New insights on golf, plant protein and joint replacements

Medical Minutes

Boosting veggie intake may benefit the brain

What you eat on a daily basis may be very important in terms of preventing dementia and Mild Cognitive Impairment (MCI), a condition that often precedes full-blown dementia. A new study shows that there may be hidden brain benefits from eating more vegetables. Postmenopausal women who ate high levels of plant protein had lower risks of premature death, cardiovascular disease and dementia-related death compared with women who ate less plant proteins, according to research published in the Journal of the American Heart Association.

Researchers analyzed data from more than 100,000 postmenopausal women ages 50 to 79 who participated in the national Women’s Health Initiative study between 1993 and 1998. All the women were followed for 20 years. At the time they enrolled in the study, participants completed questionnaires about their diet detailing how often they ate eggs, dairy, poultry, red meat, fish/shellfish and plant proteins such as tofu, nuts, beans and peas. During the study period, a total of 25,976 deaths occurred — 6,993 deaths from cardiovascular disease; 7,516 deaths from cancer; and 2,734 deaths from dementia.

Compared to postmenopausal women who had the least amount of plant protein intake, those with the highest amount of plant protein intake had a 9% lower risk of death from all causes, a 12% lower risk of death from cardiovascular disease, and a 21% lower risk of dementia-related death. Higher consumption of processed red meat was associated with a 20% higher risk of dying from dementia.

Playing golf may benefit older adults with Parkinson’s disease

When it comes to one specific exercise that doesthe most good for adults with Parkinson’s disease, golf may hit above par. A new study is suggesting that golf is even better than tai chi for improving balance and mobility.

“We know that people with Parkinson’s disease benefit from exercise, but not enough people with the disease get enough exercise as therapy,” said study author Dr. Anne-Marie A. Wills, who is with Massachusetts General Hospital, Boston, Massachusetts. “Golf is popular, the most popular sport for people over the age of 55, which might encourage people to try it and stick with it.”

The Boston researchers compared golf to tai chi because tai chi is the gold standard for balance and preventing falls in people with Parkinson’s. The study involved 20 adults with moderate Parkinson’s disease. Everyone was offered 10 weeks of two one-hour group classes per week of golf or tai chi at no cost. Eight people were randomly assigned to practice their golf swing at a driving range while 12 did tai chi. At the start and again at the end of the study, researchers evaluated everyone with tests, including one that measures balance, walking ability, and risk of falling in older adults. For the test, a person is timed while getting up from a chair, walking 10 feet and then returning to the chair and sitting down.

The golfers were 0.96 seconds faster on the test at the end of the study, while those who did tai chi were 0.33 seconds slower. “While the results for golf might be surprising, it’s important to remember that the number of participants in our study was small, and the period over which we studied them was relatively short,” Dr. Wills said. “More research in larger groups of people over longer periods of time is needed.”

Researchers said overall satisfaction with their sport was similar in both groups, however 86% of golfers compared to 33% of tai chi participants were “definitely” likely to continue the activity. “Our finding that golfers were much more likely to continue with their sport is exciting because it doesn’t matter how beneficial an exercise is on paper if you people don’t actually do it,” Dr. Wills said.

Age matters when it comes to outpatient hip or knee replacements

Having hip or knee replacement surgery and going home from the hospital the same day is becoming more common, but it is not

for all patients, according to Dr. Geoffrey Westrich, who is with the Adult Reconstruction and Joint Replacement Service at Hospital for Special Surgery (HSS) in England. Same-day joint replacement is generally performed early in the morning, and the patient goes home at the end of the day.

“Five years ago, outpatient joint replacement was almost unthinkable. But advances in technology, surgical technique and pain management over the past few years have made same-day hip or knee replacement a viable option for patients who meet certain criteria,” said Dr. Westrich, who is an orthopedic surgeon. “During the pandemic, many people find this appealing since they leave the hospital more quickly and can spend their first night after surgery in the comfort of their own home.”

Much smaller incisions and robotic-assisted joint replacement, which allows for ultraprecise positioning of the implant, benefit patients who wish to go home the day of surgery. A study in 2018 by researchers in the United Kingdom found that robotic-assisted total knee replacement was associated with decreased pain after surgery, improved early functional recovery and a shorter hospital stay.

A technique known as multimodal pain management has resulted in better pain control after surgery, another advantage for patients wishing to leave the hospital the same day, according to Dr. Westrich. The technique uses various medications that target multiple pain pathways and generally decrease the need for opioid medications.

Dr. Westrich said adults interested in same-day surgery need to be highly motivated and have a positive attitude. An individual who is very anxious about surgery or experiencing a great deal of stress about recovery may not be a good candidate for same-day joint replacement. Those who have heart or lung issues, diabetes, or sleep apnea do not qualify for outpatient joint replacement.

Adults in their 40s or 50s and 60s tend to be better candidates. Those in their early 70s in very good general health may also be candidates.

“Ultimately, outpatient joint replacement surgery is a choice that patients and their orthopedic surgeon make together after weighing the pros and cons,” Dr. Westrich said. “Even if someone qualifies, it’s an option, not a requirement. Everyone is different and should make a decision based on what makes them feel most comfortable.”

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

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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