Latest / Morning Medical with Dr. Chow / Exploring semaglutide's vision risks, sodium intake, and the mental health perks of urban gardening

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Exploring semaglutide's vision risks, sodium intake, and the mental health perks of urban gardening · Morning Medical with Dr. Chow

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  Good morning, and welcome to another episode of Morning Medical with Dr.
• 0:04
  Chow.
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  I am your host, Dr.
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  Chi-Ming Chow, and today we have a comprehensive update on some of the most
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  pressing medical and health news from around the world.
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  As always, our goal is to keep you informed with the latest research, studies, and expert
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  opinions that could impact your health and well-being.
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  So without further ado, let us dive right into today's topics.
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  First up, a new study has suggested a potential link between the use of popular weight loss and
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  diabetes medications, specifically Ozempic and Wegovy.
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  And a serious eye condition that can lead to blindness.
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  The study, conducted by researchers at Harvard and published in JAMA Ophthalmology, analyzed
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  data from 16,827 patients over a six-year period at the Massachusetts Eye and Ear Harvard
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  Teaching Hospital.
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  The active drug in both Ozempic and Wegovy is semaglutide, which belongs to a class of
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  medications known as GLP-1 receptor agonists.
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  Researchers focused on the incidence of non-arteritic anterior ischemic optic
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  neuropathy, or NAION, a condition that affects the optic nerve and can result in sudden and
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  irreversible vision loss.
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  Among the 16,827 patients analyzed, 710 had type 2 diabetes with 194 being prescribed
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  semaglutide medications.
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  Another 975 patients were either overweight or living with obesity, with 361 of them being
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  prescribed semaglutide.
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  The findings were concerning.
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  Among those prescribed semaglutide, a small percentage eventually developed NAION.
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  Specifically, 8.9% of patients taking semaglutide for type 2 diabetes developed NAION
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  compared to 1.8% who were taking non-GLP-1 medications.
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  Similarly, 6.7% of those prescribed semaglutide for weight issues developed the eye condition
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  versus 0.8% of those receiving other types of medications for weight reduction.
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  NAION affects the optic nerve, which is responsible for carrying visual information
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  from the eye to the brain.
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  This condition is essentially a type of painless eye stroke where reduced or blocked
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  blood flow and oxygen to the optic nerve can result in sudden vision loss.
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  The study found that the risk of developing NAION was greatest within the first year of
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  being prescribed semaglutide, but researchers emphasized that their findings should be
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  considered tentative for now.
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  Doctor Joseph Rizzo, the lead researcher and director of neuro-ophthalmology at Mass Eye and
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  Ear, stressed the importance of further studies to examine these questions in a larger and more
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  diverse population.
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  He noted that while the use of these drugs has exploded throughout industrialized countries,
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  providing significant benefits in many ways, future discussions between patients and their
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  physicians should include NAION as a potential risk.
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  However, it is important to highlight that medical experts are urging patients not to
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  panic or discontinue their medications.
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  Doctor Tom Elliott, medical director with BC Diabetes, described the association between
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  semaglutide and NAION as exceedingly rare.
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  He reassured patients that if they have a good reason to be taking semaglutide, the benefits
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  massively outweigh the downside.
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  These drugs not only help in managing diabetes and weight, but also contribute to
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  cardiovascular health.
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  Dr.
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  Mark Eltis, president of the College of Optometrists of Ontario, added that untreated
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  diabetes itself can cause severe vision problems.
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  He explained that untreated diabetes can lead to leaky blood vessels at the back of the eye
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  or the formation of new unstable blood vessels, which can cause hemorrhaging or bleeding.
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  Novo Nordisk, the manufacturer of Ozempic and Wegovy, also weighed in, highlighting several
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  limitations of the study design, which was not a randomized controlled trial.
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  They pointed out that the study did not account for some potentially pertinent information such
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  as the duration of diabetes in patients or whether they were smokers.
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  They emphasize that the data is not sufficient to establish a causal association between GLP-1
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  receptor agonist use and NAN.
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  Canadian warnings for both Ozempic and Wegovy do include vision changes among potential side
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  effects.
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  Therefore, it is crucial for anyone considering semaglutide to speak with their health care
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  provider about the risks and benefits and to be assessed for any eye conditions beforehand to
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  ensure an individualized treatment plan.
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  In summary, while the study's findings are significant, they should be interpreted with
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  caution.
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  The potential link between semaglutide and NAN highlights the importance of ongoing research
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  and informed discussions between patients and health care providers.
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  As always, the goal is to balance the benefits and risks. There
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  There is a significant link between high sodium intake and a range of serious health issues, as
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  evidenced by the fact that 90 percent of Americans consume too much salt.
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  While salt undoubtedly adds flavor to your food, are you aware of the potential health
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  risks of consuming it in excess?
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  Dietary guidelines recommend that adults should not have more than 2,300 milligrams of sodium
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  daily.
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  However, the average American consumes approximately 3,400 milligrams daily, which is
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  substantially higher than the recommended limit.
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  Excessive amounts of salt can increase the risk of developing high blood pressure, which is a
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  precursor to several other serious health conditions.
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  More than 4 in 10 Americans have high blood pressure, and it can elevate the risk for heart
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  disease, stroke, gastric issues, osteoporosis, kidney disease, certain types of cancer,
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  obesity, and Ménière's disease.
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  The World Health Organization reports that approximately 1,890,000 deaths each year are
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  linked to excessive sodium intake.
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  One of the primary culprits of high sodium intake is processed or convenience foods.
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  These foods tend to have higher salt content because salt helps preserve them.
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  However, only 15 percent of your sodium intake comes from the salt you add while cooking or
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  eating.
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  Some surprising sources of sodium include soups, breads, condiments, meats, and salad
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  dressings.
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  For instance, a single slice of cheese can have the same amount of sodium as an ounce of potato
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  chips.
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  To lower your salt intake, consider eating mostly fresh, minimally processed foods.
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  Cutting back on high-sodium foods, like deli meats, pizza, burritos, and sandwiches can also
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  help.
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  Additionally, using herbs and spices instead of salt to season your food can be a healthier
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  alternative.
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  Reading food labels carefully is crucial as well.
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  Alessandra Stenopoulos, a registered dietitian, emphasizes the importance of checking labels
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  before grabbing something off the shelf.
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  It is worth noting that as much as 70 percent of the sodium you consume comes from processed
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  and restaurant foods.
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  Therefore, preparing meals at home can significantly reduce your sodium intake.
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  But what about Himalayan salt?
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  Consumer testers have found that Himalayan salt contains 1,000 milligrams less sodium per
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  tablespoon compared to regular table salt.
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  While this is a slight improvement, it is still essential to monitor overall salt consumption
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  to maintain good health.
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  In summary, while salt is an essential component of our diet, excessive consumption
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  poses significant health risks.
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  By being mindful of the sources of sodium in your diet and making conscious choices to
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  reduce your intake, you can significantly lower your risk of developing serious health
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  conditions.
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  As always, consult with your health care provider for personalized advice and
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  recommendations.
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  Weight stigma is a pervasive issue in health care, and it is time for physicians to address
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  it head-on.
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  Doctor Emingi Jha, a physician and nonfiction writer, recently discussed the harmful effects
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  of weight stigma in an article published on MedPage Today.
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  Doctor Jha highlights that weight stigma is not just a societal issue, but a medical one that
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  can have severe consequences for patients.
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  Being shamed by physicians is unfortunately not uncommon.
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  A 2009 survey revealed that 50 percent of patients recalled at least one interaction with
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  a physician where they left feeling ashamed, with weight being the most common topic.
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  Alarmingly, a 2022 poll by Doctor Jha found that 70 percent of respondents had been shamed
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  by their health care teams.
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  This is not just an issue of hurt feelings.
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  It has real implications for patient care.
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  Studies have shown that physicians often show less respect and make less effort to build
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  rapport with patients who live in larger bodies.
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  This lack of effort extends beyond emotional connections.
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  For example, mothers with obesity are less likely to receive support for breastfeeding
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  from health care professionals, which can negatively impact infant health.
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  Even when it comes to weight loss, those who experience weight stigma from their physicians
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  are less likely to succeed in losing weight compared to those who do not feel judged.
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  Perhaps the most damaging outcome of patient shaming is the loss of a therapeutic
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  relationship.
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  In the 2009 study, 45% of patients who felt shamed by a physician either left, avoided, or
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  lied to their physician.
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  This avoidance can prevent patients from seeking essential care, such as cancer
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  screenings and prenatal care.
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  Consequently, patients living with obesity have higher cancer rates and worse obstetric
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  outcomes, raising the question of whether obesity is the risk factor or if weight stigma
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  itself plays a significant role.
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  It is crucial to note that addressing excess weight is important and does not inherently
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  constitute weight stigma.
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  However, when weight becomes the sole focus for all health-related issues, it acts as a
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  gatekeeper, restricting access to comprehensive care.
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  Doctor Chow has worked extensively with women suffering from hidradenitis suppurativa, a
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  chronic skin condition often comorbid with obesity.
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  Many patients reported that their doctors advised them to lose weight without even
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  examining their skin.
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  This failure to look beyond weight can lead to missed diagnoses and delayed care.
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  Moreover, the stigma surrounding weight is often baseless.
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  In the case of hidradenitis suppurativa, there is no strong evidence that weight loss
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  consistently leads to clinical improvement.
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  On the contrary, rapid weight loss after bariatric surgery may worsen symptoms in up to
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  69% of patients.
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  This highlights how physicians can become blind to their biases, failing to provide adequate
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  care to patients living with obesity, who already suffer higher all-cause mortality.
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  So what can be done to break this cycle of weight stigma in medicine?
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  First, the medical community must include people of all sizes in clinical trials.
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  Currently, patients living with obesity are not required to be included in United States
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  clinical trials, making drug dosing in larger bodies a gray area.
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  This can be life-threatening in cases such as infections, blood clots, and cancer.
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  Additionally, health care environments should adapt their facilities, equipment, and policies
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  to accommodate larger bodies appropriately.
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  Second, health care should be addressed at every size in a nonjudgmental manner.
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  The Health at Every Size framework teaches that health care is a human right for people of all
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  sizes and that refusing to provide care until arbitrary weight loss criteria are met could
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  violate a patient's bodily autonomy.
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  When discussing weight, health care providers should use person-centered, collaborative, and
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  respectful language.
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  It is essential to obtain permission before weighing patients and to ensure that the focus
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  remains on their overall health, not just their weight.
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  Lastly, training to combat anti-fat biases must begin early in medical education.
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  A 2010 randomized control trial found that medical students were more likely to recommend
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  lifestyle changes and less likely to prescribe symptom-relieving medications for patients
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  living with obesity.
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  By the time they reach residency, an alarming level of anti-fat bias exists across all
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  specialties.
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  This indicates that either medical education cultivates weight stigma or does a terrible job
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  correcting it, or perhaps both.
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  Dr.
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  Ajay emphasizes the importance of breaking this cycle.
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  When meeting new patients living with hidradenitis suppurativa, she makes it a point
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  to tell them your weight did not cause your HS.
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  Many patients are moved to tears when they hear this, as weight stigma has created significant
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  trauma outside the exam room.
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  It is crucial for health care providers to break this cycle in the one place where people
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  expect care and compassion.
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  Everybody should have a place in medicine, and everybody deserves to heal too.
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  As we wrap up today's episode, let's explore some practical tips for greening your outdoor
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  space, which could potentially boost your mood.
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  City living can often be a mood killer, with pollution, loud sirens, and congestion taking
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  their toll.
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  However, a recent study has revealed that living near diverse birds and trees can
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  significantly lift your spirits.
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  Even if you reside in a condo or an apartment with a small balcony, there are ways to
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  transform your green space and bring nature to your doorstep.
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  Ryan Godfrey, a botanist with the World Wildlife Fund Canada living in Toronto,
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  emphasizes the positive health benefits of having nature close.
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  He shares his personal experience of living in a condo and using his balcony to grow a native
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  plant garden in containers.
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  According to Godfrey, this approach attracts birds, insects, and various forms of
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  biodiversity, enriching his urban living experience.
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  A Canadian study published in Nature last month found that living in a city neighborhood rich
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  with bird diversity and tree species was linked to increased reporting of good mental health.
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  The study found that people living in areas with a greater variety of birds reported
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  feeling happier by 6.64%.
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  Similarly, those living near a wider range of tree species reported 5.36 percent higher rates
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  of good mental health.
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  Even with limited outdoor space, from a compact balcony to a modest backyard, these tips will
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  help you attract birds to your haven.
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  First, consider growing native plants.
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  Native plants are species specific to your region and have developed a special, complex,
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  and deep relationship with insects and birds in their ecosystem.
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  Their local adaptation makes them naturally tough and low maintenance, making them an
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  excellent choice for urban gardening.
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  Examples of regionally specific native plants include Saskatoon berries, a sweet and tart
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  fruit prevalent in the prairies, satin flower found on the West Coast, and the ever-popular
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  wild strawberry in Ontario.
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  Growing a native plant garden and embracing the wildness is a way to de-stress.
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  You insert yourself into the ecosystem, bring nature close, and get to learn about native
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  plants, how they grow, and what kinds of pollinators they attract.
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  If you are short on space, container gardens can be a great solution for your balcony or
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  patio.
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  You can use buckets, barrels, bushel baskets, and plastic bins for this purpose.
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  Proper drainage is essential for happy plants, so ensure your containers have drainage holes.
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  If needed, you can easily poke or drill some holes yourself.
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  This prevents water from accumulating and potentially rotting the roots of your plants.
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  Container plants also dry out faster than those in the ground, due to increased sun exposure
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  and wind.
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  Be prepared to water frequently.
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  Most plants will need it daily during hot weather.
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  Some great options for container gardening include salad greens, garlic, tomatoes, corn,
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  beans, carrots, and herbs like thyme, oregano, and mint.
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  Vertical gardens are another excellent solution for those with limited space.
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  Use wall-mounted planters, hanging pots, or trellises to create a vibrant green display.
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  Great plant choices for vertical gardens include herbs like thyme and oregano,
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  vegetables like beans and peas, and decorative plants such as ivy and ferns.
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  Ryan Godfrey mentioned that he is growing peas on his balcony where they are climbing up some
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  of his native grasses and an edible native species called sunchokes.
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  Long and narrow window boxes can also be used for a herb garden filled with basil, oregano,
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  and parsley.
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  Simply snip off leaves from the outside of the plant, and they will continue to grow week
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  after week.
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  Creating a bird-friendly environment in your green space adds life and movement while also
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  helping with pollination and pest control.
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  Native grasses with long seed heads are a favorite among birds.
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  Leaving these seed heads intact provides a natural food source that birds will appreciate.
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  Birds may also come to eat insects from the plants, creating a space that resembles their
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  natural habitat and making it more inviting for them to come and feed.
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  While bird feeders and houses can be another way to attract birds, it is important to
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  remember that regular cleaning is crucial.
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  Unclean feeders and houses can become breeding grounds for disease and parasites, potentially
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  harming the local bird population.
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  Some insects, like ladybugs, are beneficial for your garden as they are natural predators of
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  aphids.
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  Bees and butterflies play a vital role in pollination, ensuring the reproduction of many
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  flowering plants.
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  Exploring perennials can also be a great option for your garden.
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  Perennials are a long-term investment in your garden's beauty.
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  Unlike annuals that need replanting each year, perennials return season after season, bursting
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  with vibrant blooms and lush foliage.
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  Their ability to live for multiple years reduces the need for frequent replanting,
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  making them especially beneficial in urban settings, where garden space may be limited or
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  harder to access.
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  The majority of native plants are perennials, promising more suitability for urban gardening.
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  Wild strawberries are a great example.
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  If you have no idea where to start, plant some wild strawberries.
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  They are very fun to grow and send runners around to plant themselves into other
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  containers.
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  As we conclude today's episode, remember that creating a small nature-friendly space can
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  boost your mood and contribute to a healthier urban environment.
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  Whether you have a compact balcony or a modest backyard, these tips will help you bring nature
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  closer to your doorstep.
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  Thank you for joining us on Morning Medical with Dr.
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  Chow.
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  Stay healthy and see you next time.