geoffrey modest medical blogs

  There are concerns that weight loss is associated with a decreased bone mineral density (BMD) and increased osteoporosis, with the attendant clinical problems. In this light a new study found that an energy-reduced Mediterranean diet accompanied by increased physical activity mitigated the BMD decline (see  bmd inc with mediter diet plus exercise  JAMA2025 , or doi:10.1001/jamanetworkopen.2025.3710)   Details : --924 adults aged 55-75yo with metabolic syndrome (as defined by the American Heart Assn, NHLBI, and International Diabetes Federation: hypertension, triglycerides, HDL, fasting blood glucose, and central obesity) who were overweight (BMI 27-29.9, as defined by this study) or obese (BMI 30-39.9) were randomized to an energy-reduced Mediterranean diet and increased physical activity versus an ad libitum Mediterranean diet with no physical activity promotion, as a prespecified secondary analysis of the 3-year PREDIMED-Plus clinical trial in 23 centers in ...

  An important article (i think) just came out that evaluated the robustness of surrogate markers as accurate  substitutes for  clinical outcomes, finding many  concerns  (see  surrogate markers concerns JAMA2024  in dropbox, or doi:10.1001/jama.2024.4175)   Details : -- researchers accessed the FDA Adult Surrogate Endpoint Table (with >100 entries) and MEDLINE from  the  inception of th is  FDA table in 2018 to March 2023, evaluating the correlation between the surrogate markers and clinical endpoints found in the relevant meta-analyses (though they excluded oncologic treatments) -- 37 surrogate markers were identified for 32 unique nononcologic chronic diseases    Results  (my comments are embedded in the review of many of the individual surrogate markers below) : --  for 22 (59%) of the surrogate markers in 21 chronic diseases, no eligible meta-analysis was identified     -- 17 (77%...