1. Obesity – 1,399 mentions

The emergence of obesity as an epidemic disease in the US was a top discussion point during the month. Neil Floch, a surgeon and physician, shared an infographic from the US Centers for Disease Control and Prevention (CDC), which depicted the prevalence of obesity across the various states and territories in the country.

The infographic categorises obesity prevalence based on race, ethnicity and location in the US in 2018. It reveals that more than 20% of adults are suffering from obesity across all states and territories and highlights differences by race and ethnicity.

Jaime Ponce, Bariatric Surgery medical director at CHI Memorial, tweeted a video mapping the percentage of obese adults across the US between 1997 and 2017. The video shows how the number of adult patients suffering from obesity has doubled over the past three decades in several states in the US.

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2. Diabetes – 1,166 mentions

The development of a risk calculator for diabetes complications and new treatments for diabetes were some of the key topics discussed during the month. Ali Aminian, associate professor of surgery at the Cleveland Clinic Lerner College of Medicine, shared an article about the development of a risk calculator by the Cleveland Clinic.

The risk calculator is designed to provide patients with personalised information on the risks of developing health complications over the next ten years based on the selected treatment course. It details the risks faced by a diabetes patient such as heart failure, stroke, heart disease, diabetic kidney disease, and death with usual care as well as after metabolic surgery.

Atanas G. Atanasov, a scientist and editor, shared an article on how researchers from East China Normal University and First Affiliated Hospital of Shenzhen University used green tea to activate cell therapies for diabetes. The research conducted on mice and macaque monkeys showed that drinking green tea returned insulin production to normal. Although the research findings need to be proven in humans, the researchers are optimistic about their findings, the article noted.

3. Bariatric Surgery – 697 mentions

The need for bariatric surgery to treat obese and diabetic patients and the consequences of avoiding surgery were discussed during the month. Data shared by bariatric surgeon Neil Floch showed that 40% of patients, who were denied bariatric surgery due to various reasons, died within 12 years of the denial. The data was presented at the Obesity Week 2019 conducted by the American Society for Metabolic and Bariatric Surgery in November.

Ali Aminian further noted that Roux-en-Y gastric bypass (RYGB), a type of bariatric surgery, was a better option for diabetes patients rather than sleeve gastrectomy although the complication rate of the latter was 50% lower than the former. RYGB surgery is believed to improve cardiovascular outcomes in patients, along with long-term remission rate. Personalised treatment based on the condition of the patient, including body mass index, was important in selecting the type of surgery, Ali opined.

4. Diet – 480 mentions

Discussions on the impact of a healthy diet on the planet and the pros and cons of various types of diets were trending on Twitter during the month. Atanas G Atanasov, a scientist, shared an article of a study on how a healthy diet will enable a healthy planet. The study, led by the University of Oxford, showed that eating a healthy diet comprising plant-based foods will have the best effect on the environment, while a bad diet heavy in meat and processed food could negatively impact the climate, ecosystems, and water resources.

An article shared by Gregory Miller, chief science officer at National Dairy Council, however, showed that climate-friendly eating habits may not be affordable for all. The article is based on research conducted by Tufts University and the International Food Policy Research Institute and builds on a prior EAT-Lancet Commission study that detailed a planetary healthy diet to feed ten billion people. Tufts research showed that the EAT-Lancet diet cannot be afforded by approximately 1.58 billion people.

5. Insulin – 110 mentions

Insulin resistance and the impact of the condition on patients were the key topics discussed on insulin during the month. Stephan Guyenet, a scientist and author, tweeted a video of a talk given by Stephen O’Rahilly, a physician and scientist, about the mutations in the adipose tissue that led to insulin resistance and even obesity. In the video, Stephen notes that obesity and metabolic diseases such as insulin resistance are linked to the capacity of the adipose tissue to store the extra fat.

Dr Aseem Malhotra also shared another article that details how rapid weight loss and regain caused by fad dieting can lead to insulin resistance, which in turn can lead to cardiovascular diseases and diastolic dysfunction.