Day: August 25, 2025

Categories : Metabolic Disorders NeurologyTags :

The Neurons Responsible for Day-to-day Blood Glucose Regulation

On By ModernMedia
Photo by Anna Shvets

The brain controls the release of glucose in a wide range of stressful circumstances, including fasting and low blood sugar levels.

However, less attention has been paid to its role in day-to-day situations.

In a study published in Molecular Metabolism, University of Michigan researchers have shown that a specific population of neurons in the hypothalamus help the brain maintain blood glucose levels under routine circumstances.

Over the past five decades, researchers have shown that dysfunction of the nervous system can lead to fluctuations in blood glucose levels, especially in patients with diabetes.

Some of these neurons are in the ventromedial nucleus of the hypothalamus, a region of the brain that controls hunger, fear, temperature regulation and sexual activity.

“Most studies have shown that this region is involved in raising blood sugar during emergencies,” said Alison Affinati, MD, PhD, assistant professor of internal medicine and member of Caswell Diabetes Institute.

“We wanted to understand whether it is also important in controlling blood sugar during day-to-day activities because that’s when diabetes develops.”

The group focused on VMHCckbr neurons, which contain a protein called the cholecystokinin b receptor.

They used mouse models in which these neurons were inactivated.

By monitoring the blood glucose levels, the researchers found that VMHCckbr neurons play an important role in maintaining glucose during normal activities, including the early part of the fasting period between the last meal of the day and waking up in the morning.

“In the first four hours after you go to bed, these neurons ensure that you have enough glucose so that you don’t become hypoglycaemic overnight,” Affinati said.

To do so, the neurons direct the body to burn fat through a process called lipolysis.

The fats are broken down to produce glycerol, which is used to make sugar.

When the group activated the VMHCckbr neurons in mice, the animals had increased glycerol levels in their bodies.

These findings could explain what happens in patients with prediabetes, since they show an increase in lipolysis during the night.

The researchers believe that in these patients, the VMHCckbr neurons could be overactive, contributing to higher blood sugar.

These nerve cells, however, only controlled lipolysis, which raises the possibility that other cells might be controlling glucose levels through different mechanisms.

“Our studies show that the control of glucose is not an on-or-off switch as previously thought,” Affinati said.

“Different populations of neurons work together, and everything gets turned on in an emergency. However, under routine conditions, it allows for subtle changes.”

The team is working to understand how all the neurons in the ventromedial nucleus co-ordinate their functions to regulate sugar levels during different conditions, including fasting, feeding and stress.

They are also interested in understanding how the brain and nervous system together affect the body’s control of sugar, especially in the liver and pancreas.

Source: University of Michigan

Categories : Diet and NutritionTags :

Ultra-processed Foods Might Not Be the Real Villain in Our Diets – Here’s What Our Research Found

On By ModernMedia
Photo by Andriyko Podilnyk on Unsplash.

Graham Finlayson, University of Leeds and James Stubbs, University of Leeds

Ultra-processed foods (UPFs) have become public enemy number one in nutrition debates. From dementia to obesity and an epidemic of “food addiction”, these factory-made products, including crisps, ready meals, fizzy drinks and packaged snacks, are blamed for a wide range of modern health problems. Some experts argue that they’re “specifically formulated and aggressively marketed to maximise consumption and corporate profits”, hijacking our brain’s reward systems to make us eat beyond our needs.

Policymakers have proposed bold interventions: warning labels, marketing restrictions, taxes, even outright bans near schools. But how much of this urgency is based on solid evidence?

My colleagues and I wanted to step back and ask: what actually makes people like a food? And what drives them to overeat – not just enjoy it, but keep eating after hunger has passed? We studied more than 3,000 UK adults and their responses to over 400 everyday foods. What we found challenges the simplistic UPF narrative and offers a more nuanced way forward.

Two ideas often get blurred in nutrition discourse: liking a food and hedonic overeating (eating for pleasure rather than hunger). Liking is about taste. Hedonic overeating is about continuing to eat because the food feels good. They’re related, but not identical. Many people like porridge but rarely binge on it. Chocolate, biscuits and ice cream, on the other hand, top both lists.

We conducted three large online studies where participants rated photos of unbranded food portions for how much they liked them and how likely they were to overeat them. The foods were recognisable items from a typical UK shopping basket: jacket potatoes, apples, noodles, cottage pie, custard creams – more than 400 in total.

We then compared these responses with three things: the foods’ nutritional content (fat, sugar, fibre, energy density), their classification as ultra-processed by the widely used Nova system – a food classification method that groups foods by the extent and purpose of their processing – and how people perceived them (sweet, fatty, processed, healthy and so on).

Perception power

Some findings were expected: people liked foods they ate often, and calorie-dense foods were more likely to lead to overeating.

But the more surprising insight came from the role of beliefs and perceptions. Nutrient content mattered – people rated high-fat, high-carb foods as more enjoyable, and low-fibre, high-calorie foods as more “bingeable”. But what people believed about the food also mattered, a lot.

Perceiving a food as sweet, fatty or highly processed increased the likelihood of overeating, regardless of its actual nutritional content. Foods believed to be bitter or high in fibre had the opposite effect.

In one survey, we could predict 78% of the variation in people’s likelihood of overeating by combining nutrient data (41%) with beliefs about the food and its sensory qualities (another 38%).

In short: how we think about food affects how we eat it, just as much as what’s actually in it.

This brings us to ultra-processed foods. Despite the intense scrutiny, classifying a food as “ultra-processed” added very little to our predictive models.

Once we accounted for nutrient content and food perceptions, the Nova classification explained less than 2% of the variation in liking and just 4% in overeating.

That’s not to say all UPFs are harmless. Many are high in calories, low in fibre and easy to overconsume. But the UPF label is a blunt instrument. It lumps together sugary soft drinks with fortified cereals, protein bars with vegan meat alternatives.

Some of these products may be less healthy, but others can be helpful – especially for older adults with low appetites, people on restricted diets or those seeking convenient nutrition.

The message that all UPFs are bad oversimplifies the issue. People don’t eat based on food labels alone. They eat based on how a food tastes, how it makes them feel and how it fits with their health, social or emotional goals.

Relying on UPF labels to shape policy could backfire. Warning labels might steer people away from foods that are actually beneficial, like wholegrain cereals, or create confusion about what’s genuinely unhealthy.

Instead, we recommend a more informed, personalised approach:

• Boost food literacy: help people understand what makes food satisfying, what drives cravings, and how to recognise their personal cues for overeating.

• Reformulate with intention: design food products that are enjoyable and filling, rather than relying on bland “diet” options or ultra-palatable snacks.

• Address eating motivations: people eat for many reasons beyond hunger – for comfort, connection and pleasure. Supporting alternative habits while maximising enjoyment could reduce dependence on low-quality foods.

It’s not just about processing

Some UPFs do deserve concern. They’re calorie dense, aggressively marketed and often sold in oversized portions. But they’re not a smoking gun.

Labelling entire categories of food as bad based purely on their processing misses the complexity of eating behaviour. What drives us to eat and overeat is complicated but not beyond understanding. We now have the data and models to unpack those motivations and support people in building healthier, more satisfying diets.

Ultimately, the nutritional and sensory characteristics of food – and how we perceive them – matter more than whether something came out of a packet. If we want to encourage better eating habits, it’s time to stop demonising food groups and start focusing on the psychology behind our choices.

Graham Finlayson, Professor of Psychobiology, University of Leeds and James Stubbs, Professor in Appetite & Energy Balance, Faculty of Medicine and Health School of Psychology, University of Leeds

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Categories : Expert Opinion Medical IndustryTags :

The Healthcare Financing Crisis and the Impact on Gap Cover

On By ModernMedia

A Five-Year Analysis of South Africa’s Healthcare Funding Challenge

Photo by Scott Graham on Unsplash

Mega Gap Claims Surge Reveals Private Healthcare System Under Cost Pressure

Opinion by Martin Rimmer, CEO of Sirago Underwriting Managers

A comprehensive five-year analysis of gap cover claims reveals a healthcare funding crisis that’s rapidly escalating across the South African private healthcare sector. Data from Sirago Underwriting Managers shows that its mega gap claims – those exceeding R50,000 – have exploded by 512% in volume and 437% in value between 2020 and 2024.

The numbers tell a stark story: where 89 mega gap claims totalling R6.2 million were paid in 2020, this figure rocketed to 549 claims worth R34 million in 2024. Perhaps most concerning is that claims exceeding R60 000 are now daily occurrences, with the average large loss gap claim sitting at R63 000 – a far cry from the R6000 to R12 000 averages seen pre-2020.

The Perfect Storm: Medical Scheme Erosion Meets Provider Cost Inflation

This upward trajectory reflects a fundamental shift in South Africa’s healthcare landscape. Medical schemes – constrained by affordability, access, aging membership populations, and where private healthcare already consumes up to 20% of household income – are systematically reducing benefits and transferring more risk onto the member, rather than increasing premiums to match out-of-control healthcare provider cost inflation.

Healthcare provider costs have consistently outpaced inflation by more than double for years, yet unlike pharmaceuticals, there’s no pricing regulation on healthcare provider tariffs. In a country facing a dire shortage of healthcare professionals, specialists are free to charge rates often 500%+ higher than medical scheme reimbursements.

The regulatory framework compounds this issue. The Registrar of Medical Schemes mandates that for Prescribed Minimum Benefit (PMB) conditions, where no Designated Service Provider agreement exists, healthcare providers must be paid in full regardless of the charge – essentially providing a blank check.

Breaking Down Sirago’s Large Loss (Mega) Gap Claims Data (2020-2024)

Five-Year Trend Analysis

  • 2021: 118% increase in claims value paid compared to 2020, driven by COVID-19 impacts and deferred elective surgeries.
  • 2022-2024: Average annual increase of 35% year-on-year in large loss claims volumes.
  • Highest claims: R200,000+ for ischaemic heart disease conditions in the 50+ age group.

Age Demographics Challenge Assumptions

Contrary to expectations, healthcare crises aren’t limited to older populations:

  • 50-65 years: 31% of claims (average: R65,065)
  • 66-75 years: 27% of claims (average: R64,213)
  • 76+ years: 18% of claims (average: R62,773)
  • 30-49 years: 18% of claims (average: R58,116)
  • 0-29 years: 5% of claims (average: R63,360)

The under-49 age group constitutes 23% of all large loss claims, dispelling notions that major health expenses only affect older demographics, and which highlights the risk transfer challenges faced and imposed by medical schemes.

Claims Distribution

  • 62%: R40,000-R60,000
  • 30%: R61,000-R100,000
  • 6%: R101,000-R150,000
  • 2%: R151,000-R210,000

Leading Conditions Driving Claims

  • Musculoskeletal Dominance

Over 51% of claims across all age groups involve musculoskeletal conditions, with spinal stenosis leading the charge. Medical schemes often impose strict limits on elective musculoskeletal surgeries due to high costs, particularly for internal prosthetics where co-payments can reach 30% of the hospital account if members don’t subscribe to the scheme-imposed protocols.

  • Cancer and Circulatory Conditions

Each representing 10% of large loss claims, these conditions reflect both the effect from the delayed diagnosis impact of COVID-19 and the high-cost nature of specialised treatments. Malignant neoplasms of the breast, prostate, and colon lead cancer claims, while acute ischaemic heart disease dominates circulatory conditions.

  • The Exploitation Factor

Gap insurance is increasingly becoming a target for exploitation. Healthcare providers now routinely ask patients upfront about gap coverage before determining charges, creating a troubling paradox where a R700 monthly gap policy might pay R130,000 for an orthopaedic surgery shortfall, while the medical scheme with an R8,000 monthly premium pays just R30,000. This exploitation threatens the sustainability of gap insurance itself. If current trends continue, gap insurance premiums will inevitably rise, making this crucial protection unaffordable for many South Africans.

The Critical Importance of Gap Cover

Despite these challenges, gap cover remains essential, irrespective of medical scheme option. Most medical schemes have deductibles, co-payments, and reimbursement limits that can leave members significantly out of pocket. The gap between scheme payments and specialist charges can be substantial – often 200% to 500% above scheme tariffs and this isn’t limited to basic hospital cover options. Even comprehensive, top-tier medical scheme benefits leave members facing substantial tariff shortfalls for in-hospital procedures.

The Economics of Healthcare Financial Protection

When you consider the potential financial quantum of a shortfall on your medical scheme benefits, and that a gap cover premium is around R700 per month for a family (2025 Sirago Ultimate Gap), and each family member is covered for up to a maximum of R213 000 per annum, it is clear that Gap Cover is a non-negotiable part of your healthcare financing strategy.  A single gap claim of R63k, Sirago’s average large loss claim, would be the equivalent of almost 9 years of premium payments at current premium rates.

Sirago’s mega claims data reveals a private healthcare funding system under severe strain. As medical schemes transfer more financial risk to members through tariff shortfalls, co-payments, and exclusions, gap insurance becomes not just “a-nice-to-have” insurance policy, but essential for financial protection.

However, the sustainability of this model depends on addressing the root causes: unregulated provider pricing, systematic benefit erosion, and the exploitation of gap insurance by unscrupulous providers. Without intervention, South Africa’s healthcare funding crisis will continue to deepen, leaving patients to bear an ever-increasing financial burden.

For consumers, the message is clear: always negotiate pricing for planned surgeries and request formal quotes from all medical role players. In a system where healthcare providers are price makers and medical schemes and gap providers are price-takers, informed patient advocacy becomes crucial for financial survival and your continued access to quality private healthcare.

(Claims statistics drawn from Sirago’s Large Loss Claims Analysis, 2020-2025)

Sirago Underwriting Managers (Pty) Ltd is an Authorised Financial Services Provider (FSP: 4710) underwritten by GENRIC Insurance Company Limited (FSP: 43638). GENRIC is an authorised Financial Services Provider and licensed non-life Insurer and a member of the Old Mutual Group.

Note:  The content of this article does not constitute financial advice. Sirago Gap cover is subject to terms and conditions and premiums are reviewed annually. For more information go to www.sirago.co.za (Ts & Cs apply).

Categories : Diet and NutritionTags :

Fat-binding Microbeads Might Be a Drug-free Weight Loss Option

On By ModernMedia
Photo by Andres Ayrton on Pexels

Weight-loss interventions, including gastric bypass surgery and drugs that prevent dietary fat absorption, can be invasive or have negative side effects. Now, researchers have developed edible microbeads made from green tea polyphenols, vitamin E and seaweed that, when consumed, bind to fats in the gastrointestinal tract. Preliminary results from tests with rats fed high-fat diets show that this approach to weight loss may be safer and more accessible than surgery or pharmaceuticals. 

Yue Wu, a graduate student at Sichuan University, will present her team’s results at the ACS Fall 2025 Digital Meeting, a meeting of the American Chemical Society.

“Losing weight can help some people prevent long-term health issues like diabetes and heart disease,” says Wu. “Our microbeads work directly in the gut to block fat absorption in a noninvasive and gentle way.”

Weight gain is caused by genetic and lifestyle factors, including eating a high-fat diet. A high-fat diet is defined by the U.S. Department of Agriculture as one where 35% or more of a person’s daily calories come from fat, as opposed to protein or carbohydrates. Some pharmaceuticals, such as orlistat, inhibit certain gastric enzymes from breaking down dietary fats, leading to less fat being absorbed by the body. Orlistat is a U.S. Food and Drug Administration (FDA)-approved medication and is effective for weight loss. However, for some people it causes serious side effects, including liver and kidney damage. 

So, Wu and her colleagues wanted to target the fat absorption process with their weight-loss intervention but do so without negative side effects. “We want to develop something that works with how people normally eat and live,” says Wu.

To get started, the team created tiny plant-based beads that spontaneously form through a series of chemical bonds between the green tea polyphenols and vitamin E. These structures can form chemical tethers to fat droplets and serve as the fat-binding core of the microbeads. The researchers then coated the spheres in a natural polymer derived from seaweed to protect them from the acidic environment of the stomach. Once ingested, the protective polymer coating expands in response to the acidic pH, and the green tea polyphenols and vitamin E compounds bind to and trap partially digested fats in the intestine. 

The microbeads are nearly flavourless, and the researchers foresee them being easily integrated into people’s diets. For example, the microbeads could be made into small tapioca- or boba-sized balls and added to desserts and bubble teas.

The researchers assessed the microbeads as a weight-loss treatment in rats. They put the animals into three groups (eight rats per group), those which were fed a high-fat diet (60% fats) either with or without microbeads and those which were fed a normal diet (10% fats) for 30 days. Rats fed the high-fat diet and microbeads:

  • Lost 17% of their total body weight, while rats in the other groups didn’t lose weight. 
  • Had reduced adipose tissue and less liver damage compared to rats fed the high-fat and normal diets without microbeads.
  • Excreted more fat in their feces compared to rats not given microbeads. The extra fat in the rats’ feces had no apparent ill effects on the animals’ health.

Additionally, the eight rats on high-fat diets that consumed microbeads showed similar intestinal fat excretion, but without the gastrointestinal side effects the researchers observed with a fourth group of rats they treated with orlistat. 

Wu and her team have started working with a biotechnology company to manufacture the plant-based beads. “All the ingredients are food grade and FDA-approved, and their production can be easily scaled up,” says Yunxiang He, Sichuan University associate professor and co-author on Wu’s presentation.

They’ve also initiated a human clinical trial in collaboration with the West China Hospital of Sichuan University. “This represents a major step toward clinical translation of our polyphenol-based microbeads, following our foundational results,” says Wu. “We have officially enrolled 26 participants in our investigator-initiated trial, and we anticipate that preliminary data may become available within the next year.”

Source: American Chemical Society

Categories : Cardiovascular DiseaseTags :

Regular Sleep Schedule May Improve Recovery from Heart Failure Hospitalisation

On By ModernMedia
Photo by Cottonbro on Pexels

People recovering from heart failure should consider improving the regularity of their sleep, a study led by Oregon Health & Science University suggests. The research team found that even moderately irregular sleep doubles the risk of having another clinical event within six months, according to a study published in the journal JACC Advances. A clinical event could be another visit to the emergency room, hospitalisation or even death.

“Going to bed and waking up at consistent times is important for overall health,” said lead author Brooke Shafer, PhD, a research assistant professor in the Sleep, Chronobiology and Health Laboratory in the OHSU School of Nursing. “Our study suggests that consistency in sleep timing may be especially important for adults with heart failure.”

Researchers enrolled 32 patients who had been hospitalised for acutely decompensated heart failure at OHSU Hospital and Hillsboro Medical Center from September 2022 through October 2023. For one week following hospital discharge, participants used sleep diaries to record the time they fell asleep at night, woke up in the morning and the timing of naps they took during the day.

The participants were then categorised as regular sleepers or moderately irregular sleepers, based on their sleep patterns.

The study found:

  • Following discharge from the hospital, 21 participants experienced a clinical event over the course of six months.
  • Of that group, 13 were classified as moderately irregular sleepers compared with eight classified as having a regular sleep schedule.
  • Statistically, the irregular sleepers had more than double the risk of an event across the six-month time span.

The increased risk of a clinical event for moderately irregular sleepers remained even when accounting for possible contributing factors like sleep disorders and other underlying medical conditions. The research team says the study is among the first to examine the impact of sleep regularity in the context of heart failure, and the findings add to a growing body of evidence suggesting the importance of maintaining a regular sleep schedule.

“Improving sleep regularity may be a low-cost therapeutic approach to mitigate adverse events in adults with heart failure,” the authors conclude.

Shafer said the results strengthen the connection between sleep regularity and cardiovascular health.

“When we’re asleep and in a resting state, our blood pressure and heart rate decrease compared with daytime levels,” she said. “But variability in sleep timing may disrupt mechanisms involved in the regulation of the cardiovascular system. Irregular sleep may contribute to adverse outcomes, especially for people already affected by heart failure.”

The next step would be to scale up the research to a larger cohort of participants and see whether improving sleep regularity lowers the risk of another clinical event, she said.

Source: Oregon Health & Science University