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 ...

  the US Preventive Services Taskforce (USPSTF) recently published new guidelines regarding screening for osteoporosis to prevent fractures (see   osteoporosis USPSTF recs JAMA2025  in dropbox, or doi:10.1001/jama.2024.27154)   Recommendations , for adults 40 years or older without known osteoporosis or history of fragility fractures, and without having secondary osteoporosis from cancer, metabolic bone diseases ,  hyperthyroidism, or chronic steroid use: -- screen women 65 years or older for osteoporosis, moderate certainty of evidence, Grade B -- screen postmenopausal women younger than 65 at increased risk for osteoporosis, moderate certainty of evidence, Grade B -- men: insufficient evidence for screening for osteoporosis in the balance of benefits and harms, Grade I   --there are important caveats to these (and all USPSTF recommendations) noted in the document:     -- "USPSTF recognizes that clinical decisions involve more considerations than...