A rich social environment is associated with better cognitive health outcomes for older adults

Research by an interdisciplinary team from McGill University and Université Laval provides new insights into the links between social factors and cognitive health among aging adults.

While previous research had found positive correlations between specific measures of social connectedness and a variety of health outcomes, this study appears to have been the first to create profiles aggregating multiple social factors and to see how those correlated with cognitive health in older adults, the researchers said.

The team derived three social environment categories (weaker, intermediate and richer) by assembling 24 social variables – reflecting such elements as network size, social support, social cohesion and social isolation – using data from approximately 30,000 participants in the Canadian Longitudinal Study on Aging (CLSA). That data is from a nationally representative cohort of randomly selected Canadians ages 45-84 at the time baseline information was collected.

For cognition, the researchers examined three domains: executive function, episodic memory and prospective memory, using data from a battery of tests previously administered to CLSA participants.

Higher social scores, higher cognitive scores

“We identified significant associations between the social profiles and all three cognitive domains, with the intermediate and richer profiles generally exhibiting better cognitive outcomes than the weaker profile,” explained Daiva Nielsen, Associate Professor at the McGill School of Human Nutrition and co-first author of the paper.

The researcher noted that the effect size of the associations (a statistical measure assessing the strength of the relationship between variables) was, however, relatively small, which is in keeping with previous studies on this topic.

Nielsen noted that the effect sizes were somewhat stronger for participants who were 65 or older. According to the researcher, this suggests that the social environment-cognition association may be more significant in later stages of life.

The science of social connection and cognitive health

Awareness has been increasing of the importance of social connection in public health.

“Lack of social connection has been shown to be comparable to more widely acknowledged disease risk factors such as smoking, physical inactivity and obesity. It is important to translate this knowledge to the public to empower individuals to help build meaningful connections within their communities,” she said.

The authors did note that the associations found in the current study are correlational rather than causal, and it is possible, for example, that poor cognitive health also leads individuals to withdraw from social life.

The power of interdisciplinary research

The team, whose members stem from such diverse fields as marketing, human behaviour, nutrition and epidemiology, hopes to continue using CLSA data and the newly created social profiles in future research, said Nielsen.

The next steps involve studying changes in social environments and various health-related outcomes, including diet and chronic disease risk, she added.

“This work is an excellent example of the benefits of multidisciplinary research teams that can tackle complex research questions and bring diverse knowledge and expertise,” she concluded.

Life-saving cholesterol alternatives to statins

 Unhealthy cholesterol levels are a major risk factor for heart disease and stroke. When lifestyle changes like diet and exercise aren’t enough to lower cholesterol, medications can help. A new national survey commissioned by The Ohio State University Wexner Medical Center shows that while most Americans have heard of statins – the most common medicine used to lower cholesterol – many do not know there are non-statin medications.

“Statins often get a bad reputation, but the evidence consistently shows they are highly effective and remain the cornerstone of cholesterol treatment and lowering heart disease risk. At the same time, we now have non-statin medication options that can also help lower LDL – the ‘bad’ cholesterol – for patients who need alternative therapies,” said Laxmi Mehta, MD, director of Preventative Cardiology and Women’s Cardiovascular Health at the Ohio State Wexner Medical Center and Sarah Ross Soter Endowed Chair for Women’s Cardiovascular Health Research.

“Cardiovascular disease is the No. 1 killer of Americans. It’s also impacting people in their 20s and 30s much sooner than it has in the past for various reasons including a surge in risk factors such as high blood pressure, diabetes and high cholesterol. Lifestyle contributors like poor diet, physical inactivity, substance use and vaping are also playing a significant role,” Mehta said. “Most people don’t know their cholesterol or other heart numbers unless they are checked. They may feel normal but be at risk, which is why routine testing is so important.” 

Non-statin medications are available in oral or injectable forms

Mehta recommends non-statin medication for patients who can’t tolerate the side effects of statins, need more LDL cholesterol lowering than statins alone can provide and have elevated atherosclerosis (buildup of fats and cholesterol in the arteries) or risk modifiers such as elevated lipoprotein(a). Sometimes these medications are used in combination with statins for optimal cholesterol management, Mehta said.

Examples of non-statin medications that reduce cardiovascular events in high risk patients are:

• Ezetimibe: An oral medication that blocks cholesterol absorption at the intestinal level, reducing LDL cholesterol by 18–25%.

• PCSK9 Inhibitors: A highly potent injectable medication, administered every two to four weeks that can lower LDL cholesterol by 45–64%.

• Inclisiran: An injectable medication, administered twice a year after the initial doses, which can reduce LDL cholesterol by about 50%.

• Bempedoic Acid: An oral medication, particularly for people who are intolerant to statins, used to help lower LDL cholesterol by 21-24%.

What to know about lipoprotein(a) and coronary artery calcium score 

Mehta and other cardiologists have been trying to raise awareness about lipoprotein(a), also known as Lp(a). It’s an inherited heart risk that can’t be lowered by lifestyle changes. Newer medications to lower the levels are currently under research trials. High levels of Lp(a) can contribute to atherosclerosis as well as inflammation and increased clotting. Lp(a) affects about 1 in 5 people worldwide. 

The Centers for Disease Control suggests screening patients who have had a heart attack, stroke or coronary artery disease before age 55 for men or 65 for women without known risk factors like high LDL, smoking, diabetes or obesity. Testing is also recommended for those with male family members who had a heart attack or stroke before age 55 or age 65 for female family members.

“If someone has an elevated Lp(a) level, their children have a 50% chance of inheriting it,” Mehta said. “If patients have elevated Lp(a) levels, they need to be on LDL lowering therapies to reduce their overall cardiovascular disease risk.”

A coronary CT calcium scan detects calcium (plaque) deposits in the heart arteries, which can help doctors diagnose patients with coronary heart disease (hardening of the arteries) in its earlier stages. Also known as a heart scan or calcium score, it can be useful for those age 40-65 who don’t show signs of heart problems but have several risk factors such as high cholesterol levels, family history of coronary heart disease, diabetes or smoking.

Lifestyle changes weren’t enough for patient with high cholesterol

One of Mehta’s patients, Toni Gundling, resisted going on cholesterol-lowering medication for years, thinking her healthy lifestyle was enough even though high cholesterol ran in her family. Her father had the first of two quadruple bypass surgeries when he was in his 40s, and her younger brother had a triple bypass. She has underlying coronary artery calcification as well as elevated levels of Lp(a), Mehta said.

“We can’t run away from our genetics,” said Gundling, 69. “I tried everything – exercise and healthy eating – but it wasn’t enough. I’m a personal trainer and had clients talk about the reactions they had from statins. But going on medication helped reduce what I can’t fix on my own, and I’ve had no reaction to the statin I’m on.”

When a statin didn’t lower Gundling’s LDL levels enough, Mehta added the non-statin ezetimibe, which worked but caused some side effects. Gundling has been working with Mehta to figure out what medications work best for her.

“Not everyone can take the same pill. You have to find what works for you,” Gundling said. “I would wholeheartedly tell somebody to go on a statin because it’s not what you may think it is. It’s given me peace of mind to know that not only am I doing something to help my health but the medication is helping reduce what I physically can’t do.”

Evidence links wild blueberries to “whole body” health benefits

 A new scientific review summarizes the growing body of research on wild blueberries and cardiometabolic health, which includes factors like blood vessel function, blood pressure, blood lipids (cholesterol and triglycerides) and blood sugar (glucose). 

The review was published in Critical Reviews in Food Science and Nutrition and developed from an expert symposium hosted by the Wild Blueberry Association of North America (WBANA) in Bar Harbor, Maine.1 Twelve experts participated in the symposium from the fields of nutrition, food science, dietetics, nutrition metabolism and physiology, cardiovascular and cognitive function and health, gut health and microbiology, and preclinical and clinical models. Financial support was provided in the form of travel reimbursement to the symposium, but no funding was received to support the development of this manuscript. 

The paper summarizes 12 human clinical trials on the cardiometabolic effects of wild blueberries spanning 24 years and four countries, as well as dozens of other clinical, translational, and mechanistic studies on wild blueberries, cultivated blueberries, and cardiometabolic outcomes. 

The authors report that findings are most consistent for vascular function, while results for blood pressure, blood lipids and glycemic control are promising but underscore the need for larger, well-controlled clinical research studies. 

The paper also explores related health outcomes impacted by overall cardiometabolic wellness, such as gut health and cognitive function. 

A deeper look at the findings:1 

Improved blood vessel function

Across the clinical literature, improvements in blood vessel function are one of the most consistent findings. Trials included in the review suggest wild blueberries can help support endothelial function (or how well blood vessels relax and respond to stimuli), sometimes within hours after a single serving and in other cases with regular intake over weeks or months.  

Beneficial changes to the gut microbiome

The authors of the review explain that wild blueberries provide fiber and polyphenols that reach the colon (only about ~5–10% of these compounds are metabolized/absorbed in the small intestine) and are transformed by gut microbes into metabolites that can be absorbed into blood circulation. Microbial metabolites may also account for up to 40% of the active compounds in blood after eating polyphenol-rich foods like wild blueberries. In a six-week clinical study, adults who consumed 25 grams of freeze-dried wild blueberry powder daily increased beneficial Bifidobacterium species. The review highlights the gut microbiome as a likely contributor to the berries’ cardiometabolic effects, but more research is needed to better understand their role. 

Sharper thinking and memory

The review summarizes clinical intervention studies in older adults showing wild blueberry intake may support aspects of cognitive performance, possibly due to benefits on whole body circulation among other cardiometabolic improvements, including thinking speed and memory, in both single-serving and longer interventions. 

Clinically relevant improvements to blood pressure, lipids and glycemic control

For people with elevated cardiometabolic risk, several studies in the review show clinical improvements in blood pressure, glycemic control, and lipid markers such as total cholesterol, LDL cholesterol and triglycerides following weeks of wild blueberry intake. The researchers note that baseline health status, medications, background diet, and differences in metabolism and the gut microbiome may influence outcomes. The authors encourage more research designed to identify “responders,” clarify optimal dosing and food forms, and evaluate a broader set of biomarkers. 

How wild blueberries may work 

“What makes wild blueberries remarkable is that they contain numerous polyphenols and nutrients and don’t appear to exert their health benefits through just one mechanism,” explains Sarah A. Johnson, PhD, RDN, Associate Professor at Florida State University, registered dietitian nutritionist, and lead author of the review. “The evidence suggests these berries may support multiple biological pathways relevant to cardiometabolic health, from blood vessel function to inflammation and oxidative stress, with effects that can vary from person to person. Recent research on the role of the gut microbiome in determining their health benefits is exciting and may help researchers determine ways to support the gut microbiome to enhance their health benefits.” 

The review describes several pathways that may be involved, including nitric oxide signaling that supports healthy circulation, inflammation and oxidative stress pathways, lipid and glucose metabolism, and interactions with the gut microbiome. 

How much and how often? 

In this review, wild blueberries were studied in multiple forms. Benefits have been observed when consumed regularly over weeks or months and with practical amounts. This means aiming to eat about one cup of wild blueberries every day. 

Most wild blueberries are available frozen, making them easy to keep on hand year-round. Try adding them to smoothies, oatmeal, yogurt, salads, or baked goods. 

Why wild blueberries are special 

Wild blueberries, also called lowbush blueberries, grow in Maine and Eastern Canada and challenging conditions such as harsh winters. These stressors can stimulate the plants to produce a diverse profile of protective compounds, including polyphenols such as anthocyanins. Wild blueberries contain around 30 distinct anthocyanin forms. 

“Wild blueberries have been valued by people for thousands of years,” notes Dorothy Klimis-Zacas, PhD, FACN, Professor of Clinical Nutrition at the University of Maine and co-lead author on the study. “Traditional knowledge recognized their value, and today’s research continues to explore how the unique composition of wild blueberries may support health when eaten as part of an overall balanced diet.” 

Reference: 

1. Johnson SA, et al. Wild blueberries and cardiometabolic health: A current review of the evidence. Critical Reviews in Food Science and Nutrition. Published online ahead of print January 24, 2026. Doi.org/10.1080/10408398.2025.2610406. 

Eating a plant-forward diet is good for your kidneys

 

Eating a plant-forward diet and limiting added sugars and fats as part of the EAT–Lancet planetary diet was associated with a reduced risk of chronic kidney disease (CKD), according to a large study published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250457.

Chronic kidney disease affects about 10% of adults globally and is projected to become the fifth leading cause of death worldwide by 2040.

The study was based on data from the UK Biobank, a large-scale long-term study that included 179 508 eligible participants aged 40 to 69 from England, Scotland and Wales, and dietary information collected through a questionnaire. Over a median follow-up of 12 years, 4819 (2.7%) participants developed CKD.

“Greater adherence to the EAT–Lancet planetary health diet was significantly associated with a reduced risk of incident CKD. This protective association was particularly evident among individuals with low residential green space exposure and specific genetic variants,” writes Dr. Xianhui Qin, Nanfang Hospital, Southern Medical University, Guangzhou, China, with coauthors.

Although many plant-based diets are promoted, such as Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet (aMed), and others, the EAT–Lancet planetary health diet was developed to encompass human health as well as environmental sustainability. It emphasizes fruits, vegetables, legumes, and some meat and dairy and limited consumption of added sugars and fats.

“A key commonality among these dietary patterns is their emphasis on higher consumption of vegetables, fruits, and nuts, and reduced intake of red meat — components consistently associated with lower CKD risk in previous studies. A distinctive aspect of the EAT–Lancet diet is its specific limitation of added sugars and fats, which may further mitigate kidney risk through modulation of inflammation and oxidative stress pathways. These results underscore the potential of the EAT–Lancet diet as an effective dietary strategy for CKD prevention,” the authors write.

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Grandparenting is good for the brain

 

Caring for grandchildren may protect against cognitive decline, study finds

Helping to care for grandchildren may serve as a buffer against cognitive decline in older adults, according to research published by the American Psychological Association.

 “Many grandparents provide regular care for their grandchildren – care that supports families and society more broadly,” said lead researcher Flavia Chereches, MS, of Tilburg University in the Netherlands. “An open question, however, is whether caregiving for grandchildren may also benefit grandparents themselves. In this research, we wanted to see if providing grandchild care might benefit grandparents' health, potentially slowing down cognitive decline.”

The research was published in the journal Psychology and Aging.

To study this, Chereches and her colleagues examined data from 2,887 grandparents (all older than age 50, with a mean age of 67) who took part in the English Longitudinal Study of Ageing. Participants answered survey questions and completed cognitive tests three times between 2016 and 2022. 

The survey asked whether participants had provided care for a grandchild at any point in the past year. It also asked detailed questions about how frequently they provided care and what kinds of care they provided – including watching grandchildren overnight, caring for ill grandchildren, playing or engaging in leisure activities, helping with homework, driving grandchildren to school and activities, preparing meals and more.

Overall, the researchers found that grandparents who provided childcare scored higher on tests of both memory and verbal fluency compared with those who didn’t, even after adjusting for age, health and other factors. This held true regardless of the frequency and type of care the grandparents provided.

The researchers also found that grandmothers who provided care saw less decline on cognitive tests over the course of the study compared with those who didn’t. 

“What stood out most to us was that being a caregiving grandparent seemed to matter more for cognitive functioning than how often grandparents provided care or what exactly they did with their grandchildren,” said Chereches. “More research is needed to replicate these findings, yet, if there are benefits associated with caregiving for grandparents, they might not depend on how often care is provided, or on the specific activities done with grandchildren, but rather on the broader experience of being involved with caregiving.”

Further work should also be done to explore the effects of family context and other variables, Chereches said.

“Providing care voluntarily, within a supportive family environment, may have different effects for grandparents than caregiving in a more stressful environment where they feel unsupported or feel that the caregiving is not voluntary or a burden.” 

Article: “Grandparents Cognition and Caring for Grandchildren: Frequency, Type and Variety of Activities,” by Flavia Chereches, MS, Gabriel Olaru, PhD, Nicola Ballhausen, PhD, and Yvonne Brehmer, PhD, Tilburg University. Psychology and Aging, published online Jan. 26, 2026. 
 
CONTACT: Flavia Chereches, MS, can be reached at F.S.Chereches@tilburguniversity.edu. 

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA’s membership includes 173,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve lives.

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Journal

Psychology and Aging

DOI

10.1037/pag0000958 

Cannabis beverages as a substitute for alcohol could be a novel harm reduction strategy

Cannabis-infused beverages may provide a unique opportunity for helping people drink less alcohol, according to the findings of a small study led by public health researchers from the University at Buffalo.

The risks associated with drinking alcohol are many, both from a health as well as a societal standpoint. Alcohol consumption has been linked to at least seven different types of cancer and nearly 200 health conditions and diseases. Cannabis, on the other hand, poses lower risks and harms, especially compared to heavy alcohol use.

The study published this month in the Journal of Psychoactive Drugs is the first of its kind to focus on cannabis beverages and the potential for alcohol harm reduction, the authors say. It also happens to be particularly relevant given it was published in “dry January,” a month in which many people try to start the new off by reducing or eliminating alcohol consumption.

Harm reduction is a public health strategy used to reduce the risks associated with substance use. It acknowledges that while abstinence is often best, many people choose to use legally available products containing alcohol, tobacco or cannabis.

“In the first study of its kind, we introduce the concept of having cannabis as harm reduction for alcohol. Cannabis has been proposed as harm reduction for other drugs such as opioids but not talked about as often for legal substances such as alcohol,” says study first author Jessica Kruger, PhD, a clinical associate professor of community health and health behavior in UB’s School of Public Health and Health Professions.

But, she cautions, “I think we have a long way to go before this is seen as mainstream as cannabis beverages are a new modality of use.”

The market for cannabis beverages is exploding. Market research firm Euromonitor projects sales of these beverages to top $4 billion in 2028. Many Americans are also trying to drink less alcohol — and not just during so-called “Dry January.”

The survey of 438 anonymous adults who reported using cannabis in the past year found that the majority, or nearly 56%, reported drinking alcoholic beverages. About one-third used cannabis beverages, typically consuming one per session, and users were more likely to report substituting cannabis for alcohol (58.6%) than non-users (47.2%).

In this study, 89.5% of respondents drank cannabis beverages with 10 mg of cannabidiol (CBD) or less, 10.4% with more than 10 mg, and about half (48%) didn’t know the CBD content.

In addition, they reported consuming fewer alcoholic drinks after starting cannabis beverages — an average of 3.35 per week compared to 7.02 before starting cannabis beverages. They also reported binge drinking alcohol less frequently compared to before they started drinking cannabis beverages.

Nearly two-thirds of respondents (62.6%) answered that they had either reduced (61.5%) or stopped (1.1%) drinking alcohol as a result of drinking cannabis beverages; 3.3% reported increasing alcohol consumption.

The findings suggest that cannabis beverages may support alcohol substitution and reduce alcohol-related harms, offering a promising alternative for people interested in reducing their alcohol intake.

 “Several previous studies, including ours, have demonstrated that people have reduced their alcohol consumption by switching to cannabis,” says Daniel Kruger, PhD, a paper co-author and research associate professor in UB’s School of Public Health and Health Professions.

“It’s remarkable that people who use cannabis beverages report an even greater reduction in alcohol use than those who use other types of cannabis products (but not beverages). We believe this may be because of the similarity in administration method and context of use — people at parties or bars will likely have a drink in their hand, in this case a cannabis beverage rather than an alcoholic one,” he adds.

Cannabis drinks — which are often packaged in cans like common alcoholic beverages such as beer and hard seltzers — are becoming more widely available as states legalize cannabis for adult use. The first cannabis beverage sold legally in New York State was released in January 2023, one month after the state began the licensed sale of cannabis products.

The survey revealed that nearly 82% of respondents who used cannabis beverages were more likely to buy their cannabis products from cannabis dispensaries authorized for medical and adult use.

Based on the survey results, the research team plans to further explore the effect of cannabis drinks over time and compare modes of cannabis consumption.

Nitrate in drinking water = increased dementia risk; nitrate from vegetables = a lower risk

New research from Edith Cowan University (ECU) and the Danish Cancer Research Institute (DCRI) investigated the association between the intake of nitrate and nitrite from a wide range of different sources, and the associated risk of dementia. 

Dementia is a complex disease shaped by both genetics and lifestyle, and Post-Doctoral Research Fellow at ECU’s Nutrition & Health Innovation Research Institute (NHIRI) and the DCRI, Dr Nicola Bondonno said dietary factors could also be important.  

The research, which investigated the association between source-specific nitrate and nitrite intake and incident and early-onset dementia, followed more than 54,000 Danish adults for up to 27 years and found that the source of nitrate was of critical importance in a diet. 

The researchers found that people who ate more nitrate from vegetables had a lower risk of developing dementia, while those who consumed more nitrate and nitrite from animal foods, processed meats, and drinking water, had a higher risk of dementia. 

ECU Associate Professor Catherine Bondonno said that nitrate intake from vegetables has been linked with a lower risk of dementia, which is thought to be a result of the conversion of nitrate to nitric oxide in the body. 

“When we eat nitrate-rich vegetables, we are also eating vitamins and antioxidants which are thought to help nitrate form the beneficial compound, nitric oxide, while blocking it from forming N-nitrosamines which are carcinogenic and potentially damaging to the brain. 

These four foods are rich in natural nitrates:

Spinach. It is not just a great addition to salads but also a great source of natural dietary nitrates. A 100-gram serving of spinach has about 741 milligrams, although the exact amount varies depending on growing conditions.

Broccoli. Depending on its growing conditions, broccoli has about 40 milligrams per 100-gram serving.

Lettuce. Lettuce in salad mix has about 82 milligrams per 100-gram serving.

Carrots. Leafy vegetables aren’t the only source of natural nitrates. If you’re looking for a slightly earthier alternative, carrots have about 0.1 milligrams of nitrates per 100 grams.

“Unlike vegetables, animal-based foods don't contain these antioxidants. In addition, meat also contains compounds such as heme iron which may actually increase the formation of N-nitrosamines. We think this is why nitrate from different sources has opposite effects on brain health, but we need laboratory studies to confirm exactly what's happening,” she said.  

This is the first time that nitrate from drinking water has been linked to higher risks of dementia. The study found that participants exposed to drinking-water nitrate at levels below the current regulatory limits, had a higher rate of dementia, however, Dr Bondonno stressed that this was only one study, and more research was required.  

“Water doesn't contain antioxidants that can block formation of N-nitrosamines. Without these protective compounds, nitrate in drinking water may form N-nitrosamines in the body,” she said.  

In Denmark and the EU, the limit for nitrate in groundwater and drinking water is set at 50 mg/L, but the researchers observed a higher risk for drinking water containing as low as 5 mg of nitrate per litre. 

“Importantly, our results do not mean that people should stop drinking water. The increase in risk at an individual level is very small, and drinking water is much better for your health than sugary drinks like juices and soft drinks. However, our findings do suggest that regulatory agencies should re-examine current limits and better understand how long-term, low-level exposure affects brain health.”  

She simultaneously emphasises that this is an observational study, which cannot establish that nitrate directly causes dementia. The results must therefore be confirmed in other studies, and it cannot be ruled out that other factors in participants' diets or lifestyles contribute to the association. 

Dr Bondonno said the take-home results from the study is fairly simple: people who consume more nitrate from vegetables, equating to around one cup a day of baby spinach, had a lower risk of dementia. 

On the other hand, people who consumed more nitrate from animal-based foods, particularly red and processed meat, had a higher risk.  

“Eating more vegetables and less red meat and processed meat is a sensible approach based on our findings and decades of other research on diet and health,” she added.  

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Journal

Conservative approach to unexplained unintentional weight loss evaluation needed

• A new study examining the evaluation of unintentional weight loss (UWL) calls into question the widespread use of routine diagnostic testing when weight loss is unexplained, and underscores the need for a more conservative approach.
• Until this study, there was a lack of evidence-based guidance on how to best manage UWL.
• This study finds that serious conditions as causes of unexplained unintentional weight loss, including cancer, are uncommon.

CLEVELAND - Researchers at University Hospitals Cleveland Medical Center have completed a study aimed at improving how physicians evaluate unintentional weight loss, a common but challenging clinical problem, particularly among older adults.

The research was completed by the UH ADVANCE (Advancing Diagnosis through Validated Analytics and Novel Collaborations for Excellence) Center, a diagnostic error center of excellence funded by the Agency for Healthcare Research and Quality (AHRQ).

The UH ADVANCE Center found that diagnostic abnormalities were no more likely to occur among adults with unintentional weight loss than among comparison patients. In the vast majority of cases, the weight loss was not linked to a serious underlying condition. Researchers found the overall rate of cancer among patients with unintentional weight loss to be .7%.

Unintentional weight loss (UWL) frequently triggers extensive diagnostic evaluations, as physicians seek to rule out serious underlying causes. Researchers found that unintentional weight loss remains under-recognized in primary care settings, consistent with previous findings. In only 38% of cases UWL was recognized by physicians. When it is identified, physicians often respond with extensive testing. The study used electronic health record data to identify more than 3,000 patients with unintentional weight loss. Common diagnostic tests and procedures were compared among patients with recognized UWL and patients without UWL.  

The study showed none of the tests were more likely to be abnormal in patients with recognized UWL compared with patients without UWL. Based on this surprising finding, with a stakeholder panel, the UH ADVANCE Center developed a set of conservative recommendations for diagnostic evaluation of  UWL. While careful inquiry into causes of weight loss such as depression, lack of access to food, and chronic diarrhea is recommended, routine laboratory and other testing when such findings aren’t present is not recommended.

“These findings are striking,” said first author Goutham Rao, MD, Chief Clinician Experience Officer, University Hospitals. “They challenge long-standing assumptions and highlight the need for a more measured, evidence-based approach when we can’t find an obvious cause of weight loss. Our results can help clinicians better balance thorough evaluation and avoid unnecessary tests and procedures.”

Rao and his team recommend asking all patients who have lost weight the simple question, “I see you’ve lost X pounds since I last saw you. Can you tell me more about that?” That simple question is first likely to reveal whether the weight loss is intentional or point to another cause. If no obvious cause is present, Rao and his team recommend weekly self-weighing to monitor weight, rather than extensive testing. “Most patients who lose weight unintentionally gain it back within a year,” Rao noted.

In the future, researchers hope to see this recommendation incorporated into clinical decision support in electronic health records systems to raise awareness of UWL to both caregivers and patients.

“Despite how common unintentional weight loss is, there has historically been little evidence-based guidance to help clinicians determine the most appropriate evaluation,” said Rao. “Our goal is to provide physicians with data-driven insights into how often serious abnormalities are actually found and how best to approach care for these patients.”

The study began in 2022 and concluded in 2025 with the goal of providing physicians guidance on how to manage patients who are losing weight without trying. This study adds new evidence to guide caregivers in managing unintentional weight loss, with the potential to improve patient experience, reduce unnecessary testing, and support a more accurate and efficient diagnosis.

High BMI could increase dementia risk, study finds

 

High body mass index (BMI) could cause a higher risk of vascular-related dementia (a combination of vascular and unspecified dementia), according to new research from the University of Bristol and University Hospital of Copenhagen (Rigshospitalet and Herlev-Gentofte hospital). The researchers found that the effect of high BMI on dementia mainly works through high blood pressure.

 

The study published in The Journal of Clinical Endocrinology & Metabolism today [22 January] has shown that many dementia cases could be prevented if high BMI and high blood pressure is treated or prevented.

 

Previous observational studies have already found a link between midlife obesity and high risk of dementia, including vascular dementia. However, those studies did not uncover whether the obesity causes an increase in dementia risk or whether there is some other factor involved affecting both obesity and dementia risk.

 

The new study analysed population health data from Denmark, the UK and around the world using a powerful approach called Mendelian Randomisation. This statistical, computational technique looks at genetics and health data to see health patterns across large populations.

 

The researchers found that high BMI does increase the risk of vascular-related dementia. They also found that high blood pressure is the main factor in this association, pointing to the potential of treating high blood pressure to reduce dementia risk.

 

First author Dr Liv Tybjærg Nordestgaard, who initiated the project in Copenhagen and extended the work while at the University of Bristol, and who is now at the Department of Clinical Biochemistry at Copenhagen University Hospital -Bispebjerg and Frederiksberg, said: “Dementia is a devastating disease that currently affects 50 million individuals worldwide. Unfortunately, treatment and prevention options are scarce. Our study highlights the potential for reducing vascular-related dementia risk by addressing high BMI and/or high blood pressure in the population.”

 

Professor Ruth Frikke-Schmidt from the Department of Clinical Biochemistry at Copenhagen University Hospital - Rigshospitalet, and senior author, added: “Weight-loss medication has recently been tested for halting cognitive decline in early phases of Alzheimer’s disease, but with no beneficial effect. It remains, however, to be tested whether weight-loss medication initiated before the appearance of cognitive symptoms may be protective against dementia. Our study supports that early weight-loss interventions could prevent dementia, and especially vascular-related dementia.”

Treating cancer with medication before surgery continues to increase

 

Key Takeaways

• New report shows growing use of medications, such as chemotherapy, immunotherapy, and hormone therapy, given before surgery to treat many types of cancer, potentially making surgery less invasive and helping clinicians assess how a patient’s cancer responds to medication to guide the most effective treatment options.
• The report also provides in-depth data on esophageal, melanoma, and prostate cancers, including the median age at diagnosis and the most common surgery performed for each cancer.
• Researchers call for more attention to esophageal cancer, which lacks effective screening options and is diagnosed at an advanced stage in roughly half of patients.

CHICAGO — The second annual report from the National Cancer Database (NCDB) of the American College of Surgeons (ACS) documents a substantial rise in medication treatments, such as chemotherapy, immunotherapy, and hormone therapy, used before surgery to treat many cancers, often allowing less invasive surgery and helping clinicians assess how a patient’s cancer responds to medication to guide the most effective treatment options.

The report, published this week in the Journal of the American College of Surgeons (JACS), shows the most notable increases in neoadjuvant systemic therapy, which involves treatments that travel throughout the bloodstream and are given before surgery, for pancreatic, gynecologic, and abdominal lining cancers.

A comprehensive cancer database jointly run by the ACS and the American Cancer Society, the NCDB collects data on nearly 75% of cancer cases across the United States and includes metrics not often found in other cancer databases, such as tumor biology and length of hospital stay.

The report summarizes data from more than 22 million cancer cases diagnosed at 1,250 ACS Commission on Cancer (CoC) hospitals from 2004 to 2022, the most recent years for which complete data is available. It also describes in-depth data on esophageal, melanoma, and prostate cancers.

“The NCDB report includes clinically relevant data intended to inform not only researchers but also the public on recent observations of cancer involving the latest treatment, surgical options, and cancer outcomes,” said Ronald J. Weigel, MD, PhD, MBA, FACS, medical director of ACS Cancer Programs, and co-author of the JACS study. “As care at CoC-accredited facilities continues to advance, our hope is that this report reflects the vastly changing clinical landscape of cancer treatments using the latest evidence-based treatments.”

Big Picture Cancer Observations

Use of neoadjuvant systemic therapy increased notably for certain cancers. The researchers found that from 2010 to 2022, the use of neoadjuvant systemic therapy for gynecologic cancers rose nearly fivefold, from 7% to 34%. Substantial increases in neoadjuvant systemic therapy were also seen for pancreatic cancer, which more than tripled (12% to 40%), and for rarer cancers (peritoneum, omentum, and mesentery) that affect the abdominal lining and tissue, which nearly doubled (23% to 47%).

“Historically, when we thought about treating solid tumors, the first expected treatment was to have surgery to remove the tumor. Now, we are seeing treatment more frequently with targeted medication before surgery,” said Judy C. Boughey, MD, FACS, senior author of the JACS study, chair of the ACS Cancer Research Program, and chair of the Division of Breast and Melanoma Surgical Oncology at Mayo Clinic in Rochester, Minnesota.

Dr. Boughey noted the main advantage of neoadjuvant systemic therapy is twofold: first, it shrinks the tumor, ideally allowing for less invasive surgery; and second, it allows clinicians to better understand the tumor’s response to systemic treatment, which can help clinicians determine the most effective treatment for a patient.

“If a patient’s tumor responds to systemic therapy, they generally will do well with treatment; if that doesn’t happen, it tells the clinical team that they need to think about different therapy,” she said.

In-Depth Data on Three Cancers

The report also examined three cancers in depth: prostate cancer, a common (high-volume) cancer; esophageal cancer, a less common (low-volume) cancer; and melanoma, selected as a special interest cancer.

Prostate Cancer

Patients with prostate cancer, the most common cancer diagnosed in men, are increasingly being treated with non-surgical options, especially for patients with Stage 1 prostate cancer, according to the report. In 2022, roughly 60% of patients with prostate cancer were treated with methods other than surgery, a rise from 54% in 2018. Of patients who had surgery, removal of the prostate gland (prostatectomy) was the most common surgery, occurring in 85% of patients who had surgery.

Risk factors for dying from prostate cancer are also described in the report. Men who had a prostate-specific antigen (PSA) level over 20 at the time of diagnosis, as well as a higher cancer stage and grade of tumor, were more likely to die from the disease.

Esophageal Cancer

The number of patients with esophageal cancer who received immunotherapy rose sharply, increasing from 8% to 30% between 2018 and 2022. While the use of immunotherapy to treat esophageal cancer is growing, the disease is often detected at an advanced stage. About half of patients already have stage 4 disease at the time of their diagnosis.

In the JACS study, the authors call for an effective, widely used screening method to detect esophageal cancer earlier in more patients.

“If patients with esophageal cancer are diagnosed at less advanced stages, we theorize that more patients could be treated with surgery or other less invasive treatment options,” said Elizabeth B. Habermann, PhD, MPH, chair of the ACS Cancer Data Modeling Pillar, professor of health services research at Mayo Clinic in Rochester, Minnesota, and first author of the JACS study.

Melanoma

Melanoma, a skin cancer that can be deadly if not detected early, most often affected the torso (30%) or the upper limb and shoulder region (25%). Patients with scalp and neck melanomas had the lowest overall survival rates among all invasive melanomas. Ulceration, which occurs when the top layer of the skin involved by melanoma breaks down, was also associated with poorer survival, according to the report.

Future reports will focus on three other cancers to provide the public and researchers with unique data points not often included in other cancer reports, the authors added.

Co-authors of the JACS study are Courtney N. Day, MS; Bryan E. Palis, MA; Daniel Boffa, MD, FACS; Tina J. Hieken, MD, FACS; and Shaheen Alanee, MD, MBA, MPH, FACS.

This study is published as an article in press on the JACS website. 

Citation: Habermann E, Day C, Palis B, et al. National Cancer Statistics: American College of Surgeons Cancer Programs Annual Report from 2022 Participant User File. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000001747

Long-term physical inactivity linked to higher stress in midlife

Prolonged insufficient physical activity in adulthood increases the body’s stress burden, according to a large longitudinal study based on the Northern Finland Birth Cohort 1966. By contrast, engaging in physical activity in line with recommended guidelines appears to protect the body from harmful stress.

The health benefits of physical activity are well established, but the relationship between long-term physical activity and cumulative stress in the body has been studied less extensively.

A study conducted in collaboration between the University of Oulu and the Oulu Deaconess Institute Foundation sr. shows that exercise habits at different stages of adulthood influence how much long-term stress burden has accumulated in the body by midlife.

The study followed more than 3,300 individuals from the Northern Finland Birth Cohort 1966 from the age of 31 to 46. Participants’ leisure-time physical activity was examined in relation to the World Health Organization’s (WHO) physical activity recommendations. In addition, so-called allostatic load was measured, describing the strain imposed on the body by long-term stress.

According to the results, individuals who did not meet the health-enhancing physical activity recommendations during the follow-up period had a higher stress burden in midlife than those who were physically active in line with the recommendations. A decline in physical activity during adulthood was also associated with increased stress burden.

By contrast, individuals who increased their level of physical activity during adulthood did not differ in terms of stress burden from those who had remained physically active.

“The results suggest that the importance of physical activity is not limited to individual life stages; rather, regular exercise throughout adulthood may protect the body from the harmful effects of long-term stress,” says Doctoral Researcher Maija Korpisaari.

In the study, stress burden was assessed using both broader and narrower combinations of biological measures. The results were largely consistent regardless of the indicator used, strengthening the reliability of the findings.

Physical activity as part of stress management

The study provides new evidence that physical activity may be a key factor in preventing the long-term effects of stress.

“In terms of stress burden, both the amount of physical activity in youth and in adulthood are important. Regular physical activity in adulthood appears to help the body cope with stress even into midlife,” Korpisaari says.

According to the researchers, further longitudinal studies are needed to more precisely assess the use of different stress indicators and to understand how physical activity affects the body’s stress systems at different stages of the life course.

The results of the study have been published in the scientific journal Psychoneuroendocrinology. Association of longitudinal changes in physical activity with allostatic load in midlife.

https://www.oulu.fi/en/news/long-term-physical-inactivity-linked-higher-stress-burden-midlife

Two days of oatmeal reduce cholesterol level

 

A short-term oat-based diet appears to be surprisingly effective at reducing the cholesterol level. This is indicated by a trial by the University of Bonn, which has now been published in the journal Nature Communications. The participants suffered from a metabolic syndrome – a combination of high body weight, high blood pressure, and elevated blood glucose and blood lipid levels. They consumed a calorie-reduced diet, consisting almost exclusively of oatmeal, for two days. Their cholesterol levels then improved significantly compared to a control group. Even after six weeks, this effect remained stable. The diet apparently influenced the composition of microorganisms in the gut. The metabolic products, produced by the microbiome, appear to contribute significantly to the positive effects of oats.

The fact that oats have a beneficial effect on the metabolism is nothing new. German medic Carl von Noorden treated patients with diabetes with the cereal at the beginning of the 20th century – with remarkable success. “Today, effective medications are available to treat patients with diabetes,” explains Marie-Christine Simon, junior professor at the Institute of Nutritional and Food Science at the University of Bonn. “As a result, this method has been almost completely overlooked in recent decades.”

Although the test subjects in the current trial were not diabetic, they suffered from a metabolic syndrome associated with an increased risk of diabetes. The characteristics include excess body weight, high blood pressure, an elevated blood sugar level, and lipid metabolism disorders. “We wanted to know how a special oat-based diet affects patients,” explains Simon, who is also a member of the Transdisciplinary Research Areas “Life & Health” and „Sustainable Futures“ at the University of Bonn.

300 grams of oatmeal per day

The participants were asked to exclusively eat oatmeal, which they had previously boiled in water, three times a day. They were only allowed to add some fruit or vegetables to their meals. A total of 32 women and men completed this oat-based diet. They ate 300 grams of oatmeal on each of the two days and only consumed around half of their normal calories. A control group was also put on a calorie-reduced diet, although this did not consist of oats.

Both groups benefited from the change in diet. However, the effect was much more pronounced for the participants who followed the oat-based diet. “The level of particularly harmful LDL cholesterol fell by 10 percent for them – that is a substantial reduction, although not entirely comparable to the effect of modern medications,” stresses Simon. “They also lost two kilos in weight on average and their blood pressure fell slightly.”

The effect on LDL cholesterol, in particular, is likely to be relevant to health. If the blood contains too much of this, it is deposited in the vessel walls. These deposits, known as plaques, narrow the blood vessels. In addition, the deposits can rupture, for instance due to an increase in blood pressure following physical exertion, anger, or stress. As a result, a blood clot can form at the affected site, completely blocking the blood vessel. Alternatively, parts of the plaque can be washed away by the blood and cause a heart attack or stroke.

Oats promote the growth of “healthy” intestinal bacteria

But how does oatmeal exert its beneficial effect? “We were able to identify that the consumption of oatmeal increased the number of certain bacteria in the gut,” explains Simon’s colleague Linda Klümpen, the lead author of the trial. The microbiome has increasingly been the focus of research in recent decades. After all, it is now known that intestinal bacteria play a decisive role in metabolizing food. They also release the metabolic by-products that they create into their environment. They supply, among other things, the cells of the gut with energy, enabling them to better perform their tasks.

In addition, the microbes send some of their products around the body in the blood stream, where they can have various effects. “For instance, we were able to show that intestinal bacteria produce phenolic compounds by breaking down the oats,” says Klümpen. “It has already been shown in animal studies that one of them, ferulic acid, has a positive effect on the cholesterol metabolism. This also appears to be the case for some of the other bacterial metabolic products.” At the same time, other microorganisms “dispose of” the amino acid histidine. The body otherwise turns this into a molecule that is suspected of promoting insulin resistance. This insensitivity to insulin is a key feature of diabetes mellitus.

A large amount of oats for two days better than a small amount for six weeks

The positive effects of the oat-based diet tended to still be evident six weeks later. “A short-term oat-based diet at regular intervals could be a well-tolerated way to keep the cholesterol level within the normal range and prevent diabetes,” says Junior Professor Simon. However, in the current study, the cereal above all exerted its effect at a high concentration and in conjunction with a calorie reduction: A six-week diet, in which the participants consumed 80 grams of oats per day, without any other restrictions, achieved small effects. “As a next step, it can now be clarified whether an intensive oat-based diet repeated every six weeks actually has a permanently preventative effect,” continues Simon.

Test method:

A total of 68 participants took part in the trial. For the two-day short-term oat-based diet, all 17 participants on the oat-based diet and 15 participants on the control diet successfully completed the study phase. Two participants in the control group withdrew for personal reasons. For the six-week long-term oat-based intervention, 17 participants in the study group and the same number in the control group took part until the end. The sample size of 17 participants per group was calculated by the researchers on the basis of data from an earlier interventional trial.

Both the two-day intensive diet and the six-week trial with a moderate dose of oats were randomized controlled trials. In these “RCTs,” the test subjects are divided into two groups at random (i.e. randomized). One of them receives the potential active ingredient – in this case the oats –, but the other (the control group) does not. Ideally, the test subjects are “blind”: They do not know to which group they belong. This rules out any placebo effects.

In nutritional experiments, blinding is often not possible – those involved ultimately generally know what they are eating. This was also the case in these studies. However, the evaluation of the blood and stool samples was indeed “blind”: The researchers in charge of this were not informed whether the material had been taken from members of the test group or the control group. The same also applied to the blood pressure and weight measurements. This ruled out the possibility of the scientists’ expectations falsifying the results.

Blood and stool samples were taken before the participants made any changes to their diet. Their blood pressure, weight, height, waist size, and body fat were also measured. A second examination took place immediately after the two-day oat-based diet, followed by three others after two, four, and six weeks. The same analysis were conducted on these four visits as during the initial examination and further blood and stool samples were collected. The researchers took the same approach during the second nutritional study, in which the subjects consumed 80 grams of oatmeal a day for six weeks.

The blood samples were examined in the lab for their LDL cholesterol content, among other things. The researchers also measured the concentration of a key molecule, dihydroferulic acid. This phenolic compound is presumably formed by certain intestinal bacteria, which are known to have a health-promoting effect.

By examining the stool samples, the researchers were able to confirm this hypothesis. They isolated what is known as 16S RNA from the samples. This is a molecule that exclusively occurs in bacteria, but differs somewhat between different species. A 16S RNA molecule can thus be used to identify the bacterium from which it originates, just like a fingerprint. The researchers also analyzed which metabolic products were present in the stool.