Male Visceral Fat Leading to Cardiac Conditions

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"Males tend to suffer from obesity at a younger age than females due to the protective effect of  estrogen on the female metabolism. Males generally tend to be more obese and tend to have more visceral obesity, which is sometimes described as 'beer belly'."

"The effect of obesity on the heart has been studied previously also in population-based studies."

"Most studies predominately classified obesity according to BMI [body mass index] and they found that a high BMI is associated with cardiac dilatation."

"Fewer studies investigated 'visceral' obesity according to WHR [waist-to-hip ratio], and some did not find a different effect of visceral obesity compared to general obesity."

"Moreover, many studies used echocardiography [ultrasound test that checks the heart's structure and function] to investigate how obesity impacts the heart's anatomy, which is broadly available but does not allow for further tissue characterization."

Dr. Jennifer Erley, radiology resident, University Medical Center, Hamburg-Eppendorf, Germany

 

Men with higher waist-to-hip ratios showed early signs of heart damage even when their overall weight wasn’t very high. (iStock)

New  research now points to belly fat as being particularly problematic in the potential danger it poses to the male cardiac system. Abdominal obesity -- recognized as an unhealthy hip-to-waist ratio -- has been found to be associated with worrying patterns of 'cardiac remodelling' overturning the  assumption that overall weight alone is the culprit. This was discovered by researchers studying advanced cardiovascular MRI [magnetic resonance imaging] scans of 2,244  adults between the ages of 46 to 78 with no known heart disease.

 

According to the authors of the paper published in research presented at the annual meeting held in Chicago of the Radiological Society of North America, these findings "highlight the need for personalized risk assessment in obesity-related cardiovascular disease". An estimated 3 billion people worldwide are overweight or obese. This is an epidemic that significantly contributes to many other chronic health conditions such as high cholesterol levels, Type 2 diabetes, high blood pressure and sleep disorders, and places them at  higher risk of coronary artery disease and death from cardiovascular issues.

 

According to Statistics Canada, Canadians are experiencing "high and growing levels" of fat stored around the waist and stomach. Nearly half (49 percent) of adults in Canada aged 18 to 29 had a waist circumference greater than the threshold for abdominal obesity. In other words, higher than 102 centimetres for males and 88 cm for females.  

 

(The Image Bank, Getty Images)

"Similar to previous studies we found a high BMI is associated with bigger heart chambers, indicated by increased cardiac volumes [the amount of blood the heart holds and pumps] and an accompanying hypertrophy [thickening of the heart muscle]."

"Abdominal or visceral obesity, on the other  hand, was associated with a proportionally greater hypertrophy but smaller heart chambers."

"This form of remodelling where the heart muscle thickens but does not enlarge, is called 'concentric remodelling' and we know from previous studies that this form of remodelling is prone to lead to heart failure."

Dr. Jennifer Erley 

 

Up to three hours collectively of weekly physical activity is deemed to be sufficient to enable abdominal fat reduction. Physical exercise connected with dietary changes in some instances help to reduce abdominal obesity, even without achieving overall weight loss. Lifestyle changes leading to weight loss helps to improve blood sugar, blood pressure and cholesterol levels; factors referred to as metabolic syndrome. Inflammation is reduced, blood vessel function is improved and non-alcoholic fatty liver disease is eased.

Obesity may account for a fifth of all cases of atrial fibrillation -- quivering or irregular heartbeat. Each of the research subjects were measured for the size, thickness and volume of the heart's chambers through high-resolution MRI scans. Detailed health information, including weight, blood pressure, cholesterol, smoking status, and any history of diabetes was collected for all participants. The research conclusions led to clarification of the conundrum that some people with normal or moderately elevated BMI develop heart disease and others whose weight is considerably greater may not 

"The male heart is exposed to the effects of obesity longer than the female heart."

"The sex-specific differences suggest that male patients may be more vulnerable to the structural effects of obesity on the heart, a finding not widely reported in earlier studies."

"Rather than focusing on reducing overall weight, middle-aged adults should focus on preventing abdominal fat accumulation through regular exercise, a balanced diet and timely medical intervention, if necessary." 

"Nowadays, we have a broad variety of therapeutic strategies to tackle visceral obesity and it's important to address obesity as a 'pathology', just like arterial hypertension and diabetes."

"Patients and clinicians should  take obesity [particularly the accumulation of abdominal fat] just as seriously as those other pathologies."

Dr. Jennifer Erley

 

Cardiac MRI scans revealed thicker heart walls and smaller chamber volume in people with excess belly fat. (iStock)

 

A Potential Solution to Offset Dementia Onset

Pascal Geldsetzer

"All these associational studies suffer from the basic problem that people who go get vaccinated have different health behaviors than those who don’t."

"In general, they’re seen as not being solid enough evidence to make any recommendations on."

"Because of the unique way in which the vaccine was rolled out, bias in the analysis is much less likely than would usually be the case."

"What makes the study so powerful is that it’s essentially like a randomized trial with a control group — those a little bit too old to be eligible for the vaccine — and an intervention group — those just young enough to be eligible."

"It was a really striking finding. This huge protective signal was there, any which way you looked at the data."

"The most exciting part is that this really suggests the shingles vaccine doesn’t have only preventive, delaying benefits for dementia, but also therapeutic potential for those who already have dementia."  

Pascal Geldsetzer, senior study author, assistant professor, Division of Primary Care and Population Health, Stanford University

(Image Credit: PeopleImages/Shutterstock) 

 

"These findings are promising because they suggest that something can be done."

"Obviously the vaccine was not designed or optimized to prevent dementia, so this is sort of an incidental finding."

"In some ways, we are being lucky."

Alberto Ascherio, professor of epidemiology and nutrition, Harvard School of Public Health 

Researchers earlier this year reported that the risk of developing dementia can be cut by 20 percent over a seven-year period through vaccination with the shingles vaccine. Shingles vaccination was found by a large follow-up study to protect against risks at various stages of dementia, including for those people already diagnosed with the disease. Published in the journal Cell on Tuesday, the research found that  cognitively healthy people who were vaccinated were less likely to develop mild cognitive impairment, an early symptomatic preceding dementia onset.

 

The study suggest that the shingles vaccine which consists of two doses -- recommended for adults age 40 and older or for individuals 19 and older with a weakened immune system -- may help those who already have been affected with dementia. Over a nine-year period, those who received the vaccine were some 30 percent less likely to die of dementia. Which suggests that the vaccine may slow the neurodegenerative syndrome's progression. 

 

Anupa Jena, a professor of health care policy at Harvard Medical School, and a physician practising at Massachusetts General Hospital who reviewed the paper, remarked that "It appears to be protective along the spectrum or the trajectory of the disease".  Researchers are reacting with cautious optimism and excitement over these results.

 

Maxime Taquet, an associate professor at Oxford University who has conducted research into shingles vaccination and dementia risk, lauded the research, explaining that "If the findings are confirmed, then this would be groundbreaking for dementia. I think there's no other word for it", he went on. 

 

The scientists who conducted the research took advantage of an age cutoff in how Wales rolled out its shingles vaccination program in 2013 to measure dementia impact, in view of the fact that randomized controlled trials -- the gold standard in medical research -- are often unfeasible in the real world. The conclusion that a common vaccine may succeed in protecting the brain represents a bonanza finding. 

 

When Wales introduced the shingles vaccine for older adults in 2013, while those 79 years of age were eligible to receive the vaccine, those who had turned 80 were deemed ineligible. "Just a one-week difference across this date-of-birth cut-off means that you go from essentially no one getting vaccinated to about half of the population getting vaccinated," explained Professor Geldsetzer.

 

The Wales nationwide electronic health records meant that the researchers were able to study the entire population of Wales born between September 1925 and September 1942, to determine how dementia risk was affected by vaccine status. The researchers' focused analysis on those closest to either side of the eligibility for the shingles vaccine to ensure the study group was as close to the same age as possible.

 

"We know that if you take a thousand people at random born in one week and a thousand people at random, born a week later, there shouldn’t be anything different about them on average. They are similar to each other apart from this tiny difference in age. What makes the study so powerful is that it’s essentially like a randomized trial with a control group — those a little bit too old to be eligible for the vaccine — and an intervention group — those just young enough to be eligible", Professor Geldsetzer said.

 

 

A new study out of Wales has found those who received the shingles vaccine were 20 per cent less likely to develop dementia over the next seven years than those who did not receive the vaccine. (Carsten Koall/Getty Images)

 

"If the shingles vaccine really prevents or delays dementia, then this would be a hugely important finding for clinical medicine, population health, and research into the causes of dementia."  

"There is a growing body of research showing that viruses that preferentially target your nervous system and hibernate in your nervous system for much of your life may be implicated in the development of dementia."

"It suggests that from a clinical public health perspective, we should be providing this potentially at early stages, maybe on a regular basis."

Professor Pascal Geldsetzer 

 

 

"Harm Reduction" In Ontario

"You've basically got a doctor anywhere in the province telling a pharmacy somewhere else in the province to go ahead, give this person [hydromorphone] tablets."

"It's not medicine. It's just wrong."

"[There is] no  way [that patients receive adequate care under this] predatory [form of telemedicine]."

Dr. Lori Regenstreif, addiction physician, Hamilton, Ontario

 

"Many [clinics] operate virtually, with physicians seeing patients every one to two minutes from within a pharmacy setting ... Pharmacies benefit financially through high dispensing and witnessing fees, while physicians incur virtually no overhead costs."

"Urine drug testing is often performed on-site with kits supplied by the pharmacy, further blurring the lines of accountability."

"There appears to be no consistent intake process, documentation standards, or clinical guidelines governing these practices."

Dr. Janel Gracey, addiction physician, Ontario

 

"It's laziness on behalf of the physician, and it's for financial reasons."

"You can see a lot of patients by video link and get a video premium for conducting that service."

"[The practice is] dangerous to society."

Dr. Martyn Judson, addiction doctor, Ontario 

The term 'safe supply' has been used colloquially by advocates and politicians to refer to the practice of providing people with opioid use disorder alternative drugs that are safer than the street supply. (Ben Nelms/CBC)

 

Dr. Judson, as it happens, pioneered Ontario's use of methadone in the 1990s, reasoning that it would inevitably lead to weaning drug addicts away from their harsh addictions. It is the rationale behind most provinces in Canada establishing 'safe supply' prescribing free recreational drugs to addicts with minimal supervision, assuming that riskier street substances would no longer be attractive to those addicted to hard drugs of the opioid family when less harmful drugs were supplied to them free of charge. 

 

This was a 'do-good', 'feel-good' initiative that gained traction as a result of rising overdose deaths throughout the country, when deadly fentanyl began to make an impact, often used by drug dealers as fillers with other drugs. British Columbia, where overdose deaths skyrocketed made liberal use of safe injection sites, believing that handing out drugs without supervision would lower the risk of street drug use, mostly fentanyl. Until reports began circulating that the free drugs were showing up on the street, where those receiving them sold them to finance the more harmful drugs the initiative meant to keep them from. 

People take part in a rally in support of the Drug User Liberation Front after the arrest of two workers in Vancouver on Nov. 3, 2023. (Ben Nelms/CBC)

 

The federal government had given its approval to the British Columbia experiment of legalizing all drugs meant for personal use under the safer supply pilot, and then withdrew from and defunded the project when evidence began to accumulate of the pilot's failure. Just as the government of British Columbia itself stepped back from the kind of 'harm reduction' that was fuelling greater drug use, even to impacting a younger demographic for whom the rejected drugs became an introductory course on drug use, at a more affordable street price than harder opioids.

 

Now, in British Columbia, safer supply doses must be consumed under medical supervision, minimizing diversion. In Alberta, safer supply prescribing is functionally banned. Yet in Ontario little attention is given to the money-making 'electronic pill mills' where some medical practitioners set themselves up as one-stop pill-prescribing agents in an easy approach to over-prescribing drugs to the addicted, in concert with certain pharmacies in coordinated protocols financially beneficial to prescriber and supplier, but deadly to their consumers.

 

Nauman Shaikh, a pharmacist and owner of the downtown Medpoint Care Pharmacy, says he's seen positive changes in patients who are prescribed opioids they would otherwise have to buy on the street. (Kate Dubinski/CBC)

 

Video booth set-ups at pharmacies operate like confessionals; confess and forgiven. Safer supply in Ontario is being co-opted by tele-prescriptions. Drug users simply enter the premises at will to receive massive opioid prescriptions following several minutes of remote consultation; essentially rubber-stamping requests for drug supply, courtesy of the taxpayer. The user, on having their prescription filled at the pharmacy then is free to sell their drugs on the street for the formulaic transaction of resale funding a more desired drug acquired on the street.

 

These taxpayer-funded billings enrich both physician and pharmacy. And please the drug user no end for the freedom to dispense of the unwanted drug and alternately shop for the drug of choice. Large volumes of drug users simply pick up their prescriptions and they can be multiple times daily, while pharmacies collect extra dispensing fees to fatten their bottom line. Whereas in responsible addiction medicine, regular physical exams of patients and attention to psychosocial stabilization and recovery are bypassed.

 

 Concerned physicians who treat the drug-addicted, aware of what is transpiring have attempted to report the issue to the College of Physicians and Surgeons of Ontario whose purpose is to regulate doctors operating in the province. Yet despite Addiction Medicine Canada, an advocacy group led by physicians having sent the College formal requests for safer supply reform, there has been no response.  

 

“We know that there has been an issue with diversion, but we really do believe that safe supply is an evidence-based approach in saving lives,” insists Minister of Mental Health and Addictions. Photo by Darryl Dyck  /The Canadian Press

 

South Korea: ChatGPT becomes Exam CheatGPT

Yonsei University in Seodaemun-gu, western Seoul (Korea Tourism Organization via Getty Images Bank)

"A.I. is a tool for retaining and organizing information so we can no longer evaluate college students on those skills."

"[Students should be tested on their creativity which A.I. cannot replicate]." 

"The current method of  education is already out of date." 

Park Joo-Ho, professor of education, Hanyang University, Seoul, South Korea 

 

"It's inevitable that A.I. will affect our education."

"[To find research papers and aid in translating between English and Korean, I used ChatGPT] but if students break a pact with their professors to refrain from using it, [then it is a matter of trust and a bigger issue."

Ju Yuntae, Yonsei University student 

University students are seen in a lecture hall at a university in Busan on Sept. 1. [YONHAP]

 

 In South Korea, mid-term university exams have been completed and with that a sudden scandal has been revealed with the nation's most prestigious institutes of higher learning, those elite universities referred to  by the acronym SKY identifying the elite institutes of higher education in the Korean hyper-competitive world of education. The discovery that dozens of students have indulged in the use of textbooks, computer programs, even ChatGPT during online midterm examinations. The irony here is that the  course involved was itself on ChatGPT.

 

This revelation occurred when a professor at Yonsei University in Seoul  discovered the clandestine cheating taking place. When the story hit the news, two other top-tier schools in South Korea -- Seoul National University and Korea University found similar mass cheating had been discovered with students using A.I. on recent tests. Typically such incidents are found in 'lesser-reputed' universities. The discovery that underhanded student actions on tests at the elite universities sent the nation's academic reputation into a headspin.

 

In South Korea (as in Japan) the highly competitive arena of successful students leaving high school to  enroll in university with grades in the stratosphere ensuring their acceptance at these Ivy League schools represents frenetic studies toward such academic achievements and future upward social mobility. South Korea can boast one of the highest proportions of college graduates among developed countries where most students ply themselves to achieve the marks required to qualify for entrance at SKY* schools. 

 

To qualify for entrance acceptance at one of these top-tier schools, a high score on an eight-hour college entrance exam to test knowledge of Korean, mathematics, English and other subjects must be achieved. Over half of the nation's million high school seniors sit for the exam taking place on November 13. On that traditional day, flights are grounded, construction halted and there are enforced traffic restrictions to keep ambient sound to a minimum to enable students to concentrate on their exam performance.

 

High school students are seen during the College Scholastic Ability Test (CSAT), also known as Suneung, at a school in Suwon, Gyeonggi on Nov. 13. [JOINT PRESS CORPS]

 

Over 90 percent of college students in South Korea with generative A.I. experience acknowledge their use of such tools on school assignments, according to a 2024 survey by the Korea Research Institute for Vocational Education and Training.  

"Some professors don't like us using A.I. "

"Some encourage it because it helps solve problems quickly."

"[However], there isn't really a way you can stop students from using it."

Lee T.H., graduate student of computer engineering, Seoul National University 

 

*SKY schools = Seoul National University, Korea University, Yonsei University