Visceral Fat Linked to Dementia, AI Powered Heart Tests, NHS' Diabetes Prevention Program

In a recent study published by CNN, research indicates a potential connection between inflammation from abdominal fat and the early stages of Alzheimer's disease, even before symptoms arise.

Dr. Richard Isaacson, an Alzheimer's researcher not involved in the study, notes that as belly size increases, the memory centers in the brain shrink, and this study introduces a new brain imaging marker of neuroinflammation linked to belly fat.

The research focused on individuals in their 40s and 50s with hidden belly fat, finding a higher presence of an abnormal protein called amyloid in a part of the brain known for early Alzheimer's occurrence. This abnormal protein, along with tau tangles, characterizes Alzheimer's, with amyloid typically appearing first. Men, who generally have more visceral fat than women, exhibited a stronger association between belly fat and amyloid.

The study also uncovered a link between deep belly fat and brain atrophy in the hippocampus, a vital part of the brain associated with memory. Dr. Mahsa Dolatshahi, the lead author, notes that individuals with higher visceral fat tend to have more inflammation in widespread white matter tracks in the brain, affecting communication between different brain regions and the body.

Originally a pilot study, researchers expanded their participant pool, presenting findings on 52 individuals in their 40s to 60s at the Radiology Society of North America's 2023 conference. This research, focusing on midlife individuals, reveals subtle yet significant brain changes related to Alzheimer's pathology, pushing the boundaries of early detection by about 20 to 25 years before potential disease onset.

The study emphasizes the role of visceral fat, located deep in the abdomen and more metabolically active than subcutaneous fat, in triggering inflammation that leads to insulin resistance. Insulin resistance, a condition where cells don't respond effectively to insulin, is often linked to diabetes and chronic diseases and is thought to accelerate amyloid deposition, a key marker of Alzheimer's.

While full-body MRIs offer precise visceral fat measurements, estimates based on waist circumference or waist-to-height ratios are commonly used. For women, a waist measurement of 35 inches or more indicates potential health issues, while for men, it's 40 inches or more. Visceral fat might not be evident based solely on weight or BMI, as even thin individuals can harbor excess visceral fat, termed "skinny fat" or "TOFI."

The study underscores the potential to manage visceral fat through diet and exercise. Dr. Cyrus Raji highlights that visceral fat is more responsive to lifestyle changes than subcutaneous fat. Recommendations include a healthy diet, regular exercise involving muscle strength training and cardio, portion control, reducing processed foods, limiting alcohol intake, prioritizing sleep, and cutting back on high-fat dairy and meats.

Understanding and managing visceral fat at midlife could offer a preventive measure against Alzheimer's and related conditions. While the study demonstrates promising avenues for intervention, further research is needed to comprehend the intricacies of this relationship between visceral fat, inflammation, and brain health.

AI-powered precise cardiovascular medical tests.

In partnership with Intermountain Healthcare and University of Iowa Hospitals and Clinics, Cardio Diagnostics Holdings have introduced PrecisionCHD, an innovative AI-guided integrated genetic-epigenetic test designed to detect coronary heart disease (CHD).

Their article titled "The Validation of an Integrated Genetic-Epigenetic Test for the Assessment of Coronary Heart Disease" reveals a significant advancement in CHD diagnosis. Conventional CHD diagnostic methods are often invasive, involve exposure to ionizing radiation, and lack widespread accessibility due to specialized infrastructure requirements. Additionally, some tests are insensitive to various CHD forms and come with high costs. Consequently, numerous Americans miss out on timely, life-saving cardiac care. PrecisionCHD offers clinicians a powerful, scalable, and non-invasive alternative—a blood-based test that employs AI, personalized genetic, and epigenetic information to sensitively detect CHD.

The JAHA study, led by researchers from Cardio Diagnostics, Intermountain Healthcare, and the University of Iowa Hospitals and Clinics, details the development and validation of the PrecisionCHD test across three independent cohorts totaling 2,516 individuals. PrecisionCHD stands out as the initial integrated genetic-epigenetic test for CHD detection, utilizing input from six methylation sensitive digital PCR (MSdPCR) assessments to ascertain the presence or absence of CHD.

Each MSdPCR assay maps to distinct modifiable factors influencing CHD, enabling clinicians to gain personalized insights into each patient's CHD profile. Furthermore, because methylation is dynamic, the study suggests targeted re-testing to evaluate the effectiveness of CHD therapy. Lead author and Chief Medical Officer of Cardio Diagnostics, Robert Philibert MD Ph.D., hails this as a game-changer for Personalized Cardiovascular Care. He highlights the test's non-invasive nature, eliminating patient exposure to ionizing radiation or potentially damaging contrast dye. Dr. Philibert stresses the revolutionary nature of this approach, providing a comprehensive, personalized view of a patient's CHD drivers, facilitating early intervention and tailored treatment plans. He emphasizes the personal impact, seeing patients with previously limited diagnostic options now accessing cutting-edge technology as a milestone in cardiac care.

This research holds particular significance for rural healthcare, where access to specialized medical facilities and diagnostics is often constrained. Rural Americans face challenges such as limited access to specialized medical facilities and fewer healthcare providers, often requiring extensive travel for medical care. PrecisionCHD's simplicity in requiring only a blood draw will grant patients in underserved regions access to advanced cardiac assessments.

The test's administration in primary care or telemedicine settings significantly reduces the need for rural patients to travel to distant specialized clinics, marking progress in mitigating healthcare disparities, particularly in areas with limited resources. Meesha Dogan Ph.D., CEO and Co-Founder of Cardio Diagnostics, stresses their commitment to democratizing access to crucial cardiac care, especially in rural areas with scarce diagnostic tools and cardiovascular specialists. Dr. Dogan highlights the remote accessibility and deployability of PrecisionCHD in non-specialized settings as crucial steps toward achieving this goal.

She emphasizes that this study represents a significant leap in CHD diagnosis, harnessing the synergy of genetics, epigenetics, and AI to offer a highly sensitive, efficient, scalable, and personalized approach to CHD care. Notably, the test has been awarded an Innovation Technology contract from Vizient, the largest group purchasing organization in the US, granting access to clinicians at 60% of hospitals and 97% of academic medical centers in the country.

A recent Nature journal study evaluated the efficacy of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in the United Kingdom, considered among the most comprehensive behavior change initiatives for those with prediabetes globally.

The study aimed to assess the program's impact on the health outcomes of individuals with prediabetes, focusing on factors like glycated hemoglobin (HbA1c) levels, body weight, serum lipid levels, and cardiovascular risk factors.

The NHS DPP specifically targeted people with non-diabetic hyperglycemia, providing intensive lifestyle and behavior change support to prevent or delay the onset of type 2 diabetes. This included weight loss, dietary adjustments, and physical activity goals delivered through group sessions spanning nine months. With a substantial scale offering 100,000 referrals in 2021, the NHS DPP aimed to combat the rising global rates of type 2 diabetes and associated fatalities.

While prior clinical trials indicated the effectiveness of lifestyle and behavior changes in halting prediabetes progression, their applicability in real-world settings remained uncertain. Many healthcare professionals were doubtful, citing low health literacy and patient engagement as obstacles.

The study leveraged electronic health records of over two million UK patients to evaluate the NHS DPP's impact on various health parameters. Utilizing a quasi-experimental approach, researchers gauged the program's referral effects on metrics like HbA1c levels, body weight, blood pressure, and lipid levels. Results indicated that intensive lifestyle counseling via the NHS DPP led to significant improvements in HbA1c levels, body weight, and BMI. However, the program did not notably affect diabetes complications, hospitalization for cardiovascular events, or mortality.

These findings highlight the NHS DPP's success in enhancing health outcomes for individuals with prediabetes, challenging skepticism about lifestyle counseling programs. They underscore the importance of broad-scale initiatives in preventing and delaying type 2 diabetes onset. Future efforts should prioritize boosting participation rates in such programs to maximize their impact on public health.