries, and it would be interesting to see if the results can be generalized to populations of low- and middle-income countries, particularly as many of these populations shift from their traditional, plant-predominant diet to a modern diet that often includes higher amounts of animal products. MedicalResearch.com: Is there anything else you would like to add? Response: Our study provides further evidence for the promotion of healthful plant-based foods to prevent cardiometabolic diseases, such as type 2 diabetes, which continue to increase in the US and globally. Citation: Qian F, Liu G, Hu FB, Bhupathiraju SN, Sun Q. Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Intern Med. Published online July 22, 2019. doi:10.1001/jamainternmed.2019.2195 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2738784 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Prof. I-Min Lee I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: While we have many studies showing that physical activity is beneficial for health, there are few data on steps and health, particularly long-term health outcomes.  An expert committee – the 2018 Physical Activity Guidelines Advisory Committee, which reviewed the scientific evidence to support the recently released Physical Activity Guidelines for Americans, 2nd edition – noted this (i.e., the relation between steps and health outcomes) to be a critical gap in knowledge, since many individuals are using wearables and monitoring their step counts. We often hear the number 10,000 steps cited as a daily goal, but the basis for this number is unclear. It likely originated as a marketing tool: in 1965, the Yamasa Clock and Instrument Company, Japan sold a pedometer called “Manpo-kei” – “ten thousand steps meter” in Japanese. For many older people, 10,000 steps/day can be a very daunting goal; thus, we wanted to investigate whether this was necessary for lower mortality rates in older women.  Additionally, steps taken can be fast or slow, and there are no published studies on step intensity and long-term health outcomes.  Note that walking pace and step intensity are not the same concept: walking pace gauges intensity when walking purposefully (e.g., for exercise or transportation), while step intensity assesses an overall best natural effort in our daily life. MedicalResearch.com: What are the main findings?  Response: In this study, conducted among older women with mean age of 72 years, taking as few as 4,400 steps per day was significantly associated with lower risk of death compared to taking 2,700 steps per day. Risk of death during follow-up continued to decrease with more steps taken but leveled off at around 7,500 steps per day — less than the 10,000 steps default goal in many wearables.  The rate of stepping did not matter in these older women; it was the number of steps taken that mattered. MedicalResearch.com: What should readers take away from your report? Response: Step more – even a modest amount of steps is associated with lower mortality.  In this study, women who averaged 4,400 steps/day – a very doable level – had a lower mortality rate during follow-up than the least active who took 2,700 steps/day.  More steps taken per day were associated with even lower mortality rates until ~7,500 steps/day, beyond which no further declines were observed.  The rate of stepping did not matter in these older women; it was the number of steps that mattered.  We hope these findings provide encouragement for individuals for whom 10,000 steps a day may seem unattainable  MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: This study was conducted among older women, who were not very active and in whom there was little fast stepping. Thus, findings may be different in younger and/or more active persons – we would need to conduct further studies.  Additionally, we only investigated mortality; we are continuing to follow these women for other health outcomes, and hope to examine outcomes such as quality of life, functional health and cognitive health, as well as the development of various diseases.  Disclosures: The study was funded by the National Institutes of Health.  Dr. David Bassett is a member of the Scientific Advisory Board for Actigraph, which makes the device used to measure steps in the study.  The study device was chosen prior to any involvement by Dr. Bassett.  There are no other conflicts reported. Citation: Lee I, Shiroma EJ, Kamada M, Bassett DR, Matthews CE, Buring JE. Association of Step Volume and Intensity With All-Cause Mortality in Older Women. JAMA Intern Med. Published online May 29, 2019. doi:10.1001/jamainternmed.2019.0899 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article