The 2 Minute Medicine Podcast Episode 45

We begin with a discussion about our article of the week from JAMA Network Open entitled “Multivitamin Use and Mortality Risk in 3 Prospective US Cohorts”. In the second half of the episode, we begin with Kate Middleton’s appearance during chemotherapy treatment. Next, we explore the increasing popularity of whole-body MRI scans for early disease detection. Following that, we examine the spread of new COVID-19 strains in the US. Lastly, we discuss the implications of human exposure to microplastics and strategies to minimize this exposure.

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Transcript

[Deepti] Welcome to the 2 Minute Medicine Podcast, summarizing the latest medical studies, curated and written by practicing physicians.

For our full suite of daily medical study summaries and updates written by practicing doctors, please visit our website at 2minutemedicine.com to start reading new daily content right now, for free. On this podcast, twice a month, we cover the latest in health care news and research evidence. We are your hosts Deepti and Andrew. On today’s episode, we’ll start off by discussing our two articles of the week. In the second half of the episode, we will look at health issues that have arisen in popular media. 

[Andrew]  Our article of the week comes from JAMA Network Open and is entitled “Multivitamin Use and Mortality Risk in 3 Prospective US Cohorts.”

Approximately one-third of adults in the United States (US) use multivitamins (MV) to maintain or improve health and prevent chronic disease. However, the association between MV use and mortality have been mixed. This cohort study evaluated how self-reported daily MV use was associated with mortality risk in generally healthy adults. Data from three prospective cohort studies in the United States, with follow-up periods of over 20 years were analyzed. Analyses were performed for the first 12 years of follow-up (follow-up period 1 (FP1)) and the last 15 years of follow-up (follow-up period 2 (FP2)). Among 390,124 participants without a history of major chronic diseases (median [IQR] age, 61.5 [56.7-66.0] years; 21,6202 [55.4%] male), there was no association between MV use and lower all-cause mortality risk in FP1 (multivariable-adjusted hazard ratios (HRs) 1.04; 95% CI, 1.02-1.07), nor FP2 (multivariable-adjusted HR, 1.04; 95% CI, 0.99-1.08). In contrast, daily MV users had a 4% higher mortality risk than nonusers (FP1: HR, 1.04; 95% CI, 1.02-1.07; FP2: HR, 1.04; 95% CI, 0.99-1.08). Although this study did not find regular MV use among US adults to improve longevity, the authors did not rule out the possibility that daily MV use may relate to other health outcomes associated with aging. Overall, however, study findings suggest that there is no long-term mortality benefit associated with multivitamin use. 

[Andrew] Now for The Scan.​​ 

The story: Ever since Kate Middleton started her chemotherapy in late February, she made her first public appearance on June 15, when she attended King Charles’ birthday parade, and a second surprise appearance at the men’s singles final at Wimbledon on July 14. One thing that caught the public’s attention about these public appearances was Kate’s hair amid the ongoing chemotherapy. Let’s take a closer look at the relationship between hair loss and chemotherapy.  

[Deepti] Hair loss due to chemotherapy depends on variable factors including the type of chemotherapy drug and the regimen, the dose, the route of administration, and the treatment duration. 

Chemotherapy agents target and destroy rapidly growing cells, such as those in tumors. However, hair follicles are also highly active, with cells frequently dividing to produce hair growth. As a result, many chemotherapy drugs inadvertently affect hair follicles, leading to hair loss alongside the destruction of cancer cells. Eyebrows, eyelashes, underarm hair, and even pubic hair may also be affected by chemotherapy. Hair loss is gradual, and it typically starts about 2 to 4 weeks after beginning chemotherapy. While there are no drugs to prevent or minimize hair loss during chemotherapy, the good news is that hair loss is often reversible. Despite this, hair loss remains one of the most distressing side effects for patients, as it constantly reminds them of their battle with cancer. Considering the obsession with hair in our culture, the emotional impact of this visible side effect cannot be underestimated, as it affects self-esteem and daily life. Next, let’s take a closer look at MRI screening, and if it is useful.

[Andrew] With cancer becoming more common at a younger age, as seen with many celebrities such as Kate Middleton, people are seeking early detection methods. Startup companies such as Prenuvo offer whole-body MRI scans, claiming to identify several medical conditions such as aneurysms, multiple sclerosis, and most solid tumors at stage 1 when patients are asymptomatic. This technology, though not new, gained popularity after endorsements from celebrities like Kim Kardashian. In an Instagram post last year, Kim Kardashian described the Prenuvo full-body scan as a “lifesaving machine” and stated it saved some of her friends’ lives. Despite the growing interest in these scans in the US and Canada, medical experts raise concerns about the lack of evidence on the benefits of these expensive scans which cost between $1000-2500. Moreover, these scans can cause more anxiety than reassurance about one’s health. Patients may face misdiagnosis due to false positive results, leading to increased strain on the healthcare system as additional investigations are pursued. In some cases, the scans might also reveal asymptomatic abnormalities that are found incidentally, also known as “incidentalomas.” Many of these incidentalomas may be clinically insignificant and harmless, yet they can induce anxiety as they often raise more questions than they answer. So, what’s the best way of being proactive about health?  Screening tests should be specifically tailored for individuals at different ages and stages of life to increase the chance of identifying an issue that can be addressed and make a positive change in someone’s life. Next, let’s take a look at microplastics and how we can avoid them

[Deepti] Plastic waste can vary in form and dimensions, with particles smaller than five millimeters classified as “microplastics.” Microplastics originate from various sources, including the breakdown of larger plastic debris into progressively smaller fragments and they are Everywhere! They are present in the air we breathe, our drinking water, the food we consume, and in aquatic environments such as lakes, rivers, and seas. For example, findings of a new study by the University of Toronto published on July 17, suggest that consuming freshwater fish caught for recreation could expose humans to microplastics. So, what are the dangers of exposure to microplastics? Recent research indicates the presence of microplastics and nanoplastics in blood, as well as in organs such as the liver, kidney, placenta, and arteries. Moreover, studies have also shown that exposure to microplastics through air, water and food has been associated with potentially increased risk of respiratory and cardiovascular disorders, colon cancer as well as changes in metabolic functions. Considering the prevalence of microplastics, it is extremely difficult to avoid them. However, there are ways to reduce our exposure to microplastics. These include avoiding plastic packaging for storing food, refraining from heating food and drinks in plastic containers, reducing airborne dust at home, and minimizing the consumption of bottled water. Previously, celebrities such as vegan musician Moby and Canadian director and producer William Shatner promoted the use of reusable water bottles and challenged other celebrities on social media to follow suit and stop using plastic water bottles.

[Andrew] Thank you for joining us today for this episode of the 2 Minute Medicine Podcast. New episodes come out every other week and all of our content has been curated and written by practicing physicians.

Thank you for joining us today for this episode of the 2 Minute Medicine Podcast. New episodes come out every other week and all of our content has been curated and written by practicing physicians.