Medical Journal News

US health secretary Robert F Kennedy Jr said he will order the Centers for Disease Control and Prevention (CDC) to revise its recommendation, which has stood for seven decades, that fluoride be added to drinking water.The public health agency said on 7 April that it would re-examine the scientific evidence on fluoride’s safety and effectiveness after Kennedy said he will ask it to drop the guidance.1The CDC currently suggests that 0.7 mg of fluoride be added per litre of water, the equivalent of three drops of water in a 55 gallon barrel. States generally follow that advice. Kennedy said he will instruct the CDC to drop that advice. He added that he was creating a task force to study fluoride in drinking water.The announcements have caused concern in dental and scientific communities who say there is no evidence that fluoride is harmful but plenty of evidence that it delivers dental...

New England Journal of Medicine, Volume 392, Issue 14, Page 1406-1417, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1447-1450, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1452-1453, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1453-1455, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1455-1456, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1451-1452, April 10, 2025.

New England Journal of Medicine, Volume 392, Issue 14, Page 1444-1446, April 10, 2025.

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New England Journal of Medicine, Volume 392, Issue 14, Page 1418-1426, April 10, 2025.

Babies and children aged three months to 11 years with uncomplicated community acquired pneumonia should be offered a three day rather than five day course of antibiotics, the National Institute for Health and Care Excellence (NICE) has said in a draft guideline.1The recommendation follows evidence that for this group of patients a three day course of antibiotics was as effective as a five day course. It is also in line with shorter antibiotic courses for many common infections, such as urinary tract infections and acute bronchitis.Jonathan Benger, chief medical officer and interim director of the centre for guidelines at NICE, said that shorter courses of treatment also reduce the risk of antimicrobial resistance and save NHS resources.The draft guideline includes children for the first time and combines previous guidance on community acquired pneumonia and hospital acquired pneumonia published in 2019.It recommends using steroids in addition to antibiotics for adults with...

Lobbying by the advertising industry is thwarting plans that aim to protect public health by banning junk food advertisements from bus stops and billboards, The BMJ has found.Advertising companies and their representatives are warning local authorities in financial crisis that the councils’ advertising revenues will plummet if they restrict the promotion of food products high in fat, salt, or sugar (HFSS). These warnings have led some local authorities in England to shelve their plans despite the potential benefits to public health, The BMJ’s investigation discovered.media-1vid1Video 1Deny, dilute, delay—how advertisers are fighting billboard bansbmj.r667-vid1Those councils who push ahead with their plans despite such lobbying are facing delays of up to eight years to enforce the bans, because of their existing contracts with the advertising firms. Even when the bans come into effect they allow adverts for products such as McDonald’s chicken nuggets and KFC burgers to continue to be displayed (box...

In this paper by Gao C and colleagues (BMJ 2025;399:e082945, doi:10.1136/bmj-2024-082945, published), in the pdf, figure 2 had missing data for number censored at days 365, the HTML live figure was unaffected. Additionally, in figure 3, the number in the hierarchical component for death in the Ties box, should have been 929 398.

Last month NHS England issued a press release announcing a “nationwide rollout” of an “artificial intelligence tool that predicts falls and viruses.”1 It said that the tool, developed by the care provider Cera, was being “rolled out across the NHS” and “can predict a patient’s risk of falling with 97% accuracy, preventing as many as 2000 falls and hospital admissions each day.”The press release quoted senior government officials backing the tool as a “perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital.” The announcement was covered across several media outlets, including ITV News, the Independent, and the London Standard.23 The NHS Confederation issued a response, welcoming the rollout of the technology, but warning of the need for robust evaluation of AI in the health service.4How will the NHS roll out the AI?The BMJ approached Cera and NHS...

by Marie Payen de la Garanderie, Anaïs Hasenbohler, Nicolas Dechamp, Guillaume Javaux, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De Sa, Laurent Bourhis, Raphaël Porcher, Fabrice Pierre, Xavier Coumoul, Emmanuelle Kesse-Guyot, Benjamin Allès, Léopold K. Fezeu, Emmanuel Cosson, Sopio Tatulashvili, Inge Huybrechts, Serge Hercberg, Mélanie Deschasaux-Tanguy, Benoit Chassaing, Héloïse Rytter, Bernard Srour, Mathilde Touvier

Background

Mixtures of food additives are daily consumed worldwide by billions of people. So far, safety assessments have been performed substance by substance due to lack of data on the effect of multiexposure to combinations of additives. Our objective was to identify most common food additive mixtures, and investigate their associations with type 2 diabetes incidence in a large prospective cohort.

Methods and Findings

Participants (n = 108,643, mean follow-up =  7.7 years (standard deviation (SD) =  4.6), age =  42.5 years (SD =  14.6), 79.2% women) were adults from the French NutriNet-Santé cohort (2009–2023). Dietary intakes were assessed using repeated 24h-dietary records, including industrial food brands. Exposure to food additives was evaluated through multiple food composition databases and laboratory assays. Mixtures were identified through nonnegative matrix factorization (NMF), and associations with type 2 diabetes incidence were assessed using Cox models adjusted for potential socio-demographic, anthropometric, lifestyle and dietary confounders. A total of 1,131 participants were diagnosed with type 2 diabetes. Two out of the five identified food additive mixtures were associated with higher type 2 diabetes incidence: the first mixture included modified starches, pectin, guar gum, carrageenan, polyphosphates, potassium sorbates, curcumin, and xanthan gum (hazard ratio (HR)per an increment of 1SD of the NMF mixture score = 1.08 [1.02, 1.15], p = 0.006), and the other mixture included citric acid, sodium citrates, phosphoric acid, sulphite ammonia caramel, acesulfame-K, aspartame, sucralose, arabic gum, malic acid, carnauba wax, paprika extract, anthocyanins, guar gum, and pectin (HR = 1.13 [1.08,1.18], p < 0.001). No association was detected for the three remaining mixtures: HR =  0.98 [0.91, 1.06], p = 0.67; HR =  1.02 [0.94, 1.10], p = 0.68; and HR =  0.99 [0.92, 1.07], p = 0.78. Several synergistic and antagonist interactions between food additives were detected in exploratory analyses. Residual confounding as well as exposure or outcome misclassifications cannot be entirely ruled out and causality cannot be established based on this single observational study.

Conclusions

This study revealed positive associations between exposure to two widely consumed food additive mixtures and higher type 2 diabetes incidence. Further experimental research is needed to depict underlying mechanisms, including potential synergistic/antagonist effects. These findings suggest that a combination of food additives may be of interest to consider in safety assessments, and they support public health recommendations to limit nonessential additives.

Trial Registration

The NutriNet-Santé cohort is registered at clinicaltrials.gov (NCT03335644). https://clinicaltrials.gov/study/NCT03335644.

This week is National Public Health Week in the United States and perhaps the saddest one in the 70 years of this celebration. Last week, President Donald Trump’s administration enacted mass firings of staff, or a “reduction in force,” at agencies that form the scaffolding of public health in the US.1 This action continued the attacks on science and health that have quickly become a signature of the new presidency.2The scope and depth of the cuts to staff are vast, including the Centers for Disease Control and Prevention, the National Institutes of Health, the US Food and Drug Administration (FDA), Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Centers for Medicare and Medicaid Services, and many other offices.Collectively, these cuts impair government functions that are vital to society, including (but not limited to) the ability to ensure the safety of new medications, devices, food, and other...

Patients in hospital emergency departments are being put at risk because they are not getting time critical medication (TCM) for chronic conditions such as diabetes and Parkinson’s disease on time, says a report by the Royal College of Emergency Medicine.1Analysis of data from 136 UK emergency departments on patients with diabetes or Parkinson’s disease who take certain TCM such as insulin injections and levodopa found that two thirds did not receive their drugs around the expected time. This could potentially exacerbate symptoms or complications and lead to deterioration and increased mortality.Just over half (7197) of the 13 478 eligible patients were not identified within 30 minutes of their arrival in the emergency department, the analysis showed, and just 32% of 10 850 doses that patients should have had were administered within 30 minutes of their scheduled time. This proportion was 39% for levodopa and 22% for insulinIn light of the...

My name is Biotic. Andi Biotic.The UK Health Security Agency (UKHSA) has a new superhero in the form of a pill shaped cartoon character known as Andi Biotic. He’s heading up a campaign to tackle misconceptions about antibiotics among 18 to 34 year olds, as part of the ongoing “Keep Antibiotics Working” programme.A dose of good messaging?The agency is piloting this new six week digital campaign, which is being promoted across YouTube,1 Instagram, and Facebook, and by GP practices and pharmacies, to test its “potential to capture people’s attention and imagination” in order to “help raise awareness of good antibiotic stewardship.”A hard pill to swallowIndeed. An Ipsos survey of nearly 6000 UK residents aged 16 and older, commissioned by the UKHSA last year, found that over half of respondents incorrectly believed they either could not do anything personally to prevent antibiotics becoming less effective at treating infections (26%, 1535) or...

bmj;389/apr08_4/r697/FAF1faSheila Bhattacharya (née Burns) was born in St Leonards-on-Sea, East Sussex, in 1924. Her father, Robert Burns, a classics scholar, had been a colonial administrator in St Kitts and West Africa, while her mother, a highly independent Glaswegian woman, had served as a nurse in the first world war.Sheila had a passion for literature and had intended to study English at university, but the onset of the second world war while she was finishing school was the great event of her life, changing her outlook. Encouraged by her mother, she decided to study medicine and got a place at Newnham College, Cambridge, in 1942. She then decided instead to volunteer for war work and was sent to an explosives research laboratory at Woolwich Arsenal where she learnt about life beyond her privileged upbringing. It was dangerous work handling unstable chemicals, and more so during the V1 and V2 missile attacks....