Planetary health diet and mediterranean diet associated with similar survival and sustainability benefits

 Two plant-based diets were associated with similar survival benefits and low environmental impact, according to research presented today at ESC Preventive Cardiology 2025,1 a scientific congress of the European Society of Cardiology (ESC). 

Diet contributes significantly to cardiovascular disease mortality, with estimates indicating that across the European region, one in every five premature deaths could be prevented by an optimised diet.2  

“In 2019, the Planetary Health Diet (PHD) was developed to optimise global dietary quality while keeping the environmental impacts of food production within sustainable planetary boundaries,3” said study author Dr. Mercedes Sotos Prieto of the Autonomous University of Madrid, Spain. “However, there was a lack of evidence on how the PHD compares with the Mediterranean Diet, a plant-based diet with established health and environmental benefits, that is  well rooted in Mediterranean countries. We evaluated the effects of both diets on all-cause mortality and environmental impact in a large representative Spanish population.” 

The PHD involves energy intake of around 2,500 kcal/day and focuses primarily on high consumption of fruits and vegetables, whole grains, legumes, nuts and unsaturated oils; moderate intake of dairy, starchy vegetables, poultry and fish; and low consumption of saturated fats, red meat and added sugars. 

The Mediterranean Diet is characterised by a pattern rich in fruits and vegetables (seasonal), legumes, whole grains and nuts, with olive oil as the main dietary fat, greater consumption of white or lean meats than of red or processed meats, and with moderate consumption of dairy products, fish and eggs. 

In the analysis, data on food intake were collected from 11,488 participants in the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA), a prospective cohort study of individuals recruited between June 2008 and October 2010.4 The PHD Index (0–140 points) was calculated for each participant based on their consumption of 15 food groups: whole grains, starchy vegetables, vegetables, whole fruits, dairy foods, red/processed meat, chicken and other poultry, eggs, fish/shellfish, nuts, non-soy legumes, soybean/soy foods, added saturated and trans-fat, added unsaturated oils, and added sugar and fruit juice. Adherence to the Mediterranean Diet was assessed using the 14-item MEDAS score (0–14 points), which is based on components such as using olive oil for cooking and dressings, eating white meat and seafood over red meat, the consumption of fruits, vegetables, legumes and nuts, and low intake of high-fat dairy products, commercial baked goods and sugar-sweetened/carbonated beverages. The environmental impact of each diet was assessed using the SHARP-Indicators Database (SHARP-ID), which includes data on greenhouse gas emissions and land use. Mortality data were obtained from the National Death Index of Spain. Analyses were performed across tertiles of adherence to the diets, with adjustment for confounders. 

Study participants had a mean age of 47.5 years (range, 18–96 years) and around a half (52.5%) were women. A total of 1,157 all-cause deaths occurred during a mean follow-up of 14.4 years. 

Higher adherence to the PHD and Mediterranean Diet was similarly associated with lower all-cause mortality. Participants in the top third for adherence to the PHD had a 22% lower chance of dying than those in the lowest third (adjusted hazard ratio [HR] 0.78; 95% confidence interval [CI] 0.66–0.91). For the Mediterranean Diet, participants in the top third for adherence had a 21% lower chance of dying than those in the lowest third (adjusted HR 0.79; 95% CI 0.68–0.93). Adherence to some components of the PHD (fruits, dairy and unsaturated oils) and the Mediterranean Diet (nuts, low consumption of soda and pastries) was independently associated with lower mortality. 

In terms of environmental impact, both diets had similarly low footprints. For the PHD, the average level of greenhouse gas emissions was 4.15 kg of CO₂ per day and average level of land use was 5.54 m2 per daily food intake. The average level of greenhouse gas emissions for the Mediterranean Diet including dairy was 4.36 kg of CO₂ per day and the average level of land use was 5.43 m2 per daily food intake. Dairy and meat products were the largest footprint contributors. 

Dr. Sotos Prieto concluded: “Higher adherence to both diets was similarly associated with lower all-cause mortality and with comparable low environmental impact, highlighting the substantial health and planetary advantages of adopting one of these plant-based diets.” 

Eating Hot Dogs Is Common at Baseball Stadiums, but Many People Don’t Know Health Risks of Processed Meat

As baseball season gets underway, a new Physicians Committee for Responsible Medicine/Morning Consult survey finds that while most Americans have eaten a hot dog at a baseball stadium, many don’t know or are unsure of the specific health risks associated with eating hot dogs.

The poll included 2,204 U.S. adults surveyed March 10-12, 2025. When asked, “Have you ever eaten a hot dog at a baseball stadium?” 57% said that they had. When asked, “Do you know the health risks associated with eating hot dogs and other processed meats, like bacon and deli meats?” 51% said, “Somewhat, I’ve heard there are health risks but I’m unsure of what they are specifically,” while another 30% said, “No, I don’t know the health risks.”

“Tens of millions of Americans could eat hot dogs this baseball season, but most of them are unaware that doing so raises their risk of colorectal cancer and other diseases,” says Noah Praamsma, MS, RDN, nutrition education coordinator for the Physicians Committee for Responsible Medicine. An estimated 20 million hot dogs are consumed by fans during baseball season.

The World Health Organization has determined that consuming processed meat, such as hot dogs, increases the risk of colorectal cancer and has classified it as “carcinogenic to humans.” Just 50 grams of processed meat—the amount in an average hot dog—consumed daily increases colorectal cancer risk by 18%. The World Cancer Research Fund and the American Institute for Cancer Research say that “there is strong evidence” that consumption of processed meat causes colorectal cancer.

Of particular concern is the dramatic rise in colorectal cancer among younger people. The National Cancer Institute says, “There’s mounting evidence linking an unhealthy diet—in particular, one high in processed meat and fat, and low in fruits and vegetables—to early-onset colorectal cancer.”

According to “Cancer statistics 2024: All hands on deck,” a report from the American Cancer Society, colorectal cancer was the fourth leading cause of cancer death in the 1990s and has risen to the leading and second leading cause of cancer death in men and women, respectively, aged 40-49. Colorectal cancer has also moved up to the leading cause of cancer death in men aged 20-39 years and the third leading cause in women in the same age group.

When asked, “Would you try a plant-based hot dog if it was available?” a combined 40% of survey respondents said they “definitely would” or “probably would.” A combined 63% of respondents said baseball stadiums “definitely” or “probably” should make plant-based hot dogs available to fans as an option.

“The good news is that many stadiums across the country now offer plant-based hot dogs as alternatives to meat hot dogs,” says Praamsma. “Fans who trade even one serving of processed meat a day for a plant-based alternative would hit a home run for their health.”

Research shows that men who ate the most plant-based foods had a 22% reduced risk of colon cancer, compared with those who ate the least. Other studies show the benefits of whole grains, fruits, vegetables, and beans and legumes, such as peanuts. Processed plant-based foods also have a positive health impact, according to recent research.

“A vegan hot dog is a great option for ballpark food,” says Praamsma. “For the home chef or scratch-cooking backyard griller, carrot dogs also make a surprisingly delicious alternative to their dangerously processed meat counterparts.”

Replacing meat with plant-based meat alternatives may also be beneficial for heart health, while processed meats such as hot dogs are linked to heart disease risk.

No veggie dogs at your stadium? “If veggie dogs and other plant-based options aren’t available, opt for roasted peanuts—a staple at baseball stadiums,” says Praamsma. “Peanuts are packed with disease-fighting plant protein and can be protective against colorectal cancer.”

17 modifiable risk factors shared by stroke, dementia, and late-life depression

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Age-related brain diseases such as stroke, dementia, and late-life depression are a debilitating part of growing older, but people can lower their risk of these diseases through behavioral and lifestyle changes. In a new extensive systematic review, Mass General Brigham researchers identified 17 modifiable risk factors that are shared by stroke, dementia, and late-life depression. Modifying any one of them can reduce your risk of all three conditions. The findings, which provide evidence to inform novel tools, such as the Brain Care Score, are published in the Journal of Neurology, Neurosurgery, and Psychiatry.

 

“Our study identified 17 modifiable risk factors shared between stroke, dementia, and/or late-life depression, emphasizing that there are many different steps individuals can take to lower their risks for these age-related brain diseases,” said senior author Sanjula Singh, MD, PhD, MSc (Oxon), principal investigator at the Brain Care Labs at Massachusetts General Hospital (MGH), a founding member of the Mass General Brigham healthcare system.

 

The researchers systematically searched the scientific literature for previously published meta-analyses of risk factors associated with stroke, dementia, and late-life depression. Then, they combined these data to identify modifiable risk factors (i.e., those that can be altered through behavioral change) shared amongst at least two out of the three diseases. They also estimated the relative impact of each risk factor on measures of quality of life and early death.

 

Altogether, the researchers identified 17 risk factors shared by at least two of the diseases, including blood pressure, kidney disease, fasting plasma glucose, total cholesterol, alcohol use, diet, hearing loss, pain, physical activity, purpose in life, sleep, smoking, social engagement, and stress. Of these, high blood pressure and severe kidney disease had the biggest impact on the incidence and burden of stroke, dementia, and late-life depression. In contrast, physical activity and engagement in leisure activities with a cognitive aspect (e.g., puzzles) were associated with a lower risk of disease, though the researchers suspect that these associations may be symptomatic rather than causal, since individuals with brain disease may be less capable of engaging in physical and cognitive leisure activities.

 

“Dementia, stroke, and late-life depression are connected and intertwined, so if you develop one of them, there's a substantial chance you may develop another one in the future,” said first author Jasper Senff, MD, post-doctoral fellow at the Singh Lab at the Brain Care Labs at MGH. “And because they share these overlapping risk factors, preventive efforts could lead to a reduction in the incidence of more than one of these diseases, which provides an opportunity to simultaneously reduce the burden of age-related brain diseases.”

Being physically active, even just a couple of days a week, may be key to better health

Research Highlights:

• New research suggests that participating in at least 150 minutes of moderate to vigorous physical activity in just two days had similar health benefits as distributing the activity throughout the week.
• People who followed the “weekend warrior” approach, condensing physical activity into one or two days each week, had a significantly lower risk of death from all causes, cardiovascular disease and cancer, similar to those who engaged in activity throughout the week.
• The study examined the physical activity of more than 93,000 participants in a large U.K. biomedical database who wore wrist accelerometers to track their physical activity.

Being physically active for one to two days a week, often called a “weekend warrior,” may provide comparable health and life-prolonging benefits as smaller doses of daily physical activity if the physical effort is moderate to vigorous and totals 150 minutes a week in line with recommended guidelines for weekly physical activity, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

“You don’t need to exercise every day to stay healthy. As long as you get 150 minutes of moderate to vigorous physical activity per week — whether packed into one to two days or spread out — you can significantly reduce your risk of dying from cardiovascular disease, cancer or other causes,” said study corresponding author Zhi-Hao Li, Ph.D., an epidemiologist in the School of Public Health at Southern Medical University in Guangzhou, China.

“This message is encouraging news for busy people who struggle to fit in daily workouts but can manage a concentrated burst of activity on weekends or over a couple of days,” Li said. “The research provides reassuring evidence that even sporadic physical activity can have lasting health benefits, making it easier for people to prioritize their well-being amid busy schedules.”

To achieve health benefits, both the World Health Organization and the American Heart Association recommend that throughout a week adults engage in 150 to 300 minutes of moderate-intensity aerobic physical activity, or 75 to 150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate and vigorous-intensity activity.

Researchers examined health and physical activity data for more than 93,000 people in a large biomedical database in the U.K. to explore how different physical activity patterns may affect the risk of dying from all causes, specifically cardiovascular disease and cancer. They reviewed physical activity data collected from wrist accelerometers, devices that measure movement and are likely more accurate than asking participants about their activity.

The study categorized the data into three groups: “active weekend warrior” — people who completed most of their exercise in one or two days; “active regular” — those who spread their activity throughout the week; and “inactive” — participants who did not complete the recommended minimum of 150 minutes of weekly physical activity.

Compared to the inactive group, the weekend warrior and active regular groups had a significantly lower risk of death from all causes, cardiovascular disease and cancer if they completed 150 minutes of physical activity a week.

The analysis also found:

• For weekend warriors, the risk of death from all causes was 32% lower; the risk of death from cardiovascular disease was 31% lower; and the risk of death from cancer was 21% lower.
• Among participants in the active regular group, the risk of death from all causes was 26% lower; the risk of death from cardiovascular disease was 24% lower; and the risk of death from cancer was 13% lower.
• No significant differences in the risk of death surfaced between the weekend warrior vs. the active regular group.

While the new research aligns with previous studies, it is the first to analyze the relationship between physical activity patterns measured by accelerometers and the risk of death from cardiovascular disease and cancer.

Some of the findings surprised the research team, who initially expected that spreading activity throughout the week would be more beneficial. They did not anticipate that weekend warriors’ condensed physical activity would reduce the risk of death from disease.

“This reinforces the idea that meeting the 150-minutes of physical activity per week guideline is key to longevity, regardless of the activity pattern,” Li said. “Any activity — whether structured exercise such as jogging or daily tasks such as gardening — can be included if the intensity is moderate to vigorous.”

American Heart Association expert volunteer Keith Diaz, Ph.D., said the findings emphasize that the total volume of physical activity is the crucial factor for health benefits, rather than how it is distributed across a week. Diaz, the Florence Irving Associate Professor of Behavioral Medicine at Columbia University Medical Center in New York, was not involved in this research.

“Many people struggle to fit in daily exercise during the workweek; however, this research shows that even if you can only be active on the weekends, you can still gain meaningful health benefits,” said Diaz, a member of the Association’s Physical Activity Science Committee.

“One important caveat to remember is that trying to fit 150 minutes of exercise into just one or two days can be a lot on your body,” he added. “Some research suggests that weekend warriors have a slightly higher risk of musculoskeletal injuries compared to those who exercise more regularly. However, the benefits of exercising just on the weekend far outweigh the potential risks. If you are going to be a weekend warrior, make sure you do proper warm-ups and build up and progress to higher volumes of activity over time. This will help to reduce your risk of injuries.”

The study had several limitations, including that physical activity was only measured at baseline; participants lived in the U.K. and most were white, so the results may not apply to other populations. The researchers said future studies should be conducted to confirm these results in more diverse groups of people throughout the world and with more consideration for contradictory factors such as genetic predisposition or environmental exposures that may influence physical activity and the outcomes.

Study details, background and design:

• The research data focused on seven days of accelerometer-measured physical activity from 2013 to 2015 for 93,409 participants, aged 37 to 73, enrolled in the UK Biobank.
• More than 56% of the participants were women, 97% were white and their average age was 62 years old.
• Based on accelerometer data, more than 42% of participants were classified as weekend warrior, about 24% as active regular and nearly 34% as inactive.
• The accelerometers captured a range of activities, including walking, jogging, stationary cycling, elliptical exercises, household chores, gardening and leisure activities such as dancing.
• During eight years of follow-up, nearly 4,000 adults died from all causes, including about 17% from cardiovascular disease and about 45% from cancer.
• Compared to the inactive participants, those who exercised during two days each week were more likely to be men, younger, have a college degree, non-smokers, non-drinkers, less likely to have Type 2 diabetes and/or to have lower body mass index (an indicator of body fat to determine healthy weight).

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of release link
• After April 2, 2025, view the manuscript online.
• AHA news release: Short, intense bursts of exercise more effective after stroke than steady, moderate exercise (Aug. 2024)
• AHA health information: How much physical activity do you need? (Infographic)
• AHA health information: Breaking Down Barriers to Fitness
• AHA health information: Walking
• AHA health initiative: April 2 is National Walking Day.
• Follow AHA/ASA news on X @HeartNews
• Follow news from the Journal of the American Heart Association @JAHA_AHA
• 
  

Experts challenge aspirin guidelines based on their undue reliance on a flawed trial

 Recent guidelines have restricted aspirin use in the primary prevention of cardiovascular disease. The American Heart Association (AHA)/American College of Cardiology (ACC) guidelines restricted aspirin to patients under 70, and more recently, the United States Preventive Services Task Force restricted aspirin use to patients under 60. However, heart attack and stroke risks both rise with age, leaving health care providers unsure about when to stop prescribing aspirin, whether it should be used for primary prevention, and which patients would benefit most.

Researchers from Florida Atlantic University’s Schmidt College of Medicine, and other distinguished collaborators who have led major trials of aspirin in primary prevention, have published their perspectives, “Aspirin in Primary Prevention: Undue Reliance on an Uninformative Trial Led to Misinformed Clinical Guidelines,” in Clinical Trials, the official journal of the Society for Clinical Trials.  

The authors emphasize that best practices for the design, conduct, analysis and interpretation of randomized controlled trials should adhere to rigorous statistical principles. Failure to follow these principles can lead to conclusions inconsistent with the totality of evidence and inappropriate recommendations made by guideline committees. They believe that both the AHA/ACC Task Force and the U.S. Preventive Services Task Force were unduly influenced by the uninformative, not null, results of the Aspirin in Reducing Events in the Elderly (ASPREE) trial. Specifically, this trial did not provide reliable evidence that aspirin showed no benefit in the age groups they enrolled.

“The reliable evidence indicates that, to do the most good for the most patients in primary prevention of heart attacks and strokes, health care providers should make individual clinical judgments about prescribing aspirin on a case-by-case basis and based on benefit-to-risk not just age alone,” said Charles H. Hennekens, M.D., FACPM, co-author and the first Sir Richard Doll Professor of Medicine and Preventive Medicine, Schmidt College of Medicine. “Further, it seems counterintuitive among patients taking aspirin long term to stop it just because a birth milestone is reached. Finally, absence of evidence does not equate to evidence of absence of effect.”

The authors stress that patients should consult their primary care provider about whether they are candidates for aspirin, as providers have the most knowledge of all the benefits and risks for each of their individual patients. In brief, health providers are equipped to balance the benefits to each patient of clot prevention against their individual bleeding risks. Thus, whether to prescribe aspirin should be an individual clinical judgment.

“Health care providers also should be aware that all patients suffering from an acute heart attack should receive 325 milligrams of regular aspirin promptly, and daily thereafter, to reduce their death rate as well as subsequent risks of heart attacks and strokes,” said Hennekens. “In addition, health care providers and patients should remain cognizant that among survivors of prior heart attacks or occlusive strokes, aspirin should be prescribed long-term unless there is a specific contraindication.”

The authors highlight the growing burden of cardiovascular disease, stressing the need for broader lifestyle changes and effective as well as affordable drug therapies for primary prevention. These changes include quitting smoking, weight loss, increased physical activity, and using statins and other medications to manage blood pressure. With respect to costs, aspirin is a particularly attractive option.

“While patient preference is always important to consider in decision-making, this assumes even greater relevance among patients in whom the absolute benefits and risks of aspirin are similar,” said Hennekens. “Patient preference may include consideration of whether the prevention of a first heart attack or stroke is more important consideration to them than their risk of a significant gastrointestinal bleed.”

The authors also note that the absolute risk of a cerebral bleed without, as well as with aspirin, is too low to be of clinical relevance for the vast majority of patients. In the U.S. and most developed countries, the authors say that individual clinical judgments by health care providers about prescribing aspirin in primary prevention may affect a relatively large proportion of their patients. For example, metabolic syndrome, a constellation of overweight and obesity, hypertension, high cholesterol and insulin resistance, a precursor to diabetes mellitus, affects about 40% of Americans 40 years of age and older and is increasing globally. The high risks of patients with metabolic syndrome for a first heart attack and stroke may approach those of patients with a prior event.  

“Guidelines for aspirin in primary prevention do not seem to be justified,” said Hennekens. “As is generally the case, the primary care provider has the most complete knowledge about the overall benefits and risks for each patient and should make individual clinical decisions.”

According to the U.S. Centers for Disease Control and Prevention, more than 859,000 Americans die of heart attacks or stroke every year, which account for more than 1 in 3 of all U.S. deaths. These common and serious diseases take a very large economic toll, costing $213.8 billion each year to the health care system and $137.4 billion in lost productivity from premature death alone.

FAU collaborated with several distinguished academicians from the University of Wisconsin School of Medicine and Public Health, as well as the Harvard Medical School and Massachusetts General-Brigham Hospital.

Co-authors are Janet Wittes, Ph.D., an affiliate professor of biostatistics, FAU Department of Population Health; David L. DeMets, Ph.D., the first Max Halperin Professor and Chair Emeritus of Biostatistics and Informatics; KyungMann Kim, Ph.D., a professor of biostatistics and informatics; and Dennis G. Maki, M.D., FACP, all with the University of Wisconsin School of Medicine and Public Health; J. Michael Gaziano, M.D., a professor of medicine; Marc A. Pfeffer, M.D., Ph.D., FACC, Distinguished Dzau Professor of Medicine; and Sarah K. Wood, M.D., director of the Harvard Macy Institute, all at the Harvard Medical School, with Gaziano and Pfeffer also affiliated with Massachusetts General-Brigham Hospital; and Panagiota Kitsantas, Ph.D., professor of biostatistics and epidemiology and chair of the Department of Health Administration and Policy, George Mason College of Public Health.  

Hennekens was the first to discover that aspirin prevents a first heart attack in men in the U.S. Physician’s Health Study and prevents a first stroke in women in the Women’s Health Study. He was the U.S. principal investigator on the worldwide Second International Study of Infarct Survival (ISIS02), which demonstrated the lifesaving benefits of aspirin when given within 24 hours of onset of symptoms of a heart attack as well as among long-term survivors of prior occlusive events affecting their heart, brain or peripheral arteries. Gaziano was the principal investigator of the Aspirin to Reduce Risks of Initial Vascular Events (ARRIVE) trial, one of the four major trials recently reported in the peer reviewed literature.  

Older adults experience similar or even less muscle damage than young adults after exercise

Older adults experience less muscle soreness following exercise according to research which overturns the widespread belief that ageing muscles are less resilient.

The study entitled “Advancing age is not associated with greater exercise-induced muscle damage” is published in the Journal of Ageing and Physical Activity (JAPA).

Younger adults were categorised as between 18 to 25 and older adults more than 35 years old.

The research co-authored by Lancaster University provides a comprehensive analysis of how ageing affects muscle function, soreness, and biochemical markers of muscle damage after exercise. By pooling data from 36 studies, researchers found that older adults do not experience greater muscle function loss after exercise compared with younger individuals.

One striking discovery was that muscle soreness was consistently lower in older adults, with reductions of around 34% at 48 hours and 62% at 72 hours compared with younger individuals. Creatine kinase levels, an indicator of muscle damage, were approximately 28% lower in older adults at 24 hours post-exercise.  

The findings suggest that, despite physiological changes with age, muscle resilience remains relatively stable, allowing older individuals to continue engaging in regular physical activity without increased concern for prolonged weakness or loss of function.  

Interestingly, sex appeared to play a role in muscle function recovery, with males showing slightly greater decreases in muscle function after exercise than females. There was no observed impact of upper- or lower-body or exercise type (resistance training or endurance training) on muscle damage markers

Senior author Dr Lawrence Hayes from Lancaster Medical School said: “These findings are significant because they challenge the widespread belief that ageing muscles recover more slowly or are more prone to exercise-induced damage. This misconception often discourages older adults from engaging in regular physical activity due to fears of prolonged soreness or weakness.”

If older individuals experience less muscle damage symptoms than previously thought, recovery strategies, training programs, and post-exercise care could be adjusted accordingly. For example, older adults may not require significantly prolonged recovery periods compared with younger individuals, potentially allowing for more frequent or intense training sessions, leading to better long-term health outcomes.  

Overall, this study reinforces the importance of staying active throughout life and dispels myths that ageing equates to frailty or impaired recovery. These findings could contribute to greater participation in fitness activities among older adults, improving overall health, mobility, and quality of life in ageing populations.

Dr Hayes said: “This means exercise has no age limit so move more to live longer and healthier. Aim for 150 minutes of activity each week, add strength training twice per week, and most importantly, find a workout you love. When you enjoy it, you're more likely to stick with it.”

Medicinal cannabis is linked to long-term benefits in health-related quality of life

 

Patients prescribed medicinal cannabis in Australia maintained improvements in overall health-related quality of life (HRQL), fatigue, and sleep disturbance across a one-year period, according to a study published April 2, 2025, in the open-access journal PLOS One by Margaret-Ann Tait from The University of Sydney, Australia, and colleagues. Anxiety, depression, insomnia, and pain also improved over time for those with corresponding health conditions.

Research into the therapeutic benefits of medicinal cannabis has increased since the discovery of the analgesic properties in cannabis plant compounds. In 2016, advocacy groups lobbied the Australian government to bring about legislation changes that allow patients who were not responding to conventional treatment to access medicinal cannabis with a prescription from clinicians. More than one million new patients in Australia have received medicinal cannabis prescriptions for more than 200 health conditions.

A multicenter prospective study called the QUEST initiative (QUality of life Evaluation STudy) recruited adult patients with any chronic health condition newly prescribed medicinal cannabis oil between November 2020 and December 2021. Tait and colleagues gathered 12-month follow-up data to determine if previously reported improvements at three months would be maintained long-term. Of 2744 consenting participants who completed baseline assessments, 2353 also completed at least one follow-up questionnaire and were included in analyses, with completion rates declining to 778/2353 (38%) at 12 months. Participants with clinician-diagnosed conditions completed questionnaires covering condition-specific symptoms, and HRQL, which encompasses physical, emotional, social, and cognitive function, as well as bodily discomfort.

The researchers found that short-term improvements in overall HRQL reported at three months were maintained over a 12-month period in patients prescribed medicinal cannabis in Australia. People with chronic health conditions reported improvements in fatigue, pain, and sleep. Patients with anxiety, depression, insomnia, or chronic pain diagnoses also showed improvements in condition-specific symptoms over 12 months. Patients treated for generalized anxiety, chronic pain, insomnia, and PTSD all showed improvements in HRQL. Participants with movement disorders had improved HRQL but no significant improvements in upper extremity function scores.  

The study was large enough to assess patients across a wide range of chronic conditions and socio-demographics in a real-world setting. However, without a control group, it was not possible to confidently attribute changes over time to medicinal cannabis.

Despite this limitation, the results suggest that prescribing medicinal cannabis to patients with chronic health conditions may improve pain, fatigue, insomnia, anxiety, and depression and overall HRQL. The findings also suggest that any improvements would be apparent quickly and maintained long-term. According to the authors, the results from this study contribute to the emerging evidence base to inform decision making both in clinical practice and at the policy level.

The authors add: “This is promising news for patients who are not responding to conventional medicines for these conditions." 

The freely available article in PLOS One: https://plos.io/4bIvkNp