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By John Schieszer
Medical Minutes 

Eggs less risky; marijuana more discussed

Medical Minutes

 

June 1, 2018



High egg diet may be beneficial

A diet that includes a lot of eggs may be packed with nutrients and not elevate your risk for heart disease. At least that is the latest findings from researchers at the University of Sydney. They have just published a study showing that eating up to 12 eggs per week for a year did not increase cardiovascular risk factors in people with pre-diabetes and type 2 diabetes.

Published in the American Journal of Clinical Nutrition, the research extends on a previous study that found similar results over a period of three months. Dr. Nick Fuller with the University of Sydney’s Medical School said in the initial trial, participants aimed to maintain their weight while embarking on a high-egg (12 eggs per week) or low-egg (less than two eggs per week) diet. The study showed there were no differences in cardiovascular risk markers identified at the end of three months.

The same participants then embarked on a weight loss diet for an additional three months, while continuing their high or low egg consumption. For a further six months (up to 12 months in total) participants were followed up by researchers and continued their high or low egg intake. At all stages, both groups showed no adverse changes in cardiovascular risk markers and achieved equivalent weight loss, regardless of their level of egg consumption.

“Despite differing advice around safe levels of egg consumption for people with pre-diabetes and type 2 diabetes, our research indicates people do not need to hold back from eating eggs if this is part of a healthy diet,” said Dr Fuller. The extended study tracked a broad range of cardiovascular risk factors including cholesterol, blood sugar and blood pressure, with no significant difference in results between the high egg and low egg groups.

“While eggs themselves are high in dietary cholesterol, and people with type 2 diabetes tend to have higher levels of the ‘bad’ low density lipoprotein (LDL) cholesterol, this study supports existing research that shows consumption of eggs has little effect on the levels of cholesterol in the blood of the people eating them,” said Dr Fuller.

Most oncologists are discussing marijuana with patients

Many patients and their families want to know about medical marijuana for the treatment of cancer-related symptoms. Data from a new survey shows that as many as 80 percent of oncologists have discussed medical marijuana use with their patients. Researchers have just published in the Journal of Clinical Oncology the first nationally-representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state medical marijuana laws.

“The majority of oncologists think it may have utility for certain patients,” said study author Ilana Braun, MD, chief of the Division of Adult Psychosocial Oncology at the Dana-Farber Cancer Institute in Boston, Mass. “We need to bridge this gap so oncologists have the unbiased information they need to assist with decision-making related to medical marijuana use.”

California enacted the United States’ first medical marijuana law in 1996, and today its use is legal in more than 30 states, almost all of which list cancer as a qualifying condition. In the 22 intervening years, however, no randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate symptoms such as pain, insomnia, or nausea and vomiting in patients with cancer.

Many studies have explored the use of pharmaceutical cannabinoids, which are highly refined, quality-controlled products consisting of one or two active ingredients and available through a pharmacy. Non-pharmaceutical medical marijuana, however, is often whole plant, containing hundreds of active ingredients, and thus cannot easily be compared to pharmaceutical cannabinoids.

Recent clinical practice guidelines from the American Society of Clinical Oncology (ASCO) recognize knowledge gaps about medical marijuana use in oncology. The guidelines note insufficient evidence to recommend medical marijuana for initial management of chronic pain in cancer survivors, although evidence suggests it is worthy of consideration as an adjuvant analgesic and for managing pain conditions that are difficult to treat.

Researchers mailed a survey to 400 practicing oncologists in the U.S., randomly selected from a national database of board-certified medical oncologists. Of the 237 participants who responded, more than half (55 percent) practice in states where medical marijuana is legal. The survey asked oncologists about their discussions with patients, recommendations they provided, and their knowledge of medical marijuana. Respondents were also asked about their views on the effectiveness of medical marijuana for cancer-related symptoms such as pain, nausea and vomiting, depression, anxiety, poor appetite, poor sleep, and general coping, as well as its risks compared to other treatments.

Researchers found that most oncologists surveyed had encountered questions about medical marijuana, and many expressed research and education needs to better inform the care they provide to patients with cancer. Less than 30 percent felt knowledgeable enough about medical marijuana to make recommendations. Nearly half (46 percent) recommended medical marijuana use to patients in the past year. More than two-thirds (67 percent) believed medical marijuana to be a helpful treatment for alleviating pain, when used together with standard therapies, and a majority viewed it as presenting a lower risk than opioids for overdose death (75 percent) and addiction (52 percent). Nearly two-thirds (65 percent) also viewed it as equally or more effective than standard treatments for poor appetite and extreme weight loss.

The survey showed where you lived matter. Oncologists practicing in the Western United States were more likely to have discussed (95 percent) or recommended (84 percent) medical marijuana, and oncologists practicing in the South were least likely (69 percent discuss and 35 percent recommend).

The researchers call for clinical trials to address the obvious gaps in knowledge regarding medical marijuana use.

“I think we need to carry out comparative effectiveness studies of medical marijuana to clarify its role,” said Dr. Braun.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

 
 

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