Ultra-processed foods take the rap for IBD
A high intake of ultra-processed foods has been associated with the risk of developing IBD (HR 1.82).
A prospective study of 136,384 adults from 21 countries found the association was consistent across Crohn’s disease and ulcerative colitis.
Higher intake of foods such as processed meats (HR 2.07) and soft drinks (HR 1.94) doubled the risk of IBD. Similarly, a high intake of refined sweetened foods (HR 2.58) more than doubled the risk of IBD.
The study suggested non-nutritional components of processed foods such as emulsifiers may have a detrimental effect on the gut – disrupting the microbiota and triggering immune activation.
“As white meat, unprocessed red meat, dairy, starch, and fruit, vegetables, and legumes were not found to be associated with development of IBD, this study suggests that it might not be the food itself that confers this risk but rather the way the food is processed or ultra-processed.”
PPIs improve glycaemic control in people with diabetes
Proton pump inhibitors (PPI) can improve glycaemic control among individuals with diabetes but have no effect on reducing the risk of diabetes in the general population, according to a new meta-analysis.
The analysis that included seven studies with 342 participants found that PPIs reduced HbA1c levels by 0.36% in people with diabetes and lower fasting blood sugar by 10 mg/dl. (0.6 mmol/L)
For individuals without diabetes, the results of the five studies involving 244,439 showed no effect of PPIs on risk of incident diabetes.
“Our research demonstrated that prescribing antacids as an add-on to standard care was superior to standard therapy in decreasing HbA1c levels and fasting blood sugar in people with diabetes,” said study author Dr Carol Chiung-Hui Peng of the University of Maryland Medical Center, in Baltimore.
“People with diabetes should be aware that these commonly used antacid medications may improve their blood sugar control, and providers could consider this glucose-lowering effect when prescribing these medications to their patients,” said co-author Associate Professor Kashif Munir, of the division of endocrinology, diabetes and nutrition at the University of Maryland School of Medicine.
Journal of Clinical Endocrinology and Metabolism
Call for Medicare review of procedural specialist incomes
Procedural specialists are overpaid compared to other specialists and there needs to be a review of the inequities in the Medicare Benefits Schedule, according to two senior physicians.
The high incomes for procedural specialists are not justified by their long years of training, level of skill or the hours worked compared to other physicians or GPs, according to Dr Kerry Breen and Dr Kerry Goulston.
Writing in Pearls and Irritations, they say the imbalance in incomes between specialties has become wider and more distorted in recent years because of a flaw in the original MBS when Medicare was set up favoured procedural work over consultations.
The distortion is now deterring medical graduates from working in low income specialities, and there is an urgent need for the federal health department to commission a new study to review the 2005 Productivity Commission report on how to address the income bias.
“Such a study should also be invited to examine whether the earning differentials between various groups of doctors are justifiable and are in the best interests of the health care system and patients,” they suggest.