Latest / Morning Medical with Dr. Chow / Ozempic Approval, Dementia Risk from Diet, and Climate Impacts on Heart Health

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Ozempic Approval, Dementia Risk from Diet, and Climate Impacts on Heart Health · Morning Medical with Dr. Chow

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Welcome to Morning Medical with Dr.
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Chow, your daily update on the latest medical and health news from around the globe, powered
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by artificial intelligence.
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I'm your host, Dr.
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Chi-Ming Chow, a family physician, general internist, and cardiologist, based in Toronto,
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Canada.
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Let's dive into today's top stories.
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Our first story today comes from CBC News, reporting that Health Canada has approved the
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first generic version of Novo Nordisk's Ozempic.
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This is a significant development because it means more affordable options for patients who
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rely on this medication.
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Originally developed by the Danish company Novo Nordisk, Ozempic is primarily used to treat
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Type 2 diabetes, but it's also gained popularity for its off-label use as a
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weight-loss drug.
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The generic version, submitted by Indian drugmaker Dr.
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Reddy's Laboratories, has passed Health Canada's rigorous safety, efficacy, and quality
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standards.
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Dr.
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Kaberi Dasgupta, a physician-scientist and professor of medicine at McGill University,
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expressed optimism about this approval, noting that generics typically lead to substantial
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price reductions.
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This is welcome news for the approximately three million Canadian adults currently taking
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GLP-1 receptor agonists like Ozempic or Mounjaro, with many more expressing interest if
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costs were lower.
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The impact of this approval could be far-reaching.
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The patent for Ozempic expired in Canada in January 2026, opening the door for generic
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versions to enter the market.
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This could dramatically reduce costs for patients.
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Currently, a monthly supply of Ozempic or its counterpart Wegovy can cost between three
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hundred and four hundred dollars, sometimes even more, depending on the dose.
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With the introduction of generics, prices might drop significantly, potentially to around one
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hundred dollars or less.
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Experts like Mina Tadrous, an associate professor at the University of Toronto
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specializing in drug policy, suggest that with multiple generics available, there's a real
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opportunity for cost savings.
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However, whether public and private drug plans will extend their coverage to include the drug
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for obesity remains uncertain.
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Despite the excitement surrounding the approval, medical experts urge caution.
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Dr.
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Dasgupta emphasizes that semaglutide, the active ingredient in Ozempic, should only be
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used under healthcare supervision and in conjunction with a healthy diet and exercise
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regimen.
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She warns against misuse, particularly in individuals with eating disorders or those who
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might experience weight fluctuations, which could be harmful.
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While the exact timeline for when Dr.
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Reddy's generic will become available is still unknown, Health Canada is currently reviewing
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eight other generic submissions.
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As these reviews unfold, the agency will continue to monitor the safety and
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effectiveness of all generic semaglutides on the market.
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Today, we're delving into a fascinating study from Australia that links ultraprocessed foods
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to dementia risk.
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Researchers from Monash University analyzed data from over two thousand dementia-free
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Australian adults aged between forty and seventy.
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They compared the participants' diets to their cognitive function, focusing particularly on
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their intake of ultraprocessed foods.
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The study, published in the journal Alzheimer’s and Dementia by the Alzheimer’s Association,
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found that for every ten percent increase in ultraprocessed food consumption, there was a
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notable decrease in attention scores and an increase in dementia risk.
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Interestingly, this correlation held true even for individuals who generally followed a
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healthy diet, such as the Mediterranean diet.
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Ultraprocessed foods, often packed with sugar, unhealthy fats, and additives, are commonly
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found in packaged snacks, soft drinks, and ready-made meals.
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These foods can contribute to inflammation, insulin resistance, poor blood flow, and
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oxidative stress, all of which are detrimental to brain health.
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Dr.
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Daniel Amen, a renowned psychiatrist and founder of Amen Clinics, emphasizes that the
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brain requires high-quality calories, as it consumes about twenty percent of the calories
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we intake.
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Dr.
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Amen suggests that food can either act as medicine or poison for the brain.
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The study highlights that even a small increase in ultraprocessed food intake, akin to
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consuming a package of chips daily, can lead to noticeable declines in attention.
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This is significant because attention is crucial for learning, memory, decision-making,
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and problem-solving.
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The takeaway here is clear: we should aim to "love foods that love us back." Dr.
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Amen advises choosing foods that grow on plants or come from animals rather than those made in
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factories.
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This means building meals around colorful vegetables, fruits, clean proteins, healthy
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fats, nuts, seeds, and high-fiber carbohydrates.
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Simple swaps, like replacing chips with nuts or soda with water, can make a substantial
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difference.
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For those with a family history of dementia or other cognitive concerns, it's crucial to take
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preventive measures early.
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Dr.
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Amen stresses that the diet is a primary intervention for brain health, not just a side
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issue.
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Remember, with each bite, you're making a choice that can improve your brain's condition.
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Our next story highlights the ongoing challenges and progress in lung cancer
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screening rates across the United States.
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Despite some improvements, these rates remain low and uneven, according to recent research
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published in JAMA Internal Medicine.
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The study, led by Todd Burus, Doctor of Philosophy, from the University of Kentucky,
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used data from the 2024 Behavioral Risk Factor Surveillance System to assess lung cancer
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screening prevalence among eligible adults.
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The study found that about 24.49 percent of survey respondents who met the United States
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Preventive Services Task Force eligibility criteria were up to date with their lung cancer
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screening in 2024.
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This marks a six percentage point increase since 2022, indicating some progress.
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However, adherence to annual screening remains significantly lower compared to other cancer
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screenings, such as colorectal, cervical, and breast cancer.
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Interestingly, the research revealed disparities in screening rates based on age,
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race, ethnicity, and insurance status.
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Screening prevalence increased with age, from just over 11 percent among those aged 50 to 54,
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to over 31 percent among those aged 75 to 79.
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Insurance also played a role, with higher screening rates among those with
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military-related coverage, Medicare, and Medicaid, compared to those without insurance.
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Despite these increases, the study found no improvements in screening rates among Hispanic,
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Asian, or Black adults, highlighting the need for culturally tailored outreach and
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intervention strategies.
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The researchers suggest that community health workers and patient navigators could play a
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vital role in increasing screening uptake in these groups.
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State-level data showed a range in screening prevalence, from about 13 percent in South
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Dakota to over 38 percent in Massachusetts, with the highest rates generally in the
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Northeast.
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While twenty-one states saw significant increases since 2022, the overall low and
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uneven rates signal that more work is needed to address structural barriers and improve access
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to this potentially life-saving intervention.
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In an accompanying editorial note, Doctor Teva D.
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Brender from the University of California San Francisco emphasized the importance of
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integrating lung cancer screening with smoking cessation programs.
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Although there's been a decade of recommendations from the United States
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Preventive Services Task Force, understanding and addressing the barriers that keep high-risk
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individuals from accessing these screenings remains crucial.
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Our next story takes us into the realm of mental health, exploring a fascinating
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development in the treatment of depression.
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Imagine if you could manage your mental health with a device at home, much like taking a daily
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pill.
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This is the promise of transcranial direct-current stimulation, or tDCS, a
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technology that uses a weak electric current to stimulate the brain and is now gaining traction
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as an alternative to antidepressants.
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In England, tDCS has been approved for treating depression since 2019.
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It can be prescribed by a doctor or even purchased over the counter, where it sells for
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around five hundred and thirty dollars.
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Recently, the United States Food and Drug Administration gave its approval to a device
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made by the Swedish company Flow Neuroscience, marking a significant milestone for this
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technology.
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This approval signifies a shift in psychiatry's toolkit, expanding beyond the traditional
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reliance on selective serotonin reuptake inhibitors, or S.S.R.I.s, which have been the
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default treatment for depression since the late 1980s.
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The basic idea behind neuromodulation, which includes tDCS, is that depression may be partly
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due to impaired neural connectivity.
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By stimulating the brain electrically, the threshold for neurons to fire off signals is
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lowered, potentially helping the brain to function better overall.
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While this might sound more exotic than adjusting brain chemistry with medication, it's
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important to remember that electricity is actually the brain's natural language.
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Dr.
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Mark George, a leading expert in neuromodulation, explains that this method of
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brain stimulation is vastly different from electroconvulsive therapy, or ECT, which is
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known for its more intense and invasive approach.
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Instead, tDCS offers a non-invasive, portable option for at-home treatment.
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This makes it more accessible, allowing individuals to manage their mental health
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without the need for frequent clinic visits.
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Despite the potential, the journey of tDCS has not been without challenges.
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Early clinical trials produced mixed results, and some studies showed that the device was no
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more effective than a placebo.
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However, the recent trial leading to FDA approval indicated more promising results, with
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a notable percentage of participants experiencing improvement in their depression
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symptoms.
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It's important to note that the FDA approved tDCS as a first-line treatment for depression,
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to be used on its own or alongside other treatments like antidepressants.
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This opens up possibilities for more focused studies on its effectiveness and the
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development of new devices.
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Researchers are now working to enhance tDCS by exploring combinations with other treatments
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and personalizing the technology to an individual's brain anatomy.
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The allure of at-home brain stimulation lies in its potential to change the current,
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pill-centric paradigm of mental health treatment.
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It challenges psychiatrists to think beyond traditional notions of serotonin deficiencies
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and consider broader approaches to getting the brain unstuck.
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Some practitioners have found success using tDCS to help patients reduce or avoid
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antidepressant use, especially for those who are neurodivergent and may not want to add an
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S.S.R.I.
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to their treatment plan.
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For individuals like Sophie Davies, who struggled with postpartum depression, tDCS
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offered a new sense of hope.
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After trying the device, she reported feeling clearer and more optimistic about her ability
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to be a good parent.
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While it's difficult to pinpoint exactly what contributed to her improvement, whether it was
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the tDCS, the antidepressants, or a combination of factors, the shift in her mental state was
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significant.
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This story underscores the potential of tDCS to transform mental health treatment, offering an
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alternative path to well-being.
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Today, we're exploring an intriguing study on dietary changes and kidney health, specifically
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focusing on chronic kidney disease, or CKD.
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Researchers have found that a moderate reduction in protein intake could be beneficial
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for patients with CKD, particularly those in stages 3 and 4 of the disease.
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This study, conducted in Israel, followed over five hundred patients for fifteen years to
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assess the impact of dietary protein intake on kidney outcomes.
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The study revealed that patients who adopted a moderately protein-restricted diet had a
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twenty-three percent lower risk of progressing to a composite outcome.
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This outcome included a fifty percent or more decline in estimated glomerular filtration
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rate, initiation of long-term dialysis, or all-cause mortality.
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Notably, the risk of starting dialysis was thirty-five percent lower among those who
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followed the diet.
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Dr.
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Ilia Beberashvili and colleagues from Yitzhak Shamir Medical Center reported these findings
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in JAMA Network Open.
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They emphasized that while the risk reduction from dietary changes was smaller compared to
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recent pharmacologic interventions, it remains clinically meaningful.
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This suggests that dietary intervention could play a significant role in managing residual
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renal risk, even as pharmacological treatments advance.
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The study supports existing guidelines recommending CKD patients limit protein intake
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to between 0.6 to 0.8 grams per kilogram per day.
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However, the researchers point out that even moderate restrictions can provide meaningful
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benefits, without the need for strict dietary targets.
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This makes dietary changes more practical and achievable in real-world settings, where strict
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adherence can be challenging.
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The retrospective cohort study included patients with CKD stages 3 or 4, not on
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dialysis, receiving care at an Israeli center between 2007 and 2022.
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The average age of participants was sixty-seven years, and about forty percent had diabetes.
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The study assessed dietary protein intake using twenty-four-hour urinary nitrogen excretion,
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adjusted for body weight.
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Patients were categorized into two groups: those with low normalized dietary protein
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intake, less than one gram per kilogram per day, and those with higher intake.
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Interestingly, the study found consistent benefits across various subgroups, including
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age, sex, ethnic groups, diabetes status, and CKD stage.
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However, the researchers noted that the study's conclusions might be limited due to the low
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uptake of certain medications, such as SGLT2 inhibitors and GLP-1 receptor agonists, during
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the study period.
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These findings underscore the potential of moderate dietary changes as a practical
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approach to managing CKD.
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Dr.
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Beberashvili highlighted the need for further research to define optimal protein intake for
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different CKD populations, suggesting that moderate, achievable dietary changes, coupled
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with objective monitoring, could be more feasible than strict dietary targets in
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everyday practice.
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Our final story today delves into the intersection of climate change and
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cardiovascular health.
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A compelling study presented at the European Association of Preventive Cardiology congress
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sheds light on how extreme weather events may be driving an increase in heart attacks and
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strokes.
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Conducted in Eastern Poland, the research analyzed data from over eight million residents
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between 2011 and 2020, a period marked by significant climate fluctuations.
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The study recorded more than 573,000 major adverse cardiovascular and cerebrovascular
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events during this decade.
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Researchers found that both heat waves and cold snaps contribute to these health crises, albeit
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in different ways.
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Heat waves seem to have an immediate impact, with major cardiovascular events spiking by
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7.5% and cardiovascular deaths increasing by 9.5% on the day of the occurrence.
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In contrast, cold waves show a delayed but sustained effect, with the risk of major events
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rising between 4% and 5.9% in the days following exposure.
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The role of air pollution in exacerbating these risks cannot be overlooked.
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The study attributed approximately 13% of all cardiovascular deaths to pollution, accounting
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for over 71,000 years of life lost during the ten-year period.
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This underscores the considerable hazards posed by the combination of extreme temperatures and
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air pollution.
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Interestingly, the research challenges traditional assumptions about which
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demographics are most vulnerable.
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Contrary to expectations, monthly increases in pollution exposure were particularly dangerous
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for groups often considered lower risk.
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The study reported a 5% higher risk of cardiovascular events in women compared to men,
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and a 9% higher risk in individuals under the age of 65 compared to their older counterparts.
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Professor Lukasz Kuzma from the Medical University of Bialystok, who led the study,
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emphasized the need to modernize how we assess cardiovascular risk by incorporating
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environmental factors.
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This includes exploring the impacts of light and noise pollution, with the aim of developing
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a comprehensive cardiovascular risk prediction algorithm that could better target preventive
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efforts.
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The findings from this study highlight the urgent need for a broader understanding of how
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climate change affects our health, particularly through its impact on cardiovascular events.
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As we continue to experience more frequent and severe weather patterns, integrating
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environmental considerations into public health strategies will be crucial in safeguarding our
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communities.
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That wraps up today's episode of Morning Medical with Dr.
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Chow.
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Thank you for joining me as we explored the latest developments in medical and health news.
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Remember, staying informed is a key step in managing your health.
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Be sure to tune in tomorrow for more insights.
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Until then, take care and stay healthy!