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Medscape
18 hours ago
- Health
- Medscape
Can Cold Exposure Alter Energy Dynamics in Obesity?
In individuals with obesity, 90 minutes of cold exposure increases energy expenditure by 18% but also raises energy intake and causes significant discomfort. METHODOLOGY: There is a growing interest in using cold exposure as a potential weight loss strategy via its ability to increase energy expenditure and create a negative energy balance. Researchers assessed the effects of moderate cold exposure on energy expenditure, energy intake, and appetite regulation in 29 women (mean age, 27.6 years) and 18 men (mean age, 31.5 years) with obesity who engaged in fewer than two 30-minute continuous exercise sessions per week. Participants underwent two 90-minute sessions — one at 10 °C and one at ambient temperature — in a random order, separated by a minimum 2-week washout. A single dose of cold exposure involved wearing a liquid-conditioned suit with circulating diluted antifreeze. Researchers measured thermal comfort/sensation, subjective appetite (via visual analog scales), energy expenditure (via indirect calorimetry), and energy intake with a validated food menu that calculated total food consumed; blood samples were analyzed for appetite-related peptides. TAKEAWAY: Compared with exposure to ambient temperature, cold exposure over 90 minutes led to: An 18% increase in energy expenditure primarily due to increased glucose oxidation ( P < .001) Significantly reduced average skin temperature (33.0 °C vs 24.5 °C, respectively; P < .001) and decreased thermal comfort Increased energy intake during lunch following intervention ( P = .008), especially from carbohydrate and protein consumption ( P = .007 and P = .014, respectively), although intake decreased for the rest of the day ( P = .049) Decreased leptin level ( P = .004) and increased level of total glucagon-like peptide 1 ( P = .003) No significant changes were observed in subjective appetite, such as hunger, desire to eat, and fullness. IN PRACTICE: 'The negligeable impact on [energy expenditure], as well as the overall absence of effects on [energy intake], seem to make [cold exposure] an unlikely candidate for improved body weight control in individuals with obesity,' the authors wrote. SOURCE: The study was led by Kurt McInnis, University of Ottawa in Ottawa, Ontario, Canada. It was published online in International Journal of Obesity . LIMITATIONS: Energy expenditure was measured in a postprandial state, potentially masking the true effects compared with fasting conditions. The study used only a single dose of cold exposure, so the effects of repeated exposure remain unknown. Core body temperature was not measured. DISCLOSURES: This study was supported by a grant from the Canadian Institute of Health Research. One author disclosed receiving support from Bausch Health Canada. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. Credit Lead image: Intoit | Dreamstime Medscape Medical News © 2025 WebMD, LLC Cite this: Can Cold Exposure Alter Energy Dynamics in Obesity? - Medscape - June 05, 2025.
Health Line
3 days ago
- General
- Health Line
8 Tips for Reducing Screen Time
Some ways you can reduce screen time include using greyscale, turning off notifications, and engaging intentionally with content. Screen time is not inherently bad. However, too much screen time can be harmful. Excessive screen time is associated with health problems such as binge-eating disorder and sleep problems. If you are looking to reduce your screen time, you may consider implementing one or more of the following eight tips. Track your screen time The first step toward making a change is understanding the scope of the situation. Many devices track screen time. You can see the average amount of time spent on your device, how much time you've spent on specific applications, and even how many times you have picked up your device. If your device lets you see how much time is spent on each application, you can delete the apps you spend the most time on. This way, you cannot access the applications easily. Use greyscale You may consider putting your phone or other device in greyscale mode if it is an option. This will remove all colors from your screen, which may make your phone less gratifying. A 2023 study found that individuals who put their phone in greyscale saw reduced screen time. The study also found that participants were aware of their problematic smartphone use behavior, and that setting the phone in greyscale reduced this behavior. A 2019 study found that greyscale reduced the screen time in college students by an average of 37 minutes per day. Turn off notifications It can be tempting to pick up your phone when it is constantly alerting you about random things. In your settings, you can change which apps can send you alerts. This way, you may not feel the need to pick up your device. Some devices also have a 'do not disturb' or 'focus' setting, in which only urgent notifications will come through. Other people may be alerted to this setting and know you are not able to respond right away, such as in your messaging app. Designate no screen times Set certain times or situations in which you will not use your phone. For example, you may decide that you will not use screens during meals or when you are with friends. This can help you stay grounded and engaged during these activities. You may also consider not using your phone right before bed, as this can disrupt your sleep. Pick up a hobby If you are cutting out time spent on your phone, something else will have to fill that time. This is a perfect opportunity to explore activities you want to try or rediscover an old hobby you are passionate about. Some activities you may consider can include: meditation or yoga meeting with friends in-person journaling or creative writing reading coloring crafting activities, such as crocheting or scrapbooking engaging in exercise, such as taking a walk studying something independently, such as learning a new language Reducing your screen time may feel easier if you feel fulfilled by other activities. Talk about it It is easier to make a change with a support system rather than doing it alone. Giving voice to the issue can make it feel more 'real.' Your friends and loved ones can hold you accountable to your goals. You may find that they also want to cut down their screen time, and you can make changes together. Engage intentionally With social media, it can feel like there are an infinite number of things to keep up with at all times. For example, news can be shared at all hours of the day instead of just during scheduled broadcasts. You may consider setting certain times to check for news and to check up on your friends instead of constantly scrolling. This can allow you to stay keyed in to things that are happening without feeling overwhelmed. You may also consider removing people you do not know and accounts that make you feel bad from your social media following. This way, you will not see them in your feed. Use screen time positively Limiting screen time does not mean cutting it out altogether. There are several positive ways to use screen time, such as video chatting with loved ones and watching movies at the same time with long-distance friends. The next time you are using your phone, pay attention to how it makes you feel. For example, you may feel happy while talking with friends or listening to music, but you may feel sad while scrolling endlessly on social media. This way, you can keep the apps that make you feel good about yourself and focus on reducing your engagement with the apps that do not. Be kind to yourself When making a big change, you may not achieve the results you want overnight. This is true for reducing screen time. You may not be able to completely cut out all of your screen time immediately — reducing it gradually may be a more realistic approach that you are likely to maintain. Your progress also may not be linear. You may not use screens at all on one day, and use screens all day the next. This is perfectly OK. You can always pick yourself up and try again the next day. Takeaway Reducing screen time can positively impact your health. You may rediscover old hobbies, have more time for connecting with friends and family, and have a more positive experience when you are using your devices. It is important to remember that reducing your screen time can be a trial-and-error process, and it could take a long time before you see changes. Try not to feel discouraged if you face setbacks.
Medscape
3 days ago
- Health
- Medscape
Lower Blood Pressure Targets for Type 2 Diabetes
This transcript has been edited for clarity. Today I am going to discuss a recent paper on intensive blood pressure control in people with type 2 diabetes. This was a big study. It included over 12,000 participants who were older than age 50, and had type 2 diabetes and an increased risk for cardiovascular disease; either they'd had a prior cardiovascular event, had two or more risk factors, or had a reduced estimated glomerular filtration rate (eGFR). The study was performed in China and it was really done to determine, potentially once and for all, what the target should be in treating patients with type 2 diabetes. The ACCORD trial tried to answer this question, but it didn't show overall improvement in outcomes with blood pressure reduction, although when they did subset analysis, they did show benefit in certain groups. It still didn't have that definitive feel, and I think this study does. They were looking only at systolic blood pressures, and they wanted to target a systolic blood pressure of less than 120 mm Hg in the intensively treated group; in the standardly treated group, the blood pressure target was a systolic of less than 140 mm Hg. The primary endpoint was nonfatal stroke, nonfatal MI, treatment or hospitalization for heart failure, or death from cardiovascular disease causes. In this study, 45% were women. The average age was 63.8 years. Body mass index was 26.7 and 25% smoked. The baseline blood pressure was 140/76 mm Hg and the mean blood pressure over approximately 4 years of follow-up was 121.6 mm Hg in the intensively treated group vs 133.2 mm Hg in the standard treatment group. You basically began to see a difference between the two in terms of the primary endpoint after about a year, so you started to see this split. At the end of the study, there was a very significant difference in terms of the primary endpoint between the two groups. I want to point out that, in my brain, those blood pressure targets that were reached are actually fairly standard. The intensively treated group was about 120 mm Hg, and that's compared with the standard treatment group, which was around 130 mm Hg. I must say that, in my own practice, given all the changes that we've seen over the years in blood pressure targets, the results from this study have actually motivated me to lower my systolic target, at least in terms of how I treat patients in clinic, because I think they may get further benefit. That then begs the question of how did they measure blood pressures in this study? I get patients who have what's called white coat hypertension. They come into my office, their blood pressure is higher, and then I have them test at home and it's better. In this study, they tried to take away some of that interference. They had patients come into clinic having had no exercise, no coffee, and no cigarettes for at least 30 minutes before their appointment. The patients had 5 minutes of seated rest, and then they had three blood pressure measurements, each done 1 minute apart. There was no talking or joking around. They just sat there and had their blood pressures measured in the appropriate way. The average systolic blood pressure was used of those three readings to determine whether treatment was changed. They followed pretty standard treatment regimens for hypertension, which are the ones we use in our ADA guidelines for the management of hypertension. People in the intensive group ended up on one or two additional medications compared with those in the standard group. The overall rate of severe adverse events was equivalent in both groups, but there was more symptomatic hypotension and hyperkalemia in the intensively treated group. As I said, this has actually changed how I'm treating my patients. The difference between 120 mm Hg and 133 mm Hg isn't that big in my brain, and yet there does seem to be a difference in terms of outcomes, primarily cardiovascular outcomes, as the primary endpoint. I think that, if a patient can tolerate a lower blood pressure without symptomatic hypotension, I am going to be treating them down to a lower target. I think this was a well-done study that actually will probably inform practice and guidelines in the future because I think it helps inform us of what is potentially the best target for our patients.
Medscape
27-05-2025
- Health
- Medscape
Preterm Birth Risk and Second-Trimester Medical Termination
Medical termination of pregnancy (mTOP) in the second trimester was considered safe and not significantly associated with the risk for future spontaneous preterm birth (sPTB). METHODOLOGY: Researchers conducted a single-centre cohort study to investigate the association between mTOP in the second trimester and the risk for subsequent sPTB in 1438 individuals who underwent an mTOP with mifepristone and/or misoprostol between 2008 and 2023. The mean maternal age at the time of mTOP was 32.5 years; by December 2024, 1033 participants had a known subsequent pregnancy, and 405 did not. Interpregnancy intervals were categorised as 0-3, 3-6, 6-12, 12-24, and more than 24 months; the gestational age at mTOP was 12 +0 -16 +0 , 16 +0 -19 +6 , and more than 20 weeks. -16 , 16 -19 , and more than 20 weeks. The primary outcome was the rate of sPTB before 37 weeks in subsequent pregnancies, whereas secondary outcomes included rates of preterm births before 28, 32, and 37 weeks; miscarriage; repeated terminations; and variations in birth weight. TAKEAWAY: The incidence rate of subsequent sPTB before 37 weeks was 4.7% among singleton pregnancies and 16.7% among multiple pregnancies. Participants with a short interpregnancy interval (< 3 months) had a higher incidence rate of sPTB than those with an interval of 12-24 months (6.8% vs 3.2%; adjusted odds ratio [aOR], 2.2; P = .2). = .2). The incidence rate of sPTB was 5.9% and 2.6% for mTOP conducted at gestational ages of more than 20 weeks and less than 15 weeks, respectively (aOR, 2.2; P = .07). = .07). The rate of subsequent sPTB before 37 weeks after excluding participants with prior sPTB before 37 weeks was 4.1% among singletons and 17.4% among multiples; when cases with prior curettage were excluded, the rate was 4.5% among singletons and 20.0% among multiples. A higher gestational age at mTOP was significantly positively associated with subsequent sPTB before 37 weeks (β coefficient, 0.56; coefficient of determination, 0.31; P = .04). IN PRACTICE: "Second-trimester medical termination of pregnancy can be considered safe with regards to subsequent spontaneous preterm birth risk. As recommended following preterm and term birth, patient counseling should include the importance of allowing time for cervical remodeling to mitigate preterm birth risks, especially for those with a medical termination of pregnancy at higher gestational ages," the authors wrote. SOURCE: This study was led by Annabelle L. van Gils, MD, Amsterdam UMC - location University of Amsterdam, Department of Obstetrics and Gynecology, Meibergdreef, Amsterdam, the Netherlands. It was published online on May 19, 2025, in American Journal of Obstetrics and Gynecology. LIMITATIONS: This study was limited by the exclusion of subsequent pregnancies. Those who underwent mTOP for social reasons were not routinely referred for follow-up. As this study was conducted at the sole tertiary academic centre for prenatal diagnostics in North Holland, the study sample was representative, which may have affected the generalisability of results. DISCLOSURES: This study received no specific funding. Two authors reported receiving grants for PTB research and being part of a non-profit organisation that supports PTB research. One author reported being an advisor for prenatal screening in North Holland and chairing a related review committee from 2016 to 2023.
BBC News
26-05-2025
- Entertainment
- BBC News
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