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In 2025, with access to low-dose CT angiography, FAI analysis, and a deeper understanding of plaque biology, it is increasingly difficult to justify CAC scoring in younger individuals.
For patients with CKD 3b, a high-protein diet may accelerate renal decline and should be avoided. However, metabolic improvement via a moderate low-carbohydrate diet with controlled protein intake (~0.8 g/kg/day) and unsaturated fats is both feasible and safe when guided appropriately. Creatinine changes should be interpreted carefully in the context of diet, and dietary interventions should be closely monitored.
When most people think of a cooked breakfast, they picture something indulgent — bacon, eggs, toast, maybe pancakes or juice. But my version of a cooked breakfast is carefully designed to help reduce visceral fat (VAT), improve satiety, and support stable energy levels throughout the morning. Here's how I do it — and why it works.
Adipose tissue—particularly visceral adipose tissue (VAT)—is not merely a passive energy store. It is metabolically active and pro-inflammatory, secreting cytokines and adipokines that drive systemic inflammation. It is therefore plausible that reducing VAT may alleviate joint pain by lowering inflammatory signalling, not just mechanical stress.
Before birth, the foramen ovale is a vital foetal opening between the right and left atria, allowing oxygen-rich placental blood to bypass the inactive lungs. After the first breath, pressure in the left atrium increases, closing the flap naturally. In around 25% of adults, the flap does not seal fully — this persistent communication is called a Patent Foramen Ovale (PFO) which is an important cause of cryptogenic stroke. All standard tests including an echocardiogram can be normal- it can be only be diagnosed using a bubble contrast study and once diagnosed, treatment with clam shell closure is high effective.
If you have ever found yourself feeling breathless climbing stairs or walking uphill — even though your lung and heart tests are “normal” — you are not alone.Many people attribute it to age or fitness. But recent research has uncovered a powerful hidden cause of breathlessness: visceral fat — the fat stored deep inside your abdomen, around your organs. In this blog, we will explore what visceral fat is, how it affects your breathing, and — most importantly — what you can do about it.
We use waist-to-height ratio (WHtR) as a screening tool, followed by low-dose CT to measure VAT index (VATI) against gender- and ethnicity-specific thresholds. Where VATI is high, patients enter a six-month digital lifestyle programme using tools like the Dr Shape food app, CGM, and body composition scales. Pharmacological therapy, including GLP-1 receptor agonists, is reserved for non-responders—making this a precise, cost-effective, and highly personalised pathway for VAT reduction.
Traditional upper limits for ALT (often ≤55 U/L in UK labs) were derived decades ago, before the epidemic of obesity and steatosis. Current evidence suggests these ranges are too high — and that values above 30 U/L may already indicate liver injury in people with metabolic risk. The British Society of Gastroenterology (BSG) guidelines emphasise that a result within the “normal range” may not be reassuring if the patient is metabolically high-risk
For years, the Mediterranean diet has been praised as one of the healthiest ways to eat. Rich in vegetables, olive oil, fish, nuts, and whole grains, it’s been linked to lower rates of heart disease, diabetes, and obesity. But why does it work so well?
For much of modern cardiology, in its battle against coronary artery disease—one of mankind’s greatest threats—the “enemy” seemed clear. When I trained, the diagnostic armoury was focused on accurately identifying flow-limiting narrowing of one or more coronary arteries. Yet in the last decade, a profound paradigm shift has unsettled these foundations—and in some respects, turned them on their head.
An article by Dr Edward Leatham, Consultant Cardiologist © 2026 E.Leatham Introduction For decades, health advice has emphasised “low-fat” as the healthy option. Supermarket shelves are stacked with skimmed and semi-skimmed milk, marketed as the heart-friendly choice. Yet, in recent years, our […]
An article by Dr Edward Leatham, Consultant Cardiologist © 2025 E.Leatham While everyone might think the term ‘VAT’ stands for value added tax, we all need to recognise this new health term, as it is shaping up to be a critical risk […]