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New research compared the nutritional benefits of eating almond milk yogurt vs its dairy-based counterpart and found one clear overall winner. Aleksandar Nakic/Getty Images A new study has found that, overall, almond milk yogurt is more nutrient-dense than the dairy-based variety. However, there were certain areas where dairy milk excels, such as protein, calcium, and potassium. Nutrition experts say it’s important to consider your individual needs when choosing which type to eat. A plant-based diet can have multiple benefits for health as well as the environment. When it comes to its nutrient density, almond milk yogurt comes out ahead compared to dairy-based yogurt, says research out of the University of Massachusetts Amherst. Astrid D’Andrea, the food science major who led the study, noted in her report that plant-based yogurts do have some deficits when compared to dairy, such as less protein, calcium, and potassium. However, overall, almond yogurt is significantly richer in nutrients while also having less total sugar and sodium and more fiber than dairy yogurt. Comparing plant-based yogurt to dairy yogurt To arrive at their conclusions, D’Andrea and her team compiled nutritional information for a total of 612 yogurt products. Among the types of yogurt products examined were full-fat dairy, low and nonfat dairy, coconut, almond, cashew, and oat. The researchers used the Nutrient Rich Foods (NRF) index to assign scores for the nutrient density of each yogurt in order to compare desirable nutrients — such as protein, fiber, and calcium — as well as those that people would want to reduce, including saturated fat, total sugar, and sodium. The products were then ranked from highest to lowest nutrient density. Coming out on top was almond, followed by oat, low and nonfat dairy, full-fat dairy, cashew, and coconut. What consumers can take away from this study Hannah Whittaker, who is a plant-based pregnancy dietitian and the owner of Bump2baby Nutrition, shared that there are several key findings people can take away from this study. “Firstly,” she said, “they should be aware that plant-based yogurts generally have lower protein content compared to dairy-contained yogurts.” The implication of this, according to Whittaker, is that people who rely heavily on yogurt as a protein source should either look into alternative sources of protein or double-check the protein content of their chosen plant-based yogurt to ensure that they getting adequate protein for their needs. The second thing to consider, according to Whittaker, is that dairy yogurts tend to have more saturated fat compared to plant-based yogurts. If saturated fat intake is a particular concern for you, especially when it comes to heart health, then you may want to skew your intake toward plant-based yogurts. “However, it’s essential to read labels,” advised Whittaker, “as some plant-based yogurts may contain added oils or fats that contribute to their overall fat content.” A third area of concern is sugar content. “This study found that both plant-based and dairy yogurts exhibited variation in sugar content,” she noted. She advises that people be aware of their sugar intake and choose yogurts with minimal or no added sugars, regardless of whether they are plant-based or dairy. Finally, she said people need to consider their own specific nutritional needs when choosing between plant-based and dairy yogurts. “Dairy yogurts generally contained higher amounts of calcium and vitamin B12 compared to plant-based yogurts,” she said, noting that calcium is important for bone health while vitamin B12 is involved in nerve function and red blood cell production. “On the other hand, plant-based yogurts were found to be higher in dietary fiber which is essential for digestive health and can contribute to a feeling of fullness,” said Whittaker. She concluded by noting that these are all factors to look at, but “it is essential to consider a balanced and diverse diet overall, beyond just yogurt choices.” The benefits of plant-based eating Mary Sabat — a registered dietitian, ACE personal trainer, and owner of Body Designs by Mary — explained that eating a more plant-based diet can have numerous benefits, both for your health and for the environment. “Plant-based diets tend to be rich in nutrients, vitamins, minerals, and fiber while being low in saturated fats and cholesterol,” said Sabat. “By consuming a variety of plant foods, you can obtain a wide range of essential nutrients, including antioxidants, phytochemicals, and beneficial plant compounds.” According to Sabat, a plant-based diet may be able to reduce your risk for several chronic conditions, including: heart disease type 2 diabetes certain cancers obesity In addition, it can help with digestion and weight management. A plant-based diet is also more environmentally sustainable, she said. “Plant-based diets generally have a lower carbon footprint and require fewer natural resources than animal-based diets.” “By shifting toward a plant-based diet, you can help reduce the environmental impact of food production and contribute to a more sustainable future,” Sabat concluded. Simple ways to get started with plant-based eating Whittaker and Sabat said getting started with a plant-based diet doesn’t have to be difficult. Some simple ways you can get started include the following: Start gradually “Start by incorporating more plant-based meals into your diet rather than attempting a sudden and drastic change,” suggested Sabat. “Begin with one or two meatless days per week and gradually increase the frequency.” Add more vegetables and whole grains to your diet Whittaker suggests aiming to fill half your plate with a variety of colorful fruits and vegetables. “Try experimenting with different types and cooking methods to discover new flavors,” she advised. You can also add more whole grains, which are rich in fiber, vitamins, and minerals and help to maintain blood sugar levels. Reduce your meat consumption Choose plant-based protein sources instead, like beans, lentils, tofu, tempeh, seitan, and edamame, said Sabat. “These foods are versatile and can be used in a variety of recipes.” Swap dairy for fortified plant-based alternatives “Experiment with different plant-based yogurts made from soy, almond, coconut, or other plant sources,” said Whittaker. She suggests finding options that are fortified with calcium, iodine, vitamin B12, and vitamin D in order to make certain that you are getting enough of these important nutrients. Plan your meals Sabat advises planning your meals in advance to make certain that you are eating a balanced and varied diet. “This can help you stay organized, make grocery shopping easier, and prevent reliance on convenience foods,” she said. Be mindful of fats “Limit or avoid saturated and trans fats found in animal products and processed foods,” said Whittaker. Healthier choices include fats from plant sources like avocados, nuts, seeds, and olive oil. Emphasize whole foods Sabat suggests including a variety of unprocessed fruits, vegetables, whole grains, legumes, nuts, and seeds to your meals. “Experiment with different flavors, textures, and cooking methods to make your plant-based meals enjoyable,” she said. Educate yourself Finally, both Whittaker and Sabat advise that it’s important to educate yourself. There are numerous resources online where you can learn about plant-based nutrition and find recipe ideas. There are also communities you can join to get support and inspiration.

The FDA has issued a warning about GLP-1 drugs made in compounding pharmacies. Terry Vine/Getty Images The FDA has issued a warning on GLP-1 drugs similar to Ozempic and Wegovy. These drugs differ from FDA-approved Ozempic and Wegovy because they are made by online pharmacies and other uncertified sources. These compounded drugs are made via mixing or altering medications to create a drug similar to semaglutide. The Food and Drug Administration (FDA) has issued a warning against modified glucagon-like peptide-1 (GLP-1) drugs, like semaglutide, that are being sold.  The United States has been experiencing a shortage in both Ozempic, used to treat type 2 diabetes, and Wegovy, used to treat obesity, since early May 2023.  As a result, online pharmacies and uncertified sources are selling GLP-1 drugs made with different ingredients than what’s used in the approved drugs.  These drugs, called compounded drugs due to the mixing or altering of ingredients to create a medication, are being marketed as semaglutide. “Compounded drugs are not FDA-approved, and the agency does not verify the safety or effectiveness of compounded drugs,” the FDA stated in its warning. What is compounded semaglutide? The FDA issued the warning after the agency received reports of patients taking compounded semaglutide.  “Compounded drugs may contain unwanted contaminants or have unequal potency to FDA-approved medications,” says Dr. Kelly Johnson-Arbor, a medical toxicologist and co-medical director of the National Capital Poison Center. There have been incidents of people getting severely ill and even dying from other types of compounded drugs, Johnson-Arbor says.  In some of the cases, the compounded semaglutide drugs were made of salt forms of semaglutide, including semaglutide sodium and semaglutide acetate, which are different from the FDA-approved versions of semaglutide, which are sold under the brand names Ozempic and Wegovy. According to the FDA, these salt versions have not been shown to be safe or effective.  It’s also unclear what the health risks are.  “Essentially, you would be using an uncontrolled substance, likely illegally imported to the U.S., with no control of what’s in it,” said Dr. Dan Azagury, an associate professor of surgery at Stanford Healthcare.  Ozemipc and Wegovy can not be safely compounded The Alliance for Pharmacy Compounded issued a statement last week stating that compounded semaglutide technically isn’t eligible to be sold by compounding pharmacies. Certain compounded medications can be legally prescribed by a licensed healthcare provider and sold by compounding pharmacies as they must meet “rigorous compounding standards.”   For example, people with an allergy to a certain dye can get the drug made without it, says Azagury. “But in this situation, the actual semaglutide molecule is likely only manufactured by Novo Nordisk. If they don’t have enough, nobody does,” Azagury said.  David Lebo, PhD, RPh, a professor of pharmaceutical sciences at Temple University’s School of Pharmacy, says that compounding should never be used as a substitute for a commercial product, like Ozempic, unless there are specific reasons such as adjustments to dose, route of administration, or to make the drug available to special populations How to avoid off-brand Ozempic In order to avoid purchasing a compounded version of semaglutide, you should only get your prescription through a licensed healthcare provider and pick up the medications from a state-licensed pharmacy or facility registered with the FDA.  The APC warned consumers to avoid unreliable online retailers.  “If your doctor didn’t write you a prescription for compounded semaglutide and send it to a legitimate, identifiable pharmacy, beware the seller of that substance,” the APC states. If you are purchasing your medication online, ensure that the retailer is licensed and regulated and that the drugs are produced by the drug manufacturer Novo Nordisk.  For tips on evaluating the legitimacy of your online retailer, visit the FDA’s website BeSafeRx. Illegitimate versions of semaglutide tend to be cheaper.  “When searching for semaglutide online, look for clues like ‘not for human use’ or ‘for laboratory use only’ to identify formulations of the drug that are intended only for use as research chemicals and are not FDA-approved for use in humans,” says Johnson-Arbor.  If you think you took or purchased compounded semaglutide, report the incident to the FDA’s MedWatch Adverse Event Reporting. A certified healthcare provider can help get the drug to you in a supervised process with the right support, says Azagury. If you cannot access semaglutide due to the shortage, there are plenty of other drugs in this class, says Lebo.   “Patients should have a conversation with their doctor or pharmacist about some of the options,” Lebo said.  Do not take fake or compounded semaglutide under any circumstances. “You are working on losing weight to improve your health not to put it in jeopardy using these drugs,” Azagury said.  The bottom line: The FDA has issued a warning against modified GLP-1 drugs, like semaglutide, that are being sold. There has been a shortage in both Ozempic and Wegovy since May 2023 and some uncertified retailers are selling a modified version of the drug that’s made with salt forms of semaglutide. The salt versions have not undergone testing, so it’s unclear how safe and effective they are and what the health risks are. 

Prime Energy drink contains between 5-7 times the amount of caffeine as a similar serving of the average soft drink. Mike Kemp/In Pictures via Getty Images Health Experts are sounding the alarm about the health dangers energy drinks can pose for adults and children. The high amounts of caffeine in these drinks can vary widely from brand to brand and can cause negative effects on health such as insomnia, digestive issues, and interference with medications. They can also pose significant risks to people who may have undiagnosed heart conditions. Energy drinks are more popular than ever. Dozens of brands in a variety of flavors line store shelves and their wide availability makes them a convenient choice for anyone who feels they may need a quick pick-me-up. But as popular as these beverages have become, they can also pose significant health risks to adults and children alike due to the high amounts of caffeine they contain — which can vary widely from one brand to another. How much caffeine constitutes a “high amount?” To answer that, let’s set a baseline. According to the Food and Drug Administration (FDA), a typical carbonated 12 oz soft drink contains 30-40 mg of caffeine. (For ease of comparison, that’s about 2.9 mg/oz.) An 8 oz cup of green or black tea has 30-50 mg of caffeine (~5mg/oz) while an 8 oz coffee can have 80-100 mg of caffeine (~11.25 mg/oz). Some of the biggest brand-name energy drinks are in the same ballpark as coffee. An 8.4 oz can of Red Bull has 80 mg of caffeine (~9.5 mg/oz), and a 500 ml can of Monster has 160 mg of caffeine (~9.5 mg/oz). These drinks also contain sugar. However, a newer drink called Prime Energy has substantially more caffeine than its counterparts, coming in at 200 mg in a 12 oz can (~16.7 mg/oz). That’s between 5-7 times the amount of caffeine as a similar serving of the average soft drink. Prime Energy, which was launched by popular YouTube stars Logan Paul and KSI in 2022, has become particularly popular with teen and pre-teen boys — while raising concerns of school officials, parents, and health experts. Why? The amount of caffeine in these drinks can be extremely dangerous for some people, especially children who may have an undiagnosed heart condition. In fact, BirminghamLive recently reported that a child had a “cardiac episode” after consuming a can of Prime Energy and had to be rushed to the hospital to have their stomach pumped. This is one example of why many health experts are working to raise awareness of the dangers energy drinks can pose. What happens to your body when you drink caffeine Dr. Neal H. Patel, family medicine physician with Providence St. Joseph Hospital in Orange County, California, told Healthline, “Caffeine is the world’s most consumed stimulant. A stimulant does as the name applies: it stimulates the body and the mind.” Caffeine does have some positive effects, which has led to its global popularity. Some of those positive effects that adults might experience, according to Patel, include: increased focus increased attention decreased fatigue increases metabolism elevated mood These effects, however, can provide a false sense of what’s going on in your body. A perception of heightened alertness is not the same as providing your body with fuel. “Although the term ‘energy’ can be perceived to imply calories, ‘energy’ drink is a misnomer; energy drinks often contain little fuel (i.e. carbohydrates) but provide an energized sensation when the energy drink is consumed due to the stimulants,” explained Dr. Tracy Zaslow, a board-certified pediatrician, and pediatric sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. The negative effects of caffeine on adults While many adults are able to have a healthy relationship with caffeine, there are some risks involved with consuming too much of it, especially in a single serving. “The exact threshold for what constitutes ‘too much’ caffeine can vary depending on individual factors such as tolerance, sensitivity, and overall health,” Jordan Hill, a registered dietitian and sports dietetics specialist with Top Nutrition Coaching, told Healthline. According to Hill, some of the negative effects associated with caffeine include: insomnia and sleep disturbances jitteriness and restlessness digestive issues increased heart rate and blood pressure dehydration dependency and withdrawal symptoms interference with certain medications and health conditions The negative effects caffeine can have on children While the long-term effects of caffeine on children is an area that could benefit from more research, recommendations from experts are pretty clear. “Pediatricians advise against caffeine for children under 12 and against any use of energy drinks for all children and teens. They also suggest limiting caffeine to at most 100 mg (about two 12 oz cans of cola) daily for those 12-18 years old,” said Zaslow. “There are concerns about caffeine’s effects on the developing neurologic and cardiovascular systems. Sleep is essential in young adults and adolescents, and caffeine consumption has been shown to disrupt sleep patterns. There is also risk of physical dependence,” Zaslow added. Caffeine’s effects on children are not limited to the purely physical, either. “Any added and external substance introduced to the system of an adolescent, teenager, or young adult can adversely impact their development emotionally and mentally,” said Patel. Zaslow shared with Healthline that, “caffeine can increase anxiety in those with anxiety disorders.” While some children may tolerate limited amounts of caffeine with limited side effects, the high amounts in energy drinks come with a variety of potentially negative outcomes. Some of the short-term risks of caffeine consumption in children include: anxiety dehydration diarrhea heart palpitations high blood pressure insomnia jitters nausea restlessness Long-term side effects can include withdrawal symptoms like headaches and agitation. In very severe and rare cases, death can occur from overconsumption of caffeine,” said Hill. What can you do to help reduce risks Health experts say talking to your child can be an important first step toward helping them make healthy choices around caffeine and help them understand the various potential risks that different types of drinks can pose. “Energy drinks should not be confused with sports drinks,” advised Zaslow. “Sports drinks are flavored beverages that often contain carbohydrates, minerals, electrolytes (eg, sodium, potassium, calcium, magnesium), and sometimes vitamins or other nutrients. Energy drinks are beverages that typically contain stimulants, such as caffeine and guarana, with varying amounts of carbohydrate, protein, amino acids, vitamins, sodium, and other minerals,” Zaslow added. Hill pointed out that individual responses to caffeine can vary, and some people may be more sensitive to its effects than others. “Paying attention to your own body’s response and adjusting your caffeine consumption accordingly can help you manage potential crashes and ensure a balanced and healthy relationship with caffeine,” he said. “Everything comes down to moderation and if one has some of the side effects or thinks has a problem with caffeine, it’s wise to contact your primary care provider,” said Patel.

Westend61/Getty Images A new hair loss treatment has been released in Europe that uses RNA technology to help reverse hair loss. In theory the treatment can target androgen receptors in order to help hair follicles stay healthy. The product is not yet available in the U.S. Hair loss can be upsetting — whether it’s through aging or as the side effect of an illness or caused by some other means. It’s natural that someone noticing they are losing their hair would try to stay on top of the latest innovations and treatments that come down the pipeline. Recently, one South Korean company released a new product in Europe that uses siRNA (small interfering RNA) technology to address hair loss at the genetic level. It targets a protein called the androgen receptor, which binds together androgens — which are male hormones — as defined by the National Institutes of Health. Billed as the first hair loss treatment that utilizes RNA technology, CosmeRNA was released in Europe this May, developed by Bioneer and Sirnagen. But this product has yet to be released in the United States and hasn’t been approved by a regulatory agency. Experts spoke with Healthline about what RNA technology is, what it says about the future of hair loss medications and interventions, and why it’s important you speak with your healthcare provider about vetted, tried and true approaches for treating hair loss before going down the Internet rabbit hole. What is RNA technology? Board-certified dermatologist and hair loss expert Dr. Dina Strachan, who is the director of Aglow Dermatology, said that this drug class is a nucleic-acid based drug (NABDs), and works by interacting with messenger RNA, or mRNA, “to block gene expression.” “In this case, it interferes with the androgen receptor, mRNA takes the genetic information to make a protein from the nucleus of a cell, and brings it into the cytoplasm for production,” Strachan said. “This drug is reported to work by limiting the expression of the androgen receptor gene at the hair follicle.” She added that androgen shortens a hair’s growth phase, which causes thinner, shorter hair, delaying growth of the following replacement hair. As a result of having few androgen receptors at the hair follicle level, hair would then have more time to grow longer and thicker, being replaced more quickly when it is finally shed. Dr. Brian J. Abittan, director of Skin and Hair Rejuvenation and Director of Hair Transplantation at Mount Sinai Health System, told Healthline said RNA technology for hair loss utilizes “very small nanoparticles, this allows for a more direct and efficient delivery to hair follicles through the scalp when massaging after application,” he explained. “Additionally, there is supposed to be less immune activation with this delivery model, which is critical to decreasing the chance for potential side effects.” How effective is the treatment? While this specific drug hasn’t been approved domestically by the Food and Drug Administration (FDA), Strachan said the regulatory body has approved other drugs that utilize this RNA technology — Onpattro and Givlaari. The only catch? They aren’t for hair loss. Onpattro is a drug that treats a type of nerve damage called polyneuropathy, and Givlaari is used to treat acute hepatic porphyria, a family of genetic diseases that can impact the liver and lead to severe symptoms. As a result it remains unclear how effective this drug will be at stopping or reversing hair loss. Strachan added that this drug would fall under the “cosmeceutical category.” The cosmetics industry uses the cosmeceutical term for cosmetics “that have medicinal or drug-like benefits,” according to the FDA. In the U.S., the FDA doesn’t recognize this category. “The technology of RNA interference has been tested, with varying levels of success, in the laboratory setting. A significant issue has been side effects caused by an inflammatory response created upon delivery,” Abittan added. When asked if people should be skeptical of these cosmeceutical products, Abittan said “products not tested by a regulatory agency do not have robust safety and efficacy data.” “It does not mean these products won’t work, but it can be very difficult to determine accurate safety and efficacy without these trials,” he explained. How to stop hair loss Both Abittan and Strachan said we will see similar products using this RNA technology that will be developed and brought to market for hair loss. Abittan stressed that, while we will see more emerge,” they will have to undergo further testing on both efficacy and safety.” Strachan said that if you are curious about what vetted treatments currently exist for hair loss and don’t know where to turn, make sure you start by getting a proper diagnosis from a board-certified dermatologist who has expertise in hair loss. “Hair loss can be a sign of an underlying disease or other problem,” she stressed. “Understand that hair loss and alopecia are the same thing and are not a complete diagnosis. When you know what you have, then treat.” Abittan said news of new treatments makes it important that you parse through information online and make sure you seek out effective remedies for why you are losing hair. “There are so many products available for hair loss and most of them have very little supportive data,” he added. “Seeing a dermatologist who specializes in hair loss can help find the appropriate treatments for the unique needs of each individual.” If you’re worried about hair loss we have 22 tips on how to save your hair.

From maintaining a respectful demeanor to coming prepared with questions, health experts say there are several simple things you can do to make your next doctor’s visit as productive as possible. Getty Images Health experts say there are several things every person can do to help healthcare appointments run smoothly and avoid being a “difficult patient.“ Approaching interactions with doctors in an open-minded and non-confrontational way can help you get the most out of the visit. However, being a good patient doesn’t mean blindly saying yes to everything doctors tell you to do or putting up with chronically long wait times or bad bedside manners. Sometimes doctor visits are frustrating; there’s no doubt. Long wait times, rushed visits, and unresolved treatment are just a few factors that can leave you never wanting to go back. But have you ever considered whether your actions and behaviors play a part in the experience? “In general, a good patient is someone who acts in a mature manner, takes our advice, and follows through with a plan and then takes responsibility for their part of their own medical treatment,” Dr. Joan Naidorf, author of Changing How We Think about Difficult Patients: A Guide for Physicians and Healthcare Professionals, told Healthline. She said about 15% to 20% of patients that providers see daily are in some way oppositional or obstructive and considered difficult. “They don’t go along with the plan and haven’t measured up to some sort of behavior that the doctors and nurses think they should and usually they don’t mean to — they are people who are sick or ill or looking out for the best interest of their family members — we’re also talking about a patient’s family members when we talk about people who are difficult,” she said. While no one is perfect, being considered “difficult” by healthcare providers may make them less likely to spend time with you and listen intently to your concerns, resulting in ineffective care. To get the most out of your doctor visits, consider tapping into the following traits of what some healthcare providers say are the makings of a “good patient.” 1. Realize doctors are just human Some people have an idealized image of what the perfect doctor is, which can set them up for disappointment. “If you come in and say ‘I’m not better,’ but you’ve had this problem for 6 months, you have to realize we’re not going to fix it overnight. We don’t have a magic wand to make you better,” said Naidorf. Teri Dreher, RN, chief advocate and president of NShore Patient Advocates in Chicago, added that it’s also important to know that you’re not their only patient and they have other work to complete. “For every 10 minutes of patient work, doctors have about 30 minutes of computer work to do,” she told Healthline. 2. Bring a list of medical history and questions While you may think the doctor and nurses should know your entire medical history, Naidorf said this is often not the case. “Just because they have a medical record in front of them doesn’t mean they have all your history because not all the systems speak to each other. The one at the hospital where you had a procedure may not be the same system at your doctor’s office,” she said. The best way to give your doctors access to all your history is to enroll in the doctor’s office or hospital’s online portal or bring in documentation of your medical history to go over in person. 3. Make small talk quick While it’s great to break the ice with the doctor or make small talk, keep it short, so you can get the most out of your time with them. “You have relatively limited time with the doctor and if you spend a lot of time talking about the weather or your last vacation, which is really pleasant to talk about, you won’t have time to talk about the nuts and bolts. So come in with a list of questions,” said Naidorf. The same goes for using your time to complain, Dreher said. “If you spend 10 or 15 minutes complaining about something that they can’t do anything about, they start backing toward the door because everyone is short staffed, and as much as they want to give patients the time, they just don’t have the time,” she told Healthline. According to research conducted by the University of Chicago, Johns Hopkins University, and Imperial College London, if primary care doctors followed national recommendation guidelines for preventive care, chronic disease care, and acute care, it would take them 26.7 hours per day to see an average number of patients. To get everything you need in during a short, allotted time, Dreher said clump all your questions together. “If you need three things in 10 minutes, ask for all three things at one time rather than asking one thing and then hitting the call button [if in hospital] and asking another thing or asking on your way out of an office visit,” she said. 4. Report your symptoms, not suspected diagnoses Hearing you express what kind of symptoms you are experiencing is an important part of the physician’s evaluation, said Naidorf. “In the physical exam I can look for signs, but it’s more important that I have all the information – pains, itching, time of day they occur, and what makes the symptoms better or worse, despite the diagnosis that you have potentially synthesized from online research,” she said. Although there are reputable online resources that provide helpful health information, Naidorf said use that information for background and to ask your doctor questions. According to one survey, about 68% of people use electronic means to search for health information. “[But] when you make your own diagnosis, it’s really tempting to jump to the worst possible thing or something that is quite rare. From the perspective of medical professionals, common things are still most common, so we have to make sure that we cast a wide net and take advantage of the patient’s history and synthesize our plan with that,” she said. 5. Allow yourself to be examined A thorough physical exam is an important part of the diagnostic evaluation, said Naidorf. However, she has had many patients refuse to be examined, making diagnosis difficult. “A person may come in and say, ‘I just have a sore throat. Why do I need to take off my shirt?’ But you can’t really listen to someone’s breath sounds through clothing…physicians use our other senses, there are things we smell and hear and you can only hear with the stethoscope on skin,” she said. “So using our senses completely are really dependent on a patient allowing us to have access.” 6. Avoid confrontation and threatening behavior Making a doctor feel threatened by you isn’t the best way to set the tone of a visit. “Some people have an approach that they don’t realize is threatening. They announce that they are on the board of a hospital or work for the local newspaper or that they are going to write a terrible review of you online,” said Naidorf. “There’s also the threat to leave.” She said physicians’ main goal is to make patients feel better while abiding by their moral and ethical obligations. “We don’t want to hurt you, so what you think may be a proper treatment for some illness, the physicians and nurses may know is harmful for you. So we need to find some common ground [without ultimatums],” she said. 7. Comply with treatment As many as 40 to 50% of people who are prescribed medications for conditions such as diabetes or hypertension, do not take their medication.  If your reasons for not following a treatment plan involve limitations you face such as lack of insurance, transportation, or a support system, tell your doctor. Providers can refer you to resources. “When a person knows or suspects that they’re not going to be able to make a plan or make a follow-up appointment, or afford the medications, or be able to be on bed rest or be admitted because they have to take care of someone or a pet, it’s helpful to express what the problem is,” said Naidorf. “We have services and resources to help you get a medicine, to help you get more help, to provide transportation. We can’t access them unless we know what your reasons are.” 8. Advocate for yourself respectfully Being a good patient doesn’t mean blindly saying yes to everything doctors tell you to do or putting up with chronically long wait times or a bad bedside manner. There are ways to set boundaries like saying, ‘if I’m not seen or treated in a certain amount of time, I’ll have to leave,” Naidorf said. If you are concerned or confused about a diagnosis or treatment, asking your provider to explain why they are choosing this path is acceptable. “Perhaps you can say, ‘We have a strong family history of heart disease, so I’m really concerned that this discomfort I’m having in my chest is related to some sort of serious heart disease,’” Naidorf said. If your doctor isn’t open to discussing their rationale or seems uninterested, Dreher suggested confronting them politely by saying, “Looks like you’re having a busy day today, do you want to have this conversation later or should we talk about it now?” “When you feel like your doctor isn’t listening to you at all or is dismissing your complaints or is uninterested in a relationship with you, or if you feel that the doctor doesn’t care about medicine anymore, it’s time to move on” she said.

New research suggests that exercising in the afternoon may have the most benefits for people living with type 2 diabetes. Azman Jaka/Getty Images Exercise can provide several benefits for those with diabetes, including lowering blood sugar. Better blood sugar control may reduce your risk for heart disease and other adverse effects. New research indicates that afternoon exercise in particular seems to help blood sugar control. However, it is not yet certain why afternoon exercise would be more beneficial. Experts say they generally advise regular exercise as a part of diabetes management. The American Diabetes Association notes that, as of 2019, 37.3 million Americans (11.3% of the population) are living with diabetes. Diabetes, per the Centers for Disease Control and Prevention (CDC), is a medical condition in which your body either doesn’t make enough of the hormone insulin (type 1 diabetes) or it can’t use it as well as it should (type 2 diabetes). Insulin plays a vital role in removing sugar from your blood and getting it into your cells where it can be used for energy. If you are living with this condition, the CDC advises that one way you can manage your symptoms is by getting more exercise. Physical activity helps increase your sensitivity to insulin and lowers blood sugar. This, in turn, can help reduce your risk for associated nerve damage and heart disease. Now, scientists at Brigham and Women’s Hospital and Joslin Diabetes Center have published new research in the journal Diabetes Care indicating that people with type 2 diabetes might see the most improvements in blood sugar control if they exercise in the afternoon rather than the morning or evening. Afternoon exercise may help with greater blood sugar control The study utilized data from the Look AHEAD (Action for Health in Diabetes) study. This study was a randomized controlled trial comparing how an intensive lifestyle intervention, along with support and education, might help prevent cardiovascular disease for type 2 diabetes patients who are also living with obesity or overweight. For the current study, the researchers looked at how exercise at particular times of the day influenced blood sugar control. Altogether, they included 2,400 people, examining data from the first and fourth years of the Look AHEAD study. To determine the participants’ level of physical activity, each person wore a waist accelerometry recording device. Upon review of the data, the team discovered that in the first year, people who had moderate-to-vigorous levels of activity in the afternoon has the largest reduction in blood sugar levels. This same group maintained the observed reduction in blood sugar levels in the fourth year. Further, those who were most active in the afternoon were most likely to have been able to stop taking their diabetes medications because of these improvements in blood sugar control. Why afternoon exercise is better Dr. Jingyi Qian, from the Division of Sleep and Circadian Disorders at Massachusetts’ Brigham and Women’s Hospital, and co-corresponding author Dr. Roeland Middelbeek, assistant investigator at Joslin Diabetes Center, told Healthline it is not yet clear why afternoon exercise might be better for type 2 diabetes. However, one common hypothesis is that the circadian system might play a role. “This circadian system regulates many physiological functions in our body, which may play a role in the time-specific benefits of physical activity,” said Qian and Middlebeek. Another speculation is that behavioral factors — such as fasting/postprandial states or sleep-wake cycles — could contribute to the observed benefits. “For example, post-meal physical activity, which may be occurring most often after lunch in the afternoon group, is an effective strategy for managing postprandial glucose excursions in type 2 diabetes,” the pair noted. Why exercise in general is good for helping manage diabetes While particular benefits were seen with afternoon exercise, the authors note that exercise any time of the day is helpful for people with type 2 diabetes. Not only can it improve blood sugar readings; but, to some extent, it can also help manage weight, they say. Dr. Kathleen Dungan, Professor of Medicine and Interim Director of the Division of Endocrinology, Diabetes & Metabolism at The Ohio State University, agrees, calling exercise “vitally important” for people with diabetes. “Exercise can rapidly lower the glucose level … by driving excess glucose into the skeletal muscle,” she explained, “Moreover the immediate effects of exercise can linger for many hours after completion of the activity.” Dungan said that exercise is also linked to lower blood pressure and more favorable cholesterol levels, which may reduce your risk for cardiovascular events or death. And, as an added bonus, it can help improve your mood and your sense of well-being. How much to exercise for better diabetes control Amanda Beaver, MS, RDN, LD, Wellness Dietitian at Houston Methodist Wellness Services, said that how much exercise you need will depend on the intensity of the exercise. But, for most people living with diabetes, she said it’s recommended to get 150 minutes or more of moderate-to-vigorous exercise per week. “In the fitness world, moderate-intensity exercise is when we can talk, but not sing (try it for yourself next time you exercise),” she suggested. She added that other great examples of moderate-intensity exercise include: dancing brisk walking cycling swimming “It is not recommended to go more than two days in a row without exercise as it can increase insulin resistance,” said Beaver. “This means exercise should be spread out over at least 3 days of the week.” Beaver added that one type of exercise that is often overlooked is resistance training, which is recommended to be done 2-3 times per week.  “This does not necessarily have to be lifting weights in a gym,” she said, “even barre and Pilates work well for this.”   Finally, Beaver advised that people with type 2 diabetes should keep an eye on how much time they spend sitting. “It is recommended to stand up about every 30 minutes as some studies have shown this can improve blood sugar control,” she concluded  

Westend61/Getty Images Research findings shared by a multinational team found that the consumption of flavanols may boost cognitive abilities in some older adults Previous research has suggested a link between flavanol consumption and cognitive aging that may depend on diet quality. Flavnaols are naturally occurring chemicals found in a variety of foods including grapes and tea. New research, published May 30 in Proceedings of the National Academy of Sciences, suggests that consumption of flavanols—a chemical compound found in foods like cocoa—could boost memory in some older adults. The study included more than 3,500 people and spanned three years. Flavanols are a common type of chemical found naturally in a variety of foods including cocoa, tea and grapes What the study found The study was conducted by researchers at a variety of institutions including Columbia University, Harvard University, New York University, and the University of Reading in the UK. Participants were divided up into two roughly equal groups. One received a flavanol dietary supplement while the other received a placebo. Researchers used tools including Alternative Health Eating Index (aHEI) scores and the Modified Rey Auditory Verbal Learning Test (ModRey) test to identify baseline health and memory scores. Participants were followed over a 3-year period. The biggest improvements were found among those with the lowest aHEI scores (below 38) which, according to the researchers, “reflects a diet quality ranging from the US average to slightly below average.” They found that those who had a poor diet, but who received a flavanol pill had a sustained increase in baseline memory levels as compared to those who received a placebo pill. The pill contained about 500 milligrams of cocoa-based flavanols, a naturally occurring compound. The study was partially funded by the Mars Inc. food company. A focus on “cognitive aging” instead of Alzheimer’s disease Dr. Adam Brickman (PhD) one of the authors of the study, says it’s important to keep in mind that while a lot of research into memory in older adults tends to focus on conditions like Alzheimer’s, research like his and his team’s is more keyed in on what is called “cognitive aging.”  “I think that, based on the experiments that we’ve done over the past 15 years or so, we’re tapping into a memory system that we think changes with normal aging…In a segment of normal, relatively healthy, older adults, there’s been depletion of flavanol levels.” Those whose test results included medium and high aHEI scores did not see the same improvements with the pill. Kelsey Costa (MS, RDN) says that research like this can have a significant impact in the field, as practitioners and clients come to understand more of how diet can impact cognitive performance.  “Just as certain nutrients are crucial for developing brains, certain nutrients are essential for maintaining cognitive function as we age. It’s critical to prioritize preventive nutrition that promotes healthy aging, and incorporating dietary flavanols is an integral part of this strategy.” How to eat more flavanols While the designers of the study chose cocoa-based flavanols, there are many other options including tea, berries, and grapes. Maya Feller (MS, RD, CDN) says that, in order to increase your flavanol levels, it’s important to make sure you choose a method that is accessible to you.  “Flavanols are found in a wide variety of plants including fruits, vegetables, tea, cocoa, and fermented grapes. I generally recommend that people start with plants that are affordable, accessible, culturally relevant, and tasty as an entry point to incorporating them into their pattern of eating. Canned, fresh, frozen, boxed, and jarred are all options for adding more plants to a person’s pattern of eating.” Some experts remain skeptical of benefits It’s important to note that some in the field are less sure that the study shows significant benefits tied to increased flavanol levels outside of those with less-than-ideal diets. Dr. Naveed Sattar, Professor of Metabolic Medicine, University of Glasgow, said in comments shared by the Science Media Centre, that studies like this can give the “illusion of benefit” and that it’s much better for the general person to not immediately go and seek out a drastic increase in their flavanol intake.  “People should not rush to such drinks or diets but rather keep doing the things that we 100% know protect against many illnesses – eat better (and fewer calories if overweight), walk a little more and sleep well and have traditional risk factors tested and, if needed, improved.” Another person who was not involved in the study, Dr. Aedin Cassidy, Chair in Nutrition & Preventative Medicine at the Institute for Global Food Security, Queen’s University Belfast, shared in the same release that the dosage suggested by the researchers is one that most people should be able to meet if they feel they need to make dietary changes.  “The dose required for these improvements in brain health are readily achievable – for example 1 mug of tea, 6 squares of dark chocolate, a couple of serving of berries/apples would together provide about 500mg of flavanols…”

New research suggests that continuous glucose monitors may be able to diagnose prediabetes earlier that blood sugar tests, helping people make healthier lifestyle choices sooner. Anchiy/Getty Images A new study has found that prediabetes can be diagnosed by using continuous glucose monitors (CGMs). This method could potentially identify people with early signs of prediabetes, even before it would have been picked up with a blood sugar test. This might encourage people to make lifestyle changes earlier in the progression of the condition. Millions of Americans are living with type 2 diabetes, which if left untreated, puts them at greater risk of heart disease, vision loss, kidney disease, and dying early. Even more people have prediabetes, a condition where blood sugar (glucose) levels are higher than normal, but not high enough for a person to be diagnosed with type 2 diabetes. However, this doesn’t mean that prediabetes isn’t serious. “Prediabetes is not pre-problem,” said Jill Weisenberger, a Virginia-based registered dietitian nutritionist and author of Prediabetes: A Complete Guide, Second Edition. “It’s a sign that a problem has been going on for some time and only now has become measurable in blood sugar levels,” she told Healthline. While prediabetes can be diagnosed with a blood sugar test — the same tests that are used to diagnose type 2 diabetes — a new study found that it can also be diagnosed using continuous glucose monitors (CGMs). This method could potentially identify people with early signs of prediabetes, even before it would be picked up with a blood sugar test. This might encourage people to make lifestyle changes earlier in the progression of their disease. With prediabetes, “now is the time to take action, because the longer the problem continues, the more difficult it gets to manage and to reverse,” said Weisenberger, who was not involved with the new study. Continuous glucose monitors (GGMs) CGMs are devices that measure blood sugar levels in more or less real time.  The sensors for these devices are stuck to the skin with an adhesive patch and take blood sugar readings without the need for regular fingerstick tests.  These devices measure blood sugar throughout the day and track fluctuations, such as spikes in blood sugar after a meal or when blood sugar dips low. The readings taken can be viewed on a smartphone or another monitor device. In the new study, published May 24 in Mayo Clinic Proceedings: Digital Health, scientists from Canadian-based Klick Labs used data from CGMs to identify people with impaired glucose homeostasis, which is a precursor to prediabetes. They found that one in five participants who were diagnosed as healthy, according to current medical standards, actually had a glucose metabolism that resembled people with prediabetes. “For people with diabetes, blood glucose levels can rise and fall like a wild roller-coaster ride with steep drops and peaks,” study author Jaycee Kaufman, a research scientist at Klick Labs, said in a news release. In our study, “we found a similar pattern in patients with [impaired glucose homeostasis], albeit those patterns were more like gentle waves than dramatic peaks,” she said. “But intervention on this population could limit the likelihood of progression to full diabetes.” For the study, a total of 384 participants were equipped with a CGM over a two-week period. During that time, a physician diagnosed them as diabetic, pre-diabetic, or healthy, according to guidelines outlined by the American Diabetes Association. Researchers used a mathematical model to compare data from participants to data on populations without diabetes, with prediabetes, and with type 2 diabetes. From this, they classified participants into two groups based on their glucose homeostasis patterns: effective or impaired. If this work is supported by future clinical trials, it could provide a way to diagnose people earlier with prediabetes, when it is easier to intervene. Dr. Kathleen Wyne, an endocrinologist at The Ohio State University Wexner Medical Center in Columbus, said by focusing on real-time data, researchers are able to identify people earlier in the disease process. “In fact they [could potentially] identify people earlier than our current methods,” she told Healthline. “This may be early enough to actually slow the progression of the disease.” In addition, by using CGMs, researchers were able to analyze spikes in blood sugar that occurred after a meal, said Wyne, who was not involved in the new study.  This could “identify those at highest risk of progressing in their glucose intolerance,” she said, “and even predict when they will progress to type 2 diabetes.” Prediabetes causes and risks According to the Centers for Disease Control and Prevention, more than one in three American adults — approximately 96 million people — have prediabetes. Of these, more than 80% don’t know they have this condition. “That means only a small fraction of the people at high risk for type 2 diabetes — as well as heart disease, stroke, and some types of cancer — know that making changes to their lifestyle now is the best way to protect themselves from future disease and disability,” said Weisenberger. Prediabetes occurs when the cells in the body don’t respond normally to insulin. This hormone is produced by the pancreas and helps blood sugar enter the cells, where it is used as an energy source. When the cells become resistant to insulin, the pancreas responds by making more of this hormone. Eventually, the pancreas can’t keep up and the blood sugar rises. This increases the risk of health problems, as well as the development of type 2 diabetes. Risk factors for prediabetes include: Living with obesity or overweight Being 45 years or older Having a parent or sibling with type 2 diabetes Being physically active less than three times a week Having diabetes during pregnancy (gestational diabetes) or giving birth to a baby who weighed more than 9 pounds Having polycystic ovary syndrome In addition, Black, Hispanic, American Indian, Pacific Islander, and some Asian American people have a higher risk of prediabetes. Taking steps against prediabetes Wyne said CGMs could provide useful information for people about their health. The data could also be collected and shared with their doctor, she said, who could help them decide what steps to take. “For many people seeing the [information] will make it real,” she said, “and help them to understand that their body can not handle certain foods and/or portion sizes.” However, “people need to be prepared to use that data to learn how to be more healthy in food choices,” she added. Some research shows that people with prediabetes who make a few healthy lifestyle changes can reduce their risk of developing diabetes by 40% to 70%.  These changes include losing a small amount of weight if you are overweight and increasing your physical activity. According to the CDC, a small amount of weight is 5% to 7% of your body weight. For a 200-pound person, this is 10 to 14 pounds. The Physical Activity Guidelines for Americans, 2nd edition also recommends that people get at least 150 minutes of moderate-intensity physical activity each week. In addition, they should aim for muscle-strengthening activities on two or more days a week. Because prediabetes and diabetes are progressive conditions — getting worse with time if left unchecked — Weisenberger said it’s important to ”take action now, and develop the habits you need to be consistent.” In addition to spending more time moving and less time sitting, she suggests eating balanced meals filled with non-starchy vegetables such as broccoli, carrots, celery, peppers, tomatoes and zucchini.  She also recommends reducing your intake of what she calls “extra” foods, such as sweets, fried foods, and beverages with lots of added sugar. “There’s so much you can do,” she said. “The list goes on and on.”

Treatments to reverse the signs of aging like ultherapy and microneedling are growing in popularity, but how do the results compare to Botox? Goodboy Picture Company/Getty Images Alternatives to Botox that can reverse the signs of aging are gaining popularity. Two of the most popular are ultherapy and microneedling. While these alternatives can have an effect on your skin’s appearance, experts say it’s important to set expectations that the results will be different from Botox. Move over, Botox. Alternative anti-aging procedures are having a moment. In fact, dermatologist Dr. Shereene Idriss (who has nearly half a million followers on Instagram) recently went on “The Rachael Ray Show” to discuss trendy “alternatives to Botox.” Two that she mentioned in particular, ultherapy and microneedling, have been gaining popularity in recent years. But how well do they work and how do these alternatives compare to Botox? Healthline asked experts for their insights on these anti-aging treatments and the potential results they can offer. Comparing the results of needle-free alternatives to Botox Dr. Bradley Glodny, a dermatologist in New York City focusing on delivering the most comprehensive general and cosmetic dermatologic care, tells Healthline there aren’t many alternatives to Botox that will actually have the same effect as botulinum toxin in treating dynamic lines of the forehead, mid-brow, and sides of the eyes.   “To attain the amazing effects of Botox,” Glodny says, “the muscle contraction beneath the skin must be diminished or stopped entirely — similar to what happens with Botox treatments.” So besides Botox competitors including Dysport, Jeuveau, Xeomin, and Daxxify, he says nothing else on the market can attain the same effects.  That being said, treatments such as ultherapy can still have desired anti-aging effects such as skin laxity or tightness, he says. “And while microneedling can be an effective treatment for various skin concerns, it’s also important here to have realistic expectations,” adds Dr. Rahi (Raheleh Sarbaziha), who is a Beverly-Hills-based integrative aesthetics doctor who provides microneedling services. “Results may vary depending on individual factors and the specific condition being addressed,” she says. Ultherapy, explained Glodny explains that ultherapy works by utilizing ultrasound technology to break down collagen deep in the skin so that your body can rebuild it. “This results in tighter, more youthful skin,” he says. “In some areas like around the eyes, ultherapy can provide results reminiscent of Botox, but essentially different,” he adds. “At times both Botox and ultherapy can be used in a synergistic way to maximize results,” Glodny tells Healthline.  Microneedling, explained Rahi tells Healthline that microneedling is a minimally invasive cosmetic procedure that involves creating tiny punctures in the skin using a specialized device with fine needles.  “These micro-injuries stimulate the body’s natural healing response, leading to the production of collagen and elastin, which are essential components of healthy skin,” she explains. Glodny says microneedling is also a nice cosmetic procedure, but its results are more surface-level. “It can help with a variety of skin concerns such as hyperpigmentation, pore size, and very superficial textural changes,” he notes. “Microneedling will not be able to give you the same results in the forehead, midbrow, or crow’s feet area that Botox can provide,” he tells Healthline. The role of collagen in microneedling “Collagen provides structure and support, while elastin allows the skin to stretch and bounce back,” says Rahi. “As we age, the production of collagen, elastin, and hyaluronic acid in the skin decreases, resulting in the formation of fine lines, wrinkles, and enlarged pores,” she explains. “Microneedling helps address these signs of aging by promoting the regeneration of these vital skin components,” she says. Procedure basics including average cost and time Ultherapy When it comes to ultherapy, pain is a consideration. “Ultherapy has a reputation for being rather uncomfortable if not pretreated with oral analgesics and or other pain relieving techniques,” Glodny explains. “The cost can range anywhere from 2-5 thousand dollars.” However, this upside is that recovery time with ultherapy is essentially zero since the technology is non-ablative. “Results can last for many years since your body’s own collagen is being stimulated,” he adds.  Microneedling When it comes to microneedling, Rahi says the procedure is typically performed in a series of sessions, usually spaced about four weeks apart. “The number of sessions required depends on the individual’s skin condition and desired results, but it generally ranges from three to six treatments with each session lasting about 15 to 30 minutes.” “Before the microneedling procedure, a medical-grade numbing cream is applied to minimize discomfort (for 30-45 minutes),” Rahi tells Healthline.  “During the treatment, the microneedling device is gently rolled or stamped over the skin, creating controlled micro-injuries,” she explains. “The process is generally well-tolerated, but some individuals may experience mild discomfort or sensitivity.” “After microneedling, it is normal to experience redness and mild irritation, similar to a sunburn, which typically resolves within a few days,” she says. “Proper aftercare is important, including avoiding sun exposure and applying recommended skincare products as advised by your provider.” Rahi says the cost of microneedling can vary depending on factors such as the location, provider, and additional treatments combined with the procedure.  On average, the cost ranges from $500 to $1500 per session, says Rahi.  “Maintenance sessions every three to six months may be recommended to prolong the results and maintain overall skin health.” What you need to know about Botox alternatives and safety concerns  Experts say ultherapy is considered safe and the procedure provides more standardized results across different providers.  “Microneedling is much more user-dependent, and in the wrong hands can definitely lead to bad outcomes,” says Glodny.  “For example, if the device used to penetrate goes too deeply into the skin, then scarring and darkening of the skin can result,” he says. “Less often, there are reports of blood vessel growths developing after microneedling,” he adds.   “In terms of safety, microneedling is generally considered safe when performed by a trained and experienced professional,” says Rahi. However, she agrees there are potential risks if the procedure is not done correctly. Risks to microneedling include improper technique or inadequate sterilization which can lead to complications such as infection, scarring, or skin discoloration.  “It is essential to choose a reputable provider and ensure proper hygiene and sterilization protocols are followed,” says Rahi. People who may want to avoid alternatives to Botox Rahi adds that certain individuals may not be suitable candidates for microneedling in particular.  People who may not be suitable for microneedling, for example, she says, include individuals with: active skin infections open wounds certain medical conditions such as blood clotting disorders or compromised immune systems need for taking blood-thinning medications She adds that it’s recommended to discuss microneedling with a provider for individualized screening to see if you are a good candidate.  Other ways to promote skin health  In addition to cosmetic procedures, Rahi tells Healthline it is important to focus on overall skin health and adopt a comprehensive approach to anti-aging.  Expert tips from Rahi include: maintaining a healthy lifestyle protecting the skin from sun damage by using sunscreen adopting a proper skincare routine staying hydrated eating a balanced diet managing stress

While taking drugs like Ozempic and Wegovy can help people shed pounds quickly, rapid weight loss can also cause saggy skin and a ‘deflated’ appearance in curvy areas of your body. Luis Alvarez/Getty Images ‘Ozempic Butt,’ characterized by sagging skin on the butt, is gaining traction as a reported side effect of the weight loss drug semaglutide, better known by the popular brand names Ozempic and Wegovy. Experts say rapid, extreme weight loss can contribute to looser skin, particularly in curvier areas of the body. Taking a slower, more sustainable approach to weight loss can lower your risk of developing ‘Ozempic Butt.‘ Regular exercise as well as surgical and non-surgical treatments can improve the appearance of ‘Ozempic butt.’ Rumored to be used by many celebrities, semaglutide, sold under the brand names Ozempic and Wegovy, has become a popular weight loss tool.  The drug acts as an appetite suppressant and can trigger extreme weight loss. But as the pounds melt away, some people are noticing a loss of volume and a decrease in skin elasticity in the curvier parts of their bodies.  In fact, you may have heard of ‘Ozempic Face,’ a side effect associated with extreme weight loss while taking these medications which is characterized by saggy drawn skin after weight loss. Now, a similar side effect is gaining traction, which has been dubbed ‘Ozempic Butt.’  What causes ‘Ozempic Butt?’ “While the term ‘Ozempic Butt’ may be new, the concept of being left with sagging skin after rapidly losing a large amount of weight is not,” says Jana Abelovska, superintendent pharmacist at Click Pharmacy. Abelovska isn’t’ surprised that many people are experiencing this side effect when using Ozempic and Wegovy injections, as the drug can cause rapid weight loss, particularly, she says, if you’ve just started using it. To understand why this happens, Abelovska says you need to understand how the drug works. “On the surface, Ozempic may appear to be an appetite suppressant, as semaglutide tricks the brain into thinking the stomach is full when it isn’t,” she explains. However, there is more to it than that. While a decrease in appetite is partially responsible for rapid weight loss, Semaglutide also changes the way in which the body processes hunger. “It actually alters your body’s metabolism, and prevents your brain from sending out hunger signals that make you feel hungry, and thus want to eat,” Abelovska points out. When used for weight loss, Abelovska says you’re likely to see results very quickly as your hunger responses are being blocked. However, our bodies take a little while to catch up. “When we gain weight, this is done gradually which gives our skin the time to expand and stretch to accommodate the extra weight,” she explains. “Our skin is actually surprisingly elasticated, thanks to its elastin and collagen makeup, which is what makes it able to revert back to normal after stretching to accommodate a pregnancy, for example.” “But if you lose weight too quickly, your skin will remain at its looser state, rather than instantly returning to its pre-weight gain state, particularly if you have been overweight for several years,” Abelovska added. This is why, after significant weight loss, you might experience saggy skin in certain areas of your body. Abelovska says curvier regions, like the abdomen, butt, thighs, and cheeks, are the most prone to this side effect. Who is most likely to experience ‘Ozempic Butt?’ Not everyone will experience saggy skin on their butt, or indeed any other part of their body, after losing a significant amount of weight. In fact, the likelihood of saggy skin is dependent on several factors, like your age, how much you weighed before you began to gain weight, and how long you’ve been living with obesity or overweight. Generally speaking, how active you are won’t play a role in how likely you are to experience sagging skin. However, Abelovska says it can certainly play a role in reducing the sagginess after the weight has been lost. “As mentioned before, our skin is very elasticated – however, this natural elasticity does decrease with age, meaning that our skin doesn’t retain its shape quite as well when we get older. That’s why if you’re using Wegovy or Ozempic in your younger years you’re less likely to see significant loose skin in comparison to someone who uses it in their older years,” she points out. Add to that, the more weight you have gained, the more your skin will have stretched, and therefore, the more likely you are to be left with loose skin after weight loss.  “Similarly, a patient’s skin may struggle to return to its normal state if they have been overweight for a significant period of time,” Abelovska adds. “If someone is using semaglutide and they have only been overweight for a short period of time, it’s likely that their skin will be able to bounce back more quickly as it hasn’t been held in a stretched state for as long as someone that has been overweight for a long time.” How to treat sagging skin after weight loss So, if you have sagging skin after weight loss, what can you do to treat it? According to Dr. Grace Hula, aesthetic doctor and founder of G&M Healthcare, there are lots of ways to rectify the problem. She recommends skin tightening treatments like LPG Endermologie which should ideally be used as soon as you start losing weight. “Other possible treatment solutions are having a Brazilian butt lift with dermal fillers,” she adds. However, Hula advises giving your body some time to adjust after weight loss before considering treatment. “In some cases, saggy skin can correct itself if patients maintain their new weight over a long period of time, for example, a year or more,” she points out. Abelovska says your doctor may recommend a skin removal surgery to take some of the skin away if there is an excessive amount of loose skin. However, she says this will only be advised if absolutely necessary after other methods have been used.” Surgical and non-surgical options aside, there are many ways to address sagging skin at home as well. “Exercising is one of the best ways to help your skin return to normal after losing weight. In particular, patients should regularly use exercises such as weight-lifting and resistance training,” says Abelovska. This, she explains, not only builds muscle that will fill some of the space left behind after losing weight, but it can also promote more elasticity in the skin which will aid it in bouncing back. In addition, Abelovska says staying hydrated can keep the skin looking plump, while eating a diet that is high in Vitamins A, C and E can increase collagen and elastin, giving your skin more ‘bounce’. Other side effects of Ozempic and Wegovy Ultimately, we’re still learning about the side effects of these medications as a weight loss tool. Aside from ‘Ozempic Butt,’ known side effects of these drugs can include: stomach cramps nausea bloating  Losing weight too quickly can also be dangerous. Abelovska notes that rapid weight loss is associated with an increased risk of gallstones, dehydration, malnutrition, and electrolyte imbalance. If you’re looking for a way to lose weight, it’s best to consider the pros and cons before choosing medications. “If you’re hoping to use Ozempic or Wegovy, you should make yourself aware of all of the potential side effects to avoid feeling disappointed about ‘Ozempic butt’ or other similar instances after you’ve lost weight,” Abelovska advises.

Teens who use marijuana are 2 to 4 times more likely to develop mental health disorders such as depression. Oduvanchik21/Getty Images Teens who use cannabis recreationally are two to four times as likely to develop psychiatric disorders, such as depression and suicidality, compared to teens who don’t use cannabis. The Mind Over Marijuana campaign aims to inform youth about the dangers of underage cannabis use. While parents might not think so, many teenagers want to discuss important topics like cannabis with them. Although cannabis use might seem harmless to many teenagers, it can trigger serious physical and mental health issues. Teens who use marijuana recreationally are two to four times as likely to develop psychiatric disorders, such as depression and suicidality, than teens who don’t use cannabis at all, according to research from Columbia University. Plus, even using cannabis casually increases a teen’s risk for behavioral issues, including poor grades, truancy, and trouble with the law. “We definitely know that if you are an older adolescent or young adult, and you have genetic or familial predisposition for psychosis and you use cannabis, it seems to be the trigger to actually having you have that mental health issue,” Bonnie Halpern-Felsher, PhD, pediatrics developmental psychologist at Stanford, told Healthline. Why marijuana use can negatively affect younger people’s health Because the brain isn’t fully developed until age 25, she explained that during adolescence and into young adulthood, the brain over-produces neuronal connections, which manage communication. During adolescence and young adulthood, the brain gets rid of the receptors that aren’t needed anymore. For example, we are born with the ability to roll our Rs, but if we don’t roll our Rs, over time, we lose the ability to do so. “By putting cannabis into our bodies and using substances [before 25] then we are significantly more likely to become addicted because they get reinforced,” said Halpern-Felsher. While cannabis can be addictive and mind-altering at any age, she added that if adolescents and young adults inhale, smoke, or eat any addictive substance, they are much more likely to become addicted because the brain is still developing and looking for ques about what to keep or not keep. The risk of developing cannabis use disorder is also higher in people who use marijuana more often. “Increased cannabis use can affect tolerance levels, making teens who use cannabis less sensitive to tetrahydrocannabinol (THC), meaning more THC is needed to feel the same effects,” Robin Christensen, chief of the substance and addiction prevention branch at California Department of Public Health (CDPH), told Healthline. She noted that cannabis today is much stronger than in past decades because modern cannabis plants contain high amounts of THC. “The higher the THC content, the stronger the effects on the brain and behavior,” said Christensen. Legalizing cannabis does not make it safe More than 20 states in the US have legalized marijuana for adults and nearly 40 have legalized medical marijuana. However, the US government still considers cannabis an illegal Schedule I drug, which means it’s categorized as a drug with no currently accepted medical use and a high potential for abuse, according to the Drug Enforcement Administration. “When a product like cannabis is legalized, for teenagers and young adults, the message is it must be okay; it must be safe. The reason for legalization is political, it’s the tide swinging, it is to decriminalize it, but it is not at all a message that it’s safe, particularly for an adolescent or young adult,” said Halpern-Felsher. There is also the misperception that cannabis is safer than cigarette smoking. While some experts say that nicotine is the most addictive substance available right now, Halpern-Felsher said when it comes to brain development, lung health, and heart health, there’s not much difference between cannabis and nicotine. “That’s true of not just primary use but secondary smoke whether in the form of a blunt or joint, but also in the form of e-cigarettes or vaping,” she said. “The addiction is similar. Anything you inhale into your body can cause lung damage and can also cause damage to your heart.” While big tobacco companies have been vilified, making teens well aware of the dangers of smoking cigarettes, the cannabis industry has yet to be denounced in the same way. Marijuana edibles can pose bigger risks than people realize Not understanding the potency of edibles is another dangerous component of cannabis that people, especially teenagers, often don’t understand. Halpern-Felsher said while edibles will not cause lung disease, they can still cause addiction and mental health issues, as well as cannabinoid hyperemesis syndrome (CHS), a condition that causes nausea, vomiting, and abdominal pain after using cannabis. “We’ve seen this a lot in the emergency room because young people don’t understand the dosage involved,” she said. “Edibles take longer to get into your body and your brain…about 20 minutes to a couple of hours, whereas inhaled, can take a few seconds or half a minute and so what happens with teens, they think they’ll feel the effect of a high quickly and they don’t so they keep taking more and more edibles and by the time they feel the effect, they’ve actually taken too much.” While people most likely do not die from CHS directly, they can feel extremely ill and require hospitalization. Lack of awareness surrounding the details of cannabis comes down to not talking about it enough, said Halpern-Felsher. “One study we published, we talked to teens and they said, ‘You don’t talk to us enough about cannabis and so we think it’s okay,’” she said. Mind Over Marijuana campaign spreads cannabis awareness To inform youth about the dangers of underage cannabis use and how it can impact their social and emotional well-being later in life, CDPH launched the campaign Mind Over Marijuana. “The message to teens is…really helping them understand that [cannabis] use can affect brain development and within that it affects your memory, and increases stress and anxiety. A lot of teens think it helps with those, but it doesn’t,” said Halpern-Felsher. In addition to messaging targeted toward teenagers, CDPH also initiated the Let’s Talk Cannabis campaign to encourage parents, guardians, and the community to have open, two-way conversations with teens about cannabis. “Our research shows that parents are the number one influence on a teen’s behavior. Having conversations about cannabis with teens early on and often can help prevent youth cannabis use,” said Christensen. While it can feel like your teen isn’t listening to what you say, Halpern-Felsher said the reality is they want to understand what’s going on and they want to learn from you. “The key is for parents to make sure teens feel heard and seen so it’s not a lecture; it’s let’s have a two-way conversation,” she said. “It’s asking: what do you know about pot or weed or marijuana? Let me tell you what I learned or know.”

New research suggests that the risks and symptoms of heart disease are different in women compared to men. Nattrass/Getty Images According to a new study, women may be twice as likely to experience a fatal heart attack compared to men. Women have several unique risk factors that may explain this higher risk, including premature menopause, pregnancy complications, gestational hypertension, and delivering an infant that is premature. Other risk factors for heart disease in women include more well-known issues: diabetes, blood pressure, smoking, and family history. Women are frequently underrepresented in research for cardiovascular disease, and many unique risk factors and symptoms are often poorly understood. Cardiovascular disease is the leading cause of death around the world, according to the World Health Organization. While cardiovascular disease does not discriminate against gender, men are more likely to have cardiovascular conditions than women. But new research is showing that women may be more than twice as likely to die after a heart attack than men.  “There are a lot of prior studies that have shown poor outcomes among women after heart attacks, and we attributed those differences to the fact that we know women are older when they present with heart attack and have more associated comorbidities,” said Dr. Anais Hausvater, a cardiologist at NYU Langone Heart, specializing in women’s heart health who was not involved in the study. “But in this study, they adjusted for those factors and compared younger women. These findings tell us that there is more to it.” The study, which was presented at Heart Failure 2023, a scientific congress of the European Society of Cardiology, was a retrospective observational study. It included 884 patients with an average age of 62 years. Twenty-seven percent were women. Increased heart attack risk among younger women As Hausvater indicated, previous studies have found that women with ST-elevation myocardial infarction (STEMI) have a worse prognosis during their hospital stay compared to men.  “A STEMI is the highest risk type of heart attack, where every minute counts. This is the type of heart attack when you’re running the patient to the cardiac cath lab. Every minute of delay can contribute to worse outcomes,” said Hausvater. Those studies attributed those findings to older age and an increased number of comorbidities. This study, however, compares short- and long-term outcomes after STEMI in women and men and looked at whether the differences in gender were apparent in both premenopausal women (55 years and under) and postmenopausal women (over 55). The study followed patients admitted with STEMI and treated with PCI within 48 hours of symptom onset over a five-year period. Adverse outcomes were defined as 30-day all-cause mortality, five-year all-cause mortality, and five-year major adverse cardiovascular events (MACE).  Of those studied, women had higher rates of high blood pressure, diabetes, and prior stroke. Men were more likely to be smokers and have coronary artery disease. The researchers compared the risk of adverse outcomes between women and men after adjusting for other factors like diabetes, high cholesterol, hypertension, coronary artery disease, heart failure, chronic kidney disease, peripheral artery disease, stroke, and family history. At the 30-day mark, 11.8 percent of women had died compared to 4.6 percent of men. At five years, 32.1 percent of women had died versus 16.9 percent of men, and 34.2 percent of women experienced MACE within five years, whereas 19.8 percent of men experienced MACE. Unique heart disease risks for women can lead to a delay in care “We know that there is some protective effect of estrogen and that postmenopausal women tend to have higher risk,” said Hausvater. “But we’re seeing in the last 10 years heart attacks among younger women, which is concerning. A lot of that likely has to do with the fact that there are risk factors for heart disease unique among women that are under-recognized.” Hausvater said that these potential risk factors can include premature menopause, pregnancy complications, gestational hypertension, and delivering an infant that is premature. “All of those increase risk but are not captured by doctors, and women don’t know that they are risk factors for heart disease. We know from survey studies that women tend to be less aware of their heart disease risk.” Heart attack symptoms in women According to the American Heart Association, women are frequently underrepresented in research for cardiovascular disease, which can paint an incomplete picture when understanding how the disease affects different genders.  According to the AHA, “Some risk factors for heart disease are specific to women, such as risks related to menopause and treatments for breast cancer, and some, such as depression, carry a different risk for cardiovascular disease in women than in men.” “Psycho-social stress is another risk factor important for women and women, but especially women,” said Hausvater. “Increased stress, depression, and anxiety is a factor of heart disease that tends to affect women more.” A lower recognition of symptoms of heart disease could be one of the contributing factors to this study’s findings. Increasing women’s knowledge of heart disease symptoms could help prevent adverse outcomes. “Chest pain is the most common among men, but women tend to have multiple symptoms at the same time. They may also have shortness of breath, fatigue, and nausea. But because the symptoms are different, it can mean a woman delays in seeking out care. It can also delay treatment when in the hospital.” More research is needed This study was an important step in understanding the unique risks of heart disease for women. But more work is needed to understand the full picture. “The other thing to consider is that we know a lot of the treatments we use for heart attacks, like medication and other treatment options, have been studied in large trials predominantly made up of men. Women are very much under-represented in all of these clinical trials. It’s possible they are less effective in women, and we need proper representation of women in these trials,” said Hausvater. Increased awareness can save lives All of the traditional cardiac risk factors are equally important for women, such as a history of diabetes, blood pressure, smoking, and family history. But for patients who are women, there are additional specific risk factors. “I would say both women and providers need to be aware of these risk factors to understand their risk for heart disease,” said Hausvater. “If I’m seeing a patient like this in the clinic, I would adjust my risk assessment and it might lower my threshold to start a cholesterol medicine. My recommendations for lifestyle intervention would be much stricter if I felt they were at higher risk. It is important to understand the risk.”

A daily multivitamin may offer a modest benefit to cognitive function among older adults, according to a new study. Kemal Yildrim/Getty Images A daily multivitamin may offer a modest benefit to cognitive function, according to new research. The three-year study showed an improvement in memory among subjects who took a daily multivitamin. Study subjects with cardiovascular disease who took a daily multivitamin saw the greatest improvement in cognition. More rigorous research is needed to determine the brain-boosting benefits of multivitamins over the long term. A daily multivitamin or multi-mineral supplement improved memory in older adults over a three-year period, a new study shows. If supported by future research, the findings could provide an easy and inexpensive way to slow age-related memory decline, according to researchers. In the study, which, involved more than 3,500 adults over age 60, researchers randomly assigned participants to take a daily multivitamin supplement or an inactive placebo for three years. At the start of the study and at the end of each year, participants took an online cognitive test at home to assess their short-term memory. By the end of the first year, both groups saw improvements in memory, but the group taking a daily multivitamin saw a larger improvement. The researchers estimate that the changes in the multivitamin group, which were sustained over the three years of the study, were equivalent to about three years of age-related memory decline. Still, that improvement was modest and the data does not account for the long term. “You basically had stabilization of memory, where you held off cognitive decline across that three-year time period,” Dr. Thomas Holland, a physician scientist in the Division of Digestive Diseases and Nutrition at RUSH University in Chicago, who was not involved in the study, told Healthline. The new study is part of a large clinical trial called the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). The results were published May 24 in the American Journal of Clinical Nutrition. More research on cognitive benefits of multivitamins needed Taking a daily multivitamin did not appear to improve other types of brain function such as memory retention, novel object recognition, and executive function — the ability to plan, focus and juggle multiple tasks. One limitation of the study is that the majority of participants were white and more highly educated. So the results may not apply to other groups. “I’d feel more comfortable if these results were replicated in a more generalizable cohort,” Mark A. Espeland, PhD, professor of gerontology and geriatric medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina, told Healthline. The authors of the study point out that the memory improvements experienced by the multivitamin group are small, so may not be noticed by people. However, “even small effect sizes can result in large health benefits at the population level,” they wrote. Also, a daily multivitamin is relatively inexpensive, they added, and could be taken by most people. How multivitamins may boost brain health Espeland said the results are consistent with the findings of a separate COSMOS study, published in 2022, which he was involved with. In that study, which involved more than 2,200 older adults, he and his colleagues found that people who took a daily multivitamin saw an improvement in their overall cognition, memory and executive function.  As with the new study, the effect was stronger in people with cardiovascular disease, which is a risk factor for dementia. In a separate paper from the COSMOS study, published earlier this year, Espeland and his colleagues also found that a daily multivitamin appeared to help people who developed dementia during the study. “Among those people who did transition from mild cognitive impairment to dementia, if they were using multivitamins, the drop [in overall cognition and executive function] seemed to be less,” he told Healthline. “This potentially indicates that these multivitamins might provide benefits even for people with [cognitive] disease,” he added. Espeland cautions that additional studies are needed before widely recommending a daily multivitamin for older adults, especially since other research has found no benefit of a daily multivitamin on cognitive outcomes.  Healthy diet may benefit cognitive function Many factors influence memory and other cognitive abilities. A key one is diet. In the new study, researchers assessed people’s dietary patterns at the beginning — both groups were similar to the average American diet. As a result, they don’t believe that diet affected the average memory changes seen in either group.  Some clinical trials have shown that dietary interventions can improve memory. For example, the MIND diet, which was developed by researchers at RUSH University, has been linked to better cognitive performance in older adults. This diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Holland said he expects that dietary interventions such as the MIND diet would have a bigger impact on cognition than multivitamins. However, there may still be a role for taking a pill every day, he added, especially given the high cost of fresh fish, berries and other nutrient-dense foods. “In a multivitamin, you’re not going to have the same quantity and quality of vitamins and minerals that you would in a broad nutritious diet,” he said, “but you are bridging the gap of some of those potential [micronutrient] deficiencies.” In addition, “if you’re not going to change your diet, bridging with a supplement is not a bad idea,” he said. He also emphasized that a healthy diet is only one way to reduce your risk of age-related cognitive problems. It’s important to also have “physical activity, socialization, cognitive activities, and quantity and quality of sleep,” he said. Benefits for people with heart disease The effect of a daily multivitamin on memory in the study appeared stronger in people with cardiovascular disease, researchers found. These people started the study with worse memory performance, but after one year of taking the multivitamin, their memory was similar to those without heart disease. This suggests that the multivitamin is filling nutrient gaps in a person’s diet, the authors say. Other research has found that some people with cardiovascular disease may have deficiencies in certain micronutrients. The results show average changes, so some people taking a daily multivitamin saw greater improvements in memory, and others less. Takeaway New research shows a modest short-term cognitive benefit of taking a daily multivitamin and subjects with heart disease who took a daily vitamin saw the greatest improvements in memory. More rigorous studies are needed to determine whether multivitamin use has any impact on cognitive function over the long term. Multivitamins may offer general health benefits when taken in conjunction with a healthy, balanced diet. When considering multivitamins, remember that dietary supplements are not approved by the Food and Drug Administration (FDA) for safety or effectiveness. Ask your healthcare team about adding a daily multivitamin to your health regimen to determine whether it’s right for you.

New research showed that the weight loss drug semaglutide may lower heart disease risk. Jelena Markovic/Stocksy United A small study found that the popular weight loss drug semaglutide may help lower the risk of developing cardiovascular disease. After one year, study participants showed improvements in multiple cardiovascular risk factors, including blood pressure, total cholesterol, and triglycerides. Some experts suggest that by treating obesity, Ozempic appears to decrease risk factors that can lead to heart disease. New research has found that the popular weight loss drug semaglutide, sold under the brand names Wegovy and Ozempic, may help lower the risk of developing cardiovascular disease, too.  The findings, presented at this year’s European Congress on Obesity in Dublin, Ireland, found that multiple cardiovascular risk factors, including blood pressure, total cholesterol, and triglycerides, decreased after a year of taking semaglutide.  Cardiologists believe that the anti-obesity drug boosts heart health by improving these risk factors, which are proven to contribute to heart disease.  Though additional research is needed to better understand the effects of semaglutide, the findings suggest that people at risk for heart disease may potentially benefit from taking semaglutide. “In this small retrospective study amongst individuals who were overweight or obese, it appears that use of a specific agent targeting overall weight loss improved cardiovascular risk as measured by one well-utilized risk calculator,” Ajaykumar D. Rao, MD, MMSc, FACP, Chief of the Section of Endocrinology, Diabetes and Metabolism and Associate Professor of Medicine at the Lewis Katz School of Medicine at Temple University, who was not part of the original study, told Healthline. Semaglutide may improve multiple cardiovascular risk factors To understand the effect semaglutide has on cardiovascular disease in people who are overweight or have obesity, the researchers evaluated the health data of 93 patients with a body mass index (BMI) of 27 kg/m2 or higher who had no history of cardiovascular disease.  Using their demographic, clinical, and lipid panel data, they calculated each patient’s 10-year atherosclerotic cardiovascular disease (10-year ASCVD) risk before starting semaglutide and then after one year of taking semaglutide.  The 10-year ASCVD risk estimator is a tool created by the American College of Cardiology that predicts a person’s 10-year risk of developing atherosclerotic cardiovascular disease. It’s used to guide potential treatment plans in people at risk for heart disease.  The team found that the 10-year ASCVD dropped by 1.38 percent, from 7.64 percent before taking semaglutide to 6.26 percent after 12 months of taking the anti-obesity drug. The researchers also measured multiple cardiovascular risk factors, including total body weight loss percentage, change in blood pressure, HbA1c (a measure of blood sugar control), fasting glucose, lipid panel, blood pressure medications, and use of aspirin and statin before the patients began taking semaglutide and at and their last follow-up visit.  After a year of taking semaglutide, the participants’ blood pressure dropped significantly — on average, by 9.3/4.9 mmHg — as did their total cholesterol, LDL cholesterol, triglycerides, fasting glucose, and HbA1c.  Patients also lost an average of 10.9 percent of their body weight.  There were some limitations of the report. Supreeti Behuria, MD, a cardiologist at Staten Island University Hospital, says the study included a small sample size of fewer than 100 people and it had a short follow-up time of less than one year. Behuria was not involved in the research. “Almost 91 percent of patients were white, so this study did not represent our diverse patient population and I wonder at its applicability in the broader context,” Behuria said. While the report suggests Ozempic may have positive effects on cardiovascular health, more research with larger sample sizes and longer follow-up periods is needed to better understand the short and long-term impacts.  By treating obesity, Semaglutide may improve heart health Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, says there are multiple mechanisms by which obesity increases the risk of cardiovascular disease — primarily, that obesity increases atherosclerotic plaque buildup in arteries, putting people at risk for myocardial infarction. Ali was also not part of the original research. The increase in body fat in obesity contributes to other risk factors for heart disease like high blood pressure, diabetes, and obstructive sleep apnea, says Behuria. “In my opinion, it is not the medication itself that is lowering heart disease risk, but the weight loss as a result of taking it,” Ali said.  Obesity is one of the most targetable and modifiable risk factors for obesity, according to Rao.  “Semaglutide is [a] medication that helps reduce body weight and thus treats obesity. By treating obesity, helps decrease cardiovascular risk factors which further lower the risk of cardiovascular disease,” Behuria said.  The bottom line: New research has found that the popular weight loss drug semaglutide may help lower the risk of developing cardiovascular disease, too. Multiple cardiovascular risk factors, including blood pressure, total cholesterol, and triglycerides, improved after a year of taking semaglutide. By treating obesity, semaglutide appears to decrease risk factors that can lead to heart disease. 

Marijuana use may increase the risk of developing peripheral artery disease, even in younger people. Emilija Manevska/Getty Images New research suggests there may be a link between marijuana use and developing vascular disease. A study of over 623,000 cannabis users found that they had a higher risk of developing peripheral artery disease (PAD). Though PAD typically develops in people over 60 years of age, the study found that younger cannabis users were also at an increased risk. Smoking cigarettes has long been known to be a risk factor for peripheral artery disease (PAD), a condition where the buildup of fatty plaque in the arteries limits blood flow to the legs or arms. But a new study suggests that cannabis users may also have a higher risk of developing PAD, compared to the general population. Even younger adults are at risk, the results show. In the United States, 6.5 million people age 40 and older have PAD, reports the Centers for Disease Control and Prevention.  With over 48 million Americans using cannabis at least once in 2019, and cannabis use on the rise among younger adults, the authors of the new study say cannabis users should be aware of the symptoms of this condition. One well-known symptom of PAD is pain, aches or cramps in the leg, hip or buttock while walking or doing other physical activity, with relief upon rest. Other signs in the leg that may indicate PAD include muscle weakness, hair loss, smooth and shiny skin, sores or ulcers that don’t heal, and cold or numb toes. The new study was presented May 17 at the annual meeting of the Society for Cardiovascular Angiography & Interventions, in Phoenix, Ariz. Findings presented at scientific meetings should be considered preliminary until published in a peer-reviewed journal. Higher risk of PAD with cannabis use In the study, researchers examined data from 2016 to 2019 on over 623,000 hospital patients who were diagnosed as cannabis users. Patients were 38 years of age on average, with around the same percentage of men and women. The majority of patients were white. Of these patients, around 2,400 were diagnosed with PAD — less than one percent. Marijuana users had more than three times the risk of being diagnosed with PAD, compared to the general population. However, they did not have an increased risk of dying or requiring a procedure to open a clogged artery. In light of these results, “patients and physicians both need to be aware that there is some association here [between cannabis use and PAD],” study author Dr. Hirva Vyas from Hackensack University Medical Center in New Jersey, told Healthline. One particularly concerning aspect of the results, she said, is that patients were younger. PAD more commonly occurs in people 60 years or older, especially in those with other risk factors such as: smoking high blood pressure atherosclerosis diabetes high cholesterol If younger adults “have pain in their legs while walking, they may attribute it to something else, like a muscle ache or sprain,” said Vyas.  So if cannabis users — of any age — have symptoms that could be PAD, it would be worthwhile to see a doctor, she added. Cannabis linked to other health problems Because of the way the study was designed, it cannot show a cause-and-effect link between cannabis use and PAD. However, Dr. Michael Go, who specializes in vascular surgery at The Ohio State University Wexner Medical Center in Columbus, Ohio, said cannabis use has been associated for some time with cardiovascular problems. For example, one study found that young adults who reported recent cannabis use were more likely to have had a heart attack.  Dr. Claudia Martinez-Bermudez, a cardiologist and associate professor at UHealth, the University of Miami Health System, who was not involved in the new study, also pointed to a 2020 American Heart Association statement, which reviews the potential risks of medicinal and recreational cannabis, including cardiovascular ones. In the new study, researchers did not have information on which types of cannabis products people used. So the study can’t show whether the increased risk of PAD was related to smoking plant cannabis or from using gummies, oils, or other edibles. Martinez-Bermudez said more research is needed about cannabis composition in relation to PAD, because some products “may be more harmful — and others not — depending on the THC/CBD [cannabidiol] composition,” she told Healthline. In addition, more information is needed on how people who develop PAD have been using cannabis. “Cannabis can be used in many ways including smoking and in combination with tobacco,” said Martinez-Bermudez, “all of which could contribute to peripheral vascular disease.” PAD link less well studied Go, who was not involved in the new study, pointed out that the link between cannabis and PAD has been less studied than other types of cardiovascular problems. However, “there have been a handful of articles over the last ten years showing that cannabis use may be related to several forms of PAD,” he said. One study found that cannabis use disorder is linked to a sudden decrease in blood flow to the limbs. Another showed that cannabis users had a higher risk of inflammation of the arteries in the lower limbs. “All these conditions come with higher risks of amputation,” Go told Healthline. With limited research to date, scientists are not certain how cannabis use may increase the risk of PAD. The authors of the new paper suggest that cannabis may affect how blood clots form or how blood vessels function. “It is also unclear if it is the THC [delta-9-tetrahydrocannabinol] itself or other components of smoke inhalation” that increases the risk of PAD, said Go. While cannabis users in the new study did not have a higher risk of dying or requiring a procedure to open a clogged artery, Go cautioned that it’s still too soon to know whether or not cannabis use results in severe PAD. In the meantime, he recommends that people at higher risk of PAD use cannabis in moderation. In addition, “doctors should ask patients about cannabis use, and consider it to be an additional risk factor for PAD in their patients,” he said.

The younger a person is when they develop type 2 diabetes, the higher their risk of developing dementia later in life rises. Fertnig/Getty Images A new report suggests that prediabetes is not a robust risk factor for dementia when it does not progress to diabetes. Additionally, the risk of developing dementia appears to increase the younger a person develops diabetes. The findings highlight the need to delay — and, if possible, prevent — the progression of prediabetes to diabetes in order to protect cognitive function.  The risk of developing dementia appears to increase the younger you develop diabetes, a new study has discovered. The report, published in the journal Diabetologia, investigated how prediabetes and its progression to diabetes are connected to dementia later in life.  Prediabetes has previously been identified as a potential risk factor for cognitive decline and dementia, however, this new report suggests that prediabetes isn’t a substantial risk factor for dementia.  The association is largely due to the fact that most prediabetes cases (70%) progress to diabetes, which is strongly associated with the risk of dementia. In addition, the earlier people are diagnosed with diabetes, the greater their risk of developing dementia was, potentially due to long-term exposure to hyperglycemia, or high blood sugar levels. “Basically, the younger you are if you are diagnosed with diabetes, the higher the chances you may develop memory loss and other cognitive deficits later in life. This study provides more evidence that diabetes and insulin resistance can lead to neurodegeneration,” Jonathan J. Rasouli, MD, Director, Complex and Adult Spinal Deformity Surgery at Staten Island University Hospital, told Healthline.  Early diabetes diagnoses linked to higher risk of dementia  The researchers evaluated the health data of 11,656 people who were enrolled in the Atherosclerosis Risk in Communities study and were between the ages of 45 to 64 between 1987 to 1989.  At the participants’ second visit for the study, which was held between 1990 and 1992, the researchers measured their glycated hemoglobin levels, or HbA1c, a measure of blood sugar control, along with their cognitive function. At baseline, 2,330 participants had prediabetes. The risk of prediabetes was greatest among Black people and individuals who had less than a high school education.  All of the participants’ cognitive function was examined again at the fourth visit for the study, between 1996 and 1998, and more thoroughly at their fifth visit, held between 2011 and 2013, and during follow-up visits from there on out.  Of the group, 3,143 developed diabetes and 2,274 developed dementia.  The research team looked at the link between prediabetes and dementia and found that prediabetes does not appear to be a robust risk factor for dementia when it doesn’t progress to diabetes.  “The study found that it was indeed those patients who progressed from prediabetes to overt type 2 diabetes who were driving this association with dementia risk,” says Marilyn Tan, MD, an endocrinologist and chief of the Stanford Endocrine Clinic.  They also investigated how the age of people’s diabetes diagnosis influenced their future risk of developing dementia.  The team found that the earlier people were diagnosed with diabetes, the greater their risk of developing dementia later in life. People who were diagnosed with diabetes before age 60 had a nearly three times greater risk of developing dementia. Those who were diagnosed with diabetes between 60 to 69 years of age had a 73% higher risk of developing dementia and people diagnosed between ages 70 to 79 had a 23% high risk of getting dementia. Being diagnosed with diabetes after age 80 was not associated with a higher risk of dementia.  Why diabetes may influence the risk of dementia Scientists suspect that sustained exposure to hyperglycemia influences the risk of dementia.  “The younger one is when diagnosed with diabetes, the longer the body is exposed to hyperglycemia,” Dr. Tan says. Hyperglycemia can affect insulin function in the brain and impair amyloid-beta clearance and increase the accumulation of tao protein in the brain — both of which are known to contribute to dementia.  In addition, high levels of glucose can be toxic and lead to inflammation and oxidative stress.  “These, in turn, lead to cellular dysfunction, damage, and the accumulation of glycation end-products. Additionally, the cellular and vascular damage could lead to impaired blood-brain barrier and the accumulation of deleterious products in brain cells,” said Benjamin Nwosu, MD, Chief of Endocrinology at the Cohen Children’s Medical Center in Queens, New York, and researcher at the Feinstein Institutes for Medical Research. The lifestyle factors associated with diabetes, such as a poor diet and a sedentary lifestyle, can lead to cognitive decline, says Tan.  The researchers say their findings highlight the need to delay — and, if possible, prevent — the progression of prediabetes to diabetes.  Nwosu says two groups should be of focus: people diagnosed with prediabetes under the age of 65 along with Black people, who have a higher risk of being diagnosed with prediabetes.  “These findings suggest we need to be more aggressive with primary prevention and address modifiable risk factors of diabetes as early as possible. This would involve earlier screening of at-risk patients and education,” Dr. Rasouli said. The bottom line A new report suggests that prediabetes is not a robust risk factor for dementia when it does not progress to diabetes. In addition, the risk of developing dementia appears to increase the younger a person develops diabetes, the new study has discovered. The findings highlight the need to delay — and, if possible, prevent — the progression of prediabetes to diabetes in order to protect cognitive function. 

Half of teens taking Wegovy in a recent trial lost enough weight to fall below the threshold for obesity, while a quarter returned to a healthy weight. Nick David/Getty Images A 68-week trial indicated that nearly half of the teens treated with 2.4 mg semaglutide (Wegovy) lost enough weight to fall below the obesity threshold. About one-quarter of teens were at normal weight at the end of the trial. Health experts say Wegovy is an effective tool that can help treat childhood obesity. Wegovy, a brand name for semeglutide (similar to Ozempic), is a drug that has been gaining attention thanks to the medication’s weight loss benefits in adults. Despite its sudden popularity, however, Wegovy isn’t brand new. It was first approved for weight loss in patients living with obesity or overweight with a second comorbidity in 2021. However, the FDA only approved the drug for patients ages 12 to 17 in December 2022. The approval came weeks after the publication of a clinical trial indicated that teens treated with 2.4 mg of Wegovy for 68 weeks were significantly more likely to fall below the obesity threshold and return to a healthy weight than those in the placebo group.  Wegovy appears to be as effective in children ages 12 to 17 years as it is in older adults. “These…studies are giving us the information to better understand the weight loss effects on teenagers,” says Dr. Emily Breidbart, MD, an endocrinologist at Hassenfeld Children’s Hospital at NYU Langone in New York, NY. The study — and subsequent approval for Wegovy for specific patients ages 12 years and older — was a welcome one for one pediatric obesity specialist. “We have a new tool to add to our arsenal to fight childhood obesity,” says Dr. Daniel Ganjian, MD, FAAP, a pediatrician at Providence Saint John’s Health Center in Santa Monica.  More about the findings from the trial on teens treated with Wegovy The trial included 201 participants ages 12 to 17 years, 200 of which were living with obesity. Researchers gave 131 participants a 2.4 mg dose of semaglutide once per week. The rest got a placebo.  By the end of the trial, nearly 45% (44.9%) of teens who started the study with obesity had fallen below the obesity threshold, and a quarter had returned to a healthy weight.  “The study demonstrates that the drug Wegovy (semaglutide) was effective in treating teens with obesity,” says Dr. Natasha Agbai, MD, a board-certified pediatrician in San Fransisco specializing in childhood weight management. Wegovy is effective for weight loss in teens with obesity for the same reason it helps adults. “It decreases the appetite so a person gets full faster and doesn’t feel hungry between meals,” Ganjian says.  Ganjian is encouraged by the study but cautions against putting Wegovy on a pedestal alone. “It doesn’t tell us that this is the panacea or magic bullet for obesity,” Ganjian says. Indeed, even the FDA approval indicated that adolescents eligible for a Wegovy prescription should also receive dietary and physical activity guidance. “Typically, dietary changes include eating more fruits, vegetables, and whole grains,” says Dr. Michelle W. Katzow, MD, MS, FAAP, the medical director of POWER Kids Weight Management Program with Northwell Health’s Cohen Children’s Medical Center. “[Also], eating less processed, high sugar, high-fat foods. Physical activity changes include aiming to be active for 60 minutes per day.” Ganjian adds that the trial results do not indicate whether the adolescent will need to be on the medication long-term. A 2022 trial of 2,000 adults indicated that those who stopped taking a weekly 2.4 mg dose of semaglutide regained two-thirds of the weight that they lost within a year of cessation. But adolescents may still be growing. However, Breidbart says teens who start Wegovy will likely need it long-term because obesity is similar to any chronic illness like asthma or diabetes. “It is unlikely we can sustain weight loss effects to the same extent off medication,” Breidbart says. “If we are starting that medication in a teenager, they have chronic obesity. We wouldn’t expect their BMI to normalize as they grow. I wouldn’t expect that a pubertal growth spurt would normalize their BMI.” Breidbart says there may be exceptions, which is why working with a trained medical provider is critical for teens. Potential risks of Wegovy for teens Experts say that Wegovy is generally safe.  “Rare side effects include kidney, pancreas, gallbladder, and thyroid problems,” says Ganjian. Katzow agrees that Wegovy is generally safe but may have some side effects that affect people differently. These side effects may include: Stomach pain Nausea Constipation Fatigue Risks of obesity in teens According to the U.S. Centers for Disease and Control, more than 1 in 5 (22.2%) of adolescents ages 12 to 19 years have obesity, a condition that can have short and long-term effects on health.  “Obesity in adolescents poses significant risks to their overall health and well-being,” says Agbai. “These conditions can have long-term consequences, potentially leading to chronic health problems and reduced quality of life.” Agbai says the risks of childhood obesity can include: Cardiovascular disease Obstructive sleep apnea Obesity in adulthood Depression A 2021 study of participants ages 10 to 23 years indicated that those with high BMI had signs of artery stiffness, which is considered a risk factor for heart disease. A 2016 review indicated that children with obesity and obstructive sleep apnea were less likely to benefit from adenotonsillectomy, which attempts to open airways by removing adenoids and tonsils than their peers at a healthy BMI.  A 2016 review indicated that children who were obese were five times more likely to be obese as adults, which Agbai says “further exacerbates the risks of obesity-related complications later in life.” And a 2022 review suggested a link between obesity and depression, though authors could not say whether one caused the other. Katzow says it’s important to raise awareness of the mental health of young people with obesity. “It may be that a lot of the long-term adverse health outcomes associated with obesity are due to stigma and discrimination, not altered physiology,” says Katzow. “That is not the responsibility of people living with obesity to fix. That is the responsibility of everyone else.” Tackling the topic of obesity with teens In an attempt to avoid feeding into the stigma, parents may be hesitant to discuss obesity and the potential for Wegovy use with their teens who are living with obesity. Katzow says that may not be bad because customization and patient-driven care are critical. “For parents and doctors, we have to start with the teen, their interests, their motivations, their goals,” says Katzow. ”If they don’t want to talk about weight, then it may not be in the best interest of their overall well-being to talk about weight. We can do real damage, and most certainly have, by pushing the issue in the interest of health with a teen who has different goals for their health than their parents or their doctors do.” But Breidbart often sees teens who do have weight-loss goals, and she seeks to help them do so safely and effectively. Lifestyle tweaks are still the first-line treatment, but sometimes those alone are not enough. In those instances, Wegovy may help. Holistic care is critical, including the mental health component. “It’s a conversation that needs to be had with parents, the kids, and sometimes a psychologist to deliver into issues around eating or anxiety that could be contributing to binge eating or overeating or emotional eating,” Breidbart says. “Typically, it’s a decision that takes some time.”

The headlines are difficult to ignore these days.  One cannot help but feel a bit of anxiety when consuming the state of our affairs in the news — war, climate, and the economy.  So you may turn to social media instead for an escape?  Perhaps consuming manicured images or videos of travel, food, and design can help you feel less anxious.  We forget though that this constant intake of information, regardless of the attributes, can be an overload that can further create stress.  As adults, we have had some years of practice to regulate and gate our emotions and thoughts from our daily intake of information, but yet, more of us are overwhelmed than ever before.  According to an American Psychiatric Association study at the end of 2022, 37% of Americans rated their mental health being fair or poor, up from 31% the year before. If the adults are feeling this way, what about our children?  This brings me to the topic of our kids. How are they to navigate amidst our current state of affairs? Our children have had information overload coming out of the pandemic in addition to the constant change in their routines with school closures.  The Surgeon General has described mental health as the “defining public health crisis of our time” and made a mission to address the health crisis that is defining a generation.  A recent CDC report showed the alarming increased statistics of Emergency Department-related visits associated with mental health diagnoses — anxiety, eating disorders, depression, etc.  The call to action for many in the healthcare space is to advocate for solutions that help to prevent, identify, and address these issues in our youths before they are in crisis mode.  I wholeheartedly agree with this approach so that we can bring the right resources to improve the infrastructure for education and literacy, access improvement, and programming development.  But more than anything, we need to address that access to devices and social media at a young age can result in the culmination of what we are seeing today in our preteens and teens.  Should we limit access to devices? The Sapien Labs recently published a pioneering global study with over 27,000 young adult participants. The conclusion is that the later a young adult receives a smartphone the better their mental well-being as adults.  Much research on child brain development has focused on how neural pathways — or the connections within the brain are made by the stimulation of our senses from an early age.  While it certainly is convenient to hand over our mobile device when a child asks for it, the amount of time spent on a device can potentially be re-wiring those connections that are changing sleep patterns and/or creativity as suggested by this Harvard study.  I saw this in my own children after a limited amount of screen time when they were toddlers — the disrupted sleep that ensued.  Social media and mental health More than just the timing or the time spent on devices, social media continues to play a big role as well.  A survey on behalf of OnOurSleeves initiative out of Nationwide Children’s Hospital in Columbus shows that 7 out of 10 parents believe that image editing and filtering apps have a negative influence on their children’s body image.  The Surgeon General today issued a report calling for more action from the tech community in protecting our children’s data.  The same report also addresses the need for families to develop plans around “tech-free” times.  While devices, technology, and social media have many benefits, the deleterious effects on our children — the young brains under development, are contributing to this mental health crisis.  We are just seeing the cumulative effects of over a decade of social media exposure.  We have to decide how we want to act individually and collectively.  As adults, we have our experiences to lean on for developing our habits to take care of our mental well-being.  Our children do not have that luxury.  — Jenny Yu, MD FACS is the chief health officer at RVO Health which owns Healthline Media.

Eating blackberries, apples and other flavonol-rich foods can help lower your risk of developing frailty as you age by 20%. Paul Plews/Getty Images New research suggests that a compound found in many fruits and vegetables can help keep you strong as you get older. The study found that the odds of developing frailty were reduced by 20% for every 10mg of flavonols consumed per day. Experts say this is due to the dietary compound’s anti-inflammatory effects. Individuals can consume more flavonols by eating foods like apples, blackberries, broccoli, and red onion. When it comes to health, there are certain things you expect to happen as you age, like a decline in physical fitness, hearing loss, and the development of frailty.  Now, new research has found that eating flavonol-rich foods, like apples and blackberries, may lower your chances of developing the latter. The study, conducted at the Marcus Institute for Aging Research, found that for every 10mg higher intake of flavonols per day, the odds of developing frailty – a condition that carries a greater risk of falls, fractures, disability, hospitalization, and mortality and affects approximately 10-15% of older adults – were reduced by 20%. In particular, the study concluded that foods like apples and blackberries that contain flavonoids called quercetin may be the most important for frailty prevention. Commenting on the findings, the study authors said in a press release: “There may be some validity to the old saying, an apple a day keeps the doctor (or frailty) away.” The researchers also noted that “individuals can easily consume 10mg of flavonols intake per day since one medium-sized apple has about 10 mg of flavonols.” Flavonols and frailty: What’s the link? “Flavonols are one of 6 compounds that form part of the larger family of compounds known as flavonoids,” explained Dr. Shireen Kassam, co-founder of Plant Based Health Online. “This family of compounds is found in a wide variety of fruits and vegetables and in general they act as antioxidants in the body, protecting cells from oxidative stress by free radicals.” Kassam noted that the consumption of flavonol-rich foods is associated with lower levels of inflammation and cellular stress resulting in a lower risk of various chronic conditions, including: cardiovascular disease type 2 diabetes cancer dementia Where frailty is concerned, Kathleen Benson, a registered dietitian at Top Nutrition Coaching, said flavonols prevent its development in several ways. “Frailty is a condition that is most common with aging and signifies a general decline in physical function. There are a number of features that are typical of frailty, including loss of muscle mass, weight loss, difficulty mobilizing, and fatigue,” she noted. While the exact understanding of how flavonols work in the body is still being researched, Benson said a variety of experiments have shown that flavonoids have antiallergic, anti-inflammatory, antiviral, and antioxidant properties that may provide protection against frailty. She noted that flavonols work alongside other phytonutrients in a variety of mechanisms across the body. “Quercetin – one of the most researched flavonoids – for example, may help with age-related disorders, due to its potent antioxidant properties and how it works synergistically with other nutrients. Put simply, this means that quercetin naturally helps other chemical processes in the body do their job,” Benson explains. Reducing inflammation is the key For Kassam, the positive relationship between flavonol and frailty all hinges on one word: inflammation. “The most likely reason for the positive findings is that flavonols are able to reduce the level of inflammation and cellular stress in the body, which can then protect against the development of frailty,” she reasoned. “Most health conditions are driven by inflammation and when this becomes chronic it can result in physical changes that lead to frailty. Therefore, by reducing inflammation there is a lower likelihood of losing muscle mass and body weight and better functioning of the immune system,” Kassam surmised. Ultimately, both experts agreed that the results of this study are a positive development; one that may help people decide what specific fruits and vegetables they should prioritize as they age. Kassam noted that frailty can greatly impact your overall health and sense of well-being. “The presence of frailty is associated with an increased risk of adverse outcomes from a variety of conditions including infections, increased risk of falls, need for hospitalization, and the need for long-term care,” she pointed out. By eating a flavonol-rich diet, you may be able to negate some of these risks. How many flavonols do you need in your diet? The good news is you don’t need to eat a whole lot of flavonol-rich foods to experience the benefits. While it’s a good idea to eat plenty of fruit and vegetables to maintain overall health, Kassam says this study shows that even small quantities of this compound can have a positive effect. “Just 10mg, found in one medium-sized apple, was shown to have a significant benefit. However, to maintain good health, the key is to eat a variety of healthy plant foods, incorporating fruit and vegetables of different colors,” she said. How to increase your intake of flavonol-rich foods So, now that you know how much you need, how can you increase your intake of flavonol-rich foods? Benson recommended adding foods to your diet such as: blueberries broccoli red onion arugula Crucially, she noted that you don’t have to make massive dietary changes. “Tossing half a cup of kale in a mixed green salad and topping it with 1 tbsp diced red onion along with other preferred ingredients would put you just over 10mg,” she points out. You could also add a handful of blueberries into overnight oats, slice up an apple (which has approximately 10mg quercetin) and pair it with your favorite nut butter, or snack on some broccoli. You might find it offputting to focus solely on one dietary compound such as flavonol – and Kassam doesn’t advise it. Instead, to slow age-related decline, she says it’s a good idea to look at your diet as a whole. “Diets centered around healthy plant foods, including fruit, vegetables, whole grains, beans, nuts, and seeds is considered the best way to maintain good health with aging and will also help to reduce frailty,” she points out.

A new study found that CT scans do a better job than genetic testing at determining heart disease risk when conventional factors are also taken into account. Reza Estakhrian/Getty Images Conventional factors for assessing a person’s heart disease risk are helpful but may not always be the most accurate risk indicators on their own. To improve risk assessments, medical professionals may use genetic testing and CT scans. A new study compared genetic testing to CT scans and found that CT scans do a better job at determining heart disease risk for middle-aged adults when conventional factors are also taken into account. Doctors use different factors to estimate a person’s risk for heart attack, stroke, or other cardiovascular problems. This estimate takes into account conventional risk factors such as age, sex, cholesterol levels, blood pressure, diabetic status, and smoking status, among others. When combined, this information helps doctors decide when to recommend lifestyle changes, lipid-lowering statins, or other medications. Early treatment of underlying factors can reduce the risk of having a cardiovascular problem. While these conventional factors may provide a good assessment of a person’s risk, there is room for improvement. For example, some people may experience a heart attack or other cardiovascular issues even when these factors do not indicate they are at high risk. To improve risk assessment, scientists have suggested including other methods. One of these is a polygenic risk score, which is based on more than 6 million commonly occurring genetic variants associated with heart disease.  Another method is a CT scan for coronary artery calcium, which is a sign of atherosclerosis, a thickening or hardening of the arteries. Now, in a new study, published May 23 in JAMA, researchers found that CT scans for coronary artery calcium do a better job than genetic testing at estimating a person’s risk of heart disease during mid-life, when added to conventional factors. “These findings support recommendations to consider CT screening to calculate risk for heart disease in middle-aged patients when their degree of risk is uncertain or in the intermediate range,” Dr. Sadiya Khan, a cardiologist and assistant professor of medicine and preventive medicine at Northwestern University Feinberg School of Medicine, said in a news release. CT scans improve heart disease risk estimates The American College of Cardiology’s ASCVD Risk Estimator measures the risk for atherosclerotic cardiovascular disease. Low risk means someone has less than a 5% chance of developing cardiovascular disease due to atherosclerosis in the next 10 years. Above a 7.5% intermediate risk, statins are recommended. For the study, researchers looked at data from over 3,200 middle-aged and older adults ranging from 45 to 79 years old from two groups, one in the United States and the other in the Netherlands. All participants were of European descent, so the results may not apply to other groups. The researchers assessed participants’ risk of coronary heart disease using conventional risk factors.  The participants also had a CT scan done to determine their coronary artery calcium score and a genetic test to estimate their polygenic risk score. Researchers followed people for up to 17 years, with regular in-person exams and telephone check-ins. Based on conventional factors, participants’ risk of cardiovascular disease was 6% to 7% on average, researchers found. In contrast, around 8% to 9% of people developed heart disease during the follow-up period. When researchers considered the coronary artery calcium score alongside conventional factors, however, the risk estimate became greater. In contrast, the genetic score had no impact. “This suggests that incorporating genetic information through polygenic risk scores … may have limited clinical utility in predicting coronary heart disease risk, compared to traditional risk factors and the coronary artery calcium score,” Dr. Elliott J Elias, a cardiologist at Baptist Health Miami Cardiac & Vascular Institute, told Healthline. Genetic scores may still be useful Elias, who was not involved in the new study, pointed out that more research is needed to determine how well coronary artery calcium scores predict longer-term outcomes, as well as the cost-effectiveness and feasibility of this test in different healthcare settings. The authors of the new study write that more research is also needed to show whether improving heart disease risk assessments translate to better outcomes for individuals. For example, when doctors communicate this greater risk to their patients, are they more likely to take steps to lower that risk, such as by changing their diet or taking statins or blood pressure medication? A 2022 study by Australian researchers sought to answer this question. While the results of the study found that coronary artery calcium score is useful for predicting heart disease risk, the authors said there may still be a use for genetic scores. “It is possible that the polygenic risk score and coronary artery calcium score may each be clinically relevant at different life stages,” they wrote. Participants in the study were middle-aged or older, so they were more likely to have some amount of calcium in the arteries around the heart, which represents early signs of heart disease. Younger adults, though, may not have developed coronary artery calcium, the researchers said. In this case, a genetic score may be able to identify people who have a higher genetic risk of developing heart disease later on. Coronary artery calcium test recommended Dr. Mary Greene, a cardiologist with Manhattan Cardiology in New York City, said a coronary artery calcium score test is already recommended for people with a borderline to intermediate risk of coronary artery disease. This test helps refine the risk assessment. This recommendation is included in the 2019 American College of Cardiology and American Heart Association guidelines on the prevention of cardiovascular disease. “All persons over 40 years old with at least one cardiovascular risk factor should be getting a coronary artery calcium score,” Green told Healthline. Risk factors may include: family history of coronary artery disease heart attack sudden cardiac death personal history of high blood pressure high cholesterol type 2 diabetes peripheral artery disease stroke Green added that obtaining coronary artery calcium scores in lower risk groups who may have previously been overlooked will provide the “opportunity to aggressively modify their risk factors before overt clinical symptoms of heart disease occur.” “Additionally, going to the cardiologist to be risk-stratified for heart disease can enable one to identify all possible risk factors and manage those risk factors before the overt clinical disease is diagnosed,” she said. Lower your risk of heart disease People who are at higher risk of heart disease — including those who have a higher genetic risk — can take steps to lower that risk. “Taking proactive steps such as quitting smoking, adopting a healthy diet, engaging in regular physical activity, and maintaining a healthy weight are crucial for lowering the risk of heart disease,” Elias said. If your doctor diagnoses you with a health condition such as high blood pressure, type 2 diabetes and high cholesterol, managing these with lifestyle changes and medications can help lower the risk of heart disease. Elias emphasized that reducing your risk of heart disease is not something you do alone but in partnership with your healthcare team. “Encouraging patients to actively participate in their own care by implementing lifestyle modifications and adhering to prescribed treatments is essential for enhancing overall cardiovascular health,” he said. Takeaway Medical professionals assess people for heart disease by taking conventional factors like age, sex, and blood pressure levels into account. While these conventional factors are useful, they are not the only factors for determining heart disease risk. Other methods like genetic testing and CT scans may help provide a more thorough picture of a person’s cardiovascular health. A new study compared the use of CT scans and genetic testing alongside conventional factors and found that CT scans were more effective at determining heart disease risk, but genetic scores may still be useful. Healthy lifestyle choices, weight management, regular physical activity, and avoiding smoking may help reduce your risk of developing cardiovascular problems.