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Even ‘Weekend Warriors’ With Diabetes Can Reduce Death Risk

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

Diabetes Patients Cut Death Risk With Weekend Workouts

Even sporadic activity significantly boosts longevity and heart health

Adults managing diabetes can dramatically lower their risk of dying from any cause by being active on weekends or exercising consistently. These findings offer renewed hope for individuals who find regular gym routines challenging.

Activity Levels Linked to Longevity

A comprehensive analysis of over 51,000 adults with diabetes tracked over two decades revealed substantial health benefits from physical activity. Those engaging in at least 150 minutes of moderate to vigorous activity per week, even if concentrated into one or two sessions, experienced a 21% reduction in all-cause mortality compared to inactive individuals. Those who spread their activity across three or more sessions weekly saw a 17% lower risk.

Heart Health Sees Major Gains

The positive effects are particularly pronounced for cardiovascular health. “Weekend warriors” showed a 33% lower risk of dying from heart-related issues, while regularly active participants had a 19% reduction. These findings are significant given the heightened risk of premature mortality associated with diabetes.

Cancer Mortality Shows Smaller Impact

While the benefits for cancer deaths were less pronounced, regularly active individuals showed a slight decrease in risk compared to their inactive counterparts. The study noted minimal differences in cancer mortality risk between “weekend warriors” and inactive individuals.

Broader Public Health Implications

Even those who were not highly active but still engaged in some form of physical activity benefited, demonstrating a lower mortality risk than those who remained sedentary. This reinforces the idea that any movement is better than none for individuals with diabetes.

“This should be reassuring given the elevated premature mortality risk, distinct physiology, and low physical activity adherence among adults with diabetes,” the researchers reported. “These findings reinforce the importance of flexible physical activity patterns for people with diabetes as they can improve insulin sensitivity and glycemic control — especially for those who face barriers to maintaining regularly routine exercise.”

—Haibin Li, PhD, Lead Researcher

A 2023 report by the Centers for Disease Control and Prevention (CDC) indicated that only about 20% of adults with diabetes meet the recommended physical activity guidelines, highlighting the relevance of these findings for a large segment of the population.

Study Details and Limitations

The research, published in *Annals of Internal Medicine*, analyzed data from the National Health Interview Survey from 1997 to 2019. Participants were categorized into inactive, insufficiently active, weekend warrior, and regularly active groups. While the study accounted for numerous confounding factors like age, BMI, and chronic conditions, it relied on self-reported physical activity and did not capture activity outside of leisure time or changes in activity levels over the study period.

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Health

Air Pollution Linked to Increased CNS Tumor Risk

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

Air Pollution Linked to Brain Tumor Risk

Study of 4 Million Danes Reveals Association with Meningioma

Long-term exposure to common air pollutants may increase the likelihood of developing meningioma, a tumor originating from the membranes surrounding the brain and spinal cord. This finding emerges from a large-scale Danish study, adding to evidence of air pollution’s detrimental effects beyond cardiovascular and respiratory systems.

Pollutants and Tumor Development

The comprehensive cohort study, which tracked nearly 4 million adults since 1991, identified a consistent link between increased meningioma risk and exposure to ultrafine particles (UFPs), fine particulate matter, nitrogen dioxide, and elemental carbon. These associations were observed even after accounting for various individual and area-level factors.

Study Methodology

Researchers utilized nationwide Danish registries to gather data on participants’ addresses and relevant covariates. Air pollution levels at residential locations were assessed using a validated model, with contributions from local traffic and other sources quantified through a national emission inventory. The study’s primary focus was the incidence of primary central nervous system (CNS) tumors, including meningiomas, gliomas, cranial nerve tumors, and other CNS tumors, as reported in the Danish Cancer Registry.

Key Findings on Tumor Types

Over 16,000 CNS tumors were identified in the study group. Meningiomas constituted 28% of these cases. For meningioma, a 10-year mean exposure to UFPs, fine particulate matter, nitrogen dioxide, and elemental carbon each showed an associated increased risk. Sensitivity analyses indicated that traffic-related UFPs had a stronger association compared to non-traffic UFPs, while both traffic and non-traffic fine particulate matter demonstrated similar risk increases. Notably, no clear links were found between air pollutants and glioma risk, although nitrogen dioxide showed a negative association with cranial nerve tumors.

Expert Commentary

“Our study suggests that long-term exposure to air pollution from traffic and other sources may play a role in the development of meningioma and adds to the growing body of evidence that air pollution can affect the brain — not just the heart and lungs.”

—Ulla A. Hvidtfeldt, PhD, Danish Cancer Institute

The findings highlight a significant public health concern, particularly given that ambient particulate matter pollution levels in many urban areas globally exceed World Health Organization guidelines. For instance, the average annual PM2.5 concentration in London was 10.3 µg/m³ in 2022, exceeding the WHO guideline of 5 µg/m³ (IQAir 2022).

Limitations and Future Research

The researchers acknowledged certain limitations, including a strong intercorrelation among pollutants and uncertainty in pollution estimates, which could affect the precise attribution of effects and personal exposure classification. Factors such as genetic predisposition, radiation exposure, and lifestyle variables were not fully accounted for, potentially leading to residual confounding. The study also noted potential biases from differential tumor detection and reliance on emission inventories of varying accuracy for distinguishing traffic from non-traffic pollution sources.

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Health

Obesity-Related Cancer Deaths Rise Sharply: A US Study Reveals Alarming Trends

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

Here’s a breakdown of teh key details from the provided text:

Main Finding: Cancer-specific mortality related too obesity has significantly increased over the past two decades in the US.

Key statistics:

Tripling of Mortality: The overall age-adjusted mortality rate for obesity-associated cancers increased from 3.73 per million in 1999 to 13.52 per million in 2020, which is more than a tripling. Steeper Increase: This rise is steeper than many other chronic disease mortality trends during the same period.
Recent Increase: The average percent change from 2018-2020 was +19.4%.
 Annual Increase: The average annual percentage change was a statistically meaningful 5.92%.

Cancers Associated with Obesity:

Obesity is linked to a higher risk for 13 specific cancers, which account for 40% of all US cancer diagnoses:

Adenocarcinoma of the esophagus
 Postmenopausal breast cancer
Colon and rectum cancer
 Uterus cancer
Gallbladder cancer
 Upper stomach cancer
Kidney cancer
 Liver cancer
Ovary cancer
 Pancreas cancer
Thyroid cancer
 Meningioma
Multiple myeloma

Demographic Disparities in Mortality Rates:

Gender: Higher in women than men (7.22 vs 6.59 per million).
Race/Ethnicity: Higher in non-Hispanic Black persons than non-Hispanic White persons (9.20 vs 7.13 per million). Age: significantly higher in adults aged 65+ compared to those aged 25-64 (20.82 vs 3.54 per million).
geography: Higher in rural areas than urban areas (9.45 vs 6.40 per million).
 Region: Highest rates in the Midwest, lowest in the Northeast.
States: Vermont,Minnesota,and Oklahoma had the highest rates; utah,Alabama,and Virginia had the lowest.

Expert Opinions and Recommendations:

Lead Investigator: Faizan Ahmed, MD, from Jersey Shore University Medical Center.
Underappreciated link: The link between obesity and cancer mortality is often underappreciated. Call to Action for Clinicians: Clinicians should recognize obesity as a significant oncologic concern,not just a cardiovascular or metabolic risk factor. Weight management counseling should be reframed as a critical component of reducing long-term cancer risk. Socioeconomic Factors: Socioeconomic factors, access to care, delays in diagnosis, environmental exposures, and cultural factors likely contribute to the observed disparities across gender and race.
 Policy Recommendations: Policy initiatives should shift from downstream management to upstream prevention, including:
Worldwide access to cancer screening programs.
 Public health campaigns normalizing obesity management for cancer prevention.
Policies promoting equitable access to healthy foods and physical activity.

Context:

40% of US adults are living with obesity.
* The research was presented at ENDO 2025, The Endocrine Society annual Meeting.

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Health

MRI May Aid Early Pancreatic Cancer Detection in Diabetes

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

Diabetes Deterioration May Signal Hidden Cancer

MRI screening shows promise for early detection of pancreatic tumors in high-risk patients.

For individuals over 50, the emergence of new diabetes or a worsening of existing diabetes could indicate a hidden risk: pancreatic cancer. A recent study suggests MRI screenings could help detect these cancers early.

MRI Screening Uncovers Stage IB Pancreatic Cancer

The PANDOME study, led by **Richard Frank**, MD, explored the effectiveness of MRI-based screening for early pancreatic cancer detection in patients with new-onset diabetes or deteriorating diabetes. The research involved 97 patients with new-onset diabetes and 12 with deteriorating diabetes.

Those with deteriorating diabetes displayed significantly higher A1c levels, greater weight loss, and increased insulin needs, in comparison to the new-onset group.

Study Details

New-onset diabetes was defined as elevated A1c levels within the past year. Deteriorating diabetes meant long-standing diabetes (over two years) with a significant A1c increase (more than 2%) in the last six months, unrelated to weight changes or medication adherence.

All participants underwent MRI/cholangiopancreatography, blood biobanking, and monitoring for anxiety/depression. MRI results were categorized as normal, benign-abnormal, suspicious, or incidental findings.

Key Findings on Cancer Risk

Among the participants, over half had small cystic lesions, averaging 6 mm. This led to seven endoscopic ultrasound procedures, with four biopsies performed. One biopsy revealed stage IB pancreatic ductal adenocarcinoma in a patient with deteriorating diabetes.

Notably, 75% of the deteriorating diabetes group had high-risk scores for pancreatic cancer, compared to 35.6% in the new-onset diabetes group, according to the Enriching New-Onset Diabetes for Pancreatic Cancer score.

Incidental Findings

The study also uncovered extra-pancreatic incidental findings in 8.2% of cases. Two biopsies revealed a new diagnosis of follicular lymphoma and a recurrence of lymphoma, respectively.

Study Limitations

The study had some limitations including low accrual rates and potential selection bias. Most participants were referred, which may have affected detection rates. Also, the predominantly White participant pool limits the generalizability of the findings, given higher pancreatic cancer risk among Black populations.

Clinical Significance

The study, published in The Journal of Clinical Endocrinology & Metabolism, suggests that “Preliminary results from the PANDOME study support further MRI-based PC [pancreatic cancer] screening research efforts in individuals with NOD [new-onset diabetes] and DD [deteriorating diabetes].”

According to the American Cancer Society, about 66,440 people will be diagnosed with pancreatic cancer in the U.S. in 2024, and about 51,750 people will die of it (American Cancer Society).

Funding and Disclosures

The study was funded by several organizations, including a Tribute to Pamela/The Naughton Family Fund. The authors reported no conflicts of interest.

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Health

Understanding Cardiac PTSD In Search Of Prevention

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

Cardiac PTSD: New Strategies Emerge to Aid Recovery

Innovative approaches aim to mitigate trauma after life-altering cardiac events.

For those who survive major heart incidents, the ordeal doesn’t always end with physical recovery; many grapple with cardiac post-traumatic stress disorder (PTSD). Researchers are now developing new interventions to help patients avoid or escape this cycle.

Understanding Cardiac PTSD

For almost fifteen years, Donald Edmondson, PhD, at Columbia University Irving Medical Center, has focused on cardiac PTSD. His work highlights that a significant portion—up to one-third—of individuals develop this condition after major cardiac events.

Donald Edmondson, PhD

James Jackson, PsyD, at Vanderbilt University, was among the first to specifically address cardiac PTSD. He noted the scarcity of support programs for cardiovascular ICU survivors, unlike those available for cancer survivors.

Understanding Cardiac PTSD In Search Of Prevention
James Jackson, PsyD

“We tailor our care and try to individualize it, but there is always a strong psychological component, with a particular focus on mental health and neuropsychological challenges,” said Jackson. He emphasizes the importance of early intervention to prevent these issues from becoming more difficult to manage.

Simple Screening System

According to Edmondson, interventions could begin with a straightforward four-point screening system integrated into routine cardiology follow-ups. This would involve identifying patients who were significantly frightened by their cardiac event.

Additional indicators include patients who frequently discuss their cardiac sensations, report sleep disturbances, or have reduced physical activity. These factors can collectively signal a higher risk of developing cardiac PTSD, according to research findings.

If a patient is deemed high risk, Edmondson suggests referral to a behavioral health professional. Exposure therapy may be considered, alongside other therapeutic approaches, depending on the patient’s specific symptoms.

Edmondson also noted that the existing depression care model in cardiology could be expanded. Preliminary data suggests bringing behavioral health into cardiology clinics could reduce cardiac risk and improve health behaviors for recent cardiac event survivors.

The Role of Compassion and Tech

A 2019 study by Jeena Moss, MD, found that clinician compassion and a less stressful medical experience can disrupt the cycle of cardiac PTSD. However, standardizing these elements remains a challenge.

Interestingly, a 2018 study co-authored by Edmondson revealed a placebo-like effect from percutaneous coronary intervention (PCI) and stent placement. He believes some patients incorrectly feel “cured” by these procedures, embracing a “plumbing’ model of ACS.”

Tech-Driven Interventions

Jeffrey L. Birk, PhD, MS, at Columbia University, is exploring technology-based interventions to address patients’ fears of recurrent cardiac events. His work focuses on internal triggers like increased heart rate and perceived arrhythmias that can be misinterpreted as dangerous.

Photo of Jeffrey L. Birk
Jeffrey L. Birk, PhD, MS

Birk aims to develop systems that can dynamically assess these processes in real-time, understanding when and how interoceptive attention affects patients’ well-being.

Similarly, Sachin Agarwal, MD, MPH, is investigating how AI-powered models can offer personalized support, improve follow-up, and broaden family-centered interventions. According to the CDC, about 1 in 5 heart attack survivors experience depression, highlighting the need for comprehensive mental health support.

“We’re beginning to explore how AI-powered survivorship models can deliver personalized support, improve follow-up engagement, and extend the reach of family-centered interventions beyond the hospital walls,” said Agarwal. He envisions these tools as sustainable, system-wide solutions.

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Health

Supreme Court Backs Free Preventive Care Access

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

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Supreme Court Preserves Affordable care Act Mandate for Preventive Services

Table of Contents

In a 6-3 decision announced Friday, the US Supreme Court upheld a key provision of the Affordable Care Act (ACA), ensuring that health insurers must continue to cover preventive medical tests and treatments without requiring copays. This ruling preserves access to vital healthcare services for millions of Americans, although some concerns remain regarding the influence of the Health and Human Services (HHS) Secretary over the panel that determines which services are covered.

supreme Court Ruling: A Win for Preventive Care

The decision thwarts a challenge to the ACA mandate, which has been instrumental in expanding access to preventive services across the nation. The case originated from a complaint by braidwood Management, a Texas-based company with Christian ownership, which sought to exclude coverage for pre-exposure prophylaxis (PrEP) for HIV prevention, citing religious objections. The ACA requires coverage without cost-sharing for preventive services receiving an “A” or “B” rating from the US Preventive Services Task Force (USPSTF) (USPSTF).

Did You Know? The ACA mandate has lead to a meaningful increase in the utilization of preventive services, particularly among previously uninsured populations.

Impact on Healthcare Access

The mandate covers over 40 tests and treatments with “A” and “B” ratings from the USPSTF.These include screenings for various cancers and diabetes, nicotine replacement therapy for smoking cessation, statins for reducing heart disease and stroke risk, and physical therapy to prevent falls in older adults. According to the American Cancer Society, early detection through regular screenings significantly improves survival rates for many types of cancer (american Cancer Society).

Major medical groups,including the American Medical Association,the American Academy of Family Physicians,and the American cancer Society,lauded the supreme Court’s decision. These organizations had previously filed a brief arguing that the mandate enabled nearly 152 million Americans to access preventive services without cost-sharing in 2020.They warned that reducing coverage would lead to poorer patient outcomes, preventable deaths, and higher long-term medical costs.

Concerns Regarding HHS Secretary’s Authority

While celebrating the ruling, some advocates voiced concerns about the HHS Secretary’s influence over the USPSTF.Anthony Wright, executive director of families USA, noted that the decision reaffirms the HHS Secretary’s ability to control the membership and recommendations of the USPSTF. This raises concerns about potential political interference in the determination of covered preventive services.

Pro Tip: Stay informed about changes to preventive service coverage by regularly checking the USPSTF website and consulting with your healthcare provider.

USPSTF’s Role and Authority

Justice Kavanaugh addressed concerns that the USPSTF wields unchecked power, clarifying that the HHS Secretary can remove task force members and directly review or block their recommendations. This oversight ensures that the USPSTF’s recommendations are subject to executive branch review and accountability.

The Rise of Early-Onset Cancers

The ACA mandate has also played a crucial role in promoting cancer screening among younger individuals,which is increasingly important given the rising incidence of certain cancers in people under 50.Research from the National Institutes of Health (NIH) indicates that the incidence of 14 cancer types has increased in this age group between 2010 and 2019 (NIH). Removing financial barriers to screening is essential for encouraging healthy individuals to undergo tests that can detect cancer early, improving their chances of accomplished treatment.

key Preventive Services Covered Under the ACA Mandate
Service Benefit
Cancer Screenings (e.g., mammograms, colonoscopies) Early detection and improved survival rates
Diabetes Screenings Early diagnosis and management of diabetes
Nicotine Patches Support for smoking cessation
Statin Medications Reduced risk of heart disease and stroke
Physical Therapy Prevention of falls in older adults
HIV Prevention (PrEP) Reduced risk of HIV infection

Evergreen Insights: the Enduring Importance of preventive Care

Preventive care is a cornerstone of public health, focusing on proactive measures to maintain health and prevent disease rather than treating illnesses after they occur. The ACA’s mandate for no-copay preventive services has significantly expanded access to these vital services, particularly for underserved populations. By removing financial barriers, the mandate encourages individuals to seek regular check-ups, screenings, and vaccinations, leading to earlier detection of health issues and improved health outcomes.

The ancient trend in healthcare has shifted from a reactive approach to a more proactive and preventive model. This shift is driven by growing evidence that preventive measures are cost-effective and can significantly reduce the burden of chronic diseases. The ACA mandate reflects this trend,recognizing that investing in preventive care is an investment in the long-term health and well-being of the population.

Frequently Asked Questions About Preventive Care and the ACA

What is considered preventive care?

preventive care includes services such as vaccinations,screenings,and check-ups that help prevent illnesses or detect them early when they

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