In episode 526, Mike and James go PREMIUM yet again, although it takes a while – so stay till the end. We go over the latest research on low sodium in heart failure, Vitamin D for preventing COVID, and multivitamins for doing anything. Show Notes 1) Reduction of dietary sodium to less than 100 mmol…

In episode 525 – part two of our series on weight – James and Mike talk about how best to measure “weight” – and waste circumference, and hip -to-weight ratio and so on. We show that there is very little reason to measure much else other than actual weight. We also look at the evidence around whether intentional weight loss improves outcomes. Bariatric surgery evidence is also reviewed. And also a few other gems of knowledge.

Show Notes
1) The Nutrition Proposition
Book website
nutritionproposition.com

 Amazon Link

2) Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies
Lancet. 2011;377(9784):1085-1095. doi:10.1016/s0140-6736(11)60105-0
3) Central fatness and risk of all-cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies
Bmj. 2020;370:m3324. doi:10.1136/bmj.m3324
4) Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis
Prev Chronic Dis. 2020;17:E131. doi:10.5888/pcd17.200112

5) A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life
Clinical Obesity 7, 273–289, October 2017

6) Effectiveness of Weight-Loss Interventions for Reducing Pain and Disability in People With Common Musculoskeletal Disorders: A Systematic Review With Meta-Analysis
J Orthop Sports Phys Ther 2020;50(6):319–333. Epub 9 Apr 2020. doi:10.2519/jospt.2020.9041

In episode 524 – the first of a 2-part series about weight – James and Mike talk about why people wish to lose weight, the words we use to describe weight, the obesity paradox, all the cohort evidence around weight and mortality/cardiovascular disease/depression/osteoarthritis/fractures, and in a nice juxtaposition do it while eating rum and raisin ice cream – yes it is a thing.

Show Notes
1) The Nutrition Proposition
Book website

Amazon Link

2) In their own words: Topic analysis of the motivations and strategies of over 6,000 long‐term weight‐loss maintainers
Obesity (Silver Spring). 2022;30:751–7614)

3) Patients’ preferred terms for describing their excess weight: discussing obesity in clinical practice
Obesity (Silver Spring). 2012;20(1):147–50

In episode 523, James and Mike invite Jennifer Young to the podcast for the first time to help us go over all the evidence around diagnosing symptomatic uncomplicated urinary tract infections in adult women. We also delve into the “fun“ world of likelihood ratios – believe it or not, they are REALLY useful. So hang on to your hat!

Show Notes
Tools for Practice
Is booking an urgent UTI appointment the best sign of a UTI?

In episode 522, James and Mike quickly go over 3 new COVID trials that give useful PREMIUM information. BUT then we quickly go SUPER PREMIUM with evidence around the shelf life of medications and we discuss why the expiry dates on medications in almost no circumstances represent the date when medications should no longer be used.

Show Notes
1) Secondary Attack Rates for Omicron and Delta Variants of SARS-CoV-2 in Norwegian Households
JAMA. 2022 Apr 26;327(16):1610-1611. doi: 10.1001/jama.2022.3780
2)Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
N Engl J Med 2022 Aug 18;387(7):599-610
3) Nirmatrelvir Use and Severe Covid-19 Outcomes during the Omicron Surge
N Engl J Med 2022; 387:790-798
4) Determination of albuterol and montelukast post-expiry drug strength by HPLC
Heliyon. 2022 Aug 5;8(8):e10104. doi: 10.1016/j.heliyon.2022.e10104
5) A systematic review of the stability of finished pharmaceutical products and drug substances beyond their labeled expiry dates
J Pharm Biomed Anal. 2019 Mar 20;166:222-235. doi: 10.1016/j.jpba.2019.01.016

In episode 521, James and Mike invite Caitlin Finley to the podcast for the first time to talk about a very common primary care topic – recurrent UTIs. We discuss the frequency of recurrence and look at the evidence for many of the different strategies used to reduce the chance of recurrence.

Show Notes
1) Tools for practice
A dose a day keeps the UTI away?

2) PRACTICAL EVIDENCE FOR INFORMED PRACTICE (PEIP) CONFERENCE 2022
REGISTER

In episode 520, James and Mike delve into the delicious area of ultra-processed food. We review all the best available evidence and try to put it into a digestible format. At the end we put a cherry on top to make it even more appetizing/interesting.

Show Notes
The Nutrition Proposition
1) Book website
nutritionproposition.com
2)Amazon Link for The Nutrition Proposition

In episode 519, Mike and James ask Jen Potter back to the podcast to talk about a common primary care question around oral contraceptives and breast feeding. We review the best available evidence which unfortunately we find out is not the highest quality. Nonetheless, we go over the numbers and then come up with useful, hopefully, suggestions for what to do around this issue.

Show Notes
Tools for Practice
Oh Baby: Combined oral contraceptives during breastfeeding

In episode 518, Mike and James get Samantha to go through all the evidence we have for restricting lactose-containing foods in children with acute diarrhea. While we find out that looking at this evidence is at best tricky, it seems like reducing or diluting formula may provide a reasonable benefit. Listen to the podcast for the numbers.

Show Notes
Tools for Practice
“Not Milk?”: Avoiding lactose-containing products during acute pediatric diarrhea

Episode 517: PREMIUM – A podcast that hopefully won’t leave you breathless

In episode 517, Mike and James talk PREMIUMLY (not a word but it should be) about two new trials that looked at using fixed dose combinations of salbutamol/albuterol and a steroid on a PRN basis in patients with moderate to severe asthma. It seems to have an effect and it may make asthma treatment simpler, but it may also increase the costs when it comes to inhalers.

Show Notes
1) Albuterol–Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma
N Engl J Med 2022;386:2071-83.DOI: 10.1056/NEJMoa22031632
2) Reliever-Triggered Inhaled Glucocorticoid in Black and Latinx Adults with Asthma
N Engl J Med 2022;386:1505-18.DOI: 10.1056/NEJMoa2118813