Daniel Sereni, France A large proportion of adults in western countries regularly take vitamins supplements. This represents a huge market. But is it useful? It is well established that vitamins are essential for our health. Vitamin deficiencies provoke diseases and foetal and developmental abnormalities. Children are receiving vitamin D supplements for Ricketts prevention and some elderly people need vitamin D because of proven deficiency. There are indications for folic acid (a group B vitamin) supplementation during pregnancy in defined situations. Vitamin deficiency may result from insufficient intake or absorption, and this can lead to serious complications. Deficiency has also to be prevented or corrected in some diseases (for example intestinal or liver disease) or when people are given certain treatments that interfere with the absorption or the metabolism of vitamins. But millions of people without any recognised or suspected deficiency take vitamins every day (usually “multivitamins“). They do so because some medical publications have suggested that vitamin supplements can prevent major and frequent illnesses like cardio-vascular disease and cancer. Most of these assumptions were based on observational studies. There have been also a few randomised clinical trials comparing the outcome of people receiving a vitamin supplement compared to a group receiving […]

Aart Jan van der Lely, The Netherlands Endocrine disruptors are chemical substances that can interfere with the normal functioning of the endocrine system, which is responsible for producing hormones that regulate various body functions. These chemicals can mimic or block the action of hormones, leading to an imbalance in the body’s hormonal system. There are many sources of endocrine disruptors, including pesticides, herbicides, and industrial chemicals. They can also be found in certain plastics, personal care products, and food packaging. The most well-known endocrine disruptor is probably bisphenol A (BPA), which is found in many plastics and has been linked to a number of health problems, including fertility issues and cancer. Endocrine disruptors can have a range of harmful effects on human health, depending on the specific chemical and the amount of exposure. Some of the potential health impacts include: Reproductive problems: Endocrine disruptors can affect the normal functioning of the reproductive system, leading to infertility, birth defects, and other reproductive problems. Cancer: Some endocrine disruptors have been linked to an increased risk of certain types of cancer, such as breast, ovarian, and prostate cancer. Developmental problems: Exposure to endocrine disruptors during fetal development and early childhood can lead to […]

Verena Briner, Switzerland Paracelsus, a famous physician of the 16th century, wrote ‘everything is poison and nothing is poison. It is a question of the dose’. It is true in alcohol consumption. Factors such as gender, cultural reasons, comorbidities and genetics may contribute to alcohol toxicity. The danger of alcohol consumption lies primarily in alcohol addiction, leading to chronic abuse and organ damage. This results in impaired function of the brain and nerves, the heart, the liver, the pancreas, gastro-intestinal tract, immune system and metabolism. In addition, chronic heavy drinking affects family life, work and causes often economic problems. Alcohol is absorbed fast and about 15 minutes after consumption reaches all organs of the body. Alcohol is mainly metabolized in the liver. However, in the stomach and intestine, alcohol results in the production of acetaldehyde (ACD). The ACD formed is an important factor in alcohol dependence. ACD also increases the release of mediators (histamine and bradykinin) to cause flushing. The of ACD is most severe in the brain and the heart. Abstinence from alcoholcauses increase in calcium uptake in  the cells, causing arrythmia, tremor and even seizures. ACD does not pass the blood-brain barrier. In heart muscle, alcohol causes inflammation […]

Should sodium glucose co-transporter-2 inhibitors (SGLT2-i) be the first choice in the treatment of diabetes type 2? Jan Willem Elte The Netherlands For many years metformin has been the first choice drug in the treatment of diabetes type 2  after, of course, life style modifications have been applied. Recently, however, new classes of diabetes drugs have been investigated.  A new consensus report on the management of hyperglycemia in type 2 diabetes developed and published by the joint scientific associations of diabetes in Europe (EASD) and the United States (ADA) has appeared (published in Diabetes Care 2022). This report now recommends that patients with cardiorenal (heart and kidney ) risks should start with a SGLT2-i or a GLP1-RA ( glucagonlike peptide1-receptor agonist) with proven CVD (cardiovascular disease) benefit. In heart failure (HF) SGLT2-i is prefered. A combination of SGLT2-i and GLP1-RA may also be considered in patients with a very high atherosclerotic cardiovascular disease (ASCVD) risk. Use of both agents is recommended independent of HbA1,c, even if not on metformin. It should, however, be realized that the agents (GLP1-RA even more than SGLT2-i) are expensive. Before going into somewhat more detail, it is good to define what is meant by high […]

Source: BMJ2022;379: e072833 (GA Gaesser et al, Phoenix, AZ, USA) Recent research has confirmed results which have in fact been known for a long time. The walk of Mr Teabag (John Cleese) and Mr Putey (Michael Palin) in the legendary Monty Python Ministry of Silly Walks (MoSW) skit in 1970 were duplicated in 13 healthy adults (22 – 71 years, six women and seven men) with no known gait disorders. Participants performed three 5 minute walks around an indoor 30 m course in an exercise physiological laboratory. The first trial consisted of walking at a freely chosen speed. The next two trials consisted of low efficiency walks similar to the ones of Mr Teabag and Mr Putey (Figure).  The famous silly walks of Mr Teabag (the fictive Minister of Silly Walks) can be described as walking with bow knees, throwing the legs in the air every few steps, and walking backwards sometimes before walking on. The walks of Mr Putey were less pronounced. Ventilation and gas exchange were recorded and collected to determine oxygen uptake (VO₂) and energy expenditure (EE), which were the main outcome measures. VO₂ and EE were about 2.5 times higher during the Teabag walk, but not […]