Welcome back to our regular feature where we sift through thousands of new, health-related papers, and pick a few to summarize in a practical, simple, and not anxiety-inducing way.
Our main questions on each paper:
- In simple language, what does it say?
- Does it have good evidence?
- Should what it says matter to normal people?
- What simple thing, if anything, could a normal person do to take advantage of this finding?
Okay, away we go. And, as always, we rate each paper for practicality and level of interest, but we are mostly focused on finding ways to simplify findings. And more than anything else, we want to avoid over-optimization, so if a paper is telling you down to the minute how much sunlight to get at dawn, or that you should only drink coffee during eclipses, we are outta there.
This edition's articles and papers:
- Are We Adding Pain-Free Years to Life? A Test of Compression Versus Expansion of Morbidity | The Journals of Gerontology: Series A | Oxford Academic https://academic.oup.com/biomedgerontology/advance-article/doi/10.1093/gerona/glae157/7693921
- Real-world trends in GLP-1 treatment persistence and prescribing for weight management https://www.bcbs.com/sites/default/files/BHI_Issue_Brief_GLP1_Trends.pdf
- Melatonin and Risk of Age-Related Macular Degeneration | Ophthalmology | JAMA Ophthalmology | JAMA Network https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2819801?guestAccessKey=d354e01e-28df-48b0-b8b5-da0c8433ce71&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamaophthalmology&utm_term=mostread&utm_content=olf-widget_06202024&adv=null
- Krill Oil for Knee Osteoarthritis: A Randomized Clinical Trial | Geriatrics | JAMA | JAMA Network https://jamanetwork.com/journals/jama/fullarticle/2819125?guestAccessKey=4dd6adc4-d0ef-4fa6-b5c3-54f8a20d55c8&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=etoc&utm_term=061824&utm_adv=null
Now, here are our takes on the articles and papers:
Paper: Living Longer, but in Pain?
Practicality (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Interest (5/5): 🏃♂️🏃♂️🏃♂️🏃♂️🏃♂️
Summary
What is the paper's main claim?
- People are living longer but experiencing more years with pain as they age.
- There's a general trend toward increased pain for 70- and 80-year-olds, but not for those 90 and older.
Are the methods and/or data it uses appropriate and convincing?
- The study uses a large data set spanning 25 years, which is robust but can lead to variability.
- Multistate life tables capture transitions in pain status well, but the effect size of pain might not be large enough for practical actions.
What do we know now that we didn't know before, if anything?
- There's a specific increase in pain-related years for both genders at 70 and 80 years of age.
- This information clarifies that pain issues increase with longevity only up to a certain age.
What simple and practical thing could a normal person do knowing this?
- Avoid assumptions that living longer will inherently mean living healthier.
- Focus on building as large a buffer as possible now against future morbidity.
Paper: Trends in Weight Loss Drug Use
Practicality (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Interest (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Summary
Regular visits to doctors help patients stick to their weight loss medications, but many stop before seeing the benefits. People over 35 are more likely to stick with the treatment for at least 12 weeks.
What is the paper's main claim?
- Many people stop using weight loss drugs like GLP-1 before they achieve significant weight loss.
- Consistent medical follow-up increases the chances of sticking to the medication.
Are the methods and/or data it uses appropriate and convincing?
- The sample size is large and representative, covering data from January 2014 to December 2023.
- Effect sizes are evident, but the drop-off rate before 12 weeks should be examined more closely for confounding factors like side effects.
What do we know now that we didn't know before, if anything?
- Persistence with weight loss medication significantly depends on regular follow-ups and the type of doctor prescribing the medication.
- There is very large drop-off in drug use in the first three months.
What simple and practical thing could a normal person do knowing this?
- Don't think of GLP-1s and similar drugs as somehow magic and simple.
- Schedule regular visits with a healthcare provider, especially specialists like endocrinologists, to increase the chances of sticking with weight loss medications.
Paper: Melatonin's Potential in Preventing AMD
Practicality (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Interest (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Summary
The study found that taking melatonin might slow down or even prevent age-related macular degeneration (AMD). Using data from over 100,000 patients, it showed that those who used melatonin had a lower risk of developing AMD or seeing it worsen.
What is the paper's main claim?
- Melatonin use is linked to a lower risk of developing age-related macular degeneration (AMD).
- It also slows down the progression of existing AMD.
Are the methods and/or data it uses appropriate and convincing?
- The study used a large sample of over 120,000 patients, enhancing the reliability of its findings.
- The results might be influenced by lifestyle factors, and the effect size while statistically significant (risk ratios between 0.22 to 0.40), may require further detailed examination in randomized controlled trials.
What do we know now that we didn't know before, if anything?
- Previous animal and limited human studies suggested melatonin could protect against AMD. This study provides large-scale human data supporting this potential.
What simple and practical thing could a normal person do knowing this?
- Consider discussing with a healthcare provider whether melatonin supplements might be beneficial for eye health, especially for those at risk of or currently managing AMD.
Paper: Krill Oil and Knee Pain
Practicality (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Interest (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Summary
A study investigated if krill oil could alleviate knee pain in people with knee osteoarthritis, but found it had no noticeable effect compared to a placebo.
What is the paper's main claim?
- Krill oil does not reduce knee pain in people with knee osteoarthritis.
- The results suggest no benefit from taking 2 grams of krill oil daily for this condition.
Are the methods and/or data it uses appropriate and convincing?
- The sample included 262 adults, which is relatively small and might not be representative.
- The lack of statistically significant improvement (mean difference of -0.3 on a 100-point scale) suggests the effect size is too small to be meaningful.
What do we know now that we didn't know before, if anything?
- There is no substantial evidence supporting the use of krill oil for knee pain in osteoarthritis patients.
- This study contradicts earlier, smaller studies suggesting benefits of krill oil.
What simple and practical thing could a normal person do knowing this?
- Avoid spending money on krill oil supplements solely for knee pain relief, as they might not be effective.
- The placebo effect is real, however, so if patients are convince it works, they may change behaviors in ways that reduce knee pain.
Paper: Cancer Rates Increasing Among Gen X
Practicality (4/5): 🏃♂️🏃♂️🏃♂️🏃♂️
Interest (5/5): 🏃♂️🏃♂️🏃♂️🏃♂️🏃♂️
Summary
Generation X in the US is experiencing higher rates of many cancers compared to Baby Boomers, despite declines in some cancer types.
What is the paper's main claim?
- Generation X (born 1965-1980) faces sharply higher rates of common cancers compared to Baby Boomers (born 1946-1964).
Are the methods and/or data it uses appropriate and convincing?
- Analysis includes data on 3.8 million cancer cases, providing a robust sample size.
- This may not be generational, per se, but more a consequence of cancer rates increasing overall due to lifestyle and environmental reasons.
What do we know now that we didn't know before, if anything?
- There is a marked increase in the incidence of most cancers in Generation X compared to earlier generations.
What simple and practical thing could a normal person do knowing this?
- Focus on lifestyle changes such as reducing tobacco and alcohol use, improving diet, and increasing physical activity to potentially lower cancer risks.
- Given the possible role of environmental causes, be wary of air quality, environmental plastics, and other known factors.
Back next week with thoughtful and simplifying takes on papers getting attention. And if you see anything you want us to look at, let us know.
