Fudging the Numbers

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Pri-Med Morning Report

Published August 6, 2022

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Weekend Warriors vs Steady Soldiers


The World Health Organization's 2020 recommendations for adult physical activity are clear: engage in 150 minutes of moderate-to-vigorous activity or 75 minutes of vigorous activity per week. But does it matter how the minutes are divvied up? According to a new study, nope.

Soldier on, weekend warriors

A large nationwide prospective study drew battle lines between those who exercised one to two times per week (aka “weekend warriors”) and those who exercised three or more times per week (let’s call them “steady soldiers”). When it came to all-cause, cardiovascular, and cancer mortality, the battle ended in a draw. Weekend warriors achieved the same risk reduction as steady soldiers, and both groups predictably showed a lower mortality risk than a control group of inactive adults. Just reaching the recommended number of minutes was half the battle.

Key takeaway

Tell your weekend warrior patients to proudly don that face paint and warm up those battle cries. As long as patients meet the recommended weekly minutes of exercise per week, their allocation of those minutes seems inconsequential. Six of one, half a dozen of the other.

Weeding Out False Claims in Topical CBD Products



More than half of US adults take a dietary supplement, but are these consumers prolonging their lives or being duped by clever marketing? (We don’t mean to keep picking on marketers.) To answer this question, the US Preventive Services Task Force (USPSTF) did what it does best: pored over the latest evidence and issued new recommendations.


Mislabeled and Misleading

The researchers tested >100 topical CBD products from online and retail stores to see how they compared with their corresponding labels. The labelers may have been indulging in pot brownies at the time because it seems they fudged some numbers:

  • Of the 89 products that listed a total CBD amount, 58% contained more CBD than advertised, while 18% contained less
  • 35% of the products contained THC (the ingredient primarily responsible for the “high”), but 51% failed to mention THC on the label, and 11% labeled it as “THC free”
  • Many products made unsubstantiated therapeutic or cosmetic claims (eg, 22% touted a reduction in pain, but the FDA—somewhere shaking its head—has not yet approved any CBD product for this purpose)

Key takeaway

With CBD shops becoming as prevalent as Amazon delivery trucks, these misleading claims may result in widespread consequences (beyond just an uptick in Spotify downloads for Dark Side of the Moon). The authors call for “regulatory oversight … to ensure these products meet established standards for quality assurance ….” In the meantime, you may want to encourage patients to discuss their use of CBD products with you and to be aware of potential mislabeling.

And the Winner Is...

Thank you all for posting your cartoon caption contest ideas. We were impressed! It was a tough call, but the Pri-Med team agreed that the following caption gave us the heartiest chuckle.

*Restrictions apply; see

In my professional opinion, you can wear white socks until Labor Day!

Congratulations to Sharon Gottschalk, PA-C, a hospitalist from Watertown, WI, for penning this excellent caption!

Check out future issues of Morning Report for more cartoon caption contests.

The Dietary Rule of Threes


We appreciate good news at Morning Report. The glass of lemonade we make with our lemons is always half full. And we believe that good things—not just bad things—come in threes. Check out these three uplifting news summaries on the cancer front. 

1. It takes two to make a thing go right

When it comes to achieving optimal health, diet and exercise go together like Rick Astley and unwavering commitment—you shouldn’t think of one without the other. A new study analyzing data from the UK Biobank found that breaking a sweat only modestly counteracts a poor diet when it comes to all-cause or cardiovascular mortality. And a healthy diet in an inactive individual does not confer a statistically significant all-cause or CVD mortality risk reduction. The group in the study with the greatest mortality risk reduction reported both a healthy diet AND at least moderate exercise.

Key takeaway: Continue to counsel patients on the synergistic effect of both a healthy diet and moderate-to-intense exercise on lowering their overall mortality risk.

2. Jimmy Buffett, stop searching for that lost shaker of salt

Speaking of dietary improvements, a recent study suggests patients may want to skip that extra dash of salt at the dinner table. Once again, the UK Biobank supplied the data for a large study—this one determining the effect of adding salt at the table (not counting salt used while cooking) on mortality risk. The results were unsavory: adding salt conferred a 28% greater risk of premature mortality when compared with not adding salt. Furthermore, adding salt shortened the male lifespan by an average of 1.5 years and the female lifespan by 2.28 years.

Key takeaway: To mitigate the mortality risk associated with added salt, patients may want to limit their use of table salt to 2,300 mg, or one teaspoon, per day, as recommended by several dietary guidelines.

3. Trust the process—but not processed foods

One way to reduce salt consumption is to avoid processed foods. And doing so also lowers the risk for dementia, according to another large study using data from the UK Biobank. Researchers discovered that participants’ relative risk of developing dementia increased by 25% for every 10% increase in daily ultra-processed foods. The list of culprits included not only soft drinks, ice cream, deep-fried chicken, and flavored cereals but also less obvious choices like packaged versions of hummus, guacamole, and bread. Inversely, replacing these processed foods with healthier options showed a lower risk of dementia.

Key takeaway: One study author distilled the key finding as follows: “… increasing unprocessed or minimally processed foods by only 50 grams a day, which is equivalent to half an apple, a serving of corn, or a bowl of bran cereal, and simultaneously decreasing ultra-processed foods by 50 grams a day, equivalent to a chocolate bar or a serving of fish sticks, is associated with 3% decreased risk of dementia.”

Rapid-Fire COVID-19 Updates


Opioid vs Opioid-Free Analgesics for Post-Op Pain


Given the ongoing opioid crisis, you may find yourself walking a tightrope between prescribing post-operative opioid pain relief to patients and safeguarding against addiction to these powerful analgesics. Results from a recent study suggest that a more conservative management approach may be the best path forward, at least for minor and moderate surgical procedures.

Researchers conducted a systematic review and meta-analysis of nearly 50 clinical trials comprising more than 6,000 patients who underwent an array of minor to moderate procedures, including dental, orthopedic, and general surgery procedures. The results showed that postoperative pain management involving nonopioid analgesics was as effective as opioid analgesics at alleviating pain and conferred a lower risk of adverse effects. Win-win!

Key takeaway

While pain management should always be individualized, these findings indicate that prescribing nonopioid analgesics may be a reasonable approach for patients dealing with post-operative pain from minor and moderate surgeries. Click here to learn more about strategies for effective pain management in clinical practice and to earn CME/CE credits.

Interested in more healthcare news? Here are some other articles we don’t want you to miss:

Morning Report is written by:

  • Alissa Scott, Lead Author
  • Aylin Madore, MD, MEd, Editor
  • Margaret Oliverio, MD, Editor

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Please note that the summaries in Morning Report are intended to provide clinicians with a brief overview of an article, and while we do our best to select the most salient points, we ask that you please read the full article linked in each summary for clarification before making any practice-changing decisions.

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