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As psychiatric polypharmacy rises among youth, so does CVD risk
Psychotropic Polypharmacy Among Youths Enrolled in Medicaid; JAMA Network Open, Feb. 16, 2024.
Based on reported safety concerns — including a recent paper linking psychiatric medicines with cardiovascular disease risk — University of Maryland researchers studied health trends among poor teens taking multiple mental health medications, between 2015 and 2020.
Among the 126,972 Medicaid-eligible enrolled youths, polypharmacy increased from 4.2% in 2015 to 4.6% in 2020.
The approximate 4% rise per year in polypharmacy in the Maryland study tracked the rising risk of cardiovascular disease noted in the earlier study.
That paper reported no effect for less than 1 year of medication use but found the risk rose rapidly thereafter. The risk of cardiovascular disease increased by 9% for those with 1 to less than 2 years of exposure, 15% for 2 to less than 3 years, 27% for 3 to less than 5 years, and 23% for more than 5 years.
The risk for high blood pressure also rose — by 72% for exposures of 3 to less than 5 years and 80% for more than 5 years. Arterial disease risk also rose, by 65% and 49%, for those two time-period exposures.
Studies exaggerate benefits of COVID shots for children
Pitfalls of Using Observational Studies in Harm-Benefit analyses of BNT161b2 vaccination of 5-11-Year-Olds; Epidemiology & Infection, Feb. 16, 2024.
“Big research” meta-analyses and systematic reviews advocating childhood immunization for COVID-19 and questioning the relevance of natural COVID-19 immunity are seriously biased and fail to assess underlying health differences between vaccination-status groups.
That was the conclusion of a University of California, San Francisco, study that reanalyzed five observational studies evaluating the effectiveness of COVID-19 immunizations in preventing severe disease or hospitalization.
The researchers concluded that together, the five studies “failed to adequately assess differences in underlying health between vaccination groups.”
For example, raw data from the five studies suggested a 92% increase in adverse events compared with the unvaccinated. The researchers attributed this to “healthy vaccinee bias” (HVB) — the idea that individuals interested in vaccination might be healthier to begin with than individuals who are not so inclined.
HVB had been reported previously for the mRNA shots.
The University of California researchers concluded that observational studies like those they evaluated “must be suspected” of HVB confounding and that studies not correcting for this “cannot reliably be used in systematic reviews, risk-benefit analyses, or population-wide vaccination guidelines.”
Emulsifiers mess up the microbiome
Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort; PLOS Medicine, Feb. 13, 2024.
French researchers reported that emulsifiers added to improve the texture and shelf-life of processed foods wreak havoc on the gut microbiome, leading to inflammation and possibly cancer.
Their investigation included 92,000 adults enrolled in the French NutriNet-Santé study and followed for an average of 6.7 years. Subjects averaged 44.5 years old, were 78.8% female and were cancer-free at the time of enrollment.
Consumption of specific emulsifiers was estimated from three 24-hour dietary records linked to brand-specific food composition databases. During the study period, 2,604 cancer cases occurred, including 750 breast, 322 prostate and 207 colorectal.
Higher intakes of mono- and diglyceride emulsifiers were associated with a 15% higher risk for all cancers, a 24% higher risk for breast cancer risk and 46% higher prostate cancer risk.
Carrageenan emulsifiers were associated with a 30% additional breast cancer risk. No association was found for any emulsifier and colorectal cancer.
Investigators uncovered several other emulsifier-cancer associations that did not reach statistical significance.
Donated breast milk at least as good as formula for preterm babies
Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula: A Randomized Clinical Trial; JAMA, Jan. 30, 2024.
A double-blind, randomized clinical trial at 15 U.S. hospitals in the Neonatal Research Network compared the neurodevelopment effects of preterm infant formula and donated human milk among very preterm infants.
The researchers studied the infants between September 2012 and March 2019, and followed them from the time they enrolled to either hospital discharge, 120 days or death.
Infants had a median birth weight of 840 grams (just less than 2 pounds) and 52% were female. The primary outcome measured was the Bayley Scales of Infant and Toddler Development (BSID) assessment at 22-26 months’ corrected age.
The positives: Although all studied preterm infants experienced slight neurodevelopment delays the differences between groups on BSID neurodevelopment, language and motor scores were not significant. Necrotizing enterocolitis occurred in 4.2% of infants who received donated breast milk versus 9.0% of those who received formula.
The negatives: Weight gain lagged in the preterm group and 13% of the infants who received donated breast milk died, compared with 11% of babies taking formula.
Although they did not specifically address the higher occurrence of death among babies receiving donated breast milk, the authors noted that their inability to establish the quantity and relative nutritional value of donated milk versus formula may have accounted for some of the negatives.
Social media standards urged for teen mental health
Social Media Industry Standards Needed to Protect Adolescent Mental Health, Says National Academies; JAMA, Jan. 24, 2024.
An editorial in JAMA critiqued a December 2023 National Academies report noting that “young people’s smartphone usage has coincided with a decline in mental health,” with the main problem being social media.
Social media platforms are designed to maximize engagement, a form of compulsive, addictive behavior that encompasses time spent in front of devices and the number and type of online interactions.
Barriers to balancing social media’s potential benefits against possible harms are formidable, however, due to the varied nature of social media engagement and the fact that social media is only about 20 years old.
Dr. Sandro Galea, a professor and dean of Boston University School of Public Health, said in an interview with JAMA that the relatively limited time social media has been around complicates the ability to determine causality between social media use and health outcomes
“It’s difficult to draw generalizable inference about platform modifications that could make across-the-board benefits or could limit across-the-board harms,” Galea said.
The JAMA editorial followed an earlier advisory from the U.S. surgeon general calling for “immediate actions to make social media safer for youth,” and preceded a 2024 congressional hearing during which politicians who vote to fund undeclared overseas wars accused social media CEOs of having blood on their hands.
