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[13 min watch] With the launch of our new online Professional Diploma of Medicinal Cannabis program – the first university-reviewed program in medicinal cannabis for doctors in Australia – Dr Joe Kosterich recently held an insightful webinar on the uses and benefits of medicinal cannabis in primary care. Continue reading “Medicinal Cannabis FAQs: Side effects & limitations of medicinal cannabis”
Patch testing is the best diagnostic tool to evaluate patients with suspected allergic contact dermatitis. The test involves applying common allergens to the patient’s skin and assessing for a skin reaction days later. Continue reading “[7 min read] Patch testing in primary care”
Welcome to this podcast series, Conversations with Professor David Wilkinson! In this episode, Professor David Wilkinson (Deputy Vice-Chancellor at Macquarie University) speaks with Paul Elmslie (Founder and CEO of HealthCert Education and the National Skin Cancer Centres) about a key part of a successful medical business: people. Continue reading “[Podcast] Optimising people and culture in a medical business | Conversations with Prof David Wilkinson”
[10 min watch] With the launch of our new online Professional Diploma of Medicinal Cannabis program – the first university-reviewed program in medicinal cannabis for doctors in Australia – Dr Joe Kosterich recently held an insightful webinar on the uses and benefits of medicinal cannabis in primary care. Continue reading “Medicinal Cannabis FAQs: Conditions medicinal cannabis can treat”
[Nutrition Research Review] Ultra-processed food consumption is associated with increased risk of all-cause mortality and cardiovascular mortality in the Moli-sani Study.
Worldwide, the consumption of processed foods is on the rise, leading to a range of health implications. It is well evidenced that a healthier diet is one that is based on whole foods and foods which are minimally processed, as opposed to one that relies heavily on processed foods.
Food processing exists along a continuum from whole foods to minimally processed foods right through to those which are ultra-processed. Ultra-processed foods (UPF) are described in the NOVA Classification, which is a classification tool used to distinguish foods based on the extent and purpose of processing, rather than nutrient content.1 UPF do not contain significant amounts of whole or minimally processed foods, instead being comprised of a combination of substances that are derived from foods and additives. They are hyper-palatable, highly convenient, highly profitable for food manufacturers and displace less processed foods and whole foods in consumers’ diets.1
To understand the health implications of UPF consumption, Bonaccio et al. explored the association between UPF and mortality risk in a large sample of the Italian adult population drawn from the prospective, population-based Moli-sani Study cohort.2 In addition to mortality, the researchers tested which nutritional factors (sugar, saturated fats, dietary cholesterol, sodium and energy content) were potential mediators of this relationship, and which known cardiovascular disease (CVD) risk factors were likely to be on the pathway between UPF and mortality.
Drawing from 24,475 subjects, data from a validated Food Frequency Questionnaire (measuring food intake in the year before enrolment) and the Mediterranean Diet Score (MDS) (measuring adherence to the traditional Mediterranean diet)3 were analysed. Based on the FFQ, the NOVA classification1 was used to identify UPF foods and intake was calculated and divided into quartiles using a weight ratio.
Biomarkers of renal function, glucose metabolism, lipid metabolism and inflammatory markers were tested as possible mediators of the mortality risk associated with UPF consumption. Median follow up was 8.6 years and 1,216 all-cause deaths occurred.
The results of this analysis confirmed the detrimental impact of increasing UPF consumption on CV health. Specifically, results included:
- Median intake of UPF was 10% (IQR 6.6%-14.6%) of dietary intake as UPF.
- High consumers of UPF (>14.6% food consumed) were more likely to be women, younger, more educated and reported fewer risk factors and chronic diseases as baseline than people who consumed lower levels of UPF.
- As UPF intake increased, adherence with the Mediterranean diet and intake of dietary fibre decreased, while energy, fat, sodium, sugar and dietary cholesterol intakes increased.
- There was a direct linear relationship between a 5% increase in the proportion of UPF in the diet and risk of all-cause and CVD mortality. Higher UPF consumption was associated with a 58% increased risk of CVD mortality and a 52% higher risk of dying from IHD/CV causes, and that this was independent of known risk factors, including adherence to the Mediterranean diet.
- No direct association was found between BMI and UPF intake.
- High risk individuals (with CVD or T2DM) were more sensitive to higher UPF intakes in terms of CVD mortality risk.
- Sugar explained nearly 40% of the association of UPF and IHD/CV mortality. Other studied nutrients only partially accounted for the adverse relationship between UPF and mortality risk, which may indicate that nutrient composition alone is unable to fully explain the increased mortality risk associated with UPF consumption.
- Biomarkers of renal function were found to be likely mediators of the increased mortality associated with higher UPF consumption. Similarly, all CVD risk factors were significantly associated with the excess of all-cause and CVD mortality risk linked to UPF intake.
The important take home message from this research is that higher intakes of UPF are associated with increased all-cause and CVD mortality in this large sample of Mediterranean adults. This finding gives weight to the argument for ongoing public health actions that support all people to have access to, and choose, a diet in line with national dietary guidelines that is based on whole and minimally processed foods, with minimal UPF.
Anna Millichamp, APD, Bond University
Learn more in the online Professional Diploma of Medical Nutrition Management.
- Monteiro C, Cannon G, Levy R, Moubarac JC & Jaime P, al A. NOVA. The star shines bright. Position paper 2. World Nutrition. 2016;7:28-38. Accessed 23rd March 2021, URL: https://www.researchgate.net/publication/315378059_NOVA_The_star_shines_bright_Position_paper_2
- Bonaccio M, Di Castelnuovo A, Costanzo S, De Curtis A, Persichillo M, Sofi F, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study. Am J Clin Nutr. 2021 Feb 2;113(2):446-455. doi: 10.1093/ajcn/nqaa299. PMID: 33333551.
- Trichopoulou A, Costacou T, Bamia C, Trichopoulous D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl. J Med. 2003;348:2599-608. Accessed 24th March 2021. URL: https://www.nejm.org/doi/full/10.1056/nejmoa025039
For many women, pregnancy can mean lots of changes in their bodies. Fluctuating hormones and growing bellies can cause pregnancy dermatoses. It’s important to know which of these dermatoses may be dangerous, especially to both mum and baby. Because general dermatology may not always be readily available in remote regions, primary care doctors have an important role to play in the recognition and management of pregnancy dermatoses. Continue reading “[8 min read] A practical approach to pregnant patients presenting with skin rash in a primary care setting”
Hyaluronic acid fillers are emerging as a possible treatment for the rejuvenation of skin beyond just the face. Horizontal skin lines on the neck are among the most obvious signs of ageing. Wrinkling, loss of moisture and thinning of the skin, coupled with a weakening of the neck muscles, result in vertical or horizontal bands that are a common complaint from patients. Current treatments include radiofrequency to ‘blur out’ skin lines, or surgery to tighten the muscles and remove sagging skin.
Korean researchers are seeking less invasive methods. Since fillers like hyaluronic acid are common for treating wrinkles or jowls in the face, a 2017 study published in the Journal of Cosmetic Dermatology looked at the possibility of using the injectable treatment to fill out horizontal neck lines too.
What makes skin cancer work so enjoyable? In this short video, Skin Cancer Doctor Hamilton Ayres speaks about the benefits of skin cancer work and the advantages of working in a skin cancer practice (even two or three days a week!). Continue reading “[3 min watch] What makes skin cancer work so enjoyable?”
Welcome to our podcast series on medical business management, Conversations with Professor David Wilkinson! In this episode, Professor David Wilkinson (Deputy Vice-Chancellor at Macquarie University) speaks with Paul Elmslie (Founder and CEO of HealthCert Education and the National Skin Cancer Centres) about how to deliver a really high quality skin cancer service for your patients and measure patient satisfaction. Continue reading “[Podcast] Measuring patient satisfaction | Conversations with Professor David Wilkinson”
Well before COVID-19 emerged to become a global public health crisis, the world was already witnessing a much quieter epidemic: malnutrition. Continue reading “[5 min read] Managing malnutrition in older adults”