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A recent study found that excess weight affects how the immune system responds to COVID-19,
showing differences between post-infection and post-vaccination immunity. Led by Marcus Tong from
the University of Queensland, the research suggests that being overweight, not just obese, makes SARS-
CoV-2 infections more severe and changes the immune response.
In a unique study group infected at the beginning of the pandemic, blood samples were taken three and
13 months after infection. Those with a higher body mass index (BMI) experienced a faster decline in
immune response, especially against certain variants. Interestingly, vaccinated individuals did not show
this decline, highlighting the potential superiority of vaccine-induced protection for overweight people.
The study included participants who remained uninfected and unvaccinated for 13 months, allowing
researchers to isolate the effects of natural protection versus vaccination. Five months after their
second vaccine dose, participants who had never had COVID-19 were included. Regardless of BMI, no
significant differences in immunity were found in this vaccinated group.
The study emphasizes the importance of vaccination for overweight individuals, as their infection risks
and weakened immune responses may increase the chances of reinfection. Dr. Kirsty Short from the
University of Queensland stresses the crucial need for vaccination in this group.
However, for those with severe obesity (BMI > 40 kg/m2), a separate study in Nature Medicine in May
2023 showed a different scenario. Despite initially similar vaccine responses between obese and
healthy-weight individuals, those with severe obesity experienced a quicker decline in immunity
effectiveness, leading to more hospitalizations and deaths.
While a third vaccine dose restored immunity in severe obesity cases, it declined faster afterward. The
study authors suggest considering more frequent COVID-19 vaccinations for people with severe obesity
to ensure they have protection comparable to those with a normal BMI, considering the widespread
prevalence of obesity globally.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer

Eating meals earlier in the day has been associated with a reduced risk of cardiovascular disease, according to a recent study. The research, based on data from 103,389 individuals, emphasizes the importance of meal timing in the realm of chrononutrition. Beyond the content of our diets, the study highlights the significant impact of when we consume our meals on circadian rhythms and overall health.

Previous studies have shown that delaying the first or last meal of the day may have adverse effects on cardiovascular health. A growing body of evidence in the field of chrononutrition suggests that not only what we eat but also when we eat plays a crucial role in maintaining good health. The timing of meals, coupled with exposure to light, influences circadian rhythms, affecting various aspects of health.

Recent findings indicate that individuals who consume meals later in the day tend to burn calories more slowly and exhibit genetic changes that promote lipid storage, contributing to fat growth. Additionally, a study on diabetics revealed that restricting eating to a specific time window, from noon to 8 pm, resulted in greater weight loss compared to a conventional calorie-restricted diet. A mouse study from 2022 even demonstrated that restricting eating to the rodents’ most active nighttime hours extended their lifespans by 35%.

The latest research, drawing from the NutriNet-Santé study, underscores the importance of breakfast timing. For every hour of delay in having breakfast, there was a 6% increase in the risk of developing cardiovascular disease. Comparing individuals who had their first meal at 7 am to those who ate at 10 am, the latter faced an 18% higher lifetime risk of cardiovascular disease. Furthermore, the study revealed that individuals eating their last meal after 9 pm experienced a 28% higher risk of cerebrovascular diseases, such as stroke and aneurysm, compared to those concluding their calorie intake before 8 pm.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer: https://centrumpharmacy.com/disclaimer/ 

Children possess distinct clinical and practical needs when on the move. To address these concerns, the following strategies for risk assessment and prevention should be followed:

1. Book a Pre-Travel Consultation at Destinations Travel and Immunization Clinic for your family and get customised travel health advice from a professional who specializes in travel heath medicine. 
2. Diarrhea:

• Take food and water precautions.
• Breastfeeding is optimal protection against food- and water-borne illnesses.
• For formula-fed children, bring formula from home, and prepare with disinfected water.
• Go to the travel clinic and get a standby prescription of Azithromycin for moderate or severe diarrhea.

3. Insect Bites:

• Use DEET 10% for teens or picaridin for children, varying in application frequency based on age.
• For infants under six months, use for mosquito netting in high-risk areas.

4. Sunburn:

• Discourage direct sun exposure for infants under six months.
• Use SPF ≥ 30 sunscreen if sun exposure is unavoidable, applied before insect repellent if both are required.

5. Malaria:

• Children are at a higher risk of severe complications, so see the travel clinic for a malaria chemoprophylaxis prescription.
• Antimalarial options include atovaquone/proguanil, chloroquine, doxycycline (for children aged ≥ 8 years), mefloquine, or primaquine.
• Antimalarials can be crushed for children who can’t swallow tablets and added to taste-masking foods.

6. Other Considerations:

• Be watchful for animal bites in countries with high rabies rates, considering children’s susceptibility.
• Discuss the possibility of rabies vaccination for children at elevated risk.
• Book a pre-travel consultation to review routine immunization status, including influenza and COVID-19 vaccinations at Destinations Travel and Immunization Clinic well before your trip.

Resources for Families:

• Travel for Kids: Family-friendly activities, destination-specific tips, and hotel recommendations.
• Rough Guides: Travel ideas for children, packing advice, and transportation and accommodation options.
• Travel.gc.ca: Canadian regulations and procedures for flying with children, including carry-on baggage, security screening, and using child restraint systems.
• Sutter Health: Health advice for traveling with children.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer: https://centrumpharmacy.com/disclaimer/ 

The World Health Organization (WHO) designated the JN.1 coronavirus strain as a “variant of interest” and indicated that, based on current evidence, the risk to public health from this strain is low. Despite its ability to evade the immune system and exhibit higher transmissibility compared to other circulating variants. Experts assert that JN.1 does not show any signs of causing more severe disease.

While there may be an increase in cases involving the JN.1 variant, it is emphasized that it does not pose a greater risk. JN.1, initially considered a variant of interest within the BA.2.86 lineage, has now been classified separately by the WHO.

The World Health Organization assured that existing vaccines remain effective in protecting against severe disease and death caused by JN.1 and other variants of the COVID-19 virus currently in circulation.

According to the U.S. Centers for Disease Control and Prevention (CDC), as of December 8, the JN.1 subvariant constitutes an estimated 15% to 29% of cases in the United States. The CDC maintains that there is no current evidence suggesting an elevated risk to public health compared to other circulating variants. Additionally, it is stated that an updated vaccine could provide continued protection against the JN.1 variant.

First detected in the United States in September, JN.1 has also been identified in seven cases in China, as reported last week.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer: https://centrumpharmacy.com/disclaimer/ 

Zonnic Nicotine Patches : Most Effective Nicotine Replacement Therapy or an Elaborate Scheme by Big
Tobacco?
Zonnic nicotine pouches entered the market in mid-October, sparking immediate controversy. The
Health Minister and health organizations have raised objections, while the manufacturer contends that
the product is unfairly maligned.
Crafted by Imperial Tobacco Canada, Zonnic nicotine pouches aim to serve as nicotine replacement
therapy (NRT) for smokers. Health Canada granted approval for their sale in July under Natural Health
Product Regulations, given their nicotine content without tobacco. Packaged in vibrant, “attractive-to-
youth” containers resembling gum. They come in three flavors: Tropic Breeze, Chill Mint, and Berry
Frost. Users place a pouch under their lip, releasing 4 mg of nicotine slowly. These pouches are available
in convenience stores, gas stations, and pharmacies.
Studies have found that oral nicotine pouches compared favorably to other NRTs, with users reporting
fewer minor adverse events and greater satisfaction than with nicotine lozenges or gum.
Despite these positive findings, six national health organizations have called for a change in regulations,
arguing that the approval was a mistake. They highlight concerns that Zonnic can be legally sold to
minors of any age and can be promoted through billboards, advertising, and free samples. Health
Canada, in response, emphasizes the importance of preventing youth access and is considering
regulatory options.
The health groups advocate for reclassifying Zonnic as a prescription product or banning its sale. They
also call for a temporary halt on approvals for similar nicotine pouches or new nicotine product
categories.
Imperial Tobacco Canada asserts that Zonnic targets adults and emphasizes self-regulation, ensuring
sales only to those over 18 with proof of age. However, health groups argue that, despite restrictions on
sales, there are no legal penalties for retailers selling it to minors.
The advertising approach is under scrutiny, with concerns that Zonnic's ads, emphasizing lifestyle, are
likely to reach children. Health Canada specifies that NRT labels and advertisements should prominently
indicate their intended use for smoking cessation in adults.
The Health Minister expresses concerns about the tobacco industry's intentions, while Imperial Tobacco
Canada defends Zonnic's efficacy and safety for smoking cessation. The ongoing debate raises parallels
with past challenges in regulating vaping, and health advocates stress the need for robust regulatory
frameworks to prevent potential risks associated with new nicotine products.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer

‘Tis the season for festive gatherings and holiday cheer. These occasions hold significance in fostering a sense of community, contributing to mental well-being, and bringing people together. However, the convergence of respiratory viruses during this time, especially amid the winter months, poses a
heightened risk of transmission.

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Recent observational research presented at the American Heart Association (AHA) 2023 Scientific Sessions reveals a 34% higher risk of heart failure within four years associated with daily marijuana use compared to non-use. The findings, while observational and indicating association rather than causation, contribute to a growing body of evidence on the potential cardiovascular effects of marijuana. 

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LDL cholesterol, often referred to as “bad cholesterol,” silently poses a grave threat to cardiovascular health. However, a recent survey conducted in 2023 by the American Heart Association (AHA) in collaboration with the Harris Poll has unveiled a concerning lack of awareness, especially among heart attack and stroke survivors. Astonishingly, 70% of these survivors were found to be unfamiliar with the term “bad cholesterol” and its implications, indicating a significant knowledge gap and an urgent need for widespread education and proactive health management.

Cholesterol is a waxy substance produced by the liver and introduced to the body through certain foods, primarily animal sources like meat and full-fat dairy products. Cholesterol travels through the bloodstream, attached to lipoproteins. The two main types of lipoproteins are high-density lipoproteins (HDL), often referred to as “good” cholesterol, and low-density lipoproteins (LDL), known as “bad” cholesterol. Together with triglycerides, these components make up your total cholesterol level.

The pervasive lack of public awareness about “bad cholesterol” and its impact on cardiovascular health is a cause for concern. Since elevated LDL cholesterol typically exhibits no symptoms, many individuals may be unaware of their risk and how to mitigate it. Elevated LDL cholesterol can lead to the formation of fatty deposits, or plaques, in the arteries, significantly increasing the risk of heart attacks and strokes. The AHA survey found that, while 75% of heart attack and stroke survivors reported having high cholesterol, but only 49% recognized the importance of lowering it. Furthermore, 47% of survivors were unaware of their LDL cholesterol levels, despite its crucial role in preventing additional cardiovascular events.

To address this issue, the AHA recommends that all adults aged 20 or older have their cholesterol checked every four to six years, provided their risk remains low. After the age of 40, healthcare professionals should use a specific calculation to assess an individual’s 10-year risk of experiencing a heart attack or stroke. Those with a history of such events may need more frequent cholesterol checks. Knowledge is undeniably a powerful tool in this context—the more you know, the better equipped you are to reduce the risk of future heart attacks and strokes.

The journey to lower cholesterol begins with mindful eating. The AHA recommends adopting a diet rich in fruits, vegetables, whole grains, poultry, fish, and nuts, while minimizing red meat and full-fat dairy. Monitoring fat intake is crucial, particularly by reducing saturated fat to less than 6% of daily calories and avoiding trans fats.

Incorporating at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking or swimming, can have a significant impact on cholesterol levels and overall cardiovascular health. For smokers, quitting is imperative. Additionally, modest weight loss of 5% to 10% can lead to improvements in cholesterol levels and overall heart health.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer 

Erectile dysfunction is frequently associated with the same factors responsible for cardiovascular disease, such as inflammation, arterial narrowing (endothelial dysfunction), or artery hardening (atherosclerosis). Consequently, erectile dysfunction can often serve as an early warning sign or an indicator of an individual’s overall cardiovascular health. If you’re grappling with erectile dysfunction, it is advisable to consult your healthcare provider for a thorough evaluation of your heart health. This proactive approach can help identify potential cardiovascular issues and allow for timely intervention.

Engaging in regular exercise for a minimum of 30 minutes, three times a week, has been discovered to yield results almost on par with pharmaceutical options like Viagra and similar medications when it comes to enhancing erectile function. This revelation stems from a recent comprehensive analysis of the most reliable research available on the connection between aerobic exercise and erectile function.
The findings of this study, published in The Journal of Sexual Medicine, reveal that aerobic activities, such as walking or cycling, have a positive impact on erectile function for all men dealing with erectile dysfunction. Notably, this improvement occurs regardless of factors such as body weight, overall health, or the use of medication. In fact, men with the most severe cases of erectile dysfunction experienced the most significant benefits.

While the medical community has long recognized the relationship between erectile function and cardiovascular health, the evidence supporting the impact of exercise on this condition has been limited. The study’s results demonstrated that the more severe the erectile dysfunction, the more exercise aided in enhancing erectile function. On a standardized scale ranging from 6 to 30, men with severe erectile dysfunction who incorporated exercise into their routines reported a notable 5-point enhancement in erectile function. Those with mild and moderate cases of erectile dysfunction experienced improvements of 2 and 3 points, respectively.

In comparison, pharmaceutical treatments like phosphodiesterase-5 inhibitors, such as sildenafil (commonly known as Viagra) or tadalafil (Cialis), could lead to improvements within the range of 4 to 8 points, as pointed out by the study authors. Similarly, testosterone replacement therapy was found to result in an improvement of 2 points. These findings highlight the valuable role of exercise in addressing erectile dysfunction, particularly for those with more severe cases, while also underlining the effectiveness of established pharmaceutical treatments.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer

For women grappling with obesity and undergoing treatment with drugs such as semaglutide (known as Ozempic) or tirzepatide (referred to as Mounjaro), the benefits of these medications are remarkable. Belonging to a novel category known as GLP-1 receptor agonists, they offer substantial and rapid weight loss, improved blood sugar management, and an enhanced quality of life. These drugs represent a significant departure from the long-established view that surgical procedures were the most effective long-term solution for obesity.

However, the quest for accelerated weight loss and enhanced blood sugar control carries an unexpected caveat. Many women dealing with obesity, who are also taking oral contraceptives, might be unaware that these medications, particularly Mounjaro, can impede the absorption and efficacy of birth control pills, potentially increasing the risk of unintended pregnancies.

One of the mechanisms through which drugs like Ozempic operate is by delaying the transit of food from the stomach to the small intestine. While research in this area is still evolving, it is theorized that this delay in gastric emptying may influence the absorption of birth control pills. Another hypothesis suggests that vomiting, a common side effect associated with these medications, might also interfere with the contraceptive’s effectiveness. At lower doses, the impact on absorption and gastric emptying may be minimal. However, as the dosage increases, these concerns become more prevalent, sometimes resulting in diarrhea, which is another factor that can disrupt the absorption of any medication.

In the United States, approximately 42% of women are obese, with 40% of them falling between the ages of 20 and 39. While these new drugs hold the potential to improve fertility outcomes for obese women, particularly those with polycystic ovary syndrome (PCOS), only one drug, Mounjaro, currently carries a warning about its potential impact on birth control pill efficacy. Regrettably, it appears that some healthcare providers may not be fully informed about or may not be advising their patients regarding this risk. Furthermore, the data remains inconclusive regarding whether other drugs in the same class, like Ozempic, pose similar risks.

For patients seeking to safeguard themselves from unplanned pregnancies, it is advisable to use condoms when commencing treatment with GLP receptor agonists. While the effect on gastric emptying is generally minimal at lower doses, it becomes more significant with higher dosages or the onset of diarrhea. While this aspect was not a conventional subject of discussion, it is now recommended that patients consider adding a barrier contraceptive method such as a condom, at least four weeks before initiating their initial dose or when adjusting the dosage. Additionally, it is advisable to schedule the GLP receptor agonist injection at least one hour apart from any other medication, including oral contraceptives.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer