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FNS study help - Fitness Nutrition Specialist Updated: 2023

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Exam Code: FNS Fitness Nutrition Specialist study help November 2023 by team

FNS Fitness Nutrition Specialist

Exam Details:
- Number of Questions: The number of questions in the Fitness Nutrition Specialist (FNS) test can vary depending on the certifying organization. Typically, the test consists of multiple-choice questions, and the exact number can range from 100 to 150 questions.

- Time: Candidates are typically given a set time limit to complete the FNS exam, which is generally around 2 to 3 hours. It is important to manage time effectively to ensure all questions are answered within the allocated time.

Course Outline:
The FNS certification program is designed to assess the knowledge and skills required to provide nutrition guidance and support to individuals in the fitness industry. While the specific course outline may vary depending on the certifying organization, the test generally covers the following key areas:

1. Basic Nutrition Concepts:
- Macronutrients (carbohydrates, proteins, fats)
- Micronutrients (vitamins, minerals)
- Energy balance and metabolism

2. Nutrition for Fitness and Exercise:
- Pre- and post-workout nutrition
- Hydration and electrolyte balance
- Sports nutrition and performance enhancement

3. Weight Management:
- Weight loss strategies and methods
- Body composition analysis
- Behavior change techniques for sustainable weight management

4. Special Populations:
- Nutrition considerations for different age groups (children, adolescents, older adults)
- Nutrition for pregnancy and lactation
- Nutrition for individuals with specific health conditions (diabetes, cardiovascular disease, etc.)

5. Supplementation and Ergogenic Aids:
- Common dietary supplements and their effects
- Ergogenic aids and performance-enhancing substances
- Evidence-based use and safety considerations

6. Counseling and Communication Skills:
- Interviewing and assessment techniques
- Effective communication strategies
- Behavior change theories and motivational techniques

Exam Objectives:
The objectives of the FNS test typically include:
- Assessing the candidate's understanding of basic nutrition principles and their application to fitness and exercise.
- Evaluating the candidate's knowledge of weight management strategies and their ability to provide guidance to individuals seeking weight loss or weight maintenance.
- Testing the candidate's knowledge of nutrition considerations for special populations, including different age groups and individuals with specific health conditions.
- Determining the candidate's familiarity with dietary supplements, ergogenic aids, and their appropriate use in the context of fitness and exercise.
- Assessing the candidate's counseling and communication skills to effectively work with clients and support behavior change.

Exam Syllabus:
The specific test syllabus for the FNS may vary depending on the certifying organization. However, the following Topics are typically included:

1. Basic Nutrition Concepts:
- Macronutrients and their functions
- Micronutrients and their roles in the body
- Digestion, absorption, and metabolism of nutrients

2. Nutrition for Fitness and Exercise:
- Energy requirements for physical activity
- Pre- and post-workout nutrition strategies
- Nutrient timing and meal planning for optimal performance

3. Weight Management:
- Energy balance and weight regulation
- Strategies for healthy weight loss and maintenance
- Behavior change techniques for sustainable weight management

4. Special Populations:
- Nutrition considerations for different age groups (children, adolescents, older adults)
- Pregnancy and lactation nutrition
- Nutrition for individuals with specific health conditions (diabetes, cardiovascular disease, etc.)

5. Supplementation and Ergogenic Aids:
- Common dietary supplements and their effects
- Ergogenic aids and their impact on performance
- Evidence-based use, safety, and regulations

6. Counseling and Communication Skills:
- Client interviewing and assessment techniques
- Effective communication and motivational strategies
- Behavior change theories and techniques

It is important to note that the specific Topics and depth of coverage may vary depending on the certifying organization offering the FNS certification. Candidates should refer to the official guidelines and study materials provided by the certifying organization for the most accurate and up-to-date information.
Fitness Nutrition Specialist
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Fitness Nutrition Specialist
Question: 68
What is the most serious and potentially deadly deficiency in the diet?
A. Water
B. Sodium
C. Calcium
D. Vitamin C
Answer: A
The most serious and potentially deadly deficiency in the diet is a deficiency of
water. Most nutrient deficiencies take weeks or longer to show signs, but lack of
water can only be survived for a very few number of days. There are many
smaller scale responses to dehydration that will also significantly impair a client’s
ability to perform.
Question: 69
What chronic condition can initiate the elevation of insulin levels, which converts
excess blood sugar to glycoproteins and fatty acids?
A. Overeating
B. Fatigue
C. Hyperglycemia
D. Hypoglycemia
Answer: C
Hyperglycemia, when chronic, can initiate the elevation of insulin levels, which
converts excess blood sugar to glycoproteins and fatty acids.
Question: 70
Dietary treatment of chronic ulcerative colitis includes all of the following except:
A. High calorie, high-fat, high-protein diet
B. Supplementation with calcium, vitamin C, folic acid, and zinc
C. Supplementation with MCT
D. Moderate amounts of dietary fiber to stimulate bowel function
Answer: A
Dietary treatment of chronic ulcerative colitis does not include a diet high in fat,
which may worsen steatorrhea. However, high intakes of protein and calories are
recommended to maintain energy balance and to promote healing.
Supplementation with calcium, vitamin C, folic acid, and zinc is recommended to
replace losses due to diarrhea. Supplementation with MCT (medium chain
triglycerides) is useful because it does not require bile for digestion. Moderate
amounts of fiber are encouraged to stimulate normal bowel function.
Question: 71
What is the recommended level of carbohydrate intake 1-4 hours before
A. 1-4.5 g/kg of bodyweight
B. 4-6.5 g/kg of bodyweight
C. 8-10 g/kg of bodyweight
D. More than 10 g/kg of bodyweight
Answer: A
The recommended level of carbohydrate intake 1-4 hours before exercising is 1-
4.5 grams of carbohydrate per kilogram of bodyweight. Some research has
indicated that getting 4.5 g/kg 4 hours before exercise enhanced performance by
15%. Adequate carbohydrate consumption is particularly important for morning
workouts, when glycogen stores have been depleted by up to 80% overnight.
Question: 72
Why is it important to pay close attention to carbohydrate intake or insulin use
during training with diabetic clients?
A. Diabetics have decreased circulation
B. Increased hydration may be necessary
C. To reduce the risk of hypoglycemic incidents
D. Frequently, there are other medical concerns concurrently that may need
Answer: C
It is important to pay close attention to carbohydrate intake or insulin use during
training with diabetic clients in order to reduce the risk of hypoglycemic
incidents. The other factors may be true, but do not have to do with carbohydrate
Question: 73
What is the condition of being hydrated at the normal state, which is also used as
the baseline for determining adequate hydration throughout a training session?
A. Subhydration
B. Dehydration
C. Superhydration
D. Euhydration
Answer: D
Euhydration is the condition of being hydrated at the normal state, which is also
used as the baseline for determining adequate hydration throughout a training
session. It is advisable to begin training sessions only if the client is at or above
this state of normal hydration.
Question: 74
How many cups of water should the average adult drink per day?
A. 4-6
B. 5-9
C. 6-10
D. 9-13
Answer: D
The average adult should drink about 9-13 cups of water per day. Drinking
enough water improves the body’s ability to regulate its temperature and enhance
its metabolism. Another benefit to drinking water is that increased hydration
levels facilitate more efficient distribution of nutrients throughout the body.
Question: 75
Which of the following is not a function of protein within the body?
A. Build and repair tissues and structures
B. Synthesis of hormones and enzymes
C. Assists in body temperature reduction
D. Energy
Answer: C
Protein does not assist in body temperature reduction. It does serve the other
functions listed. It is a basic necessary dietary component used for different types
of synthesis and repair and when calorie or carbohydrate levels are insufficient, it
will be used as energy.
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Medical Specialist study help - BingNews Search results Medical Specialist study help - BingNews Let your pulmonologist help you breathe easier No result found, try new keyword!Pulmonologists play a pivotal role in diagnosing, treating and managing various lung diseases for those struggling with respiratory issues. Wed, 08 Nov 2023 04:21:00 -0600 en text/html Compliance With Referrals to Medical Specialist Care: Patient and General Practice Determinants

Christel E. van Dijk*, Judith D. de Jong, Robert A. Verheij, Tessa Jansen, Joke C. Korevaar and Dinny H. de Bakker

NIVEL, Netherlands Institute for Health Services Research, P.O.Tox 1568, 3500 BN, Utrecht, The Netherlands


This study was financially supported by the Dutch Ministry of Health. The Ministry of Health had no role in the analysis and interpretation of data.

Competing interests
The authors declare that they have no competing interests.

Authors' contributions
CD, JJ, RV, JK, and DB were involved in the conception of the research question. CD and TJ were involved in analysing the data. All authors had full access to all the data and contributed to the interpretation of the data. CD drafted the manuscript, which was reviewed by all authors. All authors read and approved the final manuscript.

Mon, 23 Oct 2023 11:59:00 -0500 en text/html
Stress and constipation may worsen menopause symptoms, study finds
  • Experiencing menopause can come with a wide range of symptoms and challenges.
  • One area of interest is how factors like gut health influence menopause symptoms.
  • Data from a latest study found that increased perceived stress and certain gastrointestinal symptoms were associated with worse menopause symptoms.
  • Future research in this area may help discover ways to Improve menopause symptoms.

Menopause is common, but that doesn’t make the symptoms associated with it any easier, particularly when the transition into menopause begins.

Some people may experience worse menopause symptoms than others. Research is ongoing about factors that may influence the severity of symptoms at the onset of menopause and duration.

A latest study published in Menopause: The Journal of the Menopause Society found that reporting higher stress levels, having anxiety or depression, and experiencing constipation were associated with more severe menopausal symptoms.

Future research can further examine the relationship between these factors.

Researchers of the current study sought to “evaluate whether there is a relationship between menopausal symptoms, subjectively perceived stress, and reported gastrointestinal symptoms in midlife women.”

The study was a cross-sectional study that included 693 participants.

All participants were around 50 years old. Researchers included premenopausal and postmenopausal females in their survey. They excluded some individuals, including females with hysterectomies and those currently taking hormonal contraceptives.

To examine at menopause symptoms, researchers had participants fill out the Menopause-Specific Quality of Life Questionnaire (MENQOL).

The MENQOL questionnaire examines several areas of menopause-related symptoms and the degree to which the symptoms bothered participants. A higher score indicates a worse quality of life because of menopausal symptoms.

Participants filled out a questionnaire to measure perceived stress. They also answered several questions about their health, obstetric and gynecological history, and certain gastrointestinal symptoms.

When looking at gastrointestinal symptoms, participants had to answer questions about their frequency of bowel movements and stool consistency. Participants also had to answer specific demographic questions like their age and level of education.

Results of the study found that diagnoses of anxiety and depression and higher levels of perceived stress were associated with a more severe impact of menopausal symptoms.

The study authors found that women with constipation experienced more severe menopause symptoms.

They noted that stool consistency and frequency of bowel movements may relate to a person’s gut microbiota.

Non-study author Dr. Kecia Gaither, a double board certified OB-GYN, a maternal-fetal medicine specialist, and director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx commented on the study to Medical News Today:

“Scientists are coming to recognize that microbiomes play important roles in health; vaginal microbiomes are important to neonatal health, and likewise gut microbiomes impact adult health. The gut is impacted by a multitude of factors — food consumed, medications taken, and the hormonal milieu — among other intrinsic and extrinsic influences. Gut microbiomes and its effect on health is a novel and burgeoning arena for research — which needs further information. The study proposed a great foundation on which to explore the relationship between hormonal fluctuations impacting the gut microbiome–and the physiologic and metabolic bodily changes that result from such.”

The National Institute on Aging describes menopause as “a point in time 12 months after a woman’s last period.” The time before menopause is sometimes called menopause transition or perimenopause.

Menopause and perimenopause are associated with several symptoms that can be unpleasant and affect quality of life. Symptoms of menopause include:

Sometimes, people will refer to the symptoms in the menopause and the perimenopause time frame as menopause symptoms.

Non-study author Dr. Sherry Ross, an OB-GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, CA, offered further insight into menopause symptoms to MNT:

“The most common symptoms of menopause include irregular periods, hot flashes, sweating, insomnia, depression, anxiety, feeling apprehensive, weight gain or loss, fatigue, poor concentration, memory loss, low sex drive, vaginal dryness, and heart palpitations. All of these disruptive symptoms affect a person’s quality of life and have become a major challenge for the majority of people going through this normal hormonal cycle. Lack of professional guidance and treatment from healthcare professionals is one of the major roadblocks for millions of people suffering from these common debilitating symptoms.”

The severity and number of symptoms can vary greatly. So, researchers are interested in discovering more about what may impact menopause symptoms.

This current study does have some limitations to its findings. First, it does rely on participant self-reporting, which doesn’t always result in accurate measurement. It also cannot establish a causal relationship between the factors that the researchers examined. Participants also completed the survey online, which means all participants had online access.

Researchers acknowledge the possibility of sample bias due to factors like conducting their survey in an urban area and most participants having higher education. This makes it hard to generalize the study’s results.

Researchers also note that culture and attitude toward menopause can impact menopausal symptoms. So, future studies can include more participants from more diverse backgrounds.

This current study only included ethnically Lithuanian women, limiting the generalization of the results. Researchers note that further research can examine the relationship between the studied factors and include long-term follow-up.

Overall, the study points to the complexity of factors related to menopause symptoms.

Dr. Gaither was optimistic that future research into the gut microbiome could uncover a way to Improve menopause symptoms.

Dr. Gaither explained that it might be helpful “to narrow the field to see if there was a similarity of a specific protein or gene sequence that despite exogenous factors like environment, diet, ethnicity, comorbidities was impacted by menopausal hormonal decline — and as such produced a host of clinical symptomatology.”

“To find such within analyzing the gut microbiome, perhaps treatment of menopausal symptoms might reflect the need for supplementation of that particular deficient protein — ultimately working to reverse symptoms associated with menopause. Further research along this line is needed — a breakthrough of sorts would change the lives and well-being of women — globally — who are impacted by symptoms of menopause.”

Thu, 19 Oct 2023 12:00:00 -0500 en text/html
Study: Cannabis use increases the risk of heart attack, stroke

CINCINNATI (WKRC) - A word of caution is coming from the American Heart Association about the use of cannabis. Two new studies just released on cannabis use say pot may be extremely hard on the heart.

These studies show marijuana use increases the risk of having a heart attack, heart failure and a stroke.

Nobody is quite sure if one form of marijuana delivery into the body is more harmful to the heart than another.

Dr. Loren Wold, a specialist on the impact of the environment on the heart, said new information is coming to light.

“We are really just starting to understand the role that cannabis use can play on cardiac disease,” said Dr. Wold, of Ohio State University’s Wexner Medical Center.

But these studies are giving new insights into its possible role.

One study showed people who reported daily marijuana use had a 34% increased risk of developing heart failure, compared to those who reported never using marijuana. The risk was the same regardless of age, sex at birth, or smoking history.

The other study was one of the first to look at older adults who use marijuana. It found older people with any combination of high blood pressure, type 2 diabetes and high cholesterol significantly increased their risk for a major acute heart or brain event while hospitalized, compared to those who reported not using marijuana. But it’s not clear why.

“We unfortunately don’t,” Dr. Wold said. “We don’t know the reasons for why cannabis is having this effect on the heart function, and also why it’s having worse effect on those that have pre-existing conditions.”

While more research is needed, for those who are regular cannabis users, seeing a cardiologist can help determine if a person’s own heart is at risk.

Tue, 07 Nov 2023 07:47:00 -0600 en text/html
Study Eases Fears: Knee Surgery Surge Not Linked to Premature Intervention

A meta-analysis appears to allay concerns that surgeons might be performing total knee arthroplasties (TKA) on healthier patients.

"Both the total number [of surgeons performing primary TKA] and the number of surgeons per capita have been generally increasing," wrote Peter Dust, MD, of McGill University, Montreal, Quebec, Canada, and co-authors. "Reassuringly, however, our results suggest that despite the increasing number of surgeons, the indications for surgery are not being eroded by operating on healthier patients to fill operating room time."

The study was published October 24 in the Canadian Journal of Surgery.

Rising Demand

In the paper, Dust and colleagues noted that there was a 162% increase in volume of total knee arthroplasties among people enrolled in the US Medicare program between 1991 and 2010.

Unrelated to the study, the Canadian Institute for Health Information (CIHI) has also reported similar trends. In 2018-2019, about 75,000 knee replacements were performed in Canada; an increase of 22.5% over the previous 5 years. The numbers dropped in 2020-2021 during the pandemic due to limited access to medical facilities during that time, but then rebounded between April and September 2022 to close to pre-pandemic numbers. However, about 50% of patients were waiting longer during that time than the recommended 6 months (182 days) for their surgery.

So, What’s Happening?

The trends for rising numbers of knee surgeries cannot be fully explained by population growth and increasing rates of obesity, Dust and colleagues wrote in the paper. That led them to ask whether some patients were undergoing surgery with a higher level of preoperative function compared with the past.

They conducted a systematic review and meta-analysis of the MEDLINE, Embase and Cochrane databases with the aim of determining the effect of time, age, and sex on preoperative functional status. A total of 149 studies were ultimately included in the study, with data from 257 independent groups and 57,844 patients recruited from 1991 to 2015.

The analysis revealed that patients are undergoing TKA with a level of preoperative function similar to that in the past. Also, patient age, sex, and location did not influence the functional status at which patients were considered for surgery.

Jasvinder Singh, MD, professor of medicine and epidemiology at University of Alabama at Birmingham, who was not involved with the research, offered another suggestion to Medscape Medical News to explain the trend: people today are more familiar with knee replacement surgery and thus find it a less daunting option.

"Everybody knows somebody who has had a knee done or a hip done," Singh said."People are a lot more familiar with these things than they were 30 years ago."

Subjective Criteria Persists

In the paper, Dust said that he and his colleagues had hoped this study might reveal a target physical component summary (PCS) score, used to assess functional status, based on which patients could be considered for surgery. Their findings, however, did not enable such a recommendation to be made.

Dr Claudette Lajam

In an interview with Medscape, Claudette Lajam, MD, a spokesperson for the American Academy of Orthopedic Surgeons (AAOS), agreed that there does not appear to be a trend toward earlier intervention. Also, a precise number or score that can be used to determine when patients should undergo TKA still does not exist. Lajam is a professor of orthopedic surgery and system chief for orthopedic quality and risk at NYU Langone Health, New York City.

The "sweet spot time" for TKA is still not clear based on available metrics, Lajam said. Physicians need to consider not only patient level of function before surgery, but also when to intervene so they will get the most benefit from these procedures.

The knee has to be "bad enough to justify major surgery," she said, while waiting too long might lead to inferior outcomes.

In time, she thinks artificial intelligence (AI) could help in identifying when primary care clinicians should advise patients to seek specialist care for ailing knees.

AI could allow physicians and researchers to search for clues about the best timing for surgery by combing through millions of X-rays, a variety of functional scores used in assessing patients, and other sources of information, she explained. At this time, the PCS used by Dust and colleagues is just one of many measures used to assess patient level of function. AI might be able to bring these data together for scientists to review.

"AI can see patterns that I can’t see right now," Lajam said.

But she emphasized that any AI application would be an aid to physicians in counseling patients. Evaluation by an experienced surgeon, together with guidance from any AI tool, could provide a greater understanding of how TKA could help patients with arthritis of the knee.

"The physician sees intangibles that AI would not see because we actually talk to the patient," she explained.

Dust said there was no outside funding for the study and the authors and Lajam report no relevant financial relationships. Singh said he has received consulting fees from companies including AstraZeneca and institutional research support from Zimmer Biomet Holdings. He has also received food and beverage payments from Intuitive Surgical Inc./Philips Electronics North America, and owns stock options in companies including Atai Life Sciences. He is a member of the executive committee of Outcome Measures in Rheumatology (OMERACT).

Thu, 16 Nov 2023 03:06:00 -0600 en text/html
Can ChatGPT revolutionize nutrition education? Study examines potential and challenges

In a latest study published in Applied System Innovation, researchers investigated the potential of ChatGPT application as a knowledge-enhancement tool in the nutrition domain.

Study: ChatGPT as a Virtual Dietitian: Exploring Its Potential as a Tool for Improving Nutrition Knowledge. Image Credit: SuPatMaN/ Study: ChatGPT as a Virtual Dietitian: Exploring Its Potential as a Tool for Improving Nutrition Knowledge. Image Credit: SuPatMaN/


ChatGPT, a breakthrough artificial intelligence (AI) technology, is transforming nutrition and health. Unlike other diet apps, it provides tailored nutrition instruction to those seeking information and guidance through a dynamically interactive interface.

ChatGPT could Improve clinical decision-making, streamline administrative processes, and optimize resource allocation.

Despite the abundant literature on ChatGPT applications in health and medical sciences, there is a lack of understanding of its unique potential and limits concerning nutrition. Given the growing frequency of nutrition-related disorders, it is vital to emphasize a thorough understanding of nutrition.

Existing studies are focused on health disciplines such as nursing, microbiology, radiography, medicine, and parasitology. Further research is required to determine the possible applications and limits of the AI-based ChatGPT tool related to nutrition.

About the study

In the present study, researchers investigated whether ChatGPT could be used to virtually Improve nutrition knowledge based on previous research in related domains.

ChatGPT applications and advantages as a virtual dietary tool

ChatGPT, a conversational AI tool, could be valuable for individuals lacking professional expertise related to nutrition. Despite lacking specialized training, ChatGPT has attained scores near the cutoff for clearing the United States Medical Licensing test (USMLE) exams.

ChatGPT can provide recommendations based on language processing and advanced algorithms, helping users increase their diet diversity, identify new food recipes, and optimize their calorie intake. However, ChatGPT cannot schedule tasks or manage calendar events, essential features of meal-planning applications.

Users can ask questions about different food categories and the importance of certain nutrients or get answers to common dietary myths.

ChatGPT can mimic the underlying algorithms and formulas used in assessment tools and calculators, such as calculating total daily energy expenditure based on height, weight, age, gender, and activity level.

ChatGPT uses a unique method of learning and distributing information, acting as a user-friendly learning platform where users may interact with nutrition education content. Its strength is its capacity to respond quickly and effectively to user inquiries, providing a personalized and dynamic learning experience.

ChatGPT assistance to the nutrition care process

ChatGPT is a vital tool in the Nutrition Care Process (NCP) that may help with various nutritional issues. It can provide general data on nutritional recommendations, evaluate individual dietary requirements, guide body composition, provide tools for nutritional evaluation, and elucidate common nutrition-associated medical conditions and their risk factors.

Concerning Nutrition Diagnosis, ChatGPT can offer scientific evidence-based dietary diagnoses for commonly observed conditions, identify nutrition-associated issues, explain the importance of nutritional diagnoses to develop interventions, identify probable comorbidities, and document dietary diagnoses in standardized formats.

ChatGPT can provide elementary dietary advice, individualized meal planning, recipe modification ideas, behavior change approaches, meal frequency, and portion size control to manage weight during the Nutrition Intervention phase.

Concerning Nutrition Monitoring and Evaluation, ChatGPT can aid in establishing measurable targets for nutrition interventions by providing tools to track dietary intake, lifestyle factors, and physical exercise, analyzing nutritional information, identifying challenges, and providing resources to conduct follow-up evaluations and adjust interventions.

ChatGPT limitations

ChatGPT, a system that attempts to provide individualized nutrition advice, lacks the skillset of dietitians and nutritionists. These experts not only offer nutritional advice but also emotional support. The ChatGPT interface does not follow the functionality and structure of a traditional food diary, making it more difficult to retrieve and analyze prior food intake information.

ChatGPT cannot also check whether the meal plan's suggested food has been eaten, increasing the difficulty for ChatGPT users to track their food intake. Incorrect responses, coordinated nutrition services, hands-on demonstrations, physical examination, verbal and nonverbal cues, emotional and psychological aspects, real-time monitoring and feedback, wearable device integration, and ethical and privacy concerns are among the ChatGPT limitations.

It also lacks a specific and certified nutrition database, instead depending on various publicly available sources to retrieve nutritional information.

Coordinated nutrition services and interdisciplinary teams of specialist professionals are frequently required for comprehensive and individualized nutrition management. ChatGPT can neither physically demonstrate activities involving direct manipulation of items nor evaluate anthropometric measurements to assess nutritional status and identify appropriate dietary treatments.

Based on the findings, ChatGPT, as a supplement tool in the nutrition sector, can potentially Improve nutrition knowledge. However, further study is needed to enhance its powers. ChatGPT requires expert validation for accurate and trustworthy information.

Despite its large dataset, ChatGPT may generate outdated or inaccurate data, potentially compromising precision, dependability, and accuracy, which are critical in artificial intelligence-driven applications.

Tue, 24 Oct 2023 12:00:00 -0500 en text/html
Drugs like Ozempic are popular for weight loss. That's because there's been little other help: obesity doctors

White Coat Black Art26:30Ozempic: The good, the bad and the future

Despite widely publicized reports of rare but severe side effects, obesity doctors say Ozempic and drugs like it have the potential to improve medical help for a chronic illness that patients have been forced for too long to try to cure on their own.

"There are still some aspects of our health-care community that say, 'this is not important, weight loss is not important; it's just cosmetic and you're really not improving the health of these people,'" said Dr. Daniel Drucker, a physician-scientist whose research helped pave the way for Ozempic, one of several brand names for a drug known as semaglutide. "But now I think that argument will be laid to rest."

Ozempic and other drugs in its class are known as glucagon-like peptides, or GLPs. Because GLPs act to stimulate insulin secretion, the first was approved for use as a diabetes drug in 2005, said Drucker, who is a senior scientist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto.

But it was actually back in the late 1990s that Drucker's lab, as well as that of Dr. Steve Bloom in the U.K., began to publish what they'd observed in clinical trials — that patients treated with GLP medicines for their diabetes were also losing weight.

Now new data shows that semaglutide also reduces rates of heart attacks, strokes and death in people with pre-existing cardiovascular conditions, something Drucker told White Coat, Black Art host Dr. Brian Goldman he believes will "change the conversation around the importance of treating people with obesity."

Dr. Daniel Drucker, a physician-scientist whose research helped pave the way for Ozempic, says some members of the medical community still don't take obesity seriously as a condition for which people need medical help. (Sinai Health System)

'Not feeling hungry all the time' 

Michael Morris, 58, says he's been wrestling with his weight since he was a teenager.

"I've always gone up and down, yo-yo, every diet," he said. When he needed a CPAP machine for sleep apnea about 18 months ago, he ended up in a program that supported him through some dietary changes to help address the apnea, along with his high blood pressure and cholesterol levels, and pre-diabetic blood sugar status. When Morris met with a doctor, he asked about Ozempic, and the two agreed he could give it a try.

Since then, Morris said he has gradually lost around 40 pounds and seen improvements in his other conditions as well.

Michael Morris says he has lost around 40 pounds since going on Ozempic about 18 months ago. (McLendon Photography)

"It's like it changes … the way you think about food, like I'm not feeling hungry or ravenous all the time," he said. 

Before Ozempic, Morris said he could never tell when he was full.

"I know that's probably hard for people to understand. I would eat stuff and then I would just keep eating, and then I got to the point where it made me feel sick. And then I'd be like, 'Oh, I'm not doing that again.'

"I guess food, it's like an addiction for me. And if you're an alcoholic, people don't say, 'Oh, I'm just trying not to drink.' There are programs and stuff."

Dr. Sasha High, an internal medicine and obesity physician who works in private practice in Toronto, says genes shape how our brains respond to food and contribute significantly to obesity. (ELH Photography)

The genetic component

Dr. Sasha High, an internal medicine and obesity physician who works in private practice in Toronto, says it's important to understand that not everyone experiences food in the same way.

"We know that 50 to 70 per cent of obesity is genetically determined and the genes involved are central nervous system genes, that means genes that control factors with our brain," she said. These affect the way the brain responds to the food that's around us, whether we have cravings for sugar or salty foods and whether we enjoy exercise. "All of that is kind of determined by our physiology."

When High first started working in obesity medicine, she says there was little more than advice to eat less and exercise more that doctors could offer to patients. (Joel Saget/AFP/Getty Images)

That doesn't mean weight is set in stone, said High, but it does mean there's a range of what your body shape is going to look like, determined by your genetics and then by lifestyle choices.

When she started working in the area of obesity back in 2012, High said there wasn't much doctors could offer beyond telling patients to eat less, exercise more and count calories.

That message is disempowering for people who have contended with obesity for a long time, she said.

"The issue is not that they don't understand that they need to do that. The issue is that life gets in the way and stressers come and we eat because we are bored and we eat because we're sad and we eat because it's 9:00 at night and we've had a stressful day."

Drucker said GLP medications work in two ways to tell patients that they're not hungry. First, they tell the brain to physically slow the emptying of the stomach, and second, they affect the brain's hunger signals, suppressing appetite. 

Some of Drucker's research was done in partnership with companies that produce or are working on weight-loss drugs, including Pfizer and Novo Nordisk.

On Nov. 11, the New England Journal of Medicine reported the results of a study on the safety of semaglutide in people with obesity who also had cardiovascular disease, said Drucker. On average, the patients received either semaglutide or a placebo for 34 months.

"It showed not only weight loss but reduced rates of heart attacks, strokes and death." 

However, some patients have experienced serious side effects, including stomach paralysis and malnutrition.

Pamela Cole is one of those patients. The 38-year-old from Marmora, Ont., initially responded well to the medication. But when her doctor increased her dose about eight months in, she started to get flu-like symptoms that escalated from there.

"I continued to get worse to the point I couldn't eat anything without severe stomach pain," said Cole. She wound up visiting the hospital four or five times in the space of two weeks, she said.

During the last of those visits, she was treated for severely low potassium levels that were impacting her kidney and liver function. A specialist eventually advised her to discontinue Ozempic, and after doing so, her symptoms resolved.

WATCH | Semaglutide linked to serious gastrointestinal problems:

Ozempic-class drugs linked to serious gastrointestinal risks, study suggests

1 month ago

Duration 1:59

In a statement, Ozempic manufacturer Novo Nordisk told CBC it stands behind the safety and efficacy of all of its GLP-1 medicines when used by appropriate patients consistent with the product labelling and approved indications.

Drucker said Cole's experience is atypical next to research findings from eight large cardiovascular safety trials — some with more than 10,000 subjects — that ran over periods of two to six years.

"And what we see generally are favourable results. In those trials, we see a reduction in heart attacks, strokes, cardiovascular death … and we do not see an increase in cancer or an increase in pancreatitis," he said. 

However, he said it's important to be cautious.

"With the newer, more powerful medicines and the expanding patient population, there is always the possibility to see something that we haven't before."

Dr. Nav Persaud, a family medicine physician at St. Michael's Hospital in Toronto, told CBC in January that it wouldn't be the first time the side effects of a weight-loss drug turned out to be more serious than anticipated.

"We have seen it happen many times where there were these heralded wonder drugs that turned out not to work or to harm and kill people," he said.

In France, a diet drug called Mediator that started as a Type 2 diabetes treatment was taken off the market in 2009 after being blamed for thousands of deaths due to heart-valve problems.

Dr. Sean Wharton said that until GLP drugs are less expensive and more widely available, they won't be able to address obesity on a population level. (Lindsay Palmer)

Dr. Sean Wharton is an internal medicine specialist at Michael Garron Hospital in Toronto and assistant professor at the University of Toronto who researches obesity medicine. He likens the difficulty people face accessing medical help for obesity to the experience many people with mental health issues have with expectations that they should "just be happier."

LISTEN|Dr. Arya Sharma on treating obesity as a disease not a behaviour:

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However, until weight-loss medicines become a lot more accessible, he said he doesn't see them making a big dent in the obesity epidemic. Ozempic has been in short supply since its popularity skyrocketed — more than 3.5 million prescriptions were filled at Canadian pharmacies last year The very nature of an injectable drug that's expensive to manufacture, ship and store means only people with the financial resources or particularly good drug plans can get their hands on it, said Wharton, who has done paid research for Novo Nordisk.

In September, the New England Journal of Medicine published Wharton's phase-two trial data showing that a once-a-day pill called orforglipron resulted in a weight reduction of at least 10 per cent after 36 weeks in 46 to 75 per cent of participants.

Drucker said that GLP medicines won't erase the need to address access to healthy, affordable foods, to design cities that are easier to navigate on foot or bicycle, or to promote healthy habits around diet or exercise. 

"But if you're sitting across the desk from someone who is living with obesity and they have a higher risk of heart disease and kidney disease and liver disease and cancer, you know, I think GLP medicines are a very useful option."

Wed, 15 Nov 2023 21:59:00 -0600 en text/html
Scientists develop an improved method to study Parkinson's disease in the lab

A latest study published in Progress in Neurobiology and led by researchers at the University of Arizona College of Medicine – Tucson has developed an improved method to study Parkinson's disease in the lab. Along the way, researchers also uncovered clues that may help scientists figure out how to detect Parkinson's earlier and point the way toward better treatments.

Around a million Americans are living with Parkinson's disease, a neurological disorder that causes difficulty in movement, balance and cognition. Symptoms worsen until tasks like walking, talking and swallowing present enormous challenges. While there is no cure, there are treatments that control symptoms -; but their effectiveness wanes over time and they are associated with unwanted side effects.

It's a slow-developing disorder. We only diagnose the disease at a late stage, when 60-70% of dopamine neurons are dysfunctional or have died off. We have treatments, but at that point you're trying to throw a small glass of water on a raging fire. Being able to diagnose the condition at the earliest stages would be a big step."

Lalitha Madhavan, MD, PhD, associate professor of neurology at the College of Medicine – Tucson, part of UArizona Health Sciences

Madhavan's team used cells from Parkinson's patients to create a human-derived laboratory model to study the disease. Using induced pluripotent stem cell technology -; a powerful technique that transforms adult cells into embryo-like cells that can then mature into any cell type -; the lab reprogrammed adult skin cells called fibroblasts into brain cells.

Using the reprogrammed neurons, Madhavan Lab researchers discovered several changes in the cells from Parkinson's subjects that differentiated them from cells of healthy individuals. Madhavan hopes this finding can form the basis for better cell-culture systems for studying Parkinson's disease in the lab, potentially leading to improved diagnostics and treatments.

The experiments also showed that skin cells may act as a window into the brain. Skin cells don't cause neurological symptoms, but some of the same changes that damage brain cells might also affect skin cells, producing similar molecular "signatures."

"We wanted to make neurons from skin biopsies using this fantastic technology; however, we noted along the way that the fibroblasts themselves seemed to have signatures that differentiated individuals with Parkinson's. We started to dig deeper into that," Madhavan said. "It's exciting that we've shown that connection, and that it tells us skin cells could perhaps be used to diagnose the disease early."

The team hopes that, in the future, doctors will be able to catch Parkinson's disease earlier by examining skin cells for signs that the disease is brewing.

"This could be a system in which we could very carefully diagnose people at early stages," Madhavan said, adding that her team received a patent on a method for examining skin cells for molecular signs that correlate to Parkinson's disease.

They are now investigating how skin cells change over time to learn more about how the disease progresses and how to identify it early. Tech Launch Arizona, the University of Arizona's technology commercialization office, is helping protect the innovation and developing strategies to take it from the laboratory to the marketplace where it can impact the lives patients and their doctors.

Madhavan says that if we could catch Parkinson's disease earlier, doctors could prescribe currently available treatments that can slow disease progression. Simultaneously, scientists could work to develop next-generation Parkinson's drugs that target the disease in its early stages.

Because a patient's skin cells are easy to access -; especially compared to brain cells -; Madhavan also hopes the system could be used for a precision-medicine approach, matching patients with optimized treatments based on a skin biopsy and lab test showing which drug might work best based on their unique genetic profile.

"We've been putting Parkinson's into one big bucket when actually different people express it differently," she said. "This system would allow us to carefully classify Parkinson's and assess treatments more effectively based on such a classification."

The lead authors on the study were Mandi Corenblum, MS, senior research specialist, and Aiden McRobbie-Johnson, physiological sciences graduate student. Co-authors include Kelsey Bernard and Timothy Maley, graduate students in neuroscience and physiological sciences; Emma Carruth, undergraduate student in physiology; Moulun Luo, PhD, associate research professor of medicine; Lawrence Mandarino, PhD, professor of medicine; Maria Sans-Fuentes, PhD, BIO5 Institute statistician; Dean Billheimer, PhD, professor in the UArizona Mel and Enid Zuckerman College of Public Health and director of statistical consulting at the BIO5 Institute; and Erika Eggers, PhD, professor of physiology and member of the BIO5 Institute.


Journal reference:

Corenblum, M., et al. (2023). Parallel neurodegenerative phenotypes in sporadic Parkinson’s disease fibroblasts and midbrain dopamine neurons. Progress in Neurobiology.

Thu, 16 Nov 2023 06:18:00 -0600 en text/html
Sleep disorders specialist warns of misleading takeaway from study suggesting snooze button benefits

A study out of Sweden's Stockholm University suggests hitting the snooze button on the alarm clock might not be as bad a habit as we may have been led to believe.

The researchers say their analysis of 31 people who spent several nights in sleep lab concludes that using the snooze function for a more gradual wake up does not impact , and in some cases may help spark alertness sooner in the morning.

On average, the participants who hit snooze over the course of a half hour ended up with six less minutes of sleep.

But at UConn Health's Sleep Disorders Center, Dr. Jennifer Kanaan says the study, and the way it's being presented, could send the wrong message.

"If you're coming in and out of sleep for 30 minutes, after the goes off the first time, you're costing yourself 30 minutes of uninterrupted, quality, restorative sleep," Kanaan says. "This study doesn't change that fact."

She was not involved in the Stockholm University study.

Kannan suggests rather than try to figure out how to manipulate our alarm clocks to trick ourselves into thinking we're ready to wake up, we should make a consistent good night's sleep a greater priority. That would make us less reliant on snooze buttons, or alarm clocks in general.

"The other way to look at the study is that people are undersleeping and are suffering from insufficient sleep," she says. "Simply put, instead of hitting the snooze button they should get more sleep."

But when the alarm does go off before your body is ready to wake up on its own, Kanaan suggests rather than hitting snooze, get out of bed instead and expose yourself to light. Sunlight is the most effective at resetting your body clock and recalibrating your circadian rhythm to put yourself in wake mode.

The return to standard time Nov. 5 presents a fortunately timed opportunity to Improve our sleep habits.

"In addition to getting that extra hour of sleep that Saturday night, we can take advantage of the time change to realign our sleep schedule with the environmental light cues that setting our clocks back an hour provides," Kanaan says.

Here are 10 more tips for good sleep habits throughout the year:

  1. Establish a nightly routine and consistent bedtime every night, even on weekends.
  2. Avoid screens at least 60 minutes before that bedtime, and charge your phone somewhere other than the bedroom.
  3. As part of your evening routine, chose relaxing activities rather than stressful ones.
  4. Wake up at around the same time every morning, even on weekends. You eventually may be able to throw away your !
  5. Avoid naps and sleeping late, even when it's been a late night. This can push the next night's sleep back and make it even more difficult to get back on a consistent sleep schedule.
  6. Reserve your bedroom for sleep; make it a quiet, dark, comfortable (not too warm) place that's free of distractions.
  7. Watch your afternoon caffeine intake; the stimulative effect can last up to six hours.
  8. Go easy on the alcohol. It might make it easier to fall asleep but harder to maintain quality sleep throughout the night.
  9. Be aware that strenuous exercise at night or late heavy meals and snacks can make it harder to get to sleep.
  10. Set a good example for your children; let your behavior reinforce the importance of sleep in your home.

Citation: Sleep disorders specialist warns of misleading takeaway from study suggesting snooze button benefits (2023, October 19) retrieved 17 November 2023 from

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Wed, 18 Oct 2023 12:00:00 -0500 en text/html
ConcertAI's TeraRecon Enhances its Eureka Clinical AI Platform with AI-Based Prostate Cancer Diagnostic Solutions from Lucida Medical

CAMBRIDGE, Mass., Nov. 15, 2023 /PRNewswire/ -- ConcertAI's TeraRecon, the advanced visualization and clinical AI SaaS company, today announced the addition of Lucida Medical to its Eureka Clinical AI Platform ecosystem. It will be deployed within the UK's National Health Service (NHS) and European healthcare systems.

Pi™ (Prostate Intelligence™), Lucida Medical's AI-machine learning software, is designed to help radiologists detect prostate cancer lesions from MRI, enabling faster and more accurate prostate cancer detection.  MRI is now the preferred technique to assess a range of cancers, including prostate and metastatic disease. However, radiologists currently require a labor-intensive, specialist training for interpreting prostate MRI, creating a growing skills challenge.

Prostate cancer diagnosis using MRI represents a major step forward compared to earlier methods but remains prone to human error. The ground-breaking PROMIS study (Lancet 2017; 389: 815–22) indicated that radiologists can miss 12% of significant cancers on MRI, and lead to 55% of individuals without significant cancer receiving a painful and costly biopsy. The study presented at ECR 2021 suggests that Lucida Medical's AI technology could help cut missed cancers to 7% and unnecessary biopsies to 24%, as well as making the process faster.

"Prostate Cancer is a devastating disease impacting millions of men worldwide.  As a company, ConcertAI is committed to advancing cancer research solutions and working with the worlds Biomedical and MedTech innovators," said Jeff Elton, PhD. CEO of ConcertAI.   "The addition of Lucida Medical's Pi solution as part of the TeraRecon Eureka Clinical AI ecosystem is an important advance for radiology teams working with urology and oncology healthcare practices.  Lucinda's Pi™ solution supports earlier and accurate detection, critical to achieving the best possible outcomes and treatment options for the highest quality of life for patients."  

"We are delighted to empower the wide community of TeraRecon users with our MR based prostate solution," said Dr. Antony Rix, CEO and Co-founder, Lucida Medical. "This global partnership brings healthcare providers closer to achieving faster and more accurate detection of the most common cancer in men."

Eureka Clinical AI by TeraRecon is a robust platform powering 1st, 2nd, and 3rd party algorithms on one consolidated platform that integrates seamlessly into the PACS, provides a console to see all results and conversations across the patient's health care teams, and allows clinicians to directly interact with the AI to ensure accurate and holistic algorithm training.

Learn more about the Eureka Clinical AI platform capabilities and algorithms that span across neurology, radiology, cardiology, oncology, and more: 

About TeraRecon: Serving ~1,900 clinical sites globally, TeraRecon, a ConcertAI company, is a Best in KLAS solution provider for AI-empowered radiology, oncology, cardiology, neurology, and vascular surgery. Awarded the 2020, 2021, and 2022 KLAS Category Leader for Advanced Visualization, TeraRecon solutions are independent of any one manufacturer's imaging equipment or PACS system, allowing a single, unified, and simplified clinical workflow that can Improve efficiencies and deliver actionable physician-guided insights. For more information, visit us at

About ConcertAI: ConcertAI is the leader in Real-World Evidence (RWE) and AI technology solutions for life sciences and health care. Our mission is to accelerate insights and outcomes for patients through leading real-world data, AI technologies, and scientific expertise in partnership with the leading biomedical innovators, health care providers, and medical societies. For more information, visit us at

About Lucida Medical: Lucida Medical develops AI-based technology to assist clinicians to find cancer more accurately, diagnose and treat it more effectively, and save time. A start-up business from the University of Cambridge, Lucida Medical was founded in 2019 by Dr. Antony Rix, an expert in medical devices, machine learning and AI, and Prof. Evis Sala, who at the time was Professor of Oncological Imaging at the University of Cambridge & Addenbrooke's Hospital, and who is now Chair of Radiology at the Università Cattolica del Sacro Cuore and Director of the Advanced Radiology Centre at the Policlinico Universitario A. Gemelli, IRCCS in Rome. Prostate Intelligence™ (Pi™) is intended for use to assist the diagnosis of prostate cancer, and is the company's first product to complete regulatory approvals. For further information, visit the Lucida Medical website at

Media Contact:Megan Duero,

Cision View original content:


Tue, 14 Nov 2023 22:07:00 -0600 en text/html

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