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New research finds that GLP-1 drugs like Ozempic and Wegovy may help significantly reduce alcohol cravings. Stefa Nikolic/Getty Images Six patients treated with semaglutide experienced reductions in alcohol use disorder (AUD) symptoms. Experts say it may have helped due to semaglutide’s effects on dopamine. Dopamine is the “pleasure” hormone that makes drinking alcohol feel good. More research is needed before semaglutide becomes a treatment for AUD. Experts say it may be worth a try now if you already have other indications for its use. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use disorder (AUD) is a brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. People with this disorder have a reduced ability to stop or control their drinking even though it is having negative effects on their lives. Currently, AUD has only three FDA-approved drug treatments: acamprosate, disulfiram, and naltrexone. However, a new case series that was published on November 27, 2023, in The Journal of Clinical Psychiatry, presents new evidence that semaglutide — commonly used for applications such as diabetes management and weight loss — may also be useful in the treatment of AUD. The case series, which included six patients, involved people who had positively screened for AUD. All patients were being treated with semaglutide, the active ingredient in both Ozempic and Wegovy, for weight loss. However, it was found that these people incidentally had improvement in their AUD symptoms which was described in an associated press release from the University of Oklahoma as “remarkable.” During follow-up, all six patients had AUDIT (alcohol use disorders identification test) scores that indicated “low-risk” drinking, according to the report. This would generally indicate that a person does not have a problem with drinking. The study authors caution, however, that randomized, placebo-controlled clinical studies are needed to verify whether semaglutide is a viable treatment for AUD. But, they say there is a strong potential for it to become another effective tool to help treat this disorder. Why might semaglutide reduce the desire for alcohol? Dr. Alexandra Sowa of SoWell Health, who is a board-certified obesity medicine expert and a clinical instructor of medicine at NYU, explained that it’s not surprising that a drug used to treat diabetes and obesity might also affect AUD. “GLP-1 medications don’t just work on the stomach,” she said, “they touch every organ, from the heart to the brain. “We have known for a long time that dopamine is the ‘pleasure’ hormone that becomes overly activated in addiction, be it addiction to food, alcohol or even video games,” Sowa added. “GLP-1 medications reduce the release of dopamine, making previously ‘rewarding’ behaviors, like over-drinking, far less enjoyable,” she explained. Dr. Jonathan Kaplan, a board-certified plastic surgeon and owner of Pacific Heights Plastic Surgery, added that we’ll probably also see it being utilized to treat other “OCD-like tendencies” including nail biting, online shopping, smoking, or vaping. What about the long-term effects of semaglutide? Given that AUD is not a curable condition, it is likely that a person would need to remain on semaglutide throughout their life in order to control their symptoms. So, what do we know about its long-term effects? Kaplan said, “This class of drugs have been around for 20+ years so we do know the most common side effects are GI in nature (nausea, vomiting, constipation and diarrhea).” Long-term side effects can include medullary thyroid cancer, he added. However, he pointed out that this was mostly seen in lab rats and not humans. “In fact, medullary thyroid cancer in humans has remained rare and unchanged for 30+ years,” said Kaplan. He concluded by saying that the benefits of semaglutide appear to outweigh the risks when it comes to AUD. Should people with AUD use semaglutide now? Sowa said that it’s too early to say how well semaglutide will actually work for AUD, including when it comes to long-term sobriety. “I wouldn’t recommend semaglutide for AUD in isolation, but if a patient meets BMI or blood sugar criteria for use, and over-drinking is an issue, it’s a win-win medication,” she stated. Kaplan agreed with Sowa, noting that this study only included six case studies. “Hundreds or thousands of patients would be the gold standard type of study needed before declaring ‘success’ and recommending this as sole treatment,” he declared. “But it’s certainly promising, and at this time, no reason not to try it.” Takeaway Alcohol use disorder (AUD) is a brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. Currently, only three drug treatments exist for AUD. However, a small study involving six patients found that semaglutide had a “remarkable” ability to reduce people’s AUD symptoms. This could be because of its ability to affect the “pleasure” hormone dopamine, making drinking a less rewarding experience. While larger studies are needed to determine whether semaglutide will become a treatment for AUD, experts say it’s “promising” and might be worth a try, especially if you already have other approved indications for its use, such as diabetes or obesity.

Jessica Cothran (left) was experiencing heart palpitations that doctors dismissed as a symptom of anxiety for years before a cardiologist identified the issue and diagnosed her with hypertrophic cardiomyopathy (HCM), a common form of genetic heart disease. Image Provided by “Could it Be HCM?” Hypertrophic cardiomyopathy (HCM) can be a serious heart condition. HCM is the most common form of genetic heart disease. An estimated 1 out of every 500 people have HCM, but many are undiagnosed. Jessica Cothran had always lived an active, healthy lifestyle, but for years was troubled by heart palpitations and experiencing shortness of breath when she would exercise. Initially, she passed this off as over-exertion, but then it got worse. Jessica recalls one scary episode when she experienced a palpitation while driving, her two daughters were little and she thought to herself, “I need to look into this.” When she would talk with doctors, however, her experiences were dismissed as symptoms of anxiety and she was told she had nothing to worry about. “I started being concerned with this in my 20s, and then as I got into my 30s, I noticed I was having a hard time going up stairs and I needed to take breaks. My family was more concerned with that than I was,” she told Healthline. “Then, I had another episode, a spell of heart palpitations when I was exercising that felt different than what I was used to. It was more alarming. I had to stop, it made me too afraid to exercise.” She then went to a cardiologist in 2018 who gave her the answers she was looking for. Her doctor detected a heart murmur that previous providers had pinpointed but never investigated thoroughly. She was only 38, and after having an echocardiogram, she was diagnosed with a condition she never even heard of before: hypertrophic cardiomyopathy, or HCM. It’s the most common form of genetic heart disease. After moving to the greater Nashville area, Cothran and her family found a specialist to get a second opinion. Not only did this further confirm her HCM diagnosis, the specialist conducted genetic testing on her daughters. They both were found to have the genes associated with the heart condition. It was a necessary step that put the Cothrans at ease in many ways. It put a name to what was happening with Jessica’s health and gave her daughters the information they need to get routine screenings and check-ups to keep an eye on their heart health moving forward. What is hypertrophic cardiomyopathy (HCM)? To share their family’s story and offer others with needed information about this chronic condition, Jessica and her daughter, Sarah, a singer-songwriter and TikTok influencer with more than 3 million followers, have joined Could it Be HCM?, an awareness campaign from Bristol-Myers Squibb. It’s a fairly common condition, but one that often goes under the radar. An estimated 1 out of every 500 people has HCM, but many are undiagnosed, according to the American Heart Association. HCM is often the result of the presence of abnormal genes in the heart muscle, resulting in a thickening of the left ventricle, or the heart chamber’s walls. This can lower how much blood comes in and ultimately sent out to the rest of the body with each heartbeat, according to the association. Given that it’s a genetic condition, unlike other forms of heart disease, HCM isn’t tied to one’s lifestyle or overall health. Dr. Theodore Abraham, FACC, FASE, a cardiologist and co-director of the UCSF HCM Center of Excellence and the director of the UCSF Adult Cardiac Echocardiography Laboratory, told Healthline that somewhat non-intuitively, the heart function is actually “overly robust and hyper dynamic” with HCM. It doesn’t matter if someone eats only salads and exercises daily or “smokes, or drinks alcohol, or eats a lot of hamburgers.” “The heart is very robustly functioning [with HCM] at what is often considered ‘normal,’ so it gets mistaken for other conditions,” Abraham, who is unaffiliated with the awareness campaign, explained. “The risk for a misdiagnosis or for under-diagnoses is very common.” For people who possess the genes that cause this abnormality, HCM can affect young and old and people of any gender or ethnic background. How hypertrophic cardiomyopathy is diagnosed and treated Abraham said that a diagnosis for HCM is achieved by way of cardiac imaging, like it was for Jessica. This could be an ultrasound or echocardiogram, which is the most common diagnostic tool. He said a lot of people with this disease show no symptoms, so many people who have it aren’t going in for routine screenings, especially if they are unaware of any family history. For her part, Jessica shared that her father passed away when she was just 16 years old “from something heart related.” After talking it over with her grandmother, Jessica theorizes that this condition most likely was passed down through her father’s side of the family. Abraham stressed that by way of a regular physical and standard heart disease screenings (think EKGs, listening for heart murmurs) won’t detect the often asymptomatic HCM. That is why more advanced cardiac imaging is needed. When it comes to treatments, Abraham said it depends on what type of HCM you have. There are two types of HCM Obstructive HCM: this is when the thickened are of the heart muscle blocks and reduces blood flow from left ventricle to the aorta. Nonobstructive HCM: this is where thickening still occurs but blood flow isn’t blocked, according to the American Heart Association. The most common form is obstructive HCM. With obstructive HCM, Abraham said most means of treatment are medical therapies, but if a patient can’t tolerate them, then non-medical therapies are an option. One of these involves an alcohol ablation administered through a catheter, and another would be a myectomy, which is done through open-heart surgery. He said when it comes to therapies, there have been recent breakthroughs that have seen a new class of drugs “that were able to completely dissipate the ‘obstructive gradient’ as they call it.” One drug is mavacamten, approved last year. The other is aficamten, which is in a main trial that will be announced early next year, he said. “There are multiple other therapies, too,” he added. “They are trying these same drugs for nonobstructive just to see if they are helpful…there are lots of other exciting therapies now, too. You have gene therapy, where if you have one type of genetic mutation, you could actually inject a gene into their veins that goes into the heart and starts producing the protein that’s deficient — that’s actually a trial that is just starting.” Additionally, Abraham said there’s another class of drugs being tested that would modulate the heart’s function that could work as a treatment for HCM. “Lastly, early data shows these so-called SGLT2 inhibitors — the drugs that are being used for diabetes and heart disease, heart failure — might also be useful,” Abraham said. “So, there’s lots of exciting new therapies that are being attempted and are actually recently approved to be used by the FDA [Food and Drug Administration].” Sarah Cothran (left) playing the guitar and her mother Jessica Cothran (right). Image Provided by “Could it Be HCM?” Raising awareness of HCM and the need for screenings Jessica said the decision to get her kids tested was scary at first. No parent wants to hear the news that their child might have the genes that could develop a potential heart condition down the line. Once they had a clear picture, however, she said there is comfort in having the vigilance of going in for cardiology appointments each year and to monitor if any symptoms like hers ever appear. For Sarah, it was “stressful and caused some anxiety” when she learned she had the genes needed for HCM. “It was confusing and a lot at the time,” she told Healthline of the process of learning her mom had HCM and then going in for genetic testing herself. “I talked to my doctor and I continue to get checkups and that is comforting — it makes us all feel a lot better.” Abraham stressed that routine screenings for the population as a whole aren’t the norm when it comes to this, but he said it is important to note that HCM “is thought to be the most common cause of sudden cardiac death in young athletes in high school and college.” “Awareness is important,” he said. “A low threshold of screenings are very important to kind of catch people who are at risk. The risk of sudden cardiac arrest is high regardless of what type of HCM you have — whether you have the high pressure or obstructive kind, or the normal pressure and nonobstructive kind.” He said anyone who has a family history should get screened and bring this up with a cardiologist, and also it’s important there is a low threshold for screening requirements for those people who “don’t have a clear explanation” for why they are experiencing heart disease symptoms but their other readings and testing comes out otherwise normal. Going in for that imaging can literally save your life. How is Jessica’s health today? She said she feels great. “I’m in really good shape, I’m not saying I’m totally symptom free, I do have days where it’s very obvious that something is going on there, but I know and I feel confident with my treatment, and I just feel like I”m doing really good where I’m at now,” she said. For Sarah, she may have the gene, but she hasn’t been diagnosed with HCM. “I just continue to see my doctor and do annual check-ups and try to live a healthy lifestyle. I feel we are both doing really really well,” Sarah said. Sarah added that if you have any symptoms or are experiencing doubt of any kind about your health, go see your health care provider. When it comes to sharing their story so publicly, both Cothrans said it’s important to spread the word to others who might be confused about what is happening with their health, or who might not have HCM on their radars at all, but probably should — especially if that family history exists. “I don’t think a lot of people have heard of it. You get that diagnosis and try to kind of educate yourself about it, it can be really scary,” Jessica said. “Maybe it makes it less scary for somebody to say ‘look at them, they are going through it and they are doing good.’ “

Basak Gurbuz Derman/Getty Images The CDC has issued a warning advising people to avoid pre-cut cantaloupe if they don’t know the brand. The warning comes as a salmonella outbreak linked to cantaloupe has expanded. A total of 117 people from 34 states have been sickened in the outbreak and two have died. Experts say that there are steps you can take to reduce risk. Officials from the U.S. Centers for Disease Control and Prevention are warning that you should avoid eating pre-cut cantaloupe if you don’t know what brand it is. The recall of certain brands of cantaloupe due to confirmed cases of salmonella, first announced on November 17 by the Food and Drug Administration (FDA), has been expanded. The outbreak has been connected to 117 illnesses, 61 hospitalizations, and two deaths across 34 states, according to the U.S. Centers for Disease Control and Prevention. Cantaloupe rinds may be especially hospitable to bacteria Dr. Jennifer Quinlan (PhD), a food microbiologist who is currently a professor at Drexel University, says that one of the reasons cantaloupe are at a higher risk of salmonella transmission than other produce is because of their rind, which, unlike a watermelon, has “crevices and a roughness to it.” This texture can create a safer haven for the bacteria.“This is a product that’s grown outside. Subjected to animals, potentially; unsanitary conditions, potentially. So, the bottom line is that if the pathogens get into the rind, it’s a very rough rind, and so even washing it makes it difficult to get the pathogens completely off,” Quinlan. Dr. Patrick Penfield (PhD), professor of supply chain practice at Syracuse University, says the variety in the food supply chain heightens the risk of illness.“The food supply chain specifically for fruits and vegetables is fragmented and globally sourced by many companies within the US. We literally receive fruits and vegetables from thousands of farmers and food producers from all over the world,” Penfield. “It’s incredibly difficult to prevent all potential food borne illnesses from these food growers and producers.” Unfortunately, the expectation is that you will have food borne illness issues occasionally impact the food supply chain.” Salmonella symptoms Symptoms of salmonella include the following: diarrhea that can be bloody fever stomach cramps Most people recover on their own within 4 to 7 days. However, some people are at higher risk for severe symptoms, including children under 5, pregnant women, and people over age 65. How to avoid getting salmonella If you are a regular consumer of cantaloupe, there are some steps you can take to reduce risk. The CDC suggests that, besides checking whether products you’ve bought are subject to the recall, you should not eat any cantaloupe you don’t know the origin of. This includes any product you may have previously frozen. Quinlan, whose work includes studying the impacts of food-borne illnesses on marginalized communities, says that understanding food safety can help people avoid getting sick. Quinlan advises that if you’re cutting up cantaloupe, put it in the fridge immediately to stop bacteria from growing. Quinlan also points out that there are some groups of people who may want to steer clear of the fruit for the time being. “Obviously, it’s not on every cantaloupe out there,” Quinlan said. “We don’t want to scare people from eating cantaloupes, but if you do have cantaloupe, you want to make sure it’s not associated with the outbreak. And if you do have vulnerable people in your family, or you are a vulnerable person, you might want to think twice.” Penfield says that while better regulations may help cut down on food-borne outbreaks, people can protect themselves by washing fruits and vegetables and, when cooking, making sure that food reaches a high enough temperature to kill bacteria. “Sadly, this is something we will have to live with until new technology or processes are developed to eliminate these issues from happening with fruits and vegetables within the food supply chain,” Penfield said. “Until this happens, we have to always wash fruits and vegetables and cook these items whenever we can.” A full list of measures you can take to ensure your food is safe to eat can be found on the FDA website. How to identify the recalled cantaloupe products The recall includes whole fresh cantaloupes that are labeled “Malichita” or “Rudy”, “4050,” and “Product of Mexico/produit du Mexique.” More information about how to identify the recalled produce can be found on the FDA website. The fruit is being voluntarily recalled by different businesses including Crown Jewels Produce, Sofia Produce and Pacific Trellis Fruit. “The company has ceased sales and distribution of the product as FDA and the company continue their investigation as to what caused the problem,” Crown Jewels Produce said in a voluntary recall notice posted by the FDA. Other companies that have voluntarily recalled produce include Sofia Produce which does business under the name “Trufresh.” “Trufresh is contacting each of the individual buyers to advise them of the recall. If the buyers associated with the above brands have not already been contacted by Trufresh, they should contact Trufresh at the number below,” the company said in their recall notice. Pacific Trellis Fruit said in their release that they had not received notice that any illnesses were connected to their produce. “This is an ongoing outbreak, and several illnesses have been reported to the Centers for Disease Control and Prevention in the United States and Canada. To date, Pacific Trellis Fruit has not received any reports of illness,” company officials said in a statement. Cut cantaloupe products have been voluntarily recalled from grocery chain ALDI, Vinyard Fruit and Vegetable Company, and CF Dallas. ALDI said their products have not currently been linked to any illness. “ALDI puts the safety and integrity of the products it sells first. If customers have a product affected by thisrecall, they are advised to discard it immediately or return it to their local store for a full refund,” the company said in a press release. Vineyard Fruit and Vegetable Company also said they had no links to reported illnesses. “Vinyard has contacted all retailers and wholesalers who purchased these products and notified them to remove recalled products from their inventory immediately and dispose of products or arrange for their pick-up by a Vinyard representative,” the company said in their recall notice. CF Dallas also said that as of November 22, they also had not been notified of any illnesses connected to their produce. “All CF Dallas fresh-cut fruit products associated with the recalled whole cantaloupe have expired, however, consumers who have purchased these items and may have frozen them for later use are urged not to consume the products and to dispose of them immediately or return the items to their local store for a full refund,” the company said in their recall notice. Takeaway Multiple companies have voluntarily recalled cantaloupe after the produce was linked to a salmonella outbreak that has sickened 117. At least two people have died in the outbreak, according to the CDC.

Study finds people who walk more quickly are less likely to have type 2 diabetes. SolStock/Getty Images Picking up the pace while walking is linked to a lower risk of developing type 2 diabetes, according to a new study. A faster walking speed is associated with fewer heart disease risk factors, including higher insulin resistance, higher body weight, and higher blood pressure. People who walk at a faster pace typically have better cardio-respiratory health and overall functional capacity, as well as better lower limb and core strength, compared to those who don’t walk at an increased speed. Diabetes is a chronic disease that affects millions of people of worldwide. More than 95% of those with diabetes have type 2 diabetes. To manage this health condition, experts typically recommend lifestyle changes such as diet and exercise. Now, a new study shows that walking at a speed of 4 or more km an hour (about 2.5 mph) is linked to a reduced risk of type 2 diabetes. The findings were published this week in the British Journal of Sports Medicine. The findings also demonstrated that when the walking pace was higher than 4 km/hour, the risk for developing type 2 diabetes decreased. As the speed went up by 1 km (0.6 miles) per hour the risk was lowered by 9%. A faster walk linked to lower type 2 diabetes risk After analyzing data of 508,121 adults from 1999 and 2022, researchers found that people who walked at an average or normal speed of 3-5 km/hour (1.8-3.1 mph) were associated with a 15% reduced risk of type 2 diabetes compared to people who walked at slower walking speeds. “Our main finding was that faster habitual walking is associated with a lower risk of developing type 2 diabetes in the future,” Dr. Ahmad Jayedi, study author and researcher at the Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran., told Healthline. “Surprisingly, we found that the slowest walking speed to reduce the risk of type 2 diabetes was 4 km/h, equal to 87 steps/min for males and 100 steps/min for females.” Jayedi continued: “Of the 10 studies included in the review, 5 used timed walking-pace test and 5 used self-reported questionnaires to measure walking speed, and studies with self-reported methods reported weaker associations (but still significant associations). Therefore, prospective cohort studies that used objective methods to measure walking speed, e.g., timed walking-pace test, are needed to present more robust evidence.”  Also, it is now indicated that time spent walking per day (or step count per day) and walking speed are associated with a lower risk of type 2 diabetes. Perhaps future studies can investigate the potential association between time of walking (morning, evening, night) and diabetes risk, Jayedi added.  Why a faster walking speed may reduce the risk of type 2 diabetes Fast walking strengthens the heart and helps it relax so it is a more efficient pump. Fast walking also promotes vascular health and helps boost the production of nitric oxide, a chemical that helps improve blood flow and lower blood pressure. “Faster walking pace is associated with reduced presence or severity of cardiovascular risk factors,” such as insulin resistance, higher body weight and hypertension,” said Dr. John Higgins, sports cardiologist with UTHealth Houston. Additionally, people who walk faster are less likely to develop high blood pressure, according to researchers. “Higher intensities require greater contribution from blood glucose,” Matthew Stults-Kolehmainen, exercise physiologist, Yale New Haven Health, stated. Health benefits of brisk walking  People who can walk faster generally have greater cardiac health and overall functional capacity as well as better lower limb and core strength, Higgins explained. To gauge your walking speed, you can use a pace device such a wearable monitor like a Fitbit or Garmin. “Set your goal pace – and the device will GPS monitor you to make sure you’re keeping at the correct faster pace, and warn you to speed up if you are falling behind,” said Higgins. Other options include using an electronic metronome and keeping up with a certain frequency of beats with each step and forcing yourself to do your same walk distance in a shorter time. There are numerous advantages of picking up the pace. Higgins provided a list: Better effect on lowering blood pressure  Reduced insulin resistance Lower LDL (bad) cholesterol & triglycerides and higher HDL (good) cholesterol  Slows down aging  “The main benefit of going faster is that you can do less,” said Stultz. “For instance, ACSM recommends that you can do 150 minutes a week of moderate-intensity exercise, or 75 minutes of vigorous.” To start walking faster, either use a wearable pacer device that has a pace function or use an electronic metronome and keep up with a certain frequency of beats with each step. Also, force yourself to do your same walk distance in a shorter time, Higgins recommended. Takeaway A new study indicates that walking faster can lower the risk of developing type 2 diabetes. Results show that the faster a person walked, the more the risk went down. Increased walking speed is linked to fewer and less severe cardiovascular risk factors, and lower insulin resistance, lower body weight, and lower blood pressure. Those who walk at a brisk pace generally demonstrate stronger cardio-respiratory health and functional capacity and stronger lower limbs and core.

Making simple changes to your order can help improve the nutritional value of your favorite Starbucks holiday drink. Wirestock/Getty Images Starbucks’ holiday drink menu contains many seasonal favorites and new offerings for 2023. Some of these holiday drinks contain high amounts of sugar, fat, and calories. Making simple substitutions when you order can help improve the nutritional value of these drinks. The holiday season usually signals the arrival of indulgent seasonal treats and you might consider holiday drinks from Starbucks as big a part of the festivities as putting up the tree and unwrapping gifts. But as tasty as they can be, chances are you already know that seasonal drinks aren’t the healthiest choice. Not only are they usually pretty high in sugar, fat, and calories, they’re often made with ultra-processed ingredients too.  However, health experts share that asking for these simple substitutions when you order one of your favorite items from Starbucks’ holiday menu can help improve its nutritional value. How to make Starbucks holiday drinks healthy Iced Gingerbread Oatmilk Chai. Starbucks Iced Gingerbread Oatmilk Chai With 45g of sugar, 10g of fat, and 360 calories in a 16oz grande, Aliza Marogy, registered nutritionist and founder of supplement brand Inessa, says the Iced Gingerbread Oatmilk Chai is far from healthy but may be one of the better options on the Starbucks holiday menu. However, she’s concerned about the inclusion of the preservative sodium benzoate. “Although it’s deemed safe for human consumption in the amounts permitted in food, sodium benzoate can react within the body to form benzene, a known carcinogen,” she explains. Sodium benzoate is sometimes added to syrups to intensify the flavor and increase shelf life, so one of the easiest ways to make this drink a little healthier would be to ask for fewer pumps of gingerbread-flavored syrup. That ought to cut some of the sugar and calorie content too. “The oat milk that Starbucks uses contains canola oil,” Marogy adds. Therefore, you may be better off asking for your drink with full-fat dairy instead. To cut the calories even further, consider ordering a tall instead of a grande. It has 70 fewer calories and 9g less sugar. Peppermint Mocha. Starbucks Peppermint Mocha  Signature Espresso Roast, steamed milk, sweet mocha sauce, and peppermint-flavored syrup, along with whipped cream and dark chocolate curls, give this drink its whopping calorie content. You’ll find 440 calories, 54g sugar, and 16g fat in one grande Peppermint Mocha. That’s a lot, and worse still, Marogy says a drink like this is unlikely to leave you satiated. That means you’ll want to consume more calories soon after. One of Marogy’s biggest concerns is the inclusion of the emulsifier carrageenan. “Carrageenan has been linked with disturbance of the gut microbiome and increased inflammation in the bowel,” she says. “Even in small doses, I would avoid foods containing it at all costs.” If you still want to enjoy a Starbucks Peppermint Mocha, there’s an easy way to cut carrageenan out. It’s found in whipped cream so simply ask for your drink to come without the whipped cream topping. The Peppermint Mocha is also available in short size. Choosing this option almost halves the calorie and sugar and reduces the fat content. There are other ways to make it a little healthier too. You can half the number of peppermint syrup and mocha sauce pumps and ask for it without the chocolate curls topping. Caramel Brulée Latte. Starbucks Caramel Brulée Latte  This drink – with its blend of espresso, steamed milk, caramel brulée sauce, and whipped cream and caramel brulée bits topping – racks up 410 calories, 48g sugar, and 14g fat per 160z serving. Around 120 calories in this drink come from fat, but you could ask for nonfat milk. Like the Peppermint Mocha, Marogy notes that the Caramel Brulée Latte also contains carrageenan, so forgoing the whipped cream is an easy way to cut it out and lose some of the calories and fat in the process. To skip some of the sugar, ask for your drink without the caramel brulée topping and fewer caramel brulée sauce pumps. Choosing the short serving size will cut the sugar content in half too. Chestnut Praline Latte. Starbucks Chestnut Praline Latte With 330 calories in a grande cup, Karine Patel, leading dietitian at Dietitian Fit, says the Chestnut Praline Latte is equivalent to a small meal. What’s more, she says it’s very high in fat and sugar and is unlikely to fill you up for long or provide much nutritional benefit. “Apart from the 12g of protein you get from the milk, and some of the nutrients you get from milk (calcium, Vitamin D, and other vitamins and minerals) this drink isn’t very nutritious. Add to that, the chestnut syrup and whipped cream make it a highly processed drink,” she says. The good news? Patel says a few swaps can make the chestnut praline latte healthier. “First, start by ordering a short size instead of a grande, and you will already cut the calories by half,” she advises. “Then remove the whipped cream, and ask them to put only one pump of chestnut praline syrup. This will help you save over 50 percent of the sugar and fat.” Sugar Cookie Almondmilk Latte. Starbucks Sugar Cookie Almondmilk Latte Let’s start with the good stuff. With 180 calories in a grande, the Iced Sugar Cookie Almondmilk Latte is quite a bit lower in calories than some of the other latte options at Starbucks. It’s also lower in fat than most other drinks with 6g of total fat. But, warns Patel, it’s still high in sugar — containing the equivalent of seven cubes of sugar. It’s also low in protein. “This drink has just 3g of protein due to the almond milk alternative to milk,” Patel points out. Still want to order it? “I would strongly recommend cutting the sugar cookie syrup pump by half by asking for two pumps instead of four,” says Patel. Doing so will significantly reduce the sugar content of this sweet brew. If you also opt to remove the red and green topping Patel says you’ll have a drink that contains only 70 calories, and roughly 12g of sugar. Much better. New Oleato Gingerbread Oatmilk Latte. Starbucks New Oleato Gingerbread Oatmilk Latte  The Oleato Gingerbread Oatmilk Latte is one of the newest additions to the Starbucks holiday menu. It’s made with blonde espresso roast that’s infused with extra virgin olive oil, steamed oat milk, and gingerbread-flavored syrup, and topped with a dusting of ginger and citrus. But don’t let the inclusion of oat milk fool you. “Due to the added oil, this drink is very high in fat (20g) and calories (350),” Patel points out.   “These ‘hidden’ calories can add up very quickly and lead to weight gain as they don’t fill you up,” she warns. “It may seem that the latte has less sugar, however, that’s because oat contains carbohydrates in the form of starch. This still gets broken down into sugars.” According to Patel, your best bet when ordering this brew is to opt for the short size. You might also like to ask if your drink to be made without oil. Asking for fewer gingerbread syrup shots will cut some of the calorie and sugar content too. Takeaway A balanced diet is one that includes moderate amounts of foods that are considered indulgent and at this time of year, it’s normal that you might want to treat yourself to a seasonal brew. Marogy says she’s a firm believer in enjoying everything in moderation. However, she says many of us choose to drink festive drinks without being fully aware of the amount of sugar and unhealthy fat contained within. Educate yourself on what you’re consuming and you’ll be able to make healthier swaps when ordering your favorite Starbucks holiday drinks.

A new study looked at how eating a vegan diet may help your health. Claudia Burlotti/Getty Images A new report found that those who ate a healthy vegan diet had better health markers compared to those who ate an omnivorous diet. The researchers recruited 22 pair of twins, who were randomly assigned to eat either an omnivorous or vegan diet for eight weeks.  The study looked at LDL cholesterol, fasting insulin, and body weight between the two groups. A healthy vegan diet is better for your cardiometabolic than a healthy diet that includes meat, a new study conducted in identical twins suggests.  The report, published in JAMA Network Open on Thursday, found that those who ate a healthy vegan diet experienced greater reductions in low-density lipoprotein (LDL) cholesterol, fasting insulin, and body weight compared to the twins who ate an omnivorous diet. “These effects can potentially provide a cardiovascular benefit, as we know that high LDL cholesterol, poor blood sugar control, and obesity are all risk factors for heart disease,” Dr. Cheng-Han Chen, board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, told Healthline.  Cutting out meat and animal products isn’t the only way to improve your cardiometabolic health.  Even modest reductions in meat can promote cardiovascular health, past evidence suggests.  “The take-home advice would be for individuals to find the balance that can be maintained long-term; diets that are only followed for short-term provide only short-term benefits,” the study’s senior author, Christopher Gardner, PhD, a professor of medicine at Stanford Medicine and director of nutrition studies at the Stanford Prevention Research Center, says. A vegan diet improved cholesterol, fasting insulin, and body weight The researchers recruited 22 identical twin pairs (44 people total) who were randomly assigned to eat either an omnivorous or vegan diet for eight weeks (with one twin per diet).  “The study was unique in the recruitment of identical twins as this provided an extra level of scientific ‘matching’ for characteristics other than dietary intake that could have been confounding variables in the study,” Gardner said. Both diets were designed to be healthy, and all participants were advised to opt for minimally processed foods like whole grains, fruits, and vegetables instead of added sugars, refined grains, and highly processed foods. Diet-specific meals were provided to the participants via a meal delivery service for the first four weeks in addition to health educator counseling. During the final four weeks, the participants were instructed to choose diet-appropriate foods based on counseling they received.  Both groups were instructed to eat vegetables, beans, grains and fruit, however, the vegan group ate more of these foods than the carnivorous group.  “This meant higher fiber, lower saturated fat, and more phytochemicals for the healthy vegan group,” says Gardner.  After eight weeks, those who were assigned to eat a vegan diet experienced several benefits compared to their twins, including lower LDL cholesterol levels, fasting insulin, and body weight. The vegan group also experienced improvements in fasting high-density lipoprotein cholesterol, triglycerides, vitamin B12, glucose, and TMAO levels, but they were not statistically significant. “This suggests that, within a short period of time, a plant-based diet can offer benefits to heart health even when compared to a healthy meat-based diet,” says Chen. Healthy plant-based foods have been linked to a lower risk of heart disease  Prior studies have found that plant-based diets are associated with greater cardiovascular health and a lower risk of cardiovascular disease.  For example, research suggests vegan and plant-based diets reduce body weight and improve lipid management, blood pressure, and glucose metabolism. Vegan diets, which tend to be high in vegetables, fruits, legumes, whole grains, and nuts, are higher in fiber, vitamins, minerals, and phytonutrients.  The nutrients from healthy plant-based whole foods tend to take longer to digest and absorb than animal-sourced foods, according to Gardner. “This likely meant a slow release of nutrients like glucose into the bloodstream, which likely led to the benefit observed for lower insulin levels,” he said of the study’s findings. Getting benefits without fully going vegan Growing evidence suggests people don’t need to strictly adhere to plant-based diets to reap the cardiovascular health benefits.  Even swapping out a few animal-sourced meals for plant-based foods weekly can make a difference. Ideally, people can find a healthy diet plan that works for them.  According to Chen, when eating a vegan diet, it’s important to be aware that, without proper supplementation, it can lead to deficiencies in such essential nutrients like vitamin B12, calcium, zinc, iron, omega-3 fatty acids, and protein.  In general, he recommends eating healthier foods — like fruits, vegetables, whole grains and nuts — and less unhealthy foods, such as saturated fats, sugar, and refined carbohydrates.  “Strict diets can sometimes be hard to follow for everyone, so I generally recommend that people use these principles to find a healthy diet that works for them,” Chen said. The bottom line: A new study found that a healthy vegan diet is better for your overall health than a healthy diet that includes meat and other animal products. The trial, which was conducted in identical twins, found that those who ate a healthy vegan diet experienced greater reductions in low-density lipoprotein (LDL) cholesterol, fasting insulin, and body weight compared to the twins who ate an omnivorous diet.

Chinese officials lifted strict COVID restrictions earlier this year. d3sign/Getty Images There has been a surge in respiratory illnesses in children in China, according to news reports. But this pneumonia outbreak appears to be the result of known illnesses. The surge in respiratory illness may be a result of China lifting COVID restrictions earlier this year. A recent surge in respiratory illnesses — primarily in children — in China has drawn attention from the World Health Organization (WHO), other health experts around the globe, and Western media. In mid-November, China’s National Health Commission announced a significant rise in influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Mycoplasma pneumonia (a bacteria that causes pneumonia), and respiratory syncytial virus (RSV). The country’s health authorities attributed the surge to an easing of China’s long, stringent COVID-19 restrictions and the normal cycle of cold and flu season. But given similar headlines that started appearing in late 2019, before the pandemic became global the following spring, the news has raised alarm. Should you worry about China’s respiratory illness surge? Many experts suggest that this is a normal response to the lifting of COVID restrictions, which can create a scenario where the general population’s immunity becomes more vulnerable to other common respiratory infections. Dr. William Schaffner, a professor of preventive medicine specializing in health policy and infectious diseases at the Vanderbilt University School of Medicine, told Healthline that while the headlines may seem familiar, there’s no immediate cause for alarm. “Initially, everyone was wondering whether they had seen this movie before, right? But the World Health Organization has had a virtual meeting with the Chinese scientists and infectious disease folks and I think left that meeting reassured that first of all, there is no new novel, strange virus, such as COVID,” Schaffner said. “What the Chinese authorities have said is that consequent to their opening things up and coming out of lockdown, they are having an experience which was similar to the experience that we in the United States and the Western world had last year. Their lockdown lasted longer.” Schaffner pointed out that respiratory disease in the U.S. also rose as people stopped social distancing after the peak of the COVID-19 pandemic. “We had early and very brisk influenza, and similarly RSV infections, and we had COVID also increasing,” he said. How ‘immunity debt’ may play a role The concept of “immunity debt” — in which social distancing, masks, and lockdowns weaken a population’s resistance to other pathogens — is a common theory behind China’s surge. “The term ‘immunity debt’ or ‘immunity gap’ has been employed to describe this phenomenon, but this really just means that we are more susceptible to viruses we have not seen for a few years because we don’t have any immunity to them,” Dr. Monica Gandhi, MPH, a professor and director of University of California San Francisco’s Bay Area Center for AIDS Research, told Healthline. “We saw a severe influenza season in Australia during our summer of 2022 (their winter), which was mirrored by our severe influenza and RSV season last winter in the Northern Hemisphere (especially among children).” A 2022 study in England suggested that the “unprecedented suppression of RSV activity during winter 2020–21 is likely to have resulted in a large cohort of immunologically naive children younger than 5 years who have not been exposed to natural RSV infection but who became exposed upon the lifting of restrictions.” Could China’s pneumonia outbreak spread? In the short term, it appears unlikely that these respiratory illnesses could develop into a novel virus that becomes a global pandemic. The combination of China’s extended lockdown, the expected “immunity debt” that resulted, and the country’s size are all factors that have to be considered as a reason for the current outbreak. Additionally experts pointed out that most cases have only been reported in northern China, so we can expect to see more reported surges of these illnesses as people travel throughout the country. “China is a big country. So this phenomenon may occur repeatedly in different parts of the country; the whole country is not experiencing this simultaneously,” Schaffner said. “As far as we know, this is happening mostly in northern China, is my understanding. So we may get a repeat of this in other parts of China as the weeks go by.” The number of pneumonia cases in children are certainly alarming, but context has to be considered, Gandhi said. “It is biologically plausible, given the almost three years of lockdown and avoidance of other pathogens in the country, that the immunity debt in China would be worse than in other countries, leading to this wave of pneumonias,” Dr. Gandhi said. Can respiratory illness spread by air travel? Schaffner acknowledged that respiratory infections can easily be exchanged between different populations through travel but cautioned that there’s not any indication of accelerated risk. “Any virus — influenza, for example — can be carried by travelers from one place to another. But at the moment, the Northern Hemisphere, we in the United States, for example, are seeing a somewhat early increase in our own influenza, so we don’t need external importations,” he said. “We’ve got plenty already. And our season is starting to take off.”   Takeaway China’s surge in respiratory illnesses, especially pneumonia among children, is most likely a result of the country’s extended COVID-19 lockdown, which was longer than any other country in the world. “Immunity debt,” the phenomenon in which a population’s susceptibility to certain pathogens and viruses increases from measures like social distancing, masking, and lockdowns, is the most viable explanation for the surge in these illnesses. There’s little reason for other countries to worry that this points to another global pandemic, experts say.

Changing your lifestyle can significantly help reduce your risk of cancer, new research shows. Halfpoint Images/Getty Images Modifiable lifestyle factors like diet and exercise play an important role in mitigating cancer risk. New research now indicates that the more positive lifestyle changes you make, the lower your risk. Limiting sugar, red meat, and processed food consumption are important dietary changes to make. Evidence continues to mount that modifiable lifestyle factors like diet and exercise have a significant impact on reducing your risk of cancer. New research published November 29 in Biomed Central, a medical journal, found that individuals who adhered to lifestyle recommendations made by the World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) had lower risk of all cancers, as well as site-specific cancers like breast, colorectal, and ovarian. “Our study suggests that following the WCRF/AICR lifestyle-based Cancer Prevention Recommendations is associated with lowering our risk of cancer, in particular two of the world’s top 4 cancers,” Dr. Fiona Malcomson, PhD, Lecturer in Human Nutrition at Newcastle University, and one of the authors of the study, told Healthline. However, she noted that the study’s observational nature means they can not conclude a direct causal relationship between adherence and cancer risk. How do lifestyle choices affect cancer? For each recommendation, which included exercise, limiting sugary beverages, and maintaining a healthy weight, experts created a simple “score” system to measure how well an individual followed. If, for example, you stopped drinking sugary beverages, you’d get one point, but if sodas were still part of your regular diet, you’d get zero points. There are also more incremental approaches to scoring; for example, if you partially met a recommendation, you could be awarded half a point. After getting an individual’s score, researchers could look at health outcomes to see if that score was associated with, say, incidences of cancer. To conduct this new study, researchers utilized the UK Biobank, a prospective health study with more than a half-million participants. The cohort includes both men and women ages 37–73 years from across the United Kingdom and includes data on the health, diet, and socioeconomic status of its participants. Researchers were able to draw on this wealth of data, including just under 95,000 participants with an average age of 56 years old in their study. During an average 8-year follow-up period, 7,296 participants (about 8%) developed some form of cancer.  Using the WCRF/AICR recommendations point system, participants were assigned a score between 0-7 based on their adherence. Can a healthy lifestyle prevent cancer? What the researchers found shows how significant lifestyle changes can be for cancer risk: for each point, all cancer risk dropped by 7%. In site-specific cancers, the benefits were even more stark. For every point, the risk of breast and colorectal cancer dropped by 10%; kidney cancer had an 18% lower risk;  ovarian cancer (24%), esophageal cancer (22%), and gallbladder cancer (30%) showed sizable improvements as well. “It’s exciting to see that promoting or adhering to recommended lifestyle changes can actually be protective,” said Dr. Lidia Schapira, a Professor of Oncology at Stanford University. She wasn’t affiliated with the research. There are also apparent trends across the score range. Participants in the highest range (4.5-7), demonstrating the highest levels of adherence, had a 16% reduced risk of all cancer risk, compared to those in the lowest score range. Site-specific cancers also followed suit; participants in the highest score range showed lower risk across breast cancer (18%), colorectal cancer (21%), kidney (36%), esophageal (36%), and ovarian (43%) compared to those with the least adherence. What are the lifestyle factors for cancer prevention? The WCRF/AICR established new recommendations in 2018, their first major update since their prior publication in 2007. Previous studies have examined associations between the 2007 recommendations and health-related outcomes, but this is the first time researchers have been able to utilize the updated recommendations. The recommendations include the following: maintaining a healthy weight being physically active eating healthy and including plenty of fruits and vegetables  limiting consumption of processed foods, red meat, and sugar  not drinking sugary beverages limiting alcohol consumption do not use supplements to prevent cancer They also recommend people who give birth should breastfeed if possible. Some of the changes between the 2007 and 2018 recommendations include the removal of the recommendation to “eat less salt,” due to inconclusive evidence; and the inclusion of the recommendation to specifically limit sugar from beverages like soda and juice. Malcomson encourages everyone to try following the WCRF/AICR recommendations as closely as possible, but small steps are also important. “Even improvements in one or two of these components is enough to make a difference,” she said. Schapira also encourages individuals who want to take on some of these lifestyle changes to make them manageable and positive: “Focus on one thing, instead of just saying, ‘Oh my gosh, I need to change these eight things about my life and my diet. It’s just too much so I won’t do any.’” “We should think about helping people to focus perhaps one or two recommendations, and doing it in an incremental or sequential way,” she said. The bottom line Lifestyle changes, like diet and exercise, are an important way to improve your health and cancer risk. New research indicates that individuals who adhere to World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) 2018 recommendations show lower risk for all cancer and site-specific cancer risk. Small steps like eliminating sugary drinks from your diet, eating less red meat, and exercising more frequently can have a major impact on reducing your cancer risk.

New research has found that moderate-intensity exercise may be beneficial for treating and preventing postpartum depression. Kerkez/GC Images A large study spanning 11 countries suggests that regular bouts of moderate-intensity exercise may help treat and prevent postpartum depression. The study authors say aerobic exercise like swimming, cycling, jogging, and dance were more effective for reducing postpartum depression than standard care. Experts caution that exercise should not replace first-line treatment for severe postpartum depression, such as psychotherapy and antidepressants. Postpartum depression is a debilitating condition affecting 1 in 8 pregnancies.  Diagnoses are often overlooked, meaning the prevalence of postpartum depression (PPD) may be higher than current estimates. Treatment for postpartum depression may range from antidepressants to psychotherapy and social support.  Now, a new meta-analysis found that moderate-intensity exercise was significantly effective in reducing postpartum depression compared to standard care. The findings were published November 29 in the journal PLOS ONE. Also of note, the study authors say that exercise is also associated with preventing postpartum depression onset. “The results of our study are intriguing,” study co-author Renyi Liu, a PhD student and associate professor at the China University of Geosciences in Wuhan, told Healthline. “While we anticipated positive outcomes associated with exercise, the remarkable degree of effectiveness, especially with moderate intensity and frequency, was surprising. This reinforces the potential role of exercise in managing and preventing postpartum depression.” While there are countless benefits to exercise, experts caution it should not be considered a substitute for first-line postpartum depression treatments, particularly in severe cases. Can exercise help postpartum depression? The new research builds on prior evidence suggesting the benefits of exercise for postpartum depression. The meta-analysis includes 26 studies comprising 2,867 subjects across 11 countries and regions, including China, where the study was conducted. Researchers compared subjects who participated in various forms of aerobic exercise to a control group receiving standard care. The types of exercise studied included: dance swimming cycling, walking, running yoga other sports The analysis shows the effectiveness of aerobic exercise in both prevention and treatment for postpartum depression is significant compared to standard care, with a stronger emphasis on prevention. The authors found the optimal prescribed exercise regimen is 3–4 times per week at moderate intensity for 35–45 minutes.  All forms of exercise studied were effective in treating and preventing postpartum depression with the exception of the yoga group. “Based on our research findings, initiating an exercise program during pregnancy and continuing postpartum appears to be beneficial,” Liu said.  “However, individual circumstances may vary, and it is advisable to consult healthcare providers to tailor exercise recommendations based on specific needs and conditions.” The researchers noted limitations in their findings, such as potential selection bias and variations in participant exercise regimens. The risk of bias was evident in the yoga group, Liu said, which did not show a significant improvement in postpartum depression symptoms or onset compared to the control group. Still, Liu noted that yoga is still considered a viable option for exercise. “The aim was to identify a more optimal aerobic exercise based on its effectiveness. After grouping, the variability in the intervention effects within the yoga group is most likely attributed to a risk of bias in the results of studies that employed yoga as an intervention,” Liu said.  “This bias may arise due to various factors, such as study design, intervention type, and participant characteristics.” Other factors, such as mood enhancement from team-based and supervised exercise, may have also affected the study’s outcomes.  The authors wrote it’s important to “exercise caution” when interpreting the findings. They say further research is needed to fully understand the effects of various forms of exercise, including yoga, on postpartum depression. Exercise vs. antidepressants for postpartum depression Liu explained that the standard care group in the meta-analysis involved education, psychological support, and recommendations for physical activity without prescribing structured exercise. The standard treatment group did not, however, closely examine antidepressant use. “Medication was not included in the preventive process for PPD,” Liu said. “In the treatment of PPD, medication usage is generally considered based on the severity of the condition and patient preference. In this study, which primarily focuses on treatment, the reported interventions almost entirely exclude the use of antidepressant medications.” Clinical psychologist Dr. Eynav Accortt, PhD, director of the Reproductive Psychology Program and assistant professor in the Department of Obstetrics and Gynecology at Cedars-Sinai in Los Angeles, emphasized the value of psychotherapy and antidepressants for treating postpartum depression. Accortt was not involved in the study. Severe cases of postpartum depression may interfere with an individual’s ability to function and may require fast-acting antidepressants like the recently approved postpartum depression pill, Zuranolone. According to Accortt, while research continues to show the benefits of exercise for postpartum depression, there’s typically only a slight reduction in symptoms. “Exercise is not a treatment for moderate to severe postpartum depression or anxiety,” she told Healthline. “When people tout this claim as if you don’t even need your antidepressants, you don’t need to go to psychotherapy, all you got to do is exercise, that’s really a simplified and actually dangerous approach.” Accortt noted that exercise may be a helpful adjunctive therapy for postpartum depression, but, in many cases, it is usually in combination with psychological or medical treatments. When can you start working out postpartum?  Physical activity is often recommended during pregnancy and postpartum once your physician has cleared you for exercise. However, a pregnant and postpartum person may experience significant physical changes that prevent them from safely engaging in certain forms of exercise. Accortt explained that many people might feel societal pressure to “bounce back” after giving birth. “It took 9 to 10 months to create a life, and your body has changed drastically to support that life, and now it will take a minimum of 9 to 10 months to get back to feeling like you did before you were pregnant,” she said. “So exercise in the pregnancy and immediate postpartum should only be done if you have gotten the go-ahead from your physician to do so.” What type of exercise helps postpartum depression? Accortt noted that regardless of what exercise you might try, it should be something you enjoy. “The point of this is not for weight loss — there should be no pressure. If we try to meet those expectations of bouncing back to get back to routines that we used to enjoy, we are just going to be disappointed, our depression and anxiety are certainly going to go back up, and our stress is going to go back up. So the idea is to take it really slow,” she said. As a proponent of yoga, Accortt said the benefits will inevitably vary depending on what style of yoga you practice.  For instance, you can’t really compare a slower form of yoga like Hatha to a faster, more aerobic style of yoga like Vinyasa. This may have distorted the results of the new meta-analysis, where researchers noted the potential for bias. Liu agreed that lighter forms of exercise may also be helpful in reducing postpartum depression compared to moderate aerboic exercise.  “The key is engaging in activities that are safe and suitable for the individual,” Liu said. “I think we have to mix it up so we get the most benefit physically, mentally, and emotionally, because you may enjoy a yoga class but feel you get a good workout with a hike or a jog,” Accortt noted.  “It has to be realistic, it has to be joyful, and in pregnancy and postpartum, it needs to be in small doses and supported by a physician.” Takeaway A new meta-analysis suggests that moderate-intensity aerobic exercise like swimming, cycling, jogging, and dancing may be more effective for reducing postpartum depression compared to standard care. While the research builds on evidence supporting the benefits of exercise for postpartum depression, more studies are needed before exercise should be considered a replacement for first-line treatments like antidepressants and psychotherapy.  If you’re pregnant or postpartum, be sure your physician clears you before starting a new exercise regimen. Remember to take it slow and engage in activities that bring you joy.

New research finds that three types of obesity treatments are the most effective for helping people lose weight and reduce related health risks. Westend61/Getty Images A new literature review has found that obesity is a growing problem around the world. This is a cause for concern because obesity contributes to illness and premature death. However, weight loss can reduce a person’s risk for health problems. Effective treatments for obesity include behavioral change, medications, and surgery. A combination of these approaches tailored to the individual works best. According to a recent review published in JAMA, obesity, which is defined as having a body mass index (BMI) of 30 or greater, is associated with a greater risk for illness and early death. However, weight loss can improve several associated risk factors, including elevated blood sugar, high blood pressure, and abnormal lipid values. The review — which sought to summarize current knowledge about the causes, diagnosis, and treatment of obesity — found that interventions like diet and exercise, medications, and bariatric surgery can all effectively assist with weight loss. The authors additionally concluded that treatment for obesity should include an appropriate combination of these approaches tailored to the individual. Why obesity is a growing health concern In order to make their recommendations, the authors reviewed numerous high-quality studies and policy guidelines. Altogether, they selected 126 articles for inclusion in their review. Dr. Blen Tesfu, a general practitioner and medical advisor for the UK-based healthcare platform Welzo, commented after examining the report that the findings of the study were “quite comprehensive.” She additionally pointed out that one important finding of the study is just how prevalent obesity is around the world and in the U.S. in particular. On the epidemiological front, the study authors found that worldwide obesity between the years 1975 and 2014 rose from 3.2% to 10.8% in men and 6.4% to 14.9% in women. Additionally, it was forecasted that by 2025 18% of men and 21% of women will be living with obesity. The outlook was even worse when U.S. statistics were examined. According to Tesfu, 42% of American adults are currently affected by obesity generating an estimated annual cost of $173 billion. It is expected that by the year 2030, 48.9% of Americans will be classified as obese, per the report. The authors also noted a growing racial divide in obesity with Black and Hispanic individuals outpacing their white counterparts. Health risks associated with obesity When it comes to health risks, the review found strong links between obesity and an increased risk of certain health problems. According to Tesfu, obesity “significantly impacts metabolic health,” leading to conditions such as diabetes, high blood pressure, and cardiovascular disease. It can also contribute to sleep disorders and osteoarthritis due to mechanical and structural changes in the body, she explained. Finally, Tesfu noted the psychological impact of obesity. “Associations with mental health issues, including depression and anxiety, are often exacerbated by societal stigma,” she stated. How treating obesity can help reduce health risks Dr. Praveen Guntipalli, Medical Director and Owner of Sanjiva Medical Spa in Dallas, Texas, said, “It is worth noting that even a modest weight loss — ranging from 5% to 10% — can lead to significant improvements in these risk factors.” Guntipalli added that research has shown that even small amounts of weight loss can improve blood sugar and triglycerides significantly. “More profound weight loss leads to even greater improvements,” he said, “particularly in managing conditions like type 2 diabetes, hypertension, and dyslipidemia.” Guntapalli further noted that weight loss is beneficial no matter your level of obesity and can create positive change in the various health markers irrespective of a person’s initial BMI. “Treating obesity effectively can reduce the risk of developing these comorbidities and improve overall health,” he explained. For example, dropping 10% to 15% of body weight can yield improvements in conditions like sleep apnea and non-alcoholic fatty liver. “Additionally,” said Guntapalli, “weight management can enhance quality of life, alleviate symptoms of depression, and improve mobility, sexual dysfunction, and urinary stress incontinence.” What are the best treatments for obesity? Tesfu said there were three general types of weight loss interventions that work best, according to the study: behavioral and lifestyle changes, medications, and surgical options. Behavioral and lifestyle changes include “significant focus on dietary changes, increased physical activity, and behavioral therapy,” she explained. These can help you achieve 5% to 10% weight loss, per the review. At the top of the list of effective medications that can aid with weight loss are the increasingly popular GLP-1 agonists such as: Ozempic Wegovy Mounjaro The study found that these types of medications can lead to 8% to 21% weight loss. Additionally, surgery can be an effective intervention. “Bariatric surgeries, such as laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass, are recommended for certain individuals based on BMI and comorbidities,” said Tesfu. This obesity treatment can lead to 25% to 30% weight loss. However, an approach that treats obesity from multiple angles may be best, according to the study. “Effective treatment involves a combination of lifestyle changes, medical interventions, and possibly surgical procedures,” Tesfu explained. She additionally noted that permanent lifestyle changes and possible long-term medication use may be necessary to maintain weight loss and reduce people’s risk for obesity-related health issues. Takeaway Obesity is a growing health issue throughout the world, especially in the United States. It can contribute to many health conditions, including diabetes, hypertension, and osteoarthritis. It can also lead to premature death. However, weight loss can mitigate the risk. Even a small amount of weight loss can better a person’s overall health. The most effective treatments for obesity are diet and exercise, GLP-1 medications, and weight loss surgery. Experts suggest it is best to use a combined approach based on an individual person’s needs.

“Late Show” host Stephen Colbert announced the show would canceled for a week as he recovers from a ruptured appendix. Gilbert Carrasquillo/GC Images “The Late Show With Stephen Colbert” was canceled this week while the host recovers from surgery for a ruptured appendix. Ruptured appendix is a complication of appendicitis requiring immediate medical attention. Appendicitis is common and may lead to serious complications if left untreated. “Late Show” host Stephen Colbert canceled his shows this week to recover from surgery following a ruptured appendix. The comedian shared the news on the social media platform Threads with his followers on Monday. “Sorry to say that I have to cancel our shows this week. I’m sure you’re thinking, ‘Turkey overdose, Steve? Gravy boat capsize?’ Actually, I’m recovering from surgery for a ruptured appendix,” Colbert wrote. “I’m grateful to my doctors for their care and to Evie and the kids for putting up with me. Going forward, all emails to my appendix will be handled by my pancreas,” he continued. “The Late Show With Stephen Colbert” was slated to return from Thanksgiving break on Tuesday, featuring guests like Jennifer Garner, Patrick Stewart, Barbra Streisand, and Kelsey Grammer, among others. This week marks the second time Colbert has had to cancel “Late Show” episodes due to illness in recent months. In October, Colbert canceled several shows to recover from COVID-19. Did Stephen Colbert have appendicitis? Colbert’s ruptured appendix likely began as appendicitis, an inflammation of the appendix. Dr. Tracey Childs, board certified in general and colorectal surgery and chief of surgery at Providence Saint John’s Health Center in Santa Monica, CA, explained that Colbert had appendicitis that progressed and then perforated. “Ruptured doesn’t mean that it exploded,” she told Healthline. “It means that the wall of the appendix, in the process of being infected, became a little gangrenous.” Childs described the process of appendicitis as a collection of fluid, like an abscess or an inflammatory mass.  When appendicitis becomes ruptured or perforated, it requires immediate medical attention. “It doesn’t go from zero to perforated in no time,” Childs said, noting that a ruptured appendix takes some time to develop.  “[But] if diagnosis is delayed, you can develop gangrenous appendicitis,” she said, which may lead to more serious complications. Does a ruptured appendix need to be removed? In the United States, the standard of care for acute appendicitis is surgery to remove the appendix.  However, some research has shown that antibiotics may be just as effective as surgery in treating appendicitis, but results may vary based on an individual’s health circumstances. In most cases, antibiotics should not be considered an alternative to an appendectomy. “Most people choose surgery and then go home and live their lives,” Childs said.  “Sometimes what will happen is if you have a big inflammatory mass, you perforate, and then the body recruits the tissues around it to kind of wall off the perforation,” she explained. “They will often treat that with antibiotics for 5–7 days, let everything cool down, and then do an interval appendectomy [removal of the appendix],” she added. How long does it take to recover from a ruptured appendix? Appendicitis severity falls on a spectrum, ranging from uncomplicated to complicated. For instance, a patient may have a micro-perforation or a larger perforation with an abscess or inflammatory mass. According to Childs, during early unruptured or uncomplicated appendicitis, patients are typically discharged within hours after surgery and free to return to their normal routines and work. But in complicated appendicitis, a patient may be in the hospital for a day or two or more, may require IV antibiotics, and may need to have infected fluid drained. These people often present with more serious symptoms and may require a longer recovery of two weeks or more. “The sicker you are before surgery, the longer your recovery after surgery,” Childs noted. What are the signs of appendicitis? Appendicitis is a medical emergency requiring immediate attention and may progress to perforated or ruptured appendicitis.  The sooner you’re able to get treatment, the greater your odds are of preventing a rupture. Symptoms of appendicitis include: abdominal pain lack of appetite vomiting constipation diarrhea fever  If you’re experiencing these symptoms, you should go to the emergency room immediately. You will likely receive a CT scan to help medical professionals determine whether you have appendicitis. “Appendicitis is slightly more common among males than females. It happens more often in people in their teens and 20s, but it may happen in people of any age, including older adults,” according to the National Institute of Diabetes and Digestive and Kidney Diseases. Is a ruptured appendix life threatening? Since appendicitis requires medical attention, it becomes very serious when left untreated. Treating the appendicitis with a minimally invasive appendectomy helps prevent the progression of ruptured appendicitis. Childs described untreated perforated appendicitis as a “smoldering localized infection,” a blockage in the form of a localized abscess or inflamed mass.  “If left untreated, you can develop gangrenous appendicitis and then perforation and either localized or generalized peritonitis,” she said. In these rare, severe cases, peritonitis — inflammation of the peritoneum (the thin layer of tissue that surrounds the inside of the abdomen and most of its organs — may result in sepsis and death. “When you seek access to care early in the course, then you have choices. If you don’t, then you get sick, and don’t have choices,” Childs said. What causes appendicitis — is it genetic?  The appendix is a small pouch of intestinal tissue shaped like a finger located between the small and large intestines. Appendicitis is common, but its causes are not fully understood. Childs said that appendicitis has nothing to do with diet, lack of exercise, or genetics. Appendicitis can affect anyone, regardless of age, sex, or racial or ethnic background. What causes appendicitis is as much a mystery as why we have this little finger-shaped organ, to begin with. “We don’t know what the function of the appendix is,” Childs said. “It’s like, you’re living, and something gets stuck in it. And it swells up, cuts off its own blood supply, becomes infected, and then can progress to gangrenous change and perforation, which is seepage of infected contents and then development of abscess or inflammatory mass or even generalized peritonitis. So that’s how it works. It’s a mechanical problem,” she said. “It’s just bad luck.” Takeaway “Late Show” host Stephen Colbert announced his shows were canceled this week as he recovered from surgery due to a ruptured appendix. Experts say a ruptured or perforated appendix is a complication of untreated appendicitis, a common and serious medical condition. In most cases, surgery is recommended to treat appendicitis. In some cases, antibiotics may be sufficient. If you have any symptoms resembling appendicitis, you should seek medical care immediately.

Some research shows St. John’s wort can help treat depression and other medical conditions, but experts warn there are some downsides to this herbal supplement. St. John’s wort is natural. It’s an herbal supplement that doesn’t require a prescription and you can buy it at a health food store. Sounds good, but that doesn’t necessarily make it harmless, according to a study published in 2015 in the journal Clinical and Experimental Pharmacology and Physiology. Researchers at the University of Adelaide compared adverse events of St. John’s wort and the antidepressant drug fluoxetine (Prozac). The team used information from doctors’ reports to Australia’s national agency on drug safety. Between 2000 and 2013, there were 84 adverse reaction reports for St. John’s wort. There were 447 reports for Prozac. Since reporting adverse events is voluntary, researchers said it’s likely that adverse events are underreported. Side effects of the two substances are similar. They include vomiting, dizziness, anxiety, panic attacks, aggression, and amnesia. There are also serious concerns about drug interactions. The benefits of St. John’s wort St. John’s wort (Hypericum perforatum) is a flowering plant. The flowers are used to make liquid extracts, pills, and teas. The popular herbal therapy is often used to ease symptoms of depression. People have been using St. John’s wort for centuries. A Cochrane systematic review found that St. John’s wort can be effective in treating major depression. A 2016 review of 35 studies concluded that St. John’s wort reduced symptoms of mild to moderate depression more than a placebo and similar to prescription antidepressants. A 2017 analysis of 27 studies determined that St. John’s wort had similar effects on mild to moderate depression as antidepressants. Those researchers also noted that fewer people stopped taking St. John’s wort, compared to antidepressants. Another study indicated St. John’s wort can be effective in treating wounds, bruises, burns, and sores. However, the Food and Drug Administration (FDA) has not approved the substance for depression or any other medical condition. The FDA, in fact, classifies St. John’s wort as a dietary supplement, not a drug. Therefore, the agency doesn’t test it for safety and effectiveness. Jeremy Wolf, a licensed naturopathic physician, explained that St. John’s wort creates many actions in the body. “It is a strong antidepressant and may elevate mood in individuals with mild to moderate depression,” he said. He notes that St. John’s wort is not recommended for individuals with severe depression. Wolf said St. John’s wort also has strong antiviral activity that may also promote healing and repair of wounds. He cautioned that the herb is not a fast-acting cure. It may take weeks or months before you notice any effect. How much St. John’s wort should you take? Blair Green Thielemier, PharmD, told Healthline in 2015 that dosing varies due to non-standardized manufacturing. A normal dose range would be anywhere from 300 to 1200 mg a day. It’s usually taken in divided doses (300 mg three times daily or 600 mg twice daily). The effects of St. John’s wort on the body are not fully understood. A number of the supplement’s active ingredients, including hypericin, hyperforin, and adhyperforin, may be responsible for its medicinal benefits. These ingredients appear to increase the levels of chemical messengers in the brain, such as serotonin, dopamine, and noradrenaline. These then act to lift and regulate your mood. The downside of St. John’s wort FDA regulations for dietary supplements are not the same as those for drug products. Unless there’s a new dietary ingredient, a firm doesn’t have to provide FDA officials with the evidence it relies on to substantiate safety or effectiveness before or after it markets its products. “Natural” doesn’t mean it can’t cause harm, said Thielemier. The main concerns about the herb center on the metabolic pathway known as cytochrome 450. She explained that this pathway consists of the enzymes our body uses to clear drugs and ingested chemicals from the bloodstream. “These enzymes are responsible for breaking down everything from the glass of wine you may have with dinner to a daily vitamin you take to keep your bones strong,” said Thielemier. Other substances can influence these enzymes. “If you have ever heard that grapefruit juice can interfere with your medications, then you know of this process we call enzyme induction,” said Thielemier. “St. John’s wort, like grapefruit juice, induces the body to produce more of these enzymes in order to clear the chemical from the bloodstream [faster].” That can rob other medications of their power. Wolf suggests the herb may work similarly to fluoxetine. If it inhibits the reuptake of serotonin, it would explain the similar side effects. It also interacts with many common pharmaceuticals. “When combined with SSRIs [selective serotonin reuptake inhibitors] and MAO [monoamine oxidase] inhibitors, it may lead to elevated blood pressure and could induce what is known as serotonin syndrome,” said Wolf. “This includes confusion, fever, agitation, rapid heart rate, shivering, perspiration, diarrhea, and muscle spasms.” According to the National Center for Complementary and Integrative Health, in addition to antidepressants, St. John’s wort interacts with oral contraceptives, anti-seizure medications, and anticoagulants. It can also interfere with anti-rejection medications, heart medications, and some drugs used for heart disease, HIV, and cancer. One 2011 study indicated the herbal supplement can reduce the effectiveness of Xanax, an anxiety medication. Wolf noted that pregnant or breastfeeding women should avoid St. John’s wort. So should people who are sensitive to sunlight, as the herb can intensify the effect. These side effects have prompted the Mayo Clinic in Minnesota to recommend people not use St. John’s wort if they are taking prescription medications. Regulation process not the same as drugs Should natural and herbal products include warnings and go through the same rigorous testing as prescription drugs? Thielemier thinks so. “How else will we know whether they are safe and effective? The problem lies in the insane costs of proving safety and efficacy through clinical trials,” she said. “I always advise individuals and remind them of the importance in checking with their healthcare provider or a trained practitioner before starting supplements and herbs due to the potential for side effects and interactions,” said Wolf. Editor’s Note: This story was originally published on August 6, 2015 and was updated on June 6, 2018.

A new scientific paper suggests being stuck in traffic could raise your blood pressure due to surrounding air pollution. Alexander Spatari/Getty Images Air pollution could affect your blood pressure, even when you’re in your vehicle. Particulate matter, which can be invisible to the naked eye is easily absorbed through the lungs. Experts warn that particulate matter in air pollution contributes to millions of deaths annually. If you needed another reason to hate your morning commute, here’s more bad news: traffic pollution could have a negative impact on your blood pressure. Research suggests that air pollution isn’t just some vague threat to the environment and your health, but has quantifiable effects similar to smoking or salt, that can lead to long-term, chronic effects on the heart and lungs. In a new scientific paper published in Annals of Internal Medicine, researchers found that exposure to “traffic-related air pollution,” which includes gasses like carbon dioxide and particulate matter from brakes and tires, can raise your blood pressure. And those effects persisted for a full day after the exposure. The research also finds ultrafine particulate matter, a form of pollution associated with car traffic that is currently unregulated, as a growing concern among public health officials. “The body has a complex set of systems to try to keep blood pressure to your brain the same all the time. It’s a very complex, tightly regulated system, and it appears that somewhere, in one of those mechanisms, traffic-related air pollution interferes with blood pressure,” Dr. Joel D. Kaufman, a professor of Epidemiology at the University of Washington and author of the research, told Healthline. How does rush hour traffic affect blood pressure? Kaufman and his team wanted to understand how traffic-related pollution could affect drivers’ blood pressure during their commute. So, they created a novel study concept in which they would literally drive around participants in morning rush hour in Seattle. On some of the drives, their vehicle would be equipped with a standard car air filter and a high-efficiency particulate air (HEPA) filter. All filtration was removed from the vehicle on other drives, with outside air vented directly into the cabin. 16 participants were recruited for the experiment, although full research data was only completed for thirteen. Participants were between 22 and 45 years of age, with an average age of 30. Everyone was generally heart healthy: individuals were disqualified if they had high cholesterol, hypertension, diabetes, and cardiovascular disease.  Participants underwent three separate drives for the experiment. Two drives were “unfiltered,” while the third drive was “filtered.” Each drive was separated by three weeks and the study was double-blind, meaning neither the participants nor the driver were aware of the vehicle having air filtration or not. Each drive consisted of a two-hour commute through rush hour traffic, generally between 9:30-11:30 AM.  Prior to each drive and at various points during the experiment, researchers took blood pressure readings for the participants.  Can air pollution cause high blood pressure? Effects of pollution peaked one hour into the drive and on average raised diastolic blood pressure by 4.7 mm/Hg and systolic blood pressure by 4.5 mm/Hg. While diminished, the effects lasted for an additional day. After 24 hours, diastolic blood pressure was still 3.8 mm/Hg higher than baseline, while systolic was still elevated by 1.1 mm/Hg. “The findings add more evidence in support of the experimental science showing that exposure to traffic-related air pollution particles increases the risk for cardiovascular diseases,” said Dr. Robert D. Brook, a Professor of Medicine in the Division of Cardiovascular Diseases at Wayne State University. Brook wasn’t affiliated with the research, but has previously published on the effects of air pollution on the cardiovascular system. In a 2020 paper entitled “Inhaling Hypertension,” Brook and his co-author found that fine particulate pollution contributes to 8.9 million deaths per year worldwide.  “Reducing exposure to traffic — one of the most common sources of particulate air pollution encountered every day by billions of people worldwide — can play a key role in protecting the global population from the harmful cardiovascular health effects,” he told Healthline. What does particulate matter do to the body? What is in exhaust — and how do you regulate it? Traffic-related pollution isn’t any one thing; in fact it is a lot of different things, in different sizes. Numerous gas emissions include carbon dioxide, carbon monoxide, and nitrogen dioxide. Then, there is particulate matter, which varies by size. PM10 particles are 10 micrometers or smaller, while PM2.5, classified as “fine” particulate matter, are 2.5 micrometers or smaller. Finally, PM0.1, or “ultra fine” particles, are less than one tenth of a micrometer. To put that in perspective, the diameter of a single strand of human hair is about 70 micrometers. Ultrafine particulate matter generally enters the body through the lungs and is associated with systemic inflammation and increased risk of cardiovascular disease and hypertension, among other health effects. Kaufman’s research further indicates that fine and ultrafine particulate matter can affect the body’s cardiovascular system and blood pressure. “Ultrafine particles are the pollutant that were most effectively filtered in our experiment — in other words, where the levels are most dramatically high on the road and low in the filtered environment. So, the hint is that ultrafines may be especially important for blood pressure,” said Kaufman. Dr. Panagis Galiatsatos, a pulmonary and critical care physician at Johns Hopkins University, and spokesperson for the American Lung Association, told Healthline that, like smoking, air pollution is a public health fight that can be won. “Find the right advocacy outlets in order to promote better, safer, cleaner air. The lung association is one of those organizations. You deserve that air quality. And I think this is a very winnable battle,” he said. “Economically and politically, there are ways to promote safer, cleaner cars,” said Galiatsatos. The bottom line Pollution from vehicle traffic can affect your blood pressure and cardiovascular health. New research indicates that exposure to traffic-related pollution can elevate your blood pressure, and keep it elevated for 24 hours. Air pollution can lead to long-term chronic health problems. Experts warn that it is a serious global health concern.

Getty Images Having strong thigh muscles may reduce the need for total knee replacement in people with knee osteoarthritis. In particular, having stronger quadriceps muscles compared to the hamstrings muscles may be beneficial. The quadriceps can be strengthened with specific exercises such as squats and lunges, or with activities like yoga and Tai Chi. For people with knee osteoarthritis, having stronger quadriceps muscles, in relation to the hamstrings, could reduce the need for total knee replacement, preliminary research suggests.  The findings could lead to improvements in strength-training programs for people with this degenerative joint disease, and may even benefit others, researchers say. “While these results are essential for targeted therapy in a population at risk for osteoarthritis, even the general public can benefit from our results to preventively incorporate appropriate strengthening exercises,” study author Dr. Upasana Upadhyay Bharadwaj, from the University of California, San Francisco, said in a news release. The study was presented Nov. 27 at the annual meeting of the Radiological Society of North America (RSNA). It has not yet been published in a peer-reviewed journal. Exercise stabilizes the knees An estimated 14 million Americans — including more than 3 million racial/ethnic minorities — have knee osteoarthritis severe enough that it causes symptoms such as pain, stiffness and swelling, according to a large national U.S. health survey.  While older age is a risk factor for this condition, the survey found that more half of people with symptomatic knee osteoarthritis were under 65 years old. Treatment for knee osteoarthritis generally begins with conservative methods such as physical therapy, weight loss, knee bracing or anti-inflammatory medicines. If these fail to improve symptoms, a person may need surgery. One type is a total knee replacement, also known as total knee arthroplasty. Exercise programs, when implemented early after a diagnosis with knee osteoarthritis — and maybe even before then — can improve pain symptoms and functioning in people with this condition. While many types of aerobic and strength-training exercises can be beneficial, earlier research has found that exercises that focus on strengthening the quadriceps may be especially helpful at reducing pain symptoms. The quadriceps are a group of four muscles located on the front of the thigh. They are one of the strongest muscle group in the body, and help you stand, walk and run. When you extend (straighten) the leg at the knee, or flex your thigh at the hip (such as when you step up), that’s the quadriceps working. Around the back of the thigh are the hamstrings, which are involved in movements such as walking, running and jumping. These three muscles are responsible for flexing (bending) the leg at the knee, and extending the thigh at the hip. These two muscle groups act as counter forces and protect the knee joint during a wide range of activities, said Upadhyay Bharadwaj in the release. However, “an imbalance, in addition to other factors, leads to a change in the biomechanics resulting in the progression of osteoarthritis,” she said. Strong quads reduce need for surgery In the new study, Upadhyay Bharadwaj and her colleagues evaluated thigh muscle volume in 134 participants with knee osteoarthritis who were participating in a U.S. study sponsored by the National Institutes of Health. Half of participants had undergone a total knee replacement, while the other half (known as the control group) had not. The knee replacement group and controls were matched for factors such as age and gender. Researchers examined MRI images of participants’ thigh muscles taken at the time of surgery, and two years and four years before the surgery. They used a deep learning computer model to calculate the volumes of the thigh muscles. People with a higher ratio of quadriceps volume to hamstrings volume were less likely to have had a total knee replacement. In addition, people with higher volumes of hamstrings and gracilis, a long muscle on the inside of the thigh, were also less likely to have had a total knee replacement. “Our study shows that in addition to strong muscles individually, larger extensor muscle groups [such as the quadriceps] — relative to hamstring muscle groups — are significantly associated with lower odds of total knee replacement surgery in two to four years,” Upadhyay Bharadwaj said in the release. While the overall muscle volume in the thigh is important, she said the balance between the extensor and hamstring muscles may be more important for reducing the risk of total knee replacement. How strong quads help knee stability Dr. Sean Rockett, an orthopedic surgeon with Orthopedics New England in Boston, said the results of the new study make sense, because the quadriceps play an essential role in taking pressure off the knee joint. In people with knee osteoarthritis, “stronger quadriceps would help the patella [kneecap] function better, and potentially produce less pain, thus decreasing the need for total knee replacement,” he said. Dr. Meredith Warner, an orthopedic surgeon with a private practice in Baton Rouge, Louisiana, agrees that a higher quadriceps volume, compared to the hamstrings volume, is important. “If you are weak in the [quadriceps], you lack the natural shock absorption [provided by] that muscle group,” she said. In addition, part of the quadriceps crosses both the hip and knee joints, which Warner said is important for distributing stresses in the upper leg.  The quadriceps is also closely related to the iliotibial (IT) band, which runs along the outside of the thigh and stabilizes the hip and knee during walking and running. “If one has a reduced ratio of [quadriceps] size to hamstrings, the implication is that they are sitting most of the day and quite inactive,” said Warner. “This group of people — sedentary — is well-known to be at higher risk of total knee replacement compared to an active population.” Exercise for knee osteoarthritis Kim Bennell, PhD, a research physiotherapist and professor of physiotherapy at the University of Melbourne in Australia, cautions that the new study only looked at the relationship between muscle volume and need for total knee replacement. “[The study] does not directly evaluate whether prescribing strengthening exercises designed to improve the quadriceps/hamstrings strength ratio leads to a reduced need for joint replacement,” she said. But the results add to the evidence that strengthening the quadriceps may reduce symptoms of knee osteoarthritis and reduce the need for total knee replacement surgery, she said. Many types of exercise can strengthen the quadriceps, including squats, lunges and step-ups. Even certain types of yoga may be beneficial for this muscle group. In a study published last year in the Annals of Internal Medicine, Bennell and her colleagues found that an unsupervised online yoga program reduced pain symptoms and improved functioning in people with knee osteoarthritis. They didn’t look specifically at muscle strength or whether people needed total knee replacement later on. ”However, research has shown that resistance exercise programs, as well as other forms of exercise such as Tai Chi and yoga, can improve quadriceps strength,” said Bennell, “and so are recommended for people with knee osteoarthritis.” Takeaway In a preliminary study, researchers found that stronger thigh muscles reduced the need for total knee replacement in people with knee osteoarthritis. This degenerative joint condition affects millions of Americans, including those under age 65. In particular, a higher volume of quadriceps muscles versus hamstrings was associated with a lower risk of surgery. A higher volume of hamstrings and gracilis were also linked to a reduced need for surgery. The quadriceps can be strengthened with specific exercises, such as squats, lunges and step-ups. Activities such as yoga and Tai Chi can also strengthen this muscle group and reduce symptoms of knee osteoarthritis.

The American Heart Association offers tips for safe travel with a chronic medical condition to help you reduce travel stress. urbazon/Getty Images Traveling with a medical condition may have its challenges, such as packing medications and medical equipment. The American Heart Association offers tips for safe travel with a chronic medical condition, including checking in with your doctor before you leave. Planning ahead can help reduce travel stress, such as packing extra medication in case of travel delays or finding nearby medical facilities and pharmacies at your destination. Holiday travel can be stressful for anyone. But for those with a health condition, such as heart disease or diabetes, it may come with a few unique challenges. That doesn’t mean travel is off limits for people with a chronic medical condition. With a little planning and preparation, you can take care of your health while spending the holidays with your family and friends, or while on a solo trip to the beach or mountains. “[Traveling is] not always that simple for people who have chronic health conditions that require multiple medications or special medical equipment,” Dr. Gladys Velarde, a volunteer with the American Heart Association (AHA) and a professor of medicine at the University of Florida in Jacksonville, said in a news release.  While “every individual’s condition is unique, and you’ll want to tailor your travel plans to your specific needs,” said Velarde, “by taking a little time now to plan and prepare, you can enjoy your holiday or vacation.” How do you travel with a medical condition? The AHA and other experts offer the following tips to help take some of the stress out of traveling for people with medical conditions. Check-in with your healthcare professional Before you leave for your trip, contact your primary care physician’s or specialist’s office to ask about any restrictions or precautions you need to keep in mind while traveling. For example, if you had surgery recently, your surgeon may want you to avoid walking for long distances or lifting a suitcase or other heavy objects, said Dr. Robert Miller, a doctor of internal medicine with Vista Staffing.  If you need to limit your walking, when you book your plane ticket, request a wheelchair or courtesy cart for getting through the airport. Travel also often involves sitting for long periods, which the AHA said can increase your risk for blood clots, including deep vein thrombosis and pulmonary embolism.  If you will be sitting for longer than 4 hours in a car or on a plane, take steps to decrease your risk: Wear compression socks. If traveling by car, stop every few hours to get outside and walk around. If traveling by plane, frequently walk around the airplane’s cabin when safely permitted.  While seated on a plane, do some simple heel and toe lifts to exercise your calf muscles and increase the blood flow in your legs. Miller also recommends that you carry a summary of your medical records, with health conditions, recent treatments and medications, as well as a list of phone numbers for your doctors and emergency contacts. This information is especially useful in the event that you are unable communicate for yourself in an emergency, he told Healthline.  He said you might also consider wearing a medical bracelet, which helps first responders or other healthcare professionals know your medical conditions if you can’t communicate with them. Manage your medications The AHA recommends that you carry a list of all your medications, including the dosages and pharmacy information. In addition, make sure your medications are clearly labeled, and you have enough for your entire trip. If your medications need to be refrigerated, plan for how to keep them cold while traveling and at your destination, such as in the hotel. When packing your medications, Miller suggests packing extra in case of travel delays, such as bad weather or other flight problems. In addition, make sure your medications are still usable. “I had a patient who had an allergic reaction while on a flight … but her epinephrine pen was expired,” said Miller. “Fortunately, there was someone on the flight who had a good epinephrine pen.” If traveling to another country, check with the U.S. embassy or consulate to find out if there are any medication restrictions at your destination, said Miller. This includes cannabis and cannabidiol (CBD) products, which are illegal in some countries. Plan on transporting medical devices If you have special medical equipment, you may need to check with the airline or other travel company to see how you can safely transport those. This includes: portable oxygen devices CPAP machines wheelchairs walkers other movement assistance equipment The AHA also recommends packing your blood pressure device or glucose monitor if you use one regularly. If you have a pacemaker or implantable cardioverter-defibrillator (ICD), you may need to go through special screening at the airport’s security, the AHA said. Coordinate your care at your destination Before you leave on your trip, think about the medical care you may need while you are away, especially “if you’re going to be gone for a while,” said Miller. For example, “if you’re on dialysis, you might need your nephrologist to reach out and coordinate with a doctor in the location you’re going to so you can continue your treatment while away,” he said. Also, familiarize yourself with the local emergency numbers at your destination, said the AHA, as well as the location of nearby medical facilities and pharmacies. In addition, keep in mind that “the local climate and elevation may impact how you feel — extreme heat or cold can affect circulation and put extra strain on your heart,” the AHA’s Velarde said. “In high altitudes, there is less oxygen in the air, and that means less oxygen will be carried in your blood.” If you will be going on a cruise, Miller suggests stopping by the infirmary after you board to introduce yourself to the healthcare staff and giving them a copy of your medical history and medications. Most of all, be proactive. “With chronic conditions, you’re going to be dealing [with] and managing them for a long time,” said Miller. “So it’s important to make sure that you’re aware of the things that need to be done before your trip.” Takeaway Holiday travel can be stressful, especially if you have a medical condition. But with a little planning and preparation, you can make the most out of your trip while still managing your health. Before you leave, check in with your doctor to find out about any restrictions or special precautions, as well as to update any prescriptions and get a copy of your medical record summary. If you need medical care while away, talk with your primary care doctor or specialist about coordinating care with a medical facility at your destination.

Past research has found statins may help stop tumor growth. aquaArts studio/Getty Images A new study found that taking statins may reduce the risk of death for women with breast cancer. Past research suggests high cholesterol is associated with a greater risk of breast cancer and statin use interrupts cancer cell signaling and tumor development.  Experts say further research is needed to study these early findings. Statins may reduce the risk of mortality among women with breast cancer, new research has found.  The study, published in JAMA Network Open this month, found that the risk of dying was substantially lower in women with breast cancer whose cholesterol levels dropped after starting statins, which are commonly prescribed lipid-lowering medications.  Past research suggests high cholesterol may be associated with a greater risk of breast cancer. It’s possible that statin use interrupts cancer cell signaling and tumor development. The new findings suggest statins may be beneficial for people with breast cancer, which is the most common cause of cancer death among women across the world, the researchers say. “This suggests a potentially beneficial role for statins in breast cancer treatment, highlighting the importance of cholesterol management in cancer prognosis,” Dr. Wael Harb, board-certified hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in Orange County, CA, told Healthline. Harb was not involved in the study. Statins linked to lower risk of death from breast cancer The researchers evaluated statins in 13,378 females with breast cancer. They followed up, on average, for 4.5 years after breast cancer diagnosis, during which time 16.4% of patients died and 7% died from breast cancer. The researchers found the risk of death dropped among those who started taking statins after diagnosis and experienced a reduction in cholesterol levels.  The team found that 7.6% of the participants who did not take statins died of breast cancer compared to 6.1% who took statins.  “In a retrospective study, this is a very small difference and not definitive,” Dr. Parvin Peddi, the director of Breast Medical Oncology for the Margie Petersen Breast Center at Providence Saint John’s Health Center and Associate Professor of Medical Oncology at Saint John’s Cancer Institute, said. Peddi was not involved in the study. The reduced risk of death was also observed among women with estrogen receptor–positive tumors.  The risk further declined with increasing intensity of statin use, the study found. The risk of death didn’t drop in women whose cholesterol levels did not substantially decrease after starting statins.  In addition, the decreased risk was only apparent in people with localized disease.  The researchers suspect statins may not improve survival rates among those with metastatic disease.   “The main takeaway is that post-diagnostic use of statins in breast cancer patients is associated with a reduced risk of death from the disease, especially when statin use leads to decreased cholesterol levels,” Harb said. Statins may interrupt tumor growth In studies conducted in mice, a metabolite of cholesterol — 27-hydroxycholesterol — appeared to promote tumor growth and metastases. In the current study, the researchers note that statins may be beneficial for breast cancer because they lower serum lipoproteins or interrupt cancer cell signaling pathways. Laboratory studies have found that statins have anti-invasive and antiangiogenic effects, meaning they inhibit tumor growth.  In addition, cholesterol is a precursor for estrogen production, and high estrogen levels are connected to a greater risk of breast cancer. “Statins, by lowering cholesterol levels, may reduce estrogen availability, impacting the progression of estrogen-sensitive tumors,” Harb says.  “This dual mechanism — both lowering cholesterol and influencing cell behavior — could explain why statin use after a breast cancer diagnosis might improve survival, particularly in cases where it effectively reduces cholesterol levels,” Harb added. Peddi says the anti-inflammatory effects of statins may play a role, too, however, “no study has been able to prove and definitely show that is the case.”  Should statins be used to treat breast cancer? Statins are currently not routinely prescribed to treat breast cancer.  According to Harb, the study demonstrates that people with breast cancer — particularly those with estrogen receptor-positive tumors — may benefit from statin therapy post-diagnosis, especially if it lowers their cholesterol levels.  Peddi thinks it’s too soon to start incorporating statins into breast cancer treatment plans.  “I would not recommend taking a statin at time of breast cancer diagnosis unless needed independently for its cholesterol-lowering properties,” she said. Additional studies are needed to explore the use of statins for breast cancer treatment.  “The findings of this study, coupled with existing research, may pave the way for future clinical trials and potentially integrate statin therapy into standard breast cancer treatment, but more research is needed to confirm these benefits,” Harb said. The bottom line New research has found that statins may reduce the risk of mortality among women with breast cancer. Some evidence suggests statins may interrupt cancer cell signaling pathways and inhibit tumor growth. More research is needed to understand the effects of statins before they are integrated into breast cancer treatment.

A new study suggests a link between a specific compound in red wine that triggers headaches, but more research is needed to understand the effect. puhimec/Getty Images New research suggests a link between a specific compound in red wine that triggers headaches. They say a type of flavanol, quercetin, may interfere with how alcohol in red wine is metabolized. The work is still in its early stages, with the next stage being studies involving humans. The research arrives alongside an increasing interest in the health effects of flavanols.  A new University of California study published on November 20 in Scientific Reports found a possible link between red wine consumption, flavanols, and headaches. The compound to blame? A specific type of flavanol known as quercetin. Quercetin is considered a healthy antioxidant, but it can cause issues during the metabolization process with the alcohol content in red wine. Study co-author Dr. Andrew Waterhouse, PhD, a wine chemist and professor emeritus at the University of California, Davis, said the research could help give consumers more information about how certain wines may impact their health. “It’d be much better for consumers if there is some specific information available,” Waterhouse told Healthline. Although the research is still in its early stages, the results are compelling enough to lead to the next step in the research, human trials, which will be led by researchers at the University of California, San Francisco. “I think if the human studies show a real effect, then it’ll be important for consumers to know which ones are high and which ones are low,” Waterhouse said. What causes red wine headaches? Red wine headaches typically occur within 30 minutes of consuming a glass. Prior theories have shown red wine headaches may be caused by: histamines in grape skins tannins sulfites According to the authors of the new study, however, flavanols could also be a possible cause. The flavanol quercetin — found in many different fruits and vegetables, including grapes and red wine — may affect how alcohol is metabolized. The researchers say that a common enzyme that helps metabolize alcohol in red wine, ALDH2, may be affected by the presence of quercetin in red wine, interfering with its role in the process. This disruption in metabolization could increase toxic acetaldehyde levels, which may cause symptoms such as: flushing nausea headaches “When [quercetin] gets in your bloodstream, your body converts it to a different form called quercetin glucuronide,” Waterhouse said in a press release. “In that form, it blocks the metabolism of alcohol.” More studies on flavanols and red wine headaches needed Waterhouse’s interest in what causes red wine headaches began during a trip to Napa Valley, CA. “I’ve known about red wine headaches for some time, but I was talking to a winemaker in Napa Valley about other things. And he brought this up, mentioned that he got red wine headaches and was wondering what could cause it. So that sort of piqued my interest,” he said. From there, Waterhouse and his colleagues explored the connection between inflammation, headaches, and who tends to get them after drinking certain types of alcohol. Interestingly, this research was funded via the crowdfunding program at UC Davis, and the Wine Spectator Scholarship Foundation will fund the next stage of the work. Waterhouse said this approach was taken partly because his team believes that the early stages of this type of research should reduce their reliance on funding meant for projects with the potential for broader impact. “Suffering headaches after drinking red wine isn’t something, I think, that the government should be supporting, and they should be funding research that’s [about] more urgent diseases and things like that,” he said. “Now, when we get to the stage of taking those results and investigating what causes headaches, that would be appropriate for government-funded research.” Research on the health effects of flavanols is ongoing Research on the health properties of flavanols — particularly those found in chocolate — has been ongoing for decades, but it seems public interest in flavanols has recently surged. In February 2023, flavanols reached its highest rating on Google Trends since Google launched the service in 2004. Dr. Adam Brickman, PhD, a professor of neuropsychology at Columbia University who has studied the connection between flavanols, cocoa, and cognition, told Healthline the ongoing interest in studying flavanols makes sense as more information about the compound becomes known. Brickman was not involved in the new study. “My take on it is that it’s not really surprising that many compounds in our food have bioactive properties. It’s where we get our energy from,” Brickman said. “I think there’s been a lot of interest in whether there are aspects and foods or things that we consume that have beneficial effects on how we feel or how we think and other aspects that might be somewhat harmful.” Takeaway New research suggests that a type of flavanol, quercetin, which typically has health benefits, may cause red wine headaches. The findings suggest that quercetin may affect how alcohol is metabolized, which could lead to inflammation and cause nausea, flushing, and headaches. More studies are needed to determine this effect in humans.

Casarsa/Getty Images Researchers at the Radiological Society of North America have linked a specific type of body fat to the development of Alzheimer’s Disease. Obesity is already a risk factor for the development of Alzheimer’s, but this is the first time research has linked that risk with a specific type of fat. The research opens up new avenues for prevention by focusing treatment on fat loss. Belly fat in middle age is a predictor of Alzheimer’s Disease, according to new research presented by the Radiological Society of North America. Researchers looked at visceral fat, a specific type of fat that makes up only a small portion of an individual’s body mass, but is critically located in the abdominal cavity, in close proximity to many vital organs. Visceral fat is sometimes called hidden fat because it is not visible from the outside. In a new study presented at the RSNA Annual Meeting, visceral fat was associated with changes in the brain that are an early signal of the development of Alzheimer’s Disease. Dr. Heather M. Snyder, PhD, the Alzheimer’s Association’s Vice President of Medical and Scientific relations, told Healthline that the study, although small, was important. “We know there are associations seen in past large studies that connect things like body mass index and obesity with later life risk of memory changes and possibly dementia. This new work seeks to understand the associations of things like obesity and BMI to the brain’s structure — and maybe overall health — as it relates to Alzheimer’s,” she said. Snyder was not involved with the study. ‘Hidden’ belly fat and the brain To conduct the study, researchers analyzed data from 54 participants ranging in age from 40-60 years old. All of the participants were cognitively healthy, but clinically obese, with an average BMI of 32. Using MRI scans the team was able to take images of the abdominal cavity and measure the amount of both visceral fat and subcutaneous fat (the more common type of fat found underneath the skin). The team also took MRI brain scans to observe any potential associations between brain volume and visceral fat. Of particular interest is the thickness of the cortex, which controls important functions like language, reasoning, and memory. Alzheimer’s Disease is known to destroy neurons and their connections in the cortex, resulting in loss of volume or “shrinking” as it progresses. The researchers also used a battery of other relevant tests that could indicate brain changes or biomarkers for inflammation and Alzheimer’s development, including glucose tolerance tests (insulin resistance), and PET scans focusing on amyloid plaques and tau tangles — the “plaques and tangles” that are a hallmark of Alzheimer’s. Higher amounts of hidden visceral fat linked to more inflammation Participants with a higher ratio of visceral fat to subcutaneous fat had higher levels of tau and amyloid proteins in their brains identified through the PET scans. A higher ratio of visceral fat was also associated with more inflammation, another risk factor for Alzheimer’s. “Even though there have been other studies linking body mass index (BMI) with brain atrophy or even a higher dementia risk, no prior study has linked a specific type of fat to the actual abnormal Alzheimer disease protein in cognitively normal persons up to 25 years before they would show the earliest symptoms of Alzheimer disease,” Dr. Cyrus A. Raji, MD, PhD, an Associate Professor of Radiology and Neurology and Director of Neuromagnetic Resonance Imaging at the Washington University School of Medicine, told Healthline. How to decrease your risk of Alzheimer’s disease And this is good news. Not only does the study help shed more light on one of the biological pathways that can lead to Alzheimer’s but also promotes the important message that some of these risk factors can be identified and modified early on. “We are excited to see these initial findings and look forward to more work and collaborations in this area, with a focus on brain health. The picture on the relationships between body components and brain health is evolving, and we are excited to study the potential mechanisms linking these entities,” said Raji. Lifestyle changes that include eating healthy and increasing exercise can help improve the amount of visceral fat on your body, even if it’s not visible to the naked eye. Even if you’re not losing weight, aerobic exercise is still good habit for overall health. Be careful though, not all exercise is equal; doing sit ups, for example, might help tighten up your abs, but it isn’t going to have a big effect on abdominal fat. The Alzheimer’s Association encourages individuals to try a variety of activities to help keep their brain’s sharp, including: Exercise Reading Eating healthy Stopping smoking You can find out more from their guide, “10 Ways to Love Your Brain.”  “This is such an exciting time in research, and studies like this will help us better understand these risk-related links,” said Snyder. The bottom line Visceral fat, which is found around in the organs in the abdominal cavity, is linked to other markers that indicate the development of Alzheimer’s Disease. Researchers used brain and body imaging (MRI and PET scans), as well as additional testing to demonstrate the association. The research encourages individuals to make healthy lifestyle changes, particularly in regard to their weight, earlier in life to help prevent Alzheimer’s.

SolStock/Getty Images ACOG has released a new set of guidelines for the treatment of PMS and PMDD (Premenstrual dysphoric disorder). Treatments that are recommended include antidepressants and cognitive behavioral therapy. Removal of the ovaries with or without the uterus is not advised. Experts say this will help women with PMS or PMDD get the best care. The American College of Obstetricians and Gynecologists (ACOG) has announced the release of its Clinical Practice Guideline for the management of premenstrual disorders. This document, which appears in the December 2023 issue of Obstetrics & Gynecology, is meant to provide recommendations for physicians in treating premenstrual disorders like premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The Office on Women’s Health states that PMS is very common with over 90% of women saying that they have physical and emotional symptoms such as bloating, headaches, and moodiness around the time of their periods. Symptoms tend to begin a week or two before and usually end within two to three days after it begins. They add that PMDD is similar to PMS, but is considered to be more serious and severe. It may require treatment with medication. It includes emotional symptoms such as anxiety, depression, and irritability which can be severe enough to interfere with a woman’s day-to-day life. These updated recommendations are based on the currently available evidence of what works best and is safest for patients when it comes to treating these conditions. Dr. Greg J. Marchand, who is dual board-certified in OBGYN and MIGS (Practice Focus) and is the Director of Marchand Institute for Minimally Invasive Surgery, said that publications like this one are “very important” because they indicate what the standard of care is in the U.S. Marchand further noted that premenstrual syndrome “is a serious disease that does not get enough attention. “ACOG is making the point that all OBGYNs need to be thinking more about diagnosing and treating PMS more often, as women are suffering in silence,” he said. Better treatment for PMS, PMDD include antidepressants, talk therapy Marchand said the guidelines discuss what treatments have the most evidence behind them as well as those that are not recommended. The three most effective treatments advised by the guidelines include antidepressants known as selective serotonin reuptake inhibitors (SSRIs), combined oral contraceptives, and cognitive behavioral therapy (CBT). Marchand went on to explain that SSRIs are used to treat both anxiety and depression. They are believed to work by making more of the neurotransmitter serotonin available in the brain. Oral contraceptives, on the other hand, are birth control pills containing estrogen and progesterone. They can prevent pregnancy as well as regulate periods. Finally, according to Marchand, CBT is what is often referred to as “talk therapy” and is done by a mental health professional. CBT is the most studied and scientifically validated form of psychotherapy for depression. “The guideline gives no preference as to which therapy is best,” he added, “but lists them all as being strongly recommended.”   In addition, the guidelines discuss therapies that are less recommended, although Marchand notes that the guidelines do not advise that you shouldn’t use them. These treatments include gonadotropin-releasing hormone (GnRH) agonists, exercise, calcium supplements, and types of common pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs). “GnRH agonist medications are powerful hormonal medications that work by bringing on a partial or complete menopausal state temporarily… ” Marchand explained. A study published in 2023 in Neuropharmacology reports that GnRH agonists produced “antidepressant-like effects” in male mice. Additionally, a number of studies have found that exercise can have beneficial effects on both depression and anxiety, according to a 2023 systematic review published in the British Journal of Sports Medicine. However, there is only limited evidence of a link between calcium and depression, per a 2023 study found in Frontiers in Nutrition. NSAIDs have also been proposed to help depression due to their anti-inflammatory effects, according to a 2016 article in Current Neuropharmacology. Finally, Marchand said that the document advises against bilateral oophorectomy (removing the ovaries) with or without hysterectomy (removing the uterus) as a first-line treatment for PMS or PMDD. “This is pretty much common sense as removing these organs is a very serious surgery that will cause menopause, sterility, and may increase the chance of heart attack and stroke in some women,” said Marchand. Why these new guidelines for PMS and PMDD are important Dr. Ankita Langan, an OBGYN with Novant Health in Charlotte, North Carolina, said, “These new guidelines provide some direction as far as what women can do at home to help with premenstrual symptoms as well as information on what may be helpful to do discuss with an OBGYN.” Robin Davis, MSN, ARNP, FNP-BC, a board-certified Family Nurse Practitioner with The Fountain at West Palm Beach, Florida, added that the guidelines are important because many women simply ignore their symptoms. “The reality is most people, not only women, lack the necessary knowledge when it comes to the symptoms of PMS and PMDD, as well as how to properly manage them,” she said. Davis further noted that both conditions may require lifelong management. “Unfortunately, medical professionals often overlook the symptoms of PMDD or incorrectly diagnose PMDD,” she said. Additionally, according to Davis, there are negative social and cultural connotations linked to these conditions so women tend to suffer in silence. “With proper and comprehensive guidelines, people are more likely to understand how debilitating PMS and PMDD are,” she said, adding that women would benefit from these guidelines because they would better understand their reproductive health. “Medical professionals also benefit from the guidelines because they’d be able to provide an accurate diagnosis and better care,” she concluded. Takeaway The latest guidance from experts on treating PMS and PMDD indicates that antidepressants, oral birth control, and CBT have the most evidence behind them. Other options including hormone agonists, exercise, calcium supplements, and certain types of pain relievers are less recommended although they are not actively discouraging their use. Finally, the organization states that bilateral oophorectomy (removing the ovaries) with or without hysterectomy should not be used as a first-line treatment for these disorders. Experts say these guidelines will help both women and their doctors to better understand these conditions so that women can get the healthcare that they need.

Young adults should monitor their blood pressure and cholesterol levels to assess any future risk of atherosclerosis, a new study reports. Nikola Stojadinovic/Getty Images A new study finds risk factors like high cholesterol and high blood pressure should be addressed earlier in life to help prevent atherosclerosis. Atherosclerosis is a hardening of the arteries due to plaque buildup from calcium, fats, and cholesterol. The condition can drastically increase the risk of cardiac events including stroke and heart attack. Atherosclerosis is a hardening of the arteries due to plaque buildup from calcium, fats, and cholesterol that can lead to blood clots, stroke, and heart attack or heart failure. It has commonly been associated with older adults. But a new study published Monday outlines an increased risk to younger adults for so-called “silent atherosclerosis,” suggesting that risk factors like high cholesterol and hypertension should be addressed earlier in life to prevent the disease from developing further. The study, carried out at Spain’s Centro Nacional de Investigaciones Cardiovasculares (CNIC) and published in the Journal of the American College of Cardiology, analyzed the key arteries including the carotid, femoral, and coronary arteries and aortas of more than 4,000 healthy middle-aged employees of a bank in Madrid. The researchers found that even moderate increases in blood pressure and cholesterol were shown to significantly impact the risk of atherosclerosis in younger adults. At what age should blood pressure and cholesterol be checked? Risk factors like high cholesterol and hypertension can affect younger adults’ chances of atherosclerosis later in life more than previously known. Testing earlier in life (between the ages of 20 and 25) and aggressively mitigating risk is beneficial, Dr. Borja Ibáñez, the scientific director of CNIC and one of the authors of the study, told Heathline. “Given these findings, it would be worthwhile for healthcare professionals to start assessing cardiovascular risk earlier on, including during check-ups in early adulthood,” Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Center in Santa Monica, Calif., told Heathline. “This approach is consistent with the idea of early intervention and aggressive control of cardiovascular risk factors as a means for reducing cardiovascular disease burden.” What age groups are most at risk for atherosclerosis? Given the physiological changes that come with aging, older adults are still at the highest risk, Tadwalkar said. “This includes arterial stiffening, atherosclerosis progression, and increased vulnerability to oxidative stresses and inflammation. The cumulative exposure to risk factors, such as high blood pressure and cholesterol, further amplifies cardiovascular risk as people age,” Tadwalkar noted. But the study suggests that even seemingly healthy younger adults should be monitored for risks associated with cardiovascular disease, Tadwalkar said, adding that genetic traits can play a role. “We know that those with a family history of cardiovascular diseases may face an increased risk, additionally warranting early testing and vigilant monitoring, especially considering that the progression of atherosclerosis is often silent,” he said. But younger adults seeing higher LDL (low-density lipoprotein) cholesterol levels and blood pressure results at their yearly physicals should take note, Ibáñez warned. LDL cholesterol is commonly termed as “bad” cholesterol. “We know that those who have higher LDL-cholesterol levels and blood pressure above the ideal values and smokers are at the higher risk for having early onset and progression of atherosclerosis,” Ibáñez said. “Still, future studies we are running should clearly delineate this in even younger populations.” What are the warning signs of atherosclerosis? There are a number of other lifestyle-related signs that can suggest an elevated risk for atherosclerosis. A 2022 study listed a number that should be monitored for adults between the ages of 20 and 39: tobacco use high blood pressure hypertension family history of atherosclerosis diabetes preeclampsia menopause in females under 40 A number of sleep disorders can also play a role. Obstructive sleep apnea, which can affect nearly a quarter of American adults between the ages of 30 and 70, can significantly increase the risk of cardiovascular disease. “Sleep apnea, and poor sleep quality more generally, are emerging as noteworthy factors. Disrupted sleep patterns can lead to increased stress on the cardiovascular system,” Tadwalkar said. “This underscores the importance of considering holistic factors in assessing and managing cardiovascular health.” How can you protect yourself from atherosclerosis? High cholesterol and blood pressure conditions can be initially controlled with a combination of a healthy diet, regular exercise, and prescription drugs as directed by a physician. Adjusting sugar intake and quitting smoking are also extremely important, Ibáñez said. Such a multifaceted approach is “essential,” Tadwalkar added, but getting a sense of the risk factors early is increasingly important. “Health check-ups and screenings are critical for early detection of risk factors,” Tadwalkar said. “This can also help identify individuals who need to move beyond lifestyle modifications alone and into pharmacological interventions, such as cholesterol-lowering medications or antihypertensive drugs.” Tadwalkar suggested that personalized approaches like imaging technology can be used as needed to monitor the presence and development of silent atherosclerosis. “This allows for tailored interventions based on individual risk profiles” he said. “Regular follow-up with a physician is essential to assess the effectiveness of interventions and make appropriate adjustments, as needed.” Takeaway Atherosclerosis can lead to stroke, heart attack, and heart failure. Adults as young as 20 should have regular physicals and monitor their blood pressure and cholesterol levels to assess any future risks of atherosclerosis. Anyone with a family history of atherosclerosis, a regular tobacco habit, poor diet, lack of exercise, or sleep disorders like apnea should have their risks assessed earlier than previously thought.