Journal Club

These articles summarize papers published about weight loss.

The will probably be mostly of interest to doctors, but some patient may also find them of interest.

I welcome your input and feedback.

Michael Anchors, M.D., Ph.D.
manchors@aol.com

Incompetent science

More incompetent science in the obesity field. Will it ever end? Read more...  |   Email This Article

Obesity Increases the Risk of Alzheimers

This Swedish study shows that the few obese people still alive at age 70 are more prone to dementia of all types, including Alzheimer disease. "For every 1.0 increase in BMI at age 70 years, [Alzheimer] risk increased by 36%." Read more...  |   Email This Article

Glucophage Should Not Be Used in Some Patients

Glucophage is absolutely contraindicated in patients with reduced creatinine clearance or congestive heart failure, due to the risk of lactic acidosis.

Actos and Avandia are relatively contraindicated in patients with congestive heart failure, because both drugs increase blood volume worsening heart failure.

Few doctors seem to know this. Many obese diabetics referred to me have kidney or heart failure, yet receive Glucophage or Actos/Avandia from their doctor! The journal article for this week confirms that this poor practice is common. Given that it is so common, I would like to see statistics on whether the number of cases of lactic acidosis has increased as a result. Sometimes there is a disconnect between academic theory and clinical truth . . .

. . . but in the meantime YOU should not risk your practice by ignoring the contraindication. The Glucophage/lactic acidosis connection is well known among plaintiff's attorneys. Always check the serum creatinine before prescribing Glucophage.

REFERENCE

Masoudi FA, Wang Y, Inzucchi SE, Setaro JF, Havranek EP, Foody JM, Krumholz HM. Metformin and thiazolidinedione use in Medicare patients with heart failure. JAMA 2003;290:81-85.  |   Email This Article

The "Mediterranean Diet"

This article merits attention because it was touted in many major newspapers. In this prospective study, 22,043 Greek adults filled out a food questionnaire and were then followed over a 4 year period. Patients with diabetes or known heart disease were excluded. Read more...  |   Email This Article

Moderate Exercise Does Not Cause Weight Loss in Women

The written conclusion of the Midwest Exercise Trial is "Moderate-intensity exercise sustained for 16 months is effective for weight management in young adults." In fact, the data in the article show just the opposite. Read more...  |   Email This Article

Nonalcoholic Fatty Liver Disease

It is amazing the authors could write the entire abstract and not mention the key word, obesity, but at least they mentioned the cause of NAFLD in the text. Read more...  |   Email This Article