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The dieting approach that could work better than intermittent fasting
The dieting approach that could work better than intermittent fasting

The Independent

timea day ago

  • Health
  • The Independent

The dieting approach that could work better than intermittent fasting

A new review suggests that alternate-day fasting may be more effective for weight loss compared to other intermittent fasting methods and calorie-restricted diets. The comprehensive review analysed data from 99 studies involving over 6,500 participants, many of whom had pre-existing health conditions. Researchers found that both intermittent fasting strategies and continuous energy restriction diets led to overall body weight reduction. Specifically, alternate-day fasting resulted in an average of 1.29kg more weight loss than continuous energy restriction. While the weight reduction was considered 'trivial' when compared to time-restricted eating and whole-day fasting, alternate-day fasting was the only intermittent fasting strategy to show a distinct benefit over continuous energy restriction.

MASLD Patients Have More Comorbidities, Higher Death Risk
MASLD Patients Have More Comorbidities, Higher Death Risk

Medscape

time2 days ago

  • Health
  • Medscape

MASLD Patients Have More Comorbidities, Higher Death Risk

A higher burden of multimorbidity was seen in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD) than in individuals without MASLD, with a higher risk for all-cause mortality observed in those with MASLD and multimorbidity. METHODOLOGY: In this large UK-based study, researchers determined the prevalence of multimorbidity in individuals with MASLD and assessed how MASLD, alongside the extent of multimorbidity, affects all-cause mortality. The analysis included data of 438,840 participants (mean age, 56.5 years; 42.2% men) from the UK Biobank who were recruited between 2006 and 2010. The diagnosis of MASLD was confirmed if patients had liver steatosis (fatty liver index ≥ 60%), at least one cardiometabolic risk factor, and low alcohol consumption. Overall, 47 long-term conditions were considered, including extrahepatic cancers; cardiovascular, metabolic, and endocrine disorders; and respiratory, digestive, renal, mental health, and congenital conditions. Multimorbidity was defined as having more than two of these long-term conditions. The outcome was all-cause mortality, assessed over a median follow-up duration of 13 years. TAKEAWAY: At baseline, 29.9% of participants had MASLD, with a higher prevalence of multimorbidity than that in those without MASLD (21.3% vs 14.4%). MASLD was associated with an increased risk for all-cause mortality (adjusted hazard ratio [aHR], 1.16; 95% CI, 1.13-1.19), with stronger effects seen in women (aHR, 1.25; 95% CI, 1.20-1.29) than in men (aHR, 1.10; 95% CI, 1.07-1.13). Patients with MASLD were more likely to have 32 out of the 47 long-term conditions. Each additional long-term condition increased the risk for mortality by 30% in patients with MASLD (aHR, 1.30; 95% CI, 1.29-1.31) and by 38% in individuals without MASLD (aHR, 1.38; 95% CI, 1.37-1.40). The most prevalent cardiometabolic risk factor in patients with MASLD was obesity (98.9%), and among all long-term conditions, Parkinson's disease showed the highest risk for mortality in those with MASLD (aHR, 6.09; 95% CI, 4.47-8.29). IN PRACTICE: "Addressing multimorbidity in MASLD patients through multidisciplinary and proactive management of multimorbidity is crucial to improving patient outcomes and reducing the overall public health impact of MASLD," the authors of the study wrote. SOURCE: This study was led by Qi Feng, The George Institute for Global Health (UK), School of Public Health, Faculty of Medicine, Imperial College London, London, England. It was published online on June 10, 2025, in The Journal of Clinical Endocrinology and Metabolism . LIMITATIONS: The predominantly White, more affluent UK Biobank cohort may not have reflected the wider UK population, further limiting the generalisability of the findings to other populations. Reliance on self-reported lifestyle data covering physical activity, smoking, and alcohol consumption may have led to information bias, potentially resulting in the misclassification of MASLD vs alcohol-related liver disease. DISCLOSURES: This study was supported by the National Institute for Health and Care Research Imperial Biomedical Research Centre. The authors reported having no conflicts of interest.

Is This Drug a Statin Alternative?
Is This Drug a Statin Alternative?

Medscape

time3 days ago

  • Health
  • Medscape

Is This Drug a Statin Alternative?

Monotherapy with inclisiran — an injectable small interfering RNA that targets hepatic proprotein convertase subtilisin/kexin type 9 (PCSK9) — reduced levels of low-density lipoprotein (LDL) cholesterol more effectively than placebo or ezetimibe in patients at a low-to-borderline risk for atherosclerotic cardiovascular disease who were not receiving any lipid-lowering therapy, with a favorable safety profile. METHODOLOGY: Previous studies have shown the efficacy of inclisiran in lowering the level of LDL cholesterol when used in combination with statins in patients with a high risk for atherosclerosis; however, its efficacy as a monotherapy without statins remains uncertain. Researchers conducted a 6-month multinational, randomized, phase 3 study to compare the efficacy and safety of inclisiran with those of placebo or ezetimibe in reducing levels of LDL cholesterol. They included 350 participants (mean age, 46.1 years; 62.6% women) with no history of atherosclerotic cardiovascular disease , diabetes, or familial hypercholesterolemia and a fasting LDL cholesterol level of 100-190 mg/dL. Participants were randomly assigned to receive subcutaneous inclisiran (n = 174), oral ezetimibe (n = 89), or matching placebo (n = 87), with inclisiran administered on days 1 and 90. The primary endpoint was the percentage change in the level of LDL cholesterol from baseline to day 150; several secondary endpoints, including the absolute change in LDL and safety, were assessed. TAKEAWAY: By day 150, participants who received inclisiran showed a 47.9% greater reduction in the level of LDL cholesterol than those who received placebo and a 35.4% greater reduction than those who received ezetimibe ( P < .0001 for both). < .0001 for both). The absolute reduction in the level of LDL cholesterol and the percentage reduction in PCSK9 levels were also greater in participants who received inclisiran than in those who received placebo or ezetimibe ( P < .0001 for all). < .0001 for all). In the group who received inclisiran, levels of lipoprotein(a) decreased by 25.2% compared with placebo ( P = .001) and by 24.3% compared with ezetimibe ( P = .0002) by day 150. = .001) and by 24.3% compared with ezetimibe ( = .0002) by day 150. Similar rates of treatment-emergent adverse events were noted across the three groups, with no new safety concerns. IN PRACTICE: 'There is a significant unmet clinical need for therapies that address both statin intolerance and adherence in primary prevention,' the researchers noted. 'Inclisiran is potentially uniquely positioned to meet these challenges owing to its first-in-class mechanism of action, favorable safety profile, and infrequent twice-yearly dosing,' they added. SOURCE: This study was led by Pam R. Taub, MD, of the University of California in San Diego. It was published online on June 9, 2025, in Journal of the American College of Cardiology . LIMITATIONS: A short follow-up duration and limited sample size prevented the researchers from evaluating the cardiovascular outcomes of lowering the level of LDL cholesterol with inclisiran. The analysis lacked direct comparison with statins, anti-PCSK9 monoclonal antibodies, or bempedoic acid. The response of LDL with ezetimibe was lower than that observed in other studies. DISCLOSURES: This study received funding from Novartis Pharma. Two authors reported receiving compensation for serving as principal investigators of this trial, and another author reported serving as a consultant for multiple pharmaceutical companies including the funding agency. Several other authors reported serving as employees of the US or Switzerland wings of the funding agency or being principal investigator, consultants, and/or holding shares in the same.

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