Morning Report — Not Your Typical Medical Newsletter

We get it, you see a lot of medical newsletters, so hear us out. Twice a month, we’ll highlight important medical news sprinkled with witty commentary, fun facts, giveaways, and more… because learning should be fun! Subscribe to receive the Morning Report directly.

Rewriting the Textbooks on Metabolism







Remember when we were sure that “ironic” referred to “something that is the opposite of its literal meaning,” and then in 1996 Alanis Morissette taught us that it just meant “misfortune”? Well, we now have to second guess what we thought we knew about energy expenditure in the human lifecycle as well. But unlike Alanis’ lyrics, this new information is backed by data.

The study, published in Science, analyzed data from nearly 6,500 people of diverse backgrounds—29 countries, ages 8 days to 95 years, 64% women—to determine how age, sex, and body composition affect daily energy expenditure. Total expenditure was calculated using doubly labeled water measurements (defined here) and basal expenditure with indirect calorimetry.

The study found no significant difference between male and female metabolic rates and showed that metabolism changes across four distinct (and surprising) phases of life:

  • Infants up to age 1 burn the most calories, reaching 50% above an adult’s metabolic rate; however, in the first month of life, their metabolic rate equals their mothers’
  • From age 1 to 20, an annual 3% metabolic decline takes place
  • From age 20 to 60, metabolism remains steady, even during pregnancy
  • At around age 60, metabolism begins to slow by approximately 0.7% each year

“Are you sure you included my diverse background?” asks everyone over the age of 30.

We’ve burned some mental calories trying to wrap our heads around these surprising findings. While these learnings are noteworthy on a population level, they don’t help us understand each individual’s metabolic rate, which can vary significantly. For now, we’ll just file this study away under “interesting.” It’s certainly encouraging that metabolism remains steady from young adulthood through later middle age. Unfortunately, it doesn’t change the fact that those of us of a certain age still can’t eat a pizza without remorse. Isn’t it ironic? (See Alanis’ interpretation.)

And the Winner Is…

Thank you all for sending in 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.











“Just look at the piles and piles of people on the beach.”

Congratulations to Rita Yee, NP, of San Francisco, California, for penning this excellent caption!

Check out September’s issue of Morning Report for the next cartoon caption contest.

Height Loss in Women Shortens Lifespan?







You’re checking your patients’ heights often, right? If yes, keep it up! If you need a gentle reminder, here’s a compelling one!

According to the results of a population-based cohort study of 2,406 Swedish and Danish women, height loss in middle age is a marker of excess mortality—at least in northern European women. The women were between ages 30 and 60 at the beginning of the study. Height was measured at the start of the study and then 10 to 13 years later. All women were followed up for 17 to 19 years after the last height measurement; 625 died from all causes; and 157 died from cardiovascular disease, including 37 stroke deaths.

Every centimeter of height the Swedish and Danish women lost was tied to 14% and 21% (respectively) greater relative odds of death from any cause. Major height loss (>2 cm) was linked to 74% and 80% greater relative odds. In a pooled analysis, major height loss demonstrated more than double the relative odds of death from stroke and all cardiovascular disease.

Okay, so we just need to stop height loss in middle age

Obviously, that is a challenge. But the study did note that short stature and exercise at baseline were associated with less height reduction, and we can actually do something about the latter.

The caveats to this study are that it is observational, so it can’t establish causation, and the number of stroke deaths was small (37). More studies are needed, but the findings are a good reminder to measure patients often and, as always, encourage physical activity.

Acupuncture Hits the Spot in Chronic Prostatitis/Pelvic Pain Syndrome







Don’t worry—we vow to keep our needle puns to a minimum and get right to the point. Acupuncture is more effective for moderate to severe chronic prostatitis/chronic pelvic pain syndrome than sham acupuncture, a new study confirms.

In this multicenter trial in China, 440 men were randomly assigned to either 20 sessions of acupuncture or sham acupuncture for eight weeks. At week eight, 60.6% of the acupuncture group responded to treatment, whereas only 36.8% of the sham group responded, and the effects held firm at 24 weeks of follow-up. Twenty adverse events were reported in the acupuncture group and 14 in the sham group, but none were serious.

The researchers poked holes in their own study by pointing out that they can’t be sure about whether the sham acupuncture may have led to certain physiologic effects.

The main point of this article is that acupuncture may be a promising treatment for patients with chronic prostatitis/chronic pelvic pain syndrome.

Did You Know?

Acupuncture can be traced back to the New Stone Age in China, and the first “needles” were made of—you guessed it—stone! They were polished and sharpened, of course, but could make the patient bleed, which may have been the intention. You see, when man believed that demon spirits caused disease, many believed that bleeding a patient could exorcise those demons. Later (and luckily), silver, gold, and stainless-steel needles came into fashion, and acupuncture began to look a lot more like it does today.

Slim Majority in the Creation-Evolution Debate







Life is full of unanswerable questions. Who really was the boss—Tony or Angela? Is a hot dog a sandwich? Was “You Oughta Know” really about Dave Coulier? But “How did humans evolve?” need not be one of them.

Despite the evidence for the theory of evolution, the creation-evolution controversy continues. Beginning in 1985 and biennially afterward, the National Science Board has asked Americans whether they agreed or disagreed with the following statement: “Human beings, as we know them today, developed from earlier species of animals.” For the first 25 years of the study, respondents were deadlocked at 50/50, and then in 2016, support for evolution finally reached a slim majority.

What was the genesis of this shift toward evolution?

The study’s researchers theorized that a significant increase in the number of people completing college degrees, a decrease in the number of religious fundamentalists, and an overall lift in scientific literacy have contributed to this small shift.

In case you’re curious, our answers to the questions above are Angela, definitely not, and yes.

Healthcare Humor

Patient: I tried to lie to my X-ray technician about my broken leg, but they could see right through me.

And then I didn’t have a leg to stand on.

Rapid-Fire COVID-19 Updates







CDC recommends third dose for immunocompromised

The CDC outlined recommendations for who should receive a third shot of the mRNA COVID-19 vaccine at this time. The recommended recipients include those who are moderately to severely immunocompromised and may not have built a sufficient immune response from a two-dose vaccine series. Additional doses for people who are 8 months out from their last vaccine are scheduled to begin September 20.

FDA formally approves Pfizer’s COVID-19 vaccine “Comirnaty”

On August 23, 2021, the FDA approved Comirnaty, the artist vaccine formerly known as the Pfizer-BioNTech COVID-19 vaccine, for the prevention of COVID-19 disease in individuals 16 years of age and older. This approval replaces the emergency use authorization granted in December 2020 and is the first approval of a COVID-19 vaccine. Some speculate that formal regulatory approval will make vaccination mandates easier and encourage vaccine-hesitant people to get the shot. A Kaiser Family Foundation poll from June of this year found that 31% of unvaccinated individuals reported that they would be more likely to get the COVID-19 vaccine if it had full FDA approval. We’re also hoping the name change will do for the vaccine’s popularity what it did for Nike. Does anyone remember Blue Ribbon Sports? We doubt it!

COVID-19 antibodies in the breast milk of vaccinated parents

A new study published in the American Academy of Pediatrics looked at women who received an mRNA COVID-19 vaccine while breastfeeding and found all milk samples had IgG antibodies and 89% had IgA antibodies against SARS-CoV-2. While the implications of this information in providing long-term immunity to breastfed babies are uncertain, it does provide encouragement for the vaccination of breastfeeding women. (It also begs the question, what can’t breast milk do?) Health officials continue to recommend the vaccine for breastfeeding and pregnant women, and this new information may be helpful to share with your patients who are considering vaccination under these circumstances.

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

Would you like to share your feedback with Morning Report? Drop us an email at and let us know how we’re doing.

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.

Subscribe to Morning Report

Not your typical medical newsletter… We get it, you see a lot of medical newsletters, so hear us out. This newsletter is intended to be fun, refreshing, and informative!

Every other week, we’ll highlight important medical news, sprinkled with some witty commentary, fun facts, giveaways, and more… because learning should be fun! Subscribe to receive the Morning Report directly.