Latest / Morning Medical with Dr. Chow / GLP-1 Drugs, Dementia Prevention, and Lettuce Outbreak Alerts

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GLP-1 Drugs, Dementia Prevention, and Lettuce Outbreak Alerts · Morning Medical with Dr. Chow

0:00
Welcome to Morning Medical with Dr.
0:01
Chow, where we bring you the latest updates on medical and health news from around the world.
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I'm Dr.
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Chi-Ming Chow, your host for today's episode, and I'm thrilled to have you with us.
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Let's dive into our first story of the day.
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Today, we're looking at how GLP-1 drugs are significantly boosting sales for pharmaceutical
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giants Eli Lilly and Novo Nordisk.
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These two companies are leading in the market thanks to the popularity of their GLP-1
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medications, with Eli Lilly's drugs Zepbound and Mounjaro showing remarkable sales growth.
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In fact, Eli Lilly reported that sales of Mounjaro, which is primarily used as a diabetes
0:44
treatment, rose by an impressive 91 percent in the second quarter of this year, reaching
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nearly 10 billion U.S.
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dollars.
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Zepbound, an obesity medication, also saw substantial growth with sales hitting 4.93
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billion U.S.
1:00
dollars.
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These figures contributed to 64.7 percent of Eli Lilly’s revenue for the months of April
1:08
through June.
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The company’s U.S.
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market revenue increased by 48 percent, largely fueled by these two drugs.
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Meanwhile, internationally, their revenue soared by 136 percent, driven by the success of
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Mounjaro in regions like Latin America and Asia.
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Eli Lilly's chief financial officer, Lucas Montarce, noted in a recent earnings call that
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the company’s leadership position was well-established, with a significant portion of
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total and injectable prescriptions being for their medications.
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On the other hand, Novo Nordisk has also experienced growth, though at a different pace.
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While their oral GLP-1 pill, Wegovy, met analyst expectations, some investors found the
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sales performance slightly underwhelming.
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Nonetheless, the Danish pharmaceutical company, known for Ozempic and Wegovy, managed to see an
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11 percent increase in operating profit.
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Their Wegovy pills have surpassed five million prescriptions in the U.S.
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since their launch, marking a significant milestone.
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Interestingly, Novo Nordisk's CEO, Mike Doustdar, highlighted a growing interest in
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their oral medications, indicating a preference for pills over injectable options among many
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patients.
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This trend is something the company is closely watching as they adapt to the evolving market
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demands.
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Additionally, in Canada, both companies are navigating the introduction of GLP-1 generic
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drugs.
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Novo Nordisk is employing strategies like savings card programs to maintain their market
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share, while Eli Lilly has noted some supply constraints among generic competitors.
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These developments underscore the dynamic nature of the pharmaceutical industry and the
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increasing demand for innovative treatments in diabetes and obesity management.
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As these companies continue to adapt and expand their offerings, it'll be interesting to see
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how the landscape evolves, especially with the growing competition from generic alternatives.
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Today, we're delving into a fascinating study that examines the link between inflammatory
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bowel disease, commonly known as IBD, and psychiatric disorders.
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This research explores whether psychiatric issues precede the onset of IBD or arise after
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the diagnosis.
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Conducted with a Swedish cohort, the study reveals some intriguing patterns that could
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have significant implications for patient care.
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According to the findings, there's an observable increase in the relative rate of
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psychiatric disorders in individuals starting two to three years before their IBD diagnosis.
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This rate peaks soon after the diagnosis and then rapidly decreases, although it remains
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elevated even a decade later.
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The increased risk is primarily driven by major depressive disorders, anxiety disorders, and
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substance misuse.
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Interestingly, there wasn't a marked increase in psychotic disorders, personality disorders,
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or attention-deficit hyperactivity disorder.
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The researchers, led by Jiangwei Sun from the Karolinska Institutet in Stockholm, highlight
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that the elevated risks observed prior to diagnosis might reflect the impact of
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subclinical inflammation, gastrointestinal symptoms, and the psychological stress
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experienced before the formal diagnosis of IBD.
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They note that these psychiatric symptoms can complicate the management of IBD, potentially
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leading to adverse outcomes such as disease flares, therapy escalation, hospitalization,
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and even surgery.
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Moreover, the study underscores the importance of integrating psychological care into routine
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IBD treatment practices.
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It suggests that early identification of individuals at high risk for adverse outcomes
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is crucial.
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This integration could help in managing depressive symptoms and anxiety, which are
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already known to affect the quality of life and increase mortality risk in IBD patients.
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The study involved a large sample, with over 48,000 IBD patients and more than 210,000
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matched reference individuals.
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It showed that before diagnosis, 8.6 percent of IBD patients were diagnosed with psychiatric
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disorders, compared to 6.8 percent of the control group.
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Post-diagnosis, the numbers rose to 16.5 percent in IBD patients versus 12.8 percent in
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the control group, with major depressive disorders, anxiety disorders, and substance
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misuse being the most prevalent.
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In a sibling comparison analysis, the study found that shared familial factors do not fully
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explain the association between IBD and psychiatric disorders.
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Even when comparing IBD patients to their IBD-free siblings, the former were more likely
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to develop psychiatric disorders post-diagnosis.
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This suggests that the link between IBD and psychiatric disorders is not solely due to
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genetic or familial factors.
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The findings of this study highlight the need for a holistic approach in treating IBD, one
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that includes mental health assessment and management as part of standard care.
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As the researchers pointed out, due to the lack of primary care data, the study might have
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underestimated the true absolute risk of psychiatric disorders in IBD patients, focusing
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instead on cases requiring specialist care.
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In today's segment, we're exploring the latest viral trend that has taken social media by
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storm: carrot maxxing.
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This is essentially the practice of consuming large amounts of carrots with the aim of
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achieving a golden skin tone.
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It's a new name for an old trend that's been around for quite some time.
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Many people online are sharing their experiences, claiming that by drinking carrot
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juice or eating carrots in substantial quantities, they're able to achieve a
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sun-kissed glow.
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Dr.
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Stephanie Widmer, an emergency physician and medical toxicologist at Northwell Health's
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Northern Westchester Hospital, explains that the key player in this phenomenon is
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beta-carotene, a pigment found in carrots.
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When consumed in large amounts, beta-carotene can lead to carotenemia, which is an excess of
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carotene in the blood.
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This, in turn, can cause carotenoderma, a condition where the skin takes on a yellow or
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orange hue.
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It's important to understand that while beta-carotene is generally not harmful, the
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body does regulate how much vitamin A it converts from beta-carotene.
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However, when people consume preformed vitamin A supplements in excess, it can be toxic.
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Dr.
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Raman Madan, chief of dermatology at Northwell Health's Glen Cove Hospital, notes that it
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typically takes eating two to four large carrots or drinking about sixteen ounces of
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carrot juice daily for a week or more to see visible changes in skin tone.
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Interestingly, the golden hue from carrot maxxing is most noticeable in areas of the skin
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with oil glands, such as the face, hands, and feet.
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However, results can vary from person to person, and it's often more noticeable on
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lighter skin tones.
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Some individuals may not be entirely pleased with the results, as the skin can appear more
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orange than golden.
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Dr.
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Madan points out that the changes in skin tone from carrot maxxing are different from a true
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tan.
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Unlike a tan, where sun exposure stimulates the production of pigment in the skin,
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beta-carotene simply adds color to the skin without stimulating pigment.
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Therefore, the orange hue of carotenoderma does not offer any protection from the sun's
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ultraviolet rays, making sun protection still essential.
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While carrot maxxing is considered one of the more benign skincare fads, it's crucial to
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manage expectations.
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Dr.
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Widmer mentions that carotenemia is typically seen in children who consume a lot of carrots,
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but with this trend gaining traction on platforms like TikTok, it's possible we'll see
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more teens and young adults trying it out.
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She advises healthcare providers to keep carotenemia in mind when diagnosing patients
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with golden skin, especially since it can resemble jaundice, which also affects the
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whites of the eyes.
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A recent study published in the journal Neurology Open Access reveals that avoiding
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three specific health factors during middle age can potentially delay the onset of dementia by
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about 13 years.
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The study highlights type 2 diabetes, smoking, and high blood pressure as significant risk
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factors for dementia.
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Dr.
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Josef Coresh, the senior author of the study, emphasizes that the neurodegenerative disease's
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development starts long before symptoms manifest.
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His research quantified how managing these health factors in middle age could influence
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when dementia begins.
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The study involved over 12,400 adults and found that participants with these three health
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hazards around the average age of 56 were more than twice as likely to develop dementia.
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They were also over five times more likely to die prematurely from other causes.
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Dr.
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Coresh, who is the founding director of the Optimal Aging Institute at New York University
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Grossman School of Medicine, notes that understanding the number of ‘good years’ gained
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from lifestyle changes can be more motivating than just knowing percentage risks.
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It’s important to note that the study shows an association rather than causation, as
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participants were only measured once for high blood pressure, diabetes, smoking, and other
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health factors before being followed for about 26 years.
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Dr.
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Sanjula Singh, an assistant professor in neurology at Harvard Medical School, who wasn’t
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involved in the study, advises viewing the results as an important estimate rather than an
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exact prediction for each individual.
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Cardiologist Dr.
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Andrew Freeman, who also wasn’t involved in the study, finds the research exciting, yet it
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underscores the need for promoting healthy living.
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He discusses the concept of health span versus lifespan, emphasizing that it’s not just about
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living longer but living well.
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Dr.
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Freeman, the director of cardiovascular prevention and wellness at National Jewish
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Health in Denver, warns against the so-called "American curse" of working hard, saving money,
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and then suffering health issues like heart attacks and dementia after retirement.
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Dr.
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Coresh advises those with high blood pressure, type 2 diabetes, or those wanting to quit
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smoking to consult their doctors.
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The risk factors for hypertension and diabetes include physical inactivity, obesity, poor
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diet, alcohol intake, and smoking.
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Addressing these can help in managing or preventing these conditions.
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Dr.
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Freeman recommends a lower-fat, plant-based diet like the Dietary Approaches to Stop
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Hypertension (DASH) diet, alongside ensuring adequate sleep and stress management.
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Dr.
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Singh mentions that about 45 percent of dementia cases are due to modifiable risk
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factors.
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When it comes to smoking, quitting should be a personal decision for it to be effective.
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Dr.
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Freeman suggests various methods to quit, such as nicotine patches, exercise, lozenges, gums,
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medications, therapeutic programs, and even acupuncture.
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He highlights that smoking involves habits with specific reinforcements, so altering routines
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and social circles can aid in quitting.
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The study participants were from the Atherosclerosis Risk in Communities cohort
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study, which has tracked nearly 15,800 adults from four U.S.
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communities since the late 1980s.
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The research found that avoiding the three risk factors was linked to 30.1 dementia-free years,
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compared to 17.5 years for those with these health risks.
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Women tended to remain dementia-free slightly longer than men, and Black participants
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developed dementia earlier than their White counterparts.
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Dr.
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Jacqui Hanley from Alzheimer’s Research UK, who wasn’t involved in the study, explains that
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these risk factors can damage blood vessels throughout the body, including those supplying
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the brain.
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This can heighten the risk of stroke and small vessel disease, making the brain more
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vulnerable to cognitive decline.
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Dr.
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Singh advises setting personal goals and finding accountability partners to support
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healthy living choices.
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Today, we're exploring some fascinating new research that suggests Viagra, a medication
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primarily known for treating erectile dysfunction, might have an additional,
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unexpected benefit.
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This study, conducted by researchers at the Weizmann Institute of Science in Israel, has
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uncovered potential anti-cancer properties of Viagra's active ingredient, sildenafil.
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The findings could have significant implications for cancer treatment strategies.
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Sildenafil, classified as a phosphodiesterase type 5 inhibitor, is widely recognized for its
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ability to increase blood flow, which is why it's effective in treating erectile
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dysfunction.
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However, the research team, led by Dr.
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Yarden Ariav under the guidance of Professor Ayelet Erez, discovered that sildenafil may
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play a role in preventing cancer cells from metastasizing, or spreading to other parts of
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the body.
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The study involved a comprehensive analysis of both human and mouse cancer cells, alongside 20
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years of health data from five million members of Clalit Health Services, Israel's largest
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nonprofit healthcare provider.
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By examining the interactions of genes, proteins, fats, cholesterol, and cellular
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energy, the researchers discovered that sildenafil limits the cancer cell's ability to
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utilize cholesterol.
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This mechanism is crucial because cholesterol is essential for the cancer cells to detach
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from the primary tumor and migrate.
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Interestingly, the researchers found that sildenafil's ability to block the enzyme
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phosphodiesterase type 5 and increase the signaling molecule cyclic guanosine
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monophosphate, or cGMP, is central to its potential anti-cancer effects.
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cGMP binds to a protein responsible for transporting cholesterol within cells, thereby
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limiting its availability for critical cellular functions.
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Cancer cells, it turns out, are particularly vulnerable to this reduction in cholesterol
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supply.
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The implications of these findings are quite exciting.
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The researchers suggest that combining Viagra-related drugs with statins, which are
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medications that lower cholesterol, could potentially slow the spread of cancer.
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This combined approach could reduce the tumor cells' access to cholesterol, thereby
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inhibiting their ability to metastasize.
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Professor Erez emphasized that this discovery highlights a new biological pathway linking a
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well-known signaling molecule to cholesterol regulation within cells.
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These insights underscore the importance of considering a patient's overall metabolic state
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when tailoring cancer therapies, rather than focusing solely on the tumor itself.
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It's important to note that while the findings are promising, they are based on observational
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studies and mouse models.
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This means that while there's an association between sildenafil and reduced cancer
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metastasis, it doesn't necessarily establish a cause-and-effect relationship.
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As always, further research, particularly clinical trials in humans, will be necessary to
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validate these findings and determine their practical applications in cancer treatment.
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In England, a significant push is underway to provide immediate mental health support through
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the establishment of walk-in mental health centres.
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These centres are set to open in convenient locations such as banks and libraries, with the
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government promising nearly 200 community mental health centres and mental health
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accident and emergency departments by the year 2029.
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The initiative aims to offer a lifeline to individuals experiencing mental health crises
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or distress, providing them with accessible and timely care.
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The plan comes in response to the high number of people who find themselves at accident and
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emergency departments in crisis because they cannot access mental health support elsewhere.
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Currently, one in five people struggle with mental health issues, underscoring the urgent
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need for more specialized care facilities.
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By placing these hubs in high street locations, the government hopes to make mental health
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support as accessible as possible.
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Prime Minister Andy Burnham emphasized the importance of these centres, stating that no
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one should have to face mental health challenges alone.
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He highlighted that these new hubs will bring National Health Service services closer to
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people's homes, facilitating early intervention before problems escalate.
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Health Secretary Yvette Cooper added that this approach could truly change the landscape of
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mental health care by preventing crises and reducing wait times for treatment.
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The government has already conducted trials in six areas since 2024, and the feedback has been
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promising.
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There's a commitment to opening 100 new community mental health centres in various
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locations, including newly constructed buildings.
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These centres will integrate teams of nurses, therapists, and support workers, many of whom
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will be available seven days a week.
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Some centres will even offer short-stay bed facilities, providing comprehensive care for
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those in need.
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Alongside the community centres, the government plans to add 59 dedicated mental health
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accident and emergency departments to the existing 23, many of which will be attached to
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current accident and emergency facilities.
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This expansion is backed by a substantial investment of 343 million British pounds, with
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the first sites expected to open this autumn and further facilities rolling out in March
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2027.
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While the initiative has been widely welcomed, there are concerns about staffing.
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Andy Bell, chief executive of the Centre for Mental Health, stressed the need for investment
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in the workforce to ensure the centres can meet demand.
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He also mentioned the importance of creating dedicated hubs for children and young people.
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Stephen Jones from the Royal College of Nursing echoed these sentiments, noting that specialist
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mental health nurses will be crucial for the success of the new centres.
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Overall, the initiative represents a significant step towards improving mental
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health care access in England.
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By bringing services closer to home and integrating existing healthcare teams, the
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government aims to provide more humane and effective care for those in need.
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As the first centres prepare to open, there's hope that this approach will significantly
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reduce the strain on accident and emergency departments and provide timely support to those
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in crisis.
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In our final segment today, we turn our attention to a significant health alert
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concerning a large cyclosporiasis outbreak linked to lettuce.
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This outbreak has now spread across 15 states in the United States, as confirmed by federal
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health officials.
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The outbreak has been associated with lettuce served at popular restaurant chains such as
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Taco Bell, and also available in some grocery stores.
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Six additional states—Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North
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Carolina—were recently added to the outbreak list after laboratory testing by the United
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States Centers for Disease Control and Prevention indicated that illnesses in these
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areas were probably due to the same strain of the cyclospora parasite.
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This tiny parasite can cause severe gastrointestinal distress, including explosive
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diarrhea, if not treated promptly.
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To date, the Centers for Disease Control and Prevention has reported over 6,000 cases tied
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to this outbreak, with nearly 300 individuals requiring hospitalization and, sadly, two
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fatalities.
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Experts, however, emphasize that the current numbers reflect already existing cases rather
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than an expanding outbreak.
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Bill Marler, a prominent attorney and food safety advocate, noted that the contaminated
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lettuce responsible for the illnesses was likely consumed or discarded some time ago.
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The Centers for Disease Control and Prevention has activated a level 3 emergency response,
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which is the lowest level, indicating that while the agency is actively monitoring the
23:12
situation, the risk to the general public remains low.
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This response allows the Centers for Disease Control and Prevention to reallocate staff
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resources to assist in the ongoing investigation and ensure public safety.
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Interviews with those affected revealed that many had consumed lettuce, often shredded
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iceberg lettuce from Taylor Farms, a major supplier to restaurants like Taco Bell.
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In response, Taylor Farms de Mexico has recalled all iceberg lettuce grown in central
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Mexico, including salad kits sold in grocery stores, as a precautionary measure.
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The company is also conducting an extensive review of its safety procedures and protocols.
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Taco Bell has taken steps to remove the affected lettuce from its locations in certain
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states.
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Despite lettuce being a primary suspect, not all cases may be linked to it, as some
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individuals who fell ill did not report consuming lettuce.
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This has led state health officials to consider other potential contaminated sources that may
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have contributed to the outbreak.
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In a broader context, the Centers for Disease Control and Prevention has reported over 22,700
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cases of domestic cyclosporiasis this season, with more than 10,000 confirmed cases.
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However, the true number of those affected could be much higher, as many people do not
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seek medical attention for diarrhea, and thus cases go unreported.
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Estimates suggest the actual number of infections could reach up to one million
24:46
Americans this summer.
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The United States Food and Drug Administration has been investigating several clusters of
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cyclosporiasis cases this summer, yet in many instances, the exact cause of the outbreak
24:59
remains unidentified.
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This ongoing situation highlights the challenges in tracking and controlling
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foodborne illnesses, especially when multiple sources may be involved.
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As we conclude today's episode, it's crucial to stay informed about such public health matters
25:16
and take precautions, particularly when consuming fresh produce.
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We will continue to monitor the situation and provide updates as more information becomes
25:24
available.
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Thank you for joining us on Morning Medical with Dr.
25:28
Chow.
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Wishing you a healthy and safe day ahead.
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Goodbye for now.