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BackgroundHands-on culinary medicine education for medical trainees has emerged as a promising tool for cardiovascular health promotion.PurposeTo determine whether virtual culinary medicine programming associates with Mediterranean diet (MedDiet) adherence and lifestyle medicine competencies among medical trainees across the USA.MethodA total of 1433 medical trainees across 19 sites over a 12-month period were included. The Cooking for Health Optimisation with Patients-Medical Trainees survey composed of 61 questions regarding demographics, nutritional attitudes, dietary habits including MedDiet score and lifestyle medicine counselling competencies. Multivariable logistic regression assessed the association of virtual culinary medicine education with MedDiet intake and nutritional attitudes.ResultsThere were 519 medical trainees who participated in virtual culinary medicine education and 914 medical trainees who participated in their standard nutrition curricula. More than one-half of participants were women (n=759) and the mean age was 27 years old. Compared with students enrolled in traditional nutrition curricula, participants in virtual culinary medicine education were 37% more likely to adhere to MedDiet guidelines for fruit intake (OR 1.37, 95% CI 1.03 to 1.83, p=0.03). Virtual culinary medicine education was associated with higher proficiency in lifestyle medicine counselling categories, notably recommendations involving fibre (OR 4.03; 95% CI 3.05 to 5.34), type 2 diabetes prevention (OR 4.69; 95% CI 3.51 to 6.27) and omega fatty acids (OR 5.21; 95% CI 3.87 to 7.02). Virtual culinary medicine education had a similar, although higher magnitude association with MedDiet counselling competency (OR 5.73, 95% CI 4.26 to 7.70) when compared with historical data previously reported using hands-on, in-person culinary medicine courseware (OR 4.97, 95% CI 3.89 to 6.36).ConclusionsCompared with traditional nutritional educational curricula, virtual culinary medicine education is associated with higher MedDiet adherence and lifestyle medicine counselling competencies among medical trainees. Both virtual and hands-on culinary medicine education may be useful for cardiovascular health promotion.

A partnership of federal and state agencies, tribes, industry, and scientists from academic research and environmental organizations is establishing a national, policy-relevant mercury monitoring network, called MercNet, to address key questions concerning changes in anthropogenic mercury emissions and deposition, associated linkages to ecosystem effects, and recovery from mercury contamination. This network would quantify mercury in the atmosphere, land, water, and biota in terrestrial, freshwater, and coastal ecosystems to provide a national scientific capability for evaluating the benefits and effectiveness of emission controls. Program development began with two workshops, convened to establish network goals, to select key indicators for monitoring, to propose a geographic network of monitoring sites, and to design a monitoring plan. MercNet relies strongly on multi-institutional partnerships to secure the capabilities and comprehensive data that are needed to develop, calibrate, and refine predictive mercury models and to guide effective management. Ongoing collaborative efforts include the: (1) development of regional multi-media databases on mercury in the Laurentian Great Lakes, northeastern United States, and eastern Canada; (2) syntheses and reporting of these data for the scientific and policy communities; and (3) evaluation of potential monitoring sites. The MercNet approach could be applied to the development of other monitoring programs, such as emerging efforts to monitor and assess global mercury emission controls.

Abstract Aims Limited data exist on the epidemiology, evaluation, and prognosis of otherwise unexplained anaemia of the elderly in heart failure (HF). Thus, we aimed to determine the incidence of anaemia, to characterize diagnostic testing patterns for potentially reversible causes of anaemia, and to evaluate the independent association between incident anaemia and long-term morbidity and mortality. Methods and results Within the Cardiovascular Research Network (CVRN), we identified adults age ≥65 years with diagnosed HF between 2005 and 2012 and no anaemia at entry. Incident anaemia was defined using World Health Organization (WHO) haemoglobin thresholds (<13.0 g/dL in men; <12.0 g/dL in women). All-cause death and hospitalizations for HF and any cause were identified from electronic health records. Among 38 826 older HF patients, 22 163 (57.1%) developed incident anaemia over a median (interquartile range) follow-up of 2.9 (1.2–5.6) years. The crude rate [95% confidence interval (CI)] per 100 person-years of incident anaemia was 26.4 (95% CI 26.0–26.7) and was higher for preserved ejection fraction (EF) [29.2 (95% CI 28.6–29.8)] compared with borderline EF [26.5 (95% CI 25.4–27.7)] or reduced EF [26.6 (95% CI 25.8–27.4)]. Iron indices, vitamin B12 level, and thyroid testing were performed in 20.9%, 14.9%, and 40.2% of patients, respectively. Reduced iron stores, vitamin B12 deficiency, and/or hypothyroidism were present in 29.7%, 3.2%, and 18.6% of tested patients, respectively. In multivariable analyses, incident anaemia was associated with excess mortality [hazard ratio (HR) 2.14, 95% CI 2.07–2.22] as well as hospitalization for HF (HR 1.80, 95% CI 1.72–1.88) and any cause (HR 1.77, 95% CI 1.72–1.83). Conclusion Among older adults with HF, incident anaemia is common and independently associated with substantially increased risks of morbidity and mortality. Additional research is necessary to clarify the value of routine evaluation and treatment of potentially reversible causes of anaemia.