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Lifting the Lid

Reading Time: 8 Minutes

Published August 3, 2024

Morning Report — Not Your Typical Medical Newsletter

We get it, you see a lot of medical newsletters, so hear us out. Once a month, we’ll highlight important medical news sprinkled with witty commentary, fun facts, giveaways, and more… because learning should be fun! Subscribe to receive the Morning Report directly.

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Good morning! We learned that a day in the life of Sir Paul McCartney includes a session of eye yoga, an ancient practice involving visualization techniques and reps of eye movements. The beloved Beatle and super-ager asserts that these ocular exercises have prevented him from needing glasses into his eighth decade. It’s a provocative claim, so we couldn’t just let it be.

Findings from a 2018 randomized controlled trial suggest that patients who perform eye exercises (either Trataka Yoga Kriya or the Bates Method) have a better chance of spotting Lucy in the sky with diamonds than of boosting their visual acuity. But before we officially roll our eyes at the practice, limited evidence shows that it could ease a hard day’s night of eye fatigue.

Lifting the Lid on Optimal Bowel Habits

GI GIST

How was the firmness of your pillow last night? How about the water pressure of your shower? Or the precision of your favorite barista’s latte art this morning? If you answered “just right,” you’re on your way to achieving the “Goldilocks Effect” this weekend, striking the perfect balance between too much and not enough. Now, scientists are applying the Goldilocks principle to bowel habits and outlining parameters to get it “just right” for optimal health.

In a cross-sectional study, researchers logged clinical, biologic, and lifestyle data from nearly 1,500 healthy participants and separated them into four bowel movement (BM) camps: (1) constipation (1-2 BMs per week), (2) low-normal (3-6 per week), (3) high-normal (1-3 per day), and (4) diarrhea.

Researchers flushed out the following findings:

  • Number one: Daily defecation (1-2 times) correlates with healthier gut bacteria
  • Number two: Constipation or diarrhea links to higher blood markers for kidney, liver, and neurodegenerative diseases 

It’s all about the gut microbiome (and what isn’t, these days?). When stool loiters in the body (ie, constipation), gut microbes switch from fermenting fiber to protein, generating toxins associated with kidney and neurodegenerative diseases. But when waste rushes through the system (ie, diarrhea), it clears the bacteria essential to breaking down fiber into protective short-chain fatty acids, potentially triggering inflammation and elevating bilirubin.

Key takeaways

This study indicates that suboptimal BM frequency is more than just an annoyance; it may be a bellwether of poor health. “People should manage bowel movement frequency to be in a more normal range [1-2 BMs per day] to avoid chronic exposure that could predispose them to some of these chronic diseases,” says study author Sean Gibbons, PhD. So, how do patients typically get it just right? You guessed it—eat more fruits, vegetables, and whole foods. The study revealed that a diet deficient in these foods largely predicted irregular bowel frequency. But as you know, it’s not always that simple. Various illnesses can also cause erratic stool patterns, so no one-size-fits-all bowel management strategy exists.

For more gut education, check out Pri-Med’s CME activity “Gut Check: IBS/Constipation, CRC Screening, and Acid-Peptic Disorders.”

Filling the Gender Gap in Osteoporosis

OSTEO OUTCOMES

For the cost of conducting a large randomized controlled trial (RCT), you could fund a billionaire’s weekend getaway to Mars. This astronomical expense, claims a new study, may be one reason why osteoporosis testing and treatment in men lags behind women. We simply lack data from a large RCT to confirm what smaller studies already indicate: Osteoporosis treatment works as well in men as in women.

The next best thing

In lieu of dropping millions of dollars on an RCT, researchers settled for a case-control observational study. They identified nearly 2,500 women and 800 men ≥65 years who did not have a hip fracture on CT scan but were at elevated risk (ie, a femoral neck or total hip bone mineral density T-score of -2.5 or lower). Using electronic health records, researchers segmented patients into three groups: (1) treated according to standard of care, (2) partially treated, and (3) not treated. Here are the findings at two-year follow-up:

  • Hip fractures hit 29.9% of women and 34% of men
  • 33.9% of women and 24% of men received treatment
  • 51.5% of women and 66.3% of men went untreated 
  • ~80% of women and ~90% of men filled their alendronate prescriptions
  • Treated individuals of both sexes were less likely to sustain hip fractures than untreated individuals 
  • No significant difference was found in the hip fracture odds between men and women 

Key takeaways

This study strengthens the evidence that treating osteoporosis in high-risk individuals—regardless of sex—can lower fracture risk. Will this shift perceptions and unify guidelines? Currently, the US Bone Health & Osteoporosis Foundation favors testing for all men ≥70 years and those ≥50 with a fracture, supporting FDA-approved treatments. But the USPSTF, sticking to its mantra of “out of an abundance of caution,” believes the evidence for screening and treating men is insufficient. The study authors disagree, urging changes to address this underrecognized and undertreated disease—especially in men. Despite their anecdotal prowess in loosening pickle jars, men face substantial risks from impaired bone density, with one in four hip fractures occurring in men and higher post-fracture mortality for men than for women.

For more osteoporosis education, check out Pri-Med’s CME activity “Curbside Consults: Top Questions from PCPs on Osteoporosis.”
FDA and Guideline Updates

Is Shutting Down IL-11 the Key to “Forever”

EMERGING TRENDS

Not since Mrs. Brisby rescued her family from NIMH has the mouse community had such cause to cheer. Scientists just announced that blocking the pro-inflammatory cytokine IL-11 in mice stretched their lifespan by >20%. “Yes!” raved one mouse. “Now we’ll have ample time to see what’s at the end of the hamster wheel.” Those atop the food chain call the news “tantalizing.”

Forever and a day

In their ongoing quest to make forever happen, scientists engineered mice to lack IL-11, a protein that rises with age and may lead to adverse effects such as inflammation and impaired organ healing and regeneration. It worked. The genetically modified mice lived substantially longer, with fewer cancers, reduced signs of aging, and enhanced muscle strength, imbuing some with a Mighty Mouse complex. Even better, in a cohort of middle-aged mice (think 55-year-old humans) injected with an anti–IL-11 antibody, the median survival jumped to 22% in males and 25% in females. And researchers noted only minimal side effects.

Of mice and men

While Rodentia celebrate these findings, we humans hold our breath. Study author Professor Stuart Cook believes that the anti-aging benefits of IL-11 suppression will extend to humans. Anti–IL-11 therapies have already advanced to human clinical trials for other conditions, setting the stage to soon explore their effects on aging. The first question will be how to mitigate inflammation without eradicating it, with the body requiring a certain level to combat infections.

Key takeaways 

Time is undefeated, but scientists may have scored a point. Suppressing IL-11 in mice decreased cancer-related deaths and reduced other diseases linked to characteristic signs of aging, like fibrosis, poor metabolism, and chronic inflammation. “Previously proposed life-extending drugs and treatments either had poor side-effect profiles, didn’t work in both sexes, or extended life without improving health,” explained Cook. “This does not appear to be the case for IL-11.” We may one day share in the good fortune of these delighted mouse subjects. As the rodent order likes to say, “Happy mice, happy life.”

For more education on longevity, check out Pri-Med’s Frankly Speaking podcast episode “Live Longer by Eating Better.”

Interested in more healthcare news? Here are some other articles we don’t want you to miss:

Morning Report is written by:

  • Alissa Scott, Author
  • Aylin Madore, MD, MEd, Editor
  • Margaret Oliverio, MD, Editor
  • Ariel Reinish, MD, MEd, Editor
  • Emily Ruge, Editor

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