Medscape Medical News tallied the most-read Canadian stories of 2024 to draft a list of the five that garnered the greatest interest and, in some instances, an outpouring of advice.
Here’s the countdown.
5: ED Visits for Cannabis Use a Harbinger of Anxiety Disorder
Many readers appreciated this story, which points to the risk that cannabis use may increase anxiety rather than alleviate it. This observation is particularly true for the Baby Boomer generation, who might be accustomed to a much weaker concentration of tetrahydrocannabinol (THC), the psychoactive ingredient in dried cannabis flowers. The concentration was 2% in the 1960s and 1970s and is between 20% and 30% now.
The researchers analyzed health administrative data for more than 12 million patients in Ontario aged 10-105 years with no previous visits for anxiety disorders. About 24% of those with an emergency department (ED) visit due to cannabis had an incident outpatient visit, ED visit, or hospitalization for an anxiety disorder within 3 years. These patients were almost four times more likely than the general population to be diagnosed with an anxiety disorder.
The increased risk for an anxiety order was seen across all age and sex strata. However, younger men with ED visits for cannabis use had a greater risk than younger women.
Not everyone agreed with the interpretation of the findings, however. Donald Condliffe commented, “The causal direction is missing in this type of study. It is as probable that predisposition to anxiety disorder causes more marijuana use to self-medicate as it is that marijuana use causes anxiety.”
Dr Keith Raymond agreed, noting, “We need to address the behavioral causes of the anxiety, not the drugs used to alleviate it. That’s a bit like blaming fentanyl for overdoses.”
4: Plant-Based Meat Alternatives May Be Better for the Heart
This story covers a review of randomized controlled trials of plant-based meat alternatives (PBMAs), which found that these meats are a healthy alternative to animal meat.
The researchers analyzed the literature from 1970 to 2023 on PBMAs and their impact on cardiovascular risk factors. They found that compared with animal meat, PBMAs had less saturated fat, less cholesterol, more fiber, more carbohydrates, fewer calories, less monounsaturated fat, more polyunsaturated fat, and more sodium.
They also acknowledged, however, that no long-term research has evaluated how PBMAs may affect the risk for myocardial infarction or stroke. Similarly, there is little research on the healthfulness of some common components of PBMAs, such as vital wheat gluten.
Although many readers responded favorably to the story, several commentators did not. Some agreed that animal meat may entail risks for inflammation, cancer, and other ills, and that meat production is environmentally unfriendly, whereas others pointed to the downsides of processed meat substitutes, including a high amount of saturated fats, sodium, and carbohydrates.
One commentator, Philip Caskanette, conclu