Robust evidence supports paracetamol’s (acetaminophen - Tylenol) safety during pregnancy

 Researchers from the LKS Faculty of Medicine at the University of Hong Kong (HKUMed) have found that using a commonly used pain killer (paracetamol or acetaminophen) during pregnancy does not increase the risk of autism spectrum disorder (ASD) or attention‑deficit/ hyperactivity disorder (ADHD) in children. This represents the first study in Hong Kong to apply a rigorous sibling-matched approach to compare siblings from the same mother to effectively account for shared genetic and environmental influences. The findings, published in JAMA Internal Medicine [link to the publication], offer timely reassurance for expectant mothers and clinicians in Hong Kong and globally regarding the safety of paracetamol use during pregnancy.

Addressing global anxiety: the paracetamol debate
Paracetamol is the most widely used medication for pain and fever during pregnancy. However, concerns about its potential association with ASD and ADHD have intensified following overseas reports and policy discussions. While international health authorities, including the World Health Organization and the Department of Health in Hong Kong, have reaffirmed its safety profile, robust local evidence was previously lacking – a gap that this study has now filled.

Sibling-matched analysis accounts for shared familial factors
Some previous studies suggested a modest increase in ASD and ADHD risk in offspring but did not fully account for differences between mothers who did and did not use paracetamol, such as underlying health status, lifestyle or familial factors. To address these methodological limitations, the HKUMed team analysed electronic medical records from 708,020 mother–child pairs in Hong Kong between 2000 and 2023, allowing a more comprehensive and accurate assessment.

Initial analyses without sibling matching reproduced earlier findings of a slight increase in risk. However, when the researchers applied a sibling-matched design—comparing siblings exposed and unexposed to paracetamol during mothers’ pregnancy—no association was observed between prenatal paracetamol exposure and the risk of ASD or ADHD in their offspring. These findings remained consistent regardless of dosage, timing of exposure (across all trimesters), and pattern of use (sporadic, intermittent or persistent).

Robust evidence supports paracetamol’s safety during pregnancy
Dr April Luo Shan, Research Assistant Professor in the Department of Family Medicine and Primary Care, School of Clinical Medicine, HKUMed, said: ‘I had herpes zoster during my pregnancy, but I did not take paracetamol at that time because of concerns raised in the media. As both a researcher and a mother, I deeply understand the anxiety many women face. Our study provides the reassurance I wish I had and would have helped me manage the pain I was experiencing.’

Professor Peter Tanuseputro, Clinical Professor in the same department, added, ‘Previous conflicting studies generated doubt and unnecessary stress for expectant parents, leading many mothers to endure untreated pain or resort to other medications that may be less safe. Our sibling-matched study within a massive Chinese cohort provides robust evidence that paracetamol is safe during pregnancy.’

Professor Ian Wong Chi-kei, Professor in the Department of Pharmacology and Pharmacy, HKUMed, added. ‘Monitoring the long-term outcomes of children with in-utero drug exposure requires an incredibly robust data infrastructure. Thanks to the Laboratory of Data Discovery for Health (D24H) at AIR@InnoHK, the Research Grants Council and Hospital Authority, we were able to rapidly address this urgent drug safety question with the necessary precision and scale.’

Mediterranean diet is associated with better psychological well-being

Following a Mediterranean diet may provide additional benefits for mental health. A new study has now linked it to greater psychological well-being among people over the age of 50. The research is the result of a collaboration between University College London and the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, and has been published in BMJ Open.

To date, numerous studies have shown that the Mediterranean diet—rich in fruits, vegetables, legumes, fish and olive oil—is an effective shield against physical decline and the development of disorders such as depression. However, this new study goes a step further by focusing on positive psychological well-being, which encompasses dimensions such as control, autonomy, pleasure and self-realisation, and includes questions relating to independence, enjoyment of life, sense of purpose, energy levels and future outlook. The study suggests that the benefits of following a Mediterranean diet for well-being are independent of the presence of depressive symptoms or the participants’ socioeconomic status.

The study analysed data from 3,296 individuals aged between 50 and 90 years who were participating in the English Longitudinal Study of Ageing (ELSA). Dietary habits were assessed between 2018 and 2019 using an online platform, where participants reported everything they had eaten and drunk on two non-consecutive days. Psychological well-being was evaluated through questionnaires administered on up to two occasions between 2018 and 2020.

Protection against the mental health effects of COVID-19

Data collected through the ELSA cohort show that the emergence of the COVID-19 pandemic and the restrictive measures that followed had a negative emotional impact on study participants. However, the decline in emotional well-being was less pronounced among individuals with greater adherence to the Mediterranean diet, suggesting a protective effect.

“Our study is observational and, therefore, the results should be interpreted with caution, since we cannot draw causal conclusions,” says Camille Lassale, ISGlobal researcher and senior author of the study. “Nevertheless, the questionnaires administered during the pandemic allowed us to follow participants over time, which is a major strength of the study. Although the biological mechanisms underlying the relationship between the Mediterranean diet and better mental health are still being investigated, the evidence suggests that its foundational foods and components help regulate key processes such as stress responses, inflammation, gut health and brain function”, she adds.

“This study provides further evidence of the relationship between what we eat and our mental health, an emerging field of research that we hope will generate substantial new evidence in the years to come,” says Alanna Shand, research psychologist and co-author of the study.

“Although many questions remain open, there is no doubt about the need to promote healthy lifestyles, prioritising a balanced diet rich in plant-based foods and low in foods such as processed meats and sweets, particularly among older adults,” says Andrew Steptoe, researcher at University College London and first author of the study.

Reference

Steptoe A, Shand AJ, Lassale C. Adherence to the Mediterranean diet and psychological wellbeing before and during the COVID-19 pandemic: a prospective analysis of the English Longitudinal Study of Ageing. BMJ Open. 2026; 16(6): e109599. http://dx.doi.org/10.1136/bmjopen-2025-109599

Study links birth control pills to more binge eating

 

Emotional eating increased when women were taking hormone-containing birth control pills compared to the hormone-free pills taken at the end of each monthly cycle

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Birth control pills are safe and effective for millions of women, but researchers are still working to understand how the hormones they contain may influence eating behavior.

A new study in JAMA Network Open followed 422 women who were already using combined oral contraceptives, tracking their eating patterns daily for 49 consecutive days. The goal: to examine whether binge-related eating changes depending on whether women are taking hormone-containing pills or hormone-free pills within the same cycle.

In a typical birth control pack, women take about three weeks of “active” pills that contain hormones, followed by about a week of “inactive” pills that contain no hormones.

“Because we tracked the same women day to day, we could see how eating changed with hormone exposure,” said Dr. Shaunna Clark, a co-author and associate professor of psychiatry and behavioral sciences at Texas A&M University’s Naresh K. Vashisht College of Medicine.

How birth control hormones may increase binge-eating risk

The study used a within-person design, meaning each participant served as her own comparison. Researchers measured emotional eating (overeating in response to negative emotions) while tracking whether each day corresponded to an active or inactive pill.

They found a consistent pattern:

Emotional eating was significantly higher during active pill days than during inactive pill days.

This pattern appeared:

• across two full pill cycles
• in the full sample of 422 women
• and in a subset of women with diagnosed binge eating

Clark says the findings held even after accounting for negative mood, suggesting the change was not fully explained by emotional distress.

“That tells us the hormones themselves may be playing a role, rather than those changes being driven by mood or other factors,” she said.

Why birth control may increase binge-eating risk for some women, but not others

The analysis focused on average changes across the group, but the study emphasizes that not all women experience these shifts in the same way.

“Participants ranged in age from late adolescence to young adulthood and were all using the same type of pill, monophasic combined oral contraceptives, which provide a consistent dose of hormones during active pill days,” said Clark, part of the research team led by Dr. Kelly Klump at Michigan State University.

Because the study examined within-person changes, it shows that eating behavior can shift alongside hormone exposure, even if the magnitude of that shift differs between individuals.

“These findings show a pattern at the group level,” she said, “but individual responses can vary.”

Birth control pills linked to binge eating, but not mood or body image

The study does not establish that birth control pills cause binge eating. Instead, it identifies a specific association between hormone exposure and increased emotional eating within individuals.

Importantly, researchers also tested other outcomes:

• Weight preoccupation did not change across pill type
• Mood changes in response to pill type were smaller and less consistent than the changes in eating

Clark says that suggests the effect is relatively specific to binge-related eating behavior, rather than a general shift in mood or body image concerns.

How this study changes what we know about birth control and binge eating

Previous research has shown that binge‑related eating tends to increase after ovulation, when both estrogen and progesterone are elevated.

This study extends that work by showing that synthetic hormones in birth control pills are linked to similar patterns.

By comparing hormone-containing and hormone-free days within the same individuals, the study provides some of the clearest evidence to date that binge-related eating increases during periods of hormone exposure in the birth control cycle.

“Findings like these can help us better understand how different hormone exposures affect eating behavior,” Clark said. “Over time, that could help clinicians and patients make more informed decisions about care.”

Skimping on sleep leads to weight gain

People who shortened their sleep by around 80 minutes a night for six weeks gained weight—one pound on average—and were more sedentary, researchers at Columbia University Vagelos College of Physicians and Surgeons have found.

“Our study shows that getting adequate sleep may help reduce the risk of weight gain and obesity-related conditions like heart disease and diabetes,” says Marie-Pierre St-Onge, a professor of nutritional medicine in Columbia’s Department of Medicine and Institute for Human Nutrition and study leader. “People tend to gain weight over the course of their adulthood, and obesity is a major risk factor for heart disease. But focusing on eating a healthier diet and getting more physical activity to offset weight gain is simplistic and can be difficult to maintain.” 

Studying the effects of chronic, mild sleep deficits

Much of what's known about the link between insufficient sleep and obesity is based on small, brief studies of people who endured severe sleep restriction (usually 4 hours of sleep opportunity). Such studies show that severe sleep deprivation leads to changes in appetite and overeating, which can contribute to weight gain over time.

But most people cannot tolerate severe sleep deprivation for more than a few days.

“These studies only show us what happens under the most extreme conditions and don’t tell us if mildly sleep-deprived people, like a lot of Americans who get 5 or 6 hours of sleep a night, will gain weight,” St-Onge says. 

Six weeks of short sleep = 1 extra pound

To investigate the effects of chronic mild sleep deprivation, a sleep pattern adopted by roughly 30% of adults, St-Onge and her team recruited 95 adults who usually get 7-8 hours of sleep. Participants were instructed to delay their normal bedtime by 90 minutes for one six-week phase and to get the usual amount of sleep for another six-week phase. Sleep and activity levels were measured throughout each phase with a wrist monitor, along with changes in body weight, waist circumference, body composition, and fasting levels of several hormones known to increase or suppress appetite.

“While the one-pound weight gain observed with modest sleep curtailment is not overwhelming, it is important to remember this is occurring over just six weeks,” says Faris Zuraikat, assistant professor of nutritional medicine in Columbia’s Department of Medicine and Institute for Human Nutrition and first author of the study. “Our study was designed to mimic sleep patterns that most adults experience chronically. When extrapolated to a full year, we would expect that losing less than an hour and a half of sleep per night could result in clinically meaningful weight gain.”

Sedentary time also increased by an average of 17 minutes per day during the sleep-restriction phase overall, and by nearly 30 minutes per day for men and postmenopausal women.  

“Even when we accounted for the fact that they were awake longer when sleep was shortened, participants spent more time being inactive than when they got adequate sleep,” Zuraikat says. “This is notable, as people who are more sedentary have elevated risk for chronic diseases.”

Why does mild sleep deprivation cause weight gain?

In a previous, related study of a sub-set of the same participants, St-Onge's team reported that women with increased cardiometabolic risk who shortened their sleep by around 80 minutes a night over six weeks had increased insulin resistance, a risk factor for type 2 diabetes. The effects were more pronounced in postmenopausal women.

In another study of this group, St-Onge found that men and women with elevated heart risk had an influx of inflammatory cells in the heart after mild sleep restriction.

“Though more research is needed to further understand how sleep restriction leads to weight gain, all of our findings suggest that insufficient sleep increases the risk of obesity-related conditions like type 2 diabetes and heart disease,” St-Onge says. “Now we need to understand the health effects of improving sleep in those who fail to get adequate sleep on a regular basis.”  

Intermittent fasting maintains long-term weight loss, regardless of meal timing

 

The study, in which the University of Granada (UGR) participated and which was recently published in the journal *Clinical Nutrition*, involved 99 adults—half of whom were women—who were overweight or obese

Peer-Reviewed Publication

University of Granada

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The study, in which the University of Granada (UGR) participated and which was recently published in the journal Clinical Nutrition, involved 99 adults—half of whom were women—who were overweight or obese

A team of scientists from the University of Granada (UGR), the Granada Institute for Biomedical Research (ibs.GRANADA), the Public University of Navarra, and the Biomedical Research Networking Center (CIBER) has demonstrated that limiting food intake to an eight-hour window helps maintain weight loss 12 months after the end of the intervention in overweight or obese adults.

The research has revealed that intermittent fasting—specifically the method popularly known as 16:8, in which participants fast for 16 hours and are allowed to eat during the remaining eight hours—is an effective strategy for maintaining weight loss in the medium term. The study shows that these benefits persist one year later regardless of whether the eight-hour eating window occurs early in the day (between 9 a.m. and 5 p.m., known as early fasting) or later (between 1 p.m. and 9 p.m., known as late fasting), compared to people who maintain their usual eating routine for 12 hours or more.

The results show that both the early-fasting and late-fasting groups managed to maintain significantly greater weight loss after 12 months. Furthermore, the early-fasting group maintained a greater reduction in fat mass. According to the researchers, these findings suggest that this type of nutritional intervention is not only feasible and effective in the short term but now also demonstrates sustainable effects over time.

Body Composition Assessment One Year Later

The study, recently published in the prestigious journal *Clinical Nutrition*, the official journal of the European Society for Clinical Nutrition and Metabolism, involved 99 adults—half of whom were women—who were overweight or obese. During the first 12 weeks, participants were divided into four groups, all of which followed a Mediterranean diet education program: a control group that maintained its usual eating window (12 hours or longer), an early fasting group (an 8-hour window beginning before 10:00 a.m.), a late fasting group (an 8-hour window beginning after 1:00 p.m.), and a self-selected group where participants chose their own 8-hour eating window.

Changes in weight, fat mass, and fat-free mass were measured before and after the 12-week intervention, as well as one year after the study ended. This study is part of a larger project whose main results have been published in the prestigious journal *Nature Medicine*, where it was observed that participants who practiced TRE, regardless of their eating schedule, lost an average of 3–4 kilos more than the group that received only nutritional recommendations.

Dr. Alba Camacho Cardeñosa, a researcher at the University Joint Institute for Sport and Health (iMUDS) at the University of Granada (UGR) and a postdoctoral fellow at ibs.GRANADA in the Endocrinology and Nutrition Department at San Cecilio University Clinical Hospital, is the study’s first author. She explains that “to date, although we knew that intermittent fasting promotes modest weight loss in the short term, it was unclear whether its effects were sustained over time. By evaluating the participants 12 months after the intervention ended, we demonstrated that the changes in body weight persist.” In addition, the researchers highlight that “a very positive finding is that one in three people decided to continue practicing intermittent fasting on their own during that year of follow-up, suggesting that it is a relatively easy habit to integrate into daily life.”

A Flexible Strategy Against Obesity

The study was led by researchers from ibs.GRANADA belonging to the PROFITH CTS-977 research group at the University of Granada (UGR), headed by Professor Jonatan Ruiz Ruiz, in collaboration with the San Cecilio University Clinical Hospital and the Virgen de las Nieves University Hospital in Granada, the Public University of Navarra, the CIBER on Obesity (CIBEROBN), and the CIBER on Frailty and Healthy Aging (CIBERFES).

The researchers emphasize that an intervention involving just 12 weeks of intermittent fasting may represent an effective medium-term strategy for weight control in overweight or obese adults. Since both early- and late-day fasting regimens have been shown to be effective, the findings offer valuable flexibility for patients to choose the schedule that best suits their lifestyle, thereby improving adherence and success in obesity treatment.

The MP20 group—Biomarkers of Metabolic and Bone Diseases at ibs.GRANADA—investigates biomarkers and new therapeutic targets for metabolic, bone, and cardiovascular diseases. It combines bioinformatics and clinical techniques to develop diagnostic tools and evaluate treatments. Among its findings, the group highlights the role of intermittent fasting as a treatment for obesity and its comorbidities, as well as the use of bone markers in predicting cardiovascular risk. Its multidisciplinary and collaborative approach drives high-impact research with clinical applications.

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Journal

Clinical Nutrition

DOI

10.1016/j.clnu.2026.106706 

Method of Research

Randomized controlled/clinical trial

High fructose during pregnancy impairs fetal brain

 Nutritional imbalance during pregnancy can have long-lasting effects on the health status and disease susceptibility of the offspring. As such, high fructose intake through sweetened food and beverages in pregnant women has been associated with an increased susceptibility to diabetes and cardiovascular disease, as well as neurological and cognitive impairments in the offspring. Currently, it is not well understood how early life exposure to fructose has such long-lasting effects on the cellular and molecular level.  

In a recent paper published in Stem Cell Reports, Hiroya Yamada’s team from Fujita Health University School of Medicine, Toyoake, Japan found that the performance of adult rats in learning and memory tests was impaired when the rats had been exposed to high fructose in before birth by feeding their mothers with high fructose corn syrup. Furthermore, neurogenesis, which is the generation of new neurons from neural stem cells (NSCs), in distinct regions of the brain involved in learning and cognition was reduced in those rats. Further, Yamada’s group discovered distinct changes in NSCs after high fructose exposure, which included reduced cell division and impaired generation of new neurons, and altered gene expression. To explain why prenatal high fructose exposure can have such long-lasting effects on NSCs, the researchers profiled the so-called epigenetic changes, which are chemical imprints on the DNA controlling gene activity. Strikingly, prenatal high fructose exposure introduced distinct epigenetic changes in fetal NSCs which persisted into adulthood and which deregulated the activity of genes important for adult neurogenesis.  Restoring normal expression of those genes improved the function of high fructose-exposed NSCs.

This research illustrates how early-life exposure to an adverse environment, e.g. an imbalanced maternal nutrition, can have long-lasting effects on brain development and function by changing the epigenetic regulation of gene activity in NSCs. Importantly, although epidemiological studies in human populations show similar correlations, further studies will be required to test if human NSCs are affected by high fructose and other environmental stressors in similar ways. “Our study suggests that neural stem cells may retain a biological memory of maternal nutrition during pregnancy," said Dr. Yamada. "This may help explain how a transient prenatal dietary imbalance can lead to long-lasting changes in brain development and function."

Prolonged sedentary behavior associated with increased cancer risk

 

Each additional hour of prolonged, uninterrupted sedentary behavior in a person's day is associated with a 9% higher risk of cancer death, according to a study published July 2nd in the open access journal PLOS Medicine by Frederick Ho of the University of Glasgow, UK, and colleagues.

Previous studies have shown that spending more total time on sedentary behavior, such as sitting, reclining or lying down while awake, is linked to poorer health outcomes. However, most sedentary behavior guidelines focus on total time spent sedentary, rather than whether that time is accumulated in many short intervals or fewer prolonged intervals.

In the new study, researchers analyzed data from 91,292 UK Biobank participants who had worn activity monitors for 7 days and were followed for a median of 12.38 years afterward. Activity was categorized as either prolonged sedentary (bouts of at least 30 minutes with at least 90% of time sedentary), interrupted sedentary behavior (which lasted less than 30 minutes or was broken up with more than 10% non-sedentary time), or varying degrees of physical activity.

Prolonged sedentary behavior was associated with a higher risk of cancer mortality (HR 1.09; 95% CI 1.06, 1.11), overall cancer incidence, obesity-related cancers (such as esophageal, liver, kidney, pancreatic, colorectal, breast, ovarian, and thyroid cancers), and type 2 diabetes-related cancers. Interrupted sedentary behavior showed the opposite pattern, associated with lower risk across all outcomes. Replacing one hour per day of prolonged sedentary behavior with light physical activity was associated with a 12% lower risk of cancer death (HR 0.88; 95% CI 0.79, 0.99).

As a single-cohort study of UK Biobank volunteers, who have known health volunteer bias and higher physical activity levels than the general UK population, the findings may not be generalizable and do not prove causality. The researchers also had no data on the context of sedentary behavior, such as whether it was during work or driving.

“Our findings suggest that the health effects of sedentary behavior may depend not only on total sedentary time, but also on whether that time is accumulated in prolonged bouts or interrupted by activity,” the authors say. “This pattern is biologically plausible: experimental studies have shown that interrupting prolonged sitting with short bouts of activity can improve metabolic responses compared with uninterrupted sitting.”

The authors add, “Current health guidelines focus heavily on moderate or vigorous exercise, but our findings show that light movement shouldn't be ignored. Moving forward, clinical trials will help us move beyond blanket advice and develop personalised strategies for breaking up sitting time.”

In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine: https://plos.io/4oi0sJO   

How smartphones can deepen depression in older adults

Compulsive smartphone habits in older adults can be linked to a higher risk of depression, according to a study led by a Rutgers researcher. 

Researchers said their findings raised concerns that technology widely promoted to build connections can instead deepen late-life isolation: While mobile devices can be invaluable lifelines, their impact on mental health depends heavily on the way people use them. A critical distinction, the researchers said, is whether someone uses technology to actively engage with the world or to withdraw. 

“It comes down to purposeful interaction versus compulsive escapism,” said Chien-Chung Huang, a professor at the Rutgers School of Social Work and a senior author of the study. “The same device can bridge the gap to loved ones and community or serve as a wall to shut them out.”

The study, published in JMIR Aging, drew on survey responses from 2,585 adults ages 60 and older living in 87 communities throughout five districts of Guangzhou, China. Participants reported on their smartphone habits, communication preferences and offline social participation. Researchers also collected health and demographic information, including age, gender, marital status, education and income, and measured depressive symptoms with a screening tool commonly used with older adults.

The research team – which included study coauthors Sheng Chen and Yue Song, of the School of Public Administration at Guangdong University of Foreign Studies in Guangzhou – used machine learning to identify which factors were most strongly associated with depression. A secondary analytic method helped investigators look beyond any single explanation and recognize patterns that might not have been obvious from one variable alone.

Limited social participation emerged as the strongest predictor of depression, followed closely by smartphone addiction, defined as compulsive or excessive use that disrupts daily functioning. Problematic phone reliance appeared in nearly all cases of clinical depression, with older adults who rarely used interactive communication features facing the greatest risk.

The findings suggest that phone use can support well-being when it helps older adults maintain relationships, especially across distance, through video calls, messaging and photo sharing. Long stretches of scrolling, watching videos or playing games alone were associated with a pattern of withdrawal. 

“When an older adult uses their phone as a shield to substitute or displace real-life social participation, it acts as a major red flag for depression,” Huang said.

The study identified two groups that appeared especially vulnerable to depression. One pattern involved older men with less formal education who exhibited signs of smartphone addiction. For these adults, lower digital literacy may make it more difficult to navigate complex apps, increasing the likelihood that they will fall back on passive entertainment. 

Huang said depression risk may be especially pronounced among men in this group who have relied heavily on a spouse or partner for social connection and have fewer family or community ties to draw on later in life. 

“When they lose a partner or become isolated, they can be left without the same social buffers,” he said. “Their phone becomes an isolating crutch rather than a bridge.” 

Another high-risk pattern emerged among older adults of both sexes: Those with higher incomes and education levels who suffered from smartphone addiction were more prone to clinical depression. This finding suggests that wealth, education, and technology access fail to protect against loneliness when screen time replaces real-world connections. 

The researchers said the study doesn’t prove excessive smartphone use causes depression. Because the research captured one point in time, it cannot determine whether problematic phone use contributes to depressive symptoms, whether depression leads older adults to spend more time on their phones or whether the two reinforce each other.

Huang said the relationship is likely cyclical: An older adult who feels lonely may turn to screen time for distraction. 

“Over time, passive digital consumption can begin to replace the real-world interactions that help protect mental health,” deepening isolation and worsening depressive symptoms, he said.

Huang added that families, community organizations, and health providers can help by encouraging older adults to use phones in ways that support interaction rather than solitary entertainment. The goal is not to discourage smartphone use, but to make it more social and purposeful.

“Instead of leaving a senior to scroll videos alone, family members can involve them in photo-sharing loops, text threads, and scheduled video calls that help bridge intergenerational gaps,” Huang said.

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Blood pressure and cholesterol levels in adults over 40 with obesity

• In several high-income countries including England and the USA, adults over 40 years old with obesity now have blood pressure and unhealthy cholesterol levels approaching, or healthier than, people with a normal BMI, a significant shift from 30 years ago.
• This trend coincides with a greater rise in cholesterol-lowering medication (such as statins) and blood pressure medication use among adults over 40 with obesity compared to those with a normal BMI, pointing to medication as a likely driver of the blood pressure and cholesterol level convergence. 
• For adults under 40 years old, the study found little change in the gap between blood pressure and unhealthy cholesterol levels in people with obesity and those with normal BMI, likely because young adults rarely receive cholesterol or blood pressure medication regardless of their BMI.
• Authors say these findings suggest the cardiovascular risks associated with obesity in some countries have been reduced in older adults, however they highlight other risks associated with obesity remain, including diabetes, kidney and liver diseases, and cancers.
• 
  

Over the last three decades, differences in unhealthy cholesterol levels and blood pressure between older adults with obesity and those with a normal Body Mass Index (BMI) have narrowed or disappeared in several high-income countries, suggests a study published in The Lancet. The authors propose that this trend is due to the greater, and possibly more intensive, use of cholesterol-lowering medication (such as statins) and blood pressure medication in people aged over 40 living with obesity in high-income countries. 
 
Obesity is known to increase blood pressure and unhealthy cholesterol levels, which can impact cardiovascular health and increase the risk of heart attack, heart failure, and stroke. However, prior to this study, there was little information on blood pressure and cholesterol levels, and how they have changed, for people with obesity compared with people with normal BMI.
 
Author Prof Majid Ezzati, from the School of Public Health at Imperial College London (UK), says: “Our study suggests that, in high-income countries, taking medication to lower blood pressure and cholesterol has helped middle-age and older adults lower their cardiovascular risk to levels that are similar to people with normal BMI.”
 
He continues, “At a time that weight-loss medications are becoming more widely used, our results give a picture of the cardiovascular health of people likely to be prescribed them, which allows the healthcare system to understand how blood pressure and cholesterol treatments benefit the population alongside weight-loss medications.”
 
The study analysed data on blood pressure and cholesterol in people with obesity, overweight, and normal BMI from 110 health datasets including almost one million participants from 1990 to 2024 in seven high-income countries: England, the USA, Japan, South Korea, Taiwan, Thailand and Finland. 
 
Converging cardiovascular risk markers
 
The study finds that in the 1990s adults with obesity generally had higher blood pressure and high-density lipoprotein (non-HDL) cholesterol levels [1] than people with a normal BMI.
 
Since 1990, in the majority of the seven countries studied including England and the USA, blood pressure and unhealthy cholesterol fell more steeply among middle-aged and older adults (40–79 years old) with obesity and overweight than among those with normal BMI, narrowing the gap over time. The exceptions were Taiwan and Thailand, which did not see this convergence as universally as other countries.
 
The findings were most striking in older adults (60–79 years old). In England and the USA, older adults with obesity, and especially with severe obesity, had similar or even lower blood pressure and unhealthy cholesterol levels at the end of the study period than older adults with normal BMI.
 
Heart medication likely driving the convergence
 
Over the past three decades, people with obesity were more likely to be prescribed cholesterol-lowering medication (such as a statin) and blood pressure medication than those with a normal BMI. 
 
This gap was especially pronounced in older adults. For example, in England and the USA, around 70–72% of older men with severe obesity (BMI ≥35) were taking cholesterol-lowering medication by the early 2020s, compared with 40–48% of older men with a normal BMI.
 
Author Lakshya Jain, from the School of Public Health at Imperial College London (UK), says “This latest analysis suggests that the observed convergence in cholesterol and blood pressure levels between people aged over 40 with obesity and those with a normal BMI is largely due to statins and other widely accessible medications to reduce cardiovascular risk. That is a significant public health success story, and one we should not lose sight of as new weight-loss medications enter the picture.” 
 
Cardiovascular risks remain for younger adults with obesity
 
In younger adults (under 40 years old), the study findings suggest little or no narrowing of the gap in blood pressure or cholesterol between those with obesity and those with a normal BMI. The data also suggests that use of cholesterol-lowering and blood pressure medication is low for this age group, adding further evidence that medication is the driver of the gap reduction in older adults. 
 
Author Ysé d'Ailhaud de Brisis, from the School of Public Health at Imperial College London (UK), says "While good news for older adults with obesity, our results suggest that cardiovascular health risks remain higher for adults under 40 than for their counterparts with a normal BMI. Early lifestyle interventions, screening and, when appropriate, medication in this younger group should be considered to prevent long-term cardiovascular complications linked to obesity.”
 
The researchers note some limitations of the study, including that their analysis was limited to seven countries which were all high-income, therefore the finding may not be applicable elsewhere, especially for low- and middle-income countries where the use of unhealthy cholesterol and blood pressure lowering medicines is likely to be lower. Additionally, it was not possible to look at the impact of different medication doses, which require data on prescriptions. 
 
Writing in a linked Comment, Dr Yuan Lu, Yale School of Medicine (USA), who was not involved in the study, says, “This study reframes obesity-related cardiovascular risk as reflecting not only excess adiposity, but also treatment access, health-system engagement, and timing of intervention. Convergence of risk factors should not be equated with elimination of obesity-related risk. Although treatment of high blood pressure and cholesterol might mitigate part of the cardiovascular harm associated with obesity, the persistent burden among younger adults and the broader multisystem consequences of obesity highlight the need for integrated prevention strategies that move beyond isolated risk factor treatment.”
 

NOTES TO EDITORS

1. Non-HDL cholesterol, or ‘unhealthy’ cholesterol, is a measure of how much ‘bad’ cholesterol is in the blood. It measures cholesterol carried on Low-Density Lipoprotein (LDLs), Very Low-Density Lipoprotein (VLDLs) and other particles known to cause plaque buildup in blood vessels. It doesn’t include the ‘good’ (HDL) cholesterol. High levels of non-HDL are known to raise your risk of heart disease and stroke.

Exercise boosts smoking quit rates

 

A pack-a-day smoker can spend around $14,000 a year on cigarettes, yet despite the financial and health costs, quitting remains one of the most difficult changes many people will ever attempt.

Now, new research from Adelaide University shows that exercise can help people quit smoking by reducing cigarette consumption, easing cravings and improving their chances of quitting.

Researchers found that people taking part in exercise programs were 15% more likely to achieve continuous abstinence and 21% more likely to report not smoking over a seven-day period, compared with control groups.

They also found that exercise could reduce cigarette consumption by two cigarettes per day, and that a single bout of exercise immediately reduced cigarette cravings for up to 30 minutes after exercise.

The systematic review and meta-analysis examined 59 randomised controlled trials involving more than 9000 participants, exploring the effects of both single bouts of exercise and long-term exercise programs on smoking cessation, cravings, withdrawal symptoms and mood.

Globally, tobacco smoking remains the leading preventable cause of premature morbidity and mortality, accounting for about 7 million deaths, including an estimated 1.6 million non-smokers who are exposed to second-hand smoke.

Around the world, e-cigarette use has now reached more than 100 million people.

The researchers say exercise should be viewed as an additional tool that can be used alongside established smoking cessation support.

Lead researcher, Dr Ben Singh said the findings provide smokers with a practical, low-cost tool that can support their quitting journey.

“Quitting smoking is one of the best things a person can do for their health, but it’s also one of the hardest,” Dr Singh said.

“Many smokers want to quit, but the current approaches don’t work for everyone. That’s why we need more strategies that people can incorporate into their daily lives at little or no cost.

“Something as simple as regular exercise can make a meaningful difference to people trying to quit, helping them manage cravings, smoke less and improve their chances of quitting.”

While smoking rates have reduced over the past two decades, demand for e-cigarettes and heated-tobacco products have risen, targeting the younger generation.

Today, 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries, yet in contrast, vaping has risen across many OECD countries.

Senior researcher Adelaide University’s Professor Carol Maher said exercise could be used strategically to ward off tobacco cravings.

“Quitting smoking does not have to begin and end with willpower alone,” Prof Maher said.

“Cravings can be difficult to manage, but they often pass. Our review found that even a single bout of exercise can reduce cravings for up to 30 minutes, which may help people get through some of the hardest moments of a quit attempt.

“Exercise should not replace evidence-based quit supports such as counselling and smoking cessation medication, but it may be a practical, low-cost strategy that people can use alongside them.”

The researchers say the next step is to test how exercise can be built into real-world quit programs, including digital, community and clinical services, and to examine whether it can also support people trying to quit vaping, where evidence is currently lacking.

Hearing loss in diabetes patients a ‘hidden epidemic’

 

Researchers have called for hearing tests to become a standard part of diabetes care and for hearing loss to be recognised as a significant complication of the condition.

Dr Mehwish Nisar from UQ’s School of Public Health said most people were unaware there was even a connection between hearing loss and diabetes.

“One in 4 adults with diabetes – or about 130 million people worldwide – are living with serious hearing loss,’’ Dr Nisar said.

“Diabetes is the world's fastest growing chronic disease, affecting over half a billion people, and people with diabetes are more than twice as likely to experience serious hearing loss.

“This isn't a minor inconvenience; hearing loss in people with diabetes often strikes working-age adults in their 40s and 50s, affecting daily conversations, fuelling isolation and creating significant communication challenges.

“This is a hidden epidemic, and we need to sound the alarm and add a simple hearing test to every diabetes check-up.’’

Researchers reviewed 29 studies involving more than 17,000 people worldwide, examining hearing loss in adults mostly with type 2 diabetes and prediabetes.

They found retinopathy (damage to the retina), nephropathy (kidney damage), and neuropathy (nerve damage) were recognised and routinely monitored complications.

However, hearing impairment was found to be a “significant, yet under-recognised, complication’’.

Dr Nisar said identifying hearing loss early allowed for timely hearing aid support to reduce isolation and support communication, as well as better glucose management to slow further deterioration.

“It is widely known that diabetes affects the eyes, kidneys, and nerves but almost no one knows it can also cause serious hearing loss,’’ Dr Nisar said.

“This research exposes the hidden sensory crisis affecting millions of people.

“Despite clear links, hearing loss is not yet systematically integrated into diabetes care protocols.

“Raising awareness of this hidden complication could help identify hearing problems earlier and improve quality of life for millions of people.’’

Dr Nisar said hearing loss progressed gradually, and patients were often unaware of a problem until it was more advanced.

“Crucially, clinically significant hearing loss is detectable through straightforward, low-cost audiometric screening, presenting a vital opportunity for early diagnosis and intervention,’’ she said.

“The more than 2-fold increased risk identified in this review supports the integration of routine audiometric screening into standard diabetes care, with particular urgency for younger adults.

“The damage may begin much earlier than people think and even people who have lived with diabetes for less than 10 years are more than twice as likely to develop significant hearing loss compared with those without diabetes.

“This is not just a concern for people with long-standing diabetes.

“Waiting for advanced complications before checking hearing is waiting too long.’’

Read the research in Diabetes Metabolism Research and Reviews.