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New research suggests that eating avocado may help lower the risk of type 2 diabetes in females but not males. Westend61/Getty Images A large cross-sectional study has found that avocados may reduce diabetes risk in females, though no significant association was shown in males  Females who ate 30-38 grams of avocado had significantly lower odds of diabetes than those who did not consume avocados.  Experts say the combo of fiber and unsaturated fat found in avocados plays a role in diabetes risk reduction  You can include more avocado in your diet by using it as a spread or dressing or adding it to a smoothie  Avocado may be your first choice food at brunch thanks to its creamy texture and documented benefits on heart health. Now, new research has found that this popular food may lower your risk of diabetes.  A cross-sectional study published in the Journal of the Academy of Nutrition and Dietetics investigated the relationship between avocado consumption and diabetes in adults. This study examined a large sample of more than 28,000 adults of varying ages included in the Mexican National Health and Nutrition Survey. The researchers found that compared to those who did not consume avocados, avocado-consuming females showed a lower risk of diabetes.  Females who ate avocados (30-38 grams/day) had significantly lower odds of diabetes, even after adjusting for various factors such as age, education level, body weight, physical activity, and more. However, while the study revealed a lower risk of diabetes for females who ate avocados, no significant association was observed in males.  Avocados and diabetes risk. What’s the link?  Registered dietitian and doctor of public health Wendy Bazilian, who was not involved in the study, said this study has important implications for the population included in it.  “Given what we know about the nutritional profile of avocados – they have good unsaturated fats, a good source of fiber, and a multitude of vitamins, minerals, and phytonutrients, I’m not surprised to see these findings suggesting that eating avocados may play a role in lower diabetes risk,” she said.  When it comes to the exact mechanisms at play, Bazilian said avocados offer an “ideal trifecta” for diabetes risk reduction.  Firstly, they’re rich in fiber. “Eating foods with fiber helps with blood sugar management and satiety,” Bazilian explained. “As fiber makes its way through the digestive system, it slows down digestion which does two things: it makes us feel fuller for longer and also prevents rapid rises in blood glucose after we eat a meal.” Both are important for reducing your risk of diabetes.  Secondly, avocados are high in unsaturated fat. “Like fiber, fat slows digestion which can help promote blood sugar management and satiety,” Bazilian noted.  Another important aspect of the duo of unsaturated fats and fiber is that both these nutrients support heart health. “Diabetes and heart disease are closely linked because their risk factors are similar,” Bazilian explained. “Avocados are a heart-healthy food, and the unsaturated fat and fiber found in avocados can help to maintain healthy LDL cholesterol levels, which can help reduce the risk of heart disease.”  According to Bazilian, “what’s good for the heart is good for diabetes risk, blood sugar, and metabolic function and control.”  Finally, you might be surprised to learn that avocados are actually fruits. “A healthy eating pattern that is predominantly plant foods, including fruits and vegetables, is associated with a reduced risk of type 2 diabetes and related CVD risk factors,” Bazilian pointed out.  “It’s also important to recognize that, unlike most other fruits, avocados contain no naturally occurring sugars and do not affect the glycemic response,” she added.”  Why avocados may help lower diabetes risk in females and not males  Interestingly, while the study found that eating avocados seems to reduce the risk of diabetes for females, no significant observations were shown in males.  Why might that be?  “The researchers point out that the difference in findings in men vs women may be attributed to the different lifestyle factors between men and women,” Bazilian noted. “Specifically, more men in the study tended to be smokers (~38%) compared to women (~12%), and smoking can increase the risk of developing diabetes.”  Registered dietitian nutritionist Kristen White agreed that differing lifestyle factors could be at play. Additionally, she said it’s possible that hormonal differences between males and females could contribute to variations in how avocados affect metabolic health.  While this particular finding is intriguing — maybe even confusing — Bazilian said it’s important to remember that sometimes we can’t always explain the results we see in nutrition research.  “This is why it’s important to both continue doing research and looking at the body of evidence on a topic and what other studies have shown,” she said.  Simple ways to include more avocado in your diet If the findings of this study have inspired you to eat more avocado, Bazilian said there are some swaps you can make that are “very doable.”  She believes that slightly less than one serving of avocado per day is a healthy amount that’s achievable for most people.  “One way to include more avocado in your diet is to swap mayo or butter on sandwiches with mashed avocado for a creamy, nutrient-rich spread,” White suggested. “You could also replace store-bought salad dressings with a homemade avocado dressing. Simply combine avocado, lemon juice, olive oil, and herbs.”  Another suggestion? “Instead of using sour cream or cheese as toppings, use sliced avocado to add creaminess and flavor to tacos, burritos, or salads,” White advised.  Avocados are also a great addition to smoothies. “Blend avocado into smoothies for a creamy texture and added nutrients, or use it as a base for desserts like avocado chocolate pudding,” White suggested.  Takeaway  Avocados have many proven health benefits, and new research suggests they can reduce your risk of diabetes, too. The results suggest you don’t have to eat a lot of avocados to experience the benefits. You can make simple swaps, like using it as a spread, dressing, or smoothie ingredient to increase the amount of avocados in your diet.

The Food and Drug Administration approved Pivya to treat uncomplicated urinary tract infections in female adults. Maskot/Getty Images The Food and Drug Administration (FDA) recently approved a new antibiotic to treat urinary tract infections (UTIs). Doctors can now prescribe the drug, called Pivya (pivmecillinam), to female adults with uncomplicated UTIs.  Clinical trials show that Pivya is effective and side effects are limited. As antibiotic resistance continues to increase, Pivya’s addition to available treatments is welcome. Urinary tract infections (UTIs) are one of the most common reasons for visits to general practitioners. During their lifetimes, almost 1 in 2 females will experience a UTI, accounting for around 25% of all infections in females. Treatment for a UTI may vary and often require antibiotics. Now, for the first time in 20 years in the United States, the FDA has approved a new oral antibiotic to treat uncomplicated UTIs. The drug, pivmecillinam, marketed as Pivya, is a synthetic version of penicillin. Experts describe UTIs as “uncomplicated” when the urinary tract is otherwise healthy, and there are no ongoing chronic conditions, immune issues, recent urologic surgery, or pregnancy. Treating UTIs with Pivya may be new in the U.S., but doctors in Canada and some European countries have been prescribing the drug for UTIs for the past 40 years. In fact, the first studies demonstrating Pivya’s effectiveness against uncomplicated UTIs were published in the 1970s. Pivya is a narrow-spectrum antibiotic, meaning it kills only a small number of bacterial species. For this reason, Pivya is only approved for use in UTIs caused by Escherichia coli, Proteus mirabilis, and Staphylococcus saprophyticus. The drug is owned by Utility Therapeutics, a company that focuses on treatments for UTIs. Pivya effectively treats UTIs in clinical trials The FDA’s April 24 approval of Pivya was based on the results of three clinical trials: Pivya vs placebo This study involved 271 participants. Of those who received Pivya, 62% achieved the composite response compared with 10% in the placebo group. Pivya vs another antibacterial For this study, scientists recruited 259 people. In total, 72% of those taking Pivya achieved a composite response, compared with 76% of those taking the other antimicrobial. Pivya vs ibuprofen In this study, involving 224 people, 66% of those taking Pivya achieved composite response compared with 22% of those taking ibuprofen.  The most important measure in these studies was the “composite response rate,” which combines two important outcomes: Clinical cure: Symptoms of the uncomplicated UTI are gone and no new symptoms appear. Microbiological response: Levels of bacteria in the urine are reduced. The composite response rate means symptoms have subsided and the bacteria are gone. Taken together, these studies demonstrate that Pivya worked better than placebo and ibuprofen and similarly to other available antibiotics. Side effects were also relatively minor. Most commonly, they included nausea and diarrhea. Are there any risks to treating UTIs with Pivya? Healthline asked Niels Frimodt-Møller, a professor in the Department of Clinical Microbiology at Rigshospitalet in Denmark and expert on UTIs, about the possible side effects of the new FDA-approved drug. “All drugs have adverse effects, but this has relatively few. However, it does produce the same allergic reactions as other penicillins,” he said. The FDA explains that certain people should avoid using Pivya, including those with “carnitine deficiency resulting from inherited disorders of mitochondrial fatty acid oxidation and carnitine metabolism.” Also, people living with porphyria should avoid the drug. Healthline spoke with Bjørn Åsheim Hansen, MD from Vestfold Hospital Trust in Denmark, who has published papers on pivmecillinam. “Of course, there are side-effects like nausea and rash as with every other drug. But Pivya is well tolerated,” Hansen said. As the FDA mentioned, Hansen noted “there have been some concerns” about carnitine deficiency, which may cause serious symptoms. However, Hansen believes this has “insignificant clinical consequences,” and is currently writing a paper on the topic. Prevalence of UTIs is increasing The prevalence of UTIs is on the rise, especially in higher-income countries, like the U.S. UTIs are an unpleasant and painful experience for younger people. In older adults, who are more susceptible to them, UTIs can be even more serious, leading to hospitalization. In some cases, UTIs in older adults can be fatal. While antibiotic treatment for UTIs is generally effective, a growing number of bacteria have developed ways to protect themselves against antibiotics, making them less effective. This is known as antibiotic resistance, and it is a serious and growing public health concern. A global surveillance report from the World Health Organization, (WHO) found that around 20% of E. coli in urine samples — the most common cause of UTIs — were resistant to first- and second-line antibiotics. That’s around 1 in 5 UTI cases, according to the report. Thomas Lodise, PharmD, PhD, a professor at Albany College of Pharmacy and Health Sciences and a clinical pharmacist at the Stratton VA Medical Center in Albany, New York, told Healthline that resistance to “two of the most widely used oral antibiotics for uncomplicated UTIs has been reported to exceed 20% in most regions of the U.S.” This is why discovering new drugs or, as in this case, revisiting overlooked antibiotics, is an important area of research. Antibiotic resistance is a growing concern Having a new antibiotic to treat UTIs is a positive step forward, but it does not completely remove the issue of antibiotic resistance, a growing problem worldwide.  Møller explained that, while Pivya is a “great antibiotic for uncomplicated UTIs, if it’s used too broadly, it will generate resistance as do all other antibiotics.” However, Hansen noted they “have used the drug for decades in Scandinavia and still resistance is not a problem.” Antibiotic resistance related to Pivya is still at low levels — around 5%.  According to some experts, this may be because Pivya does not interfere with bacteria living in the gut. Hansen cited growing evidence that Pivya might also be effective against antibiotic-resistant E.coli, which could have future implications for how this drug is prescribed. Takeaway The FDA has approved the first new antibiotic to treat uncomplicated UTIs in two decades. The move will help health professionals navigate the growing issue of antibiotic resistance and bring relief to many people who experience this condition.

Researchers report that men with heart disease are treated with statins more often than women with the same condition. They note that cholesterol-lowering medications are used more frequently immediately after a diagnosis and decline over the next three years, with the decline more pronounced in women. Women develop heart disease less often than men but have a higher rate of death from it. Men with heart disease are treated for high cholesterol more often than women with heart disease, according to research presented at the ESC Preventive Cardiology 2024, a scientific congress of the European Society of Cardiology. In their study, which hasn’t been published yet in a peer-reviewed journal, the scientists from Sweden examined electronic health records of 1,452 people (1,037 men and 415 women) with a chronic cardiac syndrome diagnosed between 2012 and 2020. The subjects had a mean age of 68 for men and 70 for women. None of the participants had previously had a heart attack. The researchers looked at data on cholesterol levels and dispensed medication from the Swedish National Prescribed Drug Registry. Participants were followed up for three years following their diagnosis. At the end of the third year, 54% of women had been treated with cholesterol-lowering medications compared with 74% of men. Five percent of women were treated with statins compared to 8% of men. The researchers also examined cholesterol levels in individuals diagnosed with coronary syndrome and treatments in different age groups: Less than 60 60 to 69 70 to 79 80 and older Statin prescriptions for women, men The scientists reported that prescriptions of cholesterol-lowering treatment (statins) were highest immediately following diagnosis and declined over the next three years in all age groups. The decline was more pronounced in women compared to men. The study authors reported that for people younger than 60, 65% of women and 79% of men received cholesterol-lowering medication after diagnosis. Three years later, 52% of women and 78% of men continued to receive this treatment. Reaching and maintaining target LDL cholesterol levels was lower in women than in men. “Data has shown that providers did not offer statins as often as men,” said Dr. Laxmi Mehta, a cardiologist at The Ohio State University Wexner Medical Center who was not involved in the study. “One barrier has been the complexity of prescribing medications during the childbearing years,” Mehta explained to Healthline. “When recommended statin therapy, women were more likely to decline it and more likely to discontinue it after starting treatment. Women have less belief in the safety and effectiveness of statins in preventing heart disease.” Healthcare differences for men, women The disparity isn’t just when treating cholesterol issues. According to an article in the International Journal for Equity in Health, gender disparity in healthcare is embedded in the health system. The authors noted that over a 21-year period, women were diagnosed later than men for more than 700 different diseases. “The study highlights an unfortunate inequity in our health system that has led to the under-treatment of women with heart disease,” said Dr. Sameer Amin, the chief medical officer of the LA Care Health Plan in California who was not involved in the study. “As a medical community, we need to ensure equal access to preventative care and refashion our prescribing practices so they are agnostic to patients’ gender, ethnicity, background, and beliefs.” “As with most entrenched issues, the disparity is multifactorial,” Amin told Healthline. “Changing course will require a more aligned system of care that addresses these inequities head-on. We need to push toward a more algorithmic approach to cardiac care. Similar to goal directed therapy for treating blood-borne infections, we know the right thing to do and when. We need to ensure that our prescribing practices have automatic triggers and reminders so that patients do not fall through the gaps. More can also be done to strengthen primary care while focusing on culturally sensitive care.” Experts say there isn’t just one reason for the disparity. “While I don’t think it is intentional, women get lesser care than men in healthcare settings,” said Dr. Yu-Ming Ni, a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California who was not involved in the study. “In the recent past, the American Heart Association has worked to raise awareness of heart disease in women. There is a fallacy that men get heart disease more than women, but that is ignoring the fact that heart disease is the number one killer of men and women.” “We need to keep pushing awareness and place more emphasis on gender-based care. I think about disparities a lot— not just gender but socioeconomic ones as well,” Ni told Healthline. I hope that the newer generation of doctors is more aware of gender bias.” Why statins are prescribed Women develop cardiovascular disease less often than men, according to a study published in 2023. However, they have a higher rate of death from cardiovascular disease. The authors of the study note that cardiovascular disease is under-recognized and often untreated in women. “Despite statins reducing risks of heart attacks and strokes, historically in the U.S., women have also received less aggressive treatment than men in terms of cholesterol management,” Mehta said. Cholesterol-lowering medications such as statins are recommended for both men and women with coronary artery disease. They can help reduce symptoms and prevent heart attacks and death. If statins alone do not lower cholesterol levels, the European Society of Cardiologists recommends adding a second medication, such as ezetimibe (Zetia/Vytorin). “I have noticed that most patients with statin intolerance are women,” Ni said. “This might explain less ongoing treatment with statins, but it wouldn’t explain the disparity in initial prescriptions for them.” Despite the same recommendations for men and women, women are less likely to reduce their cholesterol and achieve the target level. “Cholesterol-lowering drugs save lives and prevent heart attacks and should be prescribed to all patients with coronary artery disease,” Dr. Nina Johnston, a study author and cardiologist at Uppsala University in Sweden, said in a press release. “Unfortunately, our study shows that women are missing out on these essential medications.” “Our findings should be a wake-up call about the under-treatment of women with heart disease,” she added. “Equal prescribing practices are needed so that women receive all recommended therapies and are protected from adverse outcomes.”

A new study suggests regular stair climbing can lower the risk of heart disease and death from all causes. Igor Alecsander/Getty Images New research shows climbing stairs is linked to improved heart health and a reduced risk of all-cause mortality. Experts recommend regular stair climbing for overall health, aiming for three to six flights of stairs daily. To incorporate more stair climbing into your health and fitness routine, take the stairs whenever possible. The benefits of exercise are well-known, from better heart health and lower blood pressure to improved mood. There are many ways to be active on a regular basis, such as taking the stairs. According to the authors of a new study, climbing stairs is associated with improved heart health and longevity. “One of the main motivators behind this study was that I was often seeing people take the lifts at work rather than taking the stairs — even medical students 10 years younger than myself,” Sophie Paddock, MD, of the University of East Anglia and Norfolk and Norwich University Hospital Foundation Trust, in the United Kingdom, told Healthline. “I’d like to think that we can now use the results of this study to encourage people to incorporate more physical activity into their daily lives. We hope that our research will influence policy makers and health care professionals to promote physical activity and stair climbing.” The research is being presented at the European Society of Cardiology’s Preventive Cardiology conference April 25–27 in Athens, Greece. The study has not yet been published in a peer-reviewed scientific journal. Climbing stairs promotes heart health, longevity For this study, researchers conducted a meta-analysis, examining nine studies with 480,479 participants. Participants included healthy adults ages 35 to 84 and adults with a prior history of heart attack or peripheral arterial disease.  Following the analysis, researchers found that stair climbing was linked to a 24% reduced risk of death from any cause and a 39% lower risk of death from heart disease. Climbing stairs was also associated with a reduced risk of cardiovascular events, such as heart attack, heart failure, and stroke. According to the authors, the next steps for the research will be to objectively evaluate the optimal number of stairs people should be climbing each day and at what intensity.  “The current research is heavily reliant on patients recalling their day-to-day activities, which can lead to bias,” Paddock explained. Regular exercise helps prevent heart disease John Higgins MD, a sports cardiologist at McGovern Medical School at UTHealth in Houston, not involved in the study, told Healthline exercise strengthens the heart muscle and improves vascular function, among other positive effects, such as: improved nitric oxide production improved vascular endothelial function reduced cardiovascular risk factors Cardiovascular disease affects the heart and blood vessels. Aerobic exercises such as walking, running, biking, and swimming can help strengthen the heart and improve its ability to function. “Aerobic exercise can help the heart pump blood more efficiently, reducing the risk of heart failure,” Benjamin Boudreaux, PhD, a postdoctoral fellow in Columbia’s Center for Behavioral Cardiovascular Health, told Healthline. Boudreaux was not involved in the study. “Climbing stairs is a form of aerobic exercise, which provides numerous heart health benefits,” Boudreaux noted. Regular aerobic exercise helps lower blood pressure over a 24-hour period, which increases flexibility in the blood vessels and reduces the risk of high blood pressure (hypertension), Boudreaux explained. Exercise also increases levels of “good” HDL cholesterol, he said, which helps reduce “bad” LDL cholesterol and the risk of atherosclerosis, he said. In addition, Boudreaux noted that exercise helps regulate blood sugar and improve insulin sensitivity, which helps reduce the risk of type 2 diabetes and related blood vessel damage. How many stairs should you climb each day? The new study did not make a specific recommendation for stair climbing frequency. According to experts interviewed for this article, aiming for three to six flights of stairs per day (assuming each flight is 10 to 15 stairs) is a good goal for overall health. A 2023 study suggests climbing more than five flights of stairs (or 50 stair steps) daily may reduce the risk of cardiovascular diseases, such as stroke, heart attacks, and blood clots. “When you increase your heart rate through stair climbing, it helps strengthen the heart muscle and makes it more efficient at pumping blood, so the heart works less now to complete its daily mission of pumping blood packed with nutrients and oxygen throughout your body,” Higgins explained. Boudreaux recommended climbing a minimum of at least one flight of stairs daily. “Climbing stairs is considered to be a vigorous physical activity. The amount of time doing this activity may largely depend on the individual’s motive (it could be for fitness or staying active throughout the day),” he said. Tips to climb more stairs Even if you don’t have stairs in your home, there are plenty of ways to incorporate more stair climbing into your daily life. For instance, if you work in an office or other type of building with multiple floors, you can take the stairs instead of the elevator. Other buildings, such as hotels, malls, airports, doctor’s offices, and hospitals, have stairwells that are typically available for public use. “You are more likely to get to your destination faster by climbing a few flights of stairs than being in an elevator that may stop multiple times. At the airport, taking the stairs is a good way to get your legs moving before sitting during a flight,” Boudreaux said. To get the most out of stair climbing, experts recommend picking up the pace to strengthen your cardiorespiratory fitness. You could also try the stair climbing machine at the gym if you belong to one, or invest in a sturdy fitness step and perform step-ups at home. Takeaway Climbing stairs is linked to improved heart health and longevity, according to new research. Experts advise climbing stairs each day, aiming for three to six flights. To incorporate more stair climbing into your day, take the stairs whenever possible, whether at the office or other public venues, use a stair climber at the gym, or perform step-ups on a fitness step at home.

The FDA announced that traces of the bird flu virus have been detected in dairy milk. Grace Cary/Getty Images The FDA has discovered the presence of the avian flu virus in dairy milk. Commercially available milk products are still believed to be safe for consumers because they have undergone pasteurization. Raw milk products may carry the avian flu virus, in addition to other risks. Avian influenza, or bird flu, has been detected in dairy milk in the United States, but the FDA has indicated that the disease has a low likelihood of causing illness in humans. In an advisory issued this week, the Food and Drug Administration announced that they — along with the CDC and the USDA — are investigating the presence of H5N1 avian influenza in dairy cows and their milk. The disease, known as highly pathogenic avian influenza (HPAI), is very contagious and often deadly in poultry, but, despite its name, is not readily transmissible to humans, though some infections have occurred.  The FDA has stated that despite identifying bird flu in raw milk, as well as traces of the H5N1 virus in milk sold at grocery stores, commercial dairy products are still safe to consume because almost all of them (99%) have undergone pasteurization. However, the virus may be present in raw milk products, which the organization has continuously warned consumers about. William Schaffner, MD,  a Professor of Infectious Diseases at the Vanderbilt University Medical Center, concurred with the FDAs assessment that transmission of the disease is unlikely, especially from milk. “This is a virus that does not have the genetic capacity to be transmitted from person to person. And this virus has been around in the world, in bird populations for a decade, and it still has not acquired this capacity,” he told Healthline. “I have in my hand a cup of coffee with milk in it. I put milk into my oatmeal. I had no concern about it,” he added. How did bird flu get into the milk supply? According to the latest information, the FDA has confirmed the detection of HPAI in dairy cow herds in several states, including Idaho, Kansas, New Mexico, Texas, and more. In an announcement yesterday, regulators issued a federal order requiring testing for and reporting of HPAI in livestock. Despite being found in dairy cows, to date, regulators and public health entities are only aware of two cases of HPAI transmission to humans. At the beginning of April, the CDC announced that an individual in Texas was confirmed to carry the disease. The patient had been exposed to dairy cattle, but the report wasn’t more specific. The exposure resulted in symptoms of conjunctivitis (“pink eye”), and the individual was subsequently treated with antiviral medication for flu. A previous case of transmission occurred in Colorado in 2022 when an individual known to be working around HPAI-infected poultry tested positive for the disease. The individual reported symptoms of fatigue and was again treated with an antiviral. Diseases transmitted between animals and humans, known as zoonotic diseases, are very common. According to the CDC, more than 60% of infectious diseases in humans can be spread from animals, and 75% of emerging diseases in people come from animals.  Transmission can also occur between different species of animals, such as birds and cows. “When wild birds set down to drink water and feed along their migratory path, they can actually excrete the virus out of their saliva and their urine and their poop, and put it into the environment in such a way that it can occasionally get into mammals,” said Schaffner. From there, it can easily spread across feedlots and, in this case, the milk supply. “Not surprisingly, in a herd that’s jammed close together, where there’s a lot of cow saliva and urine and poop,  it can be transmitted among the cows,” he said. Why commercial dairy products are still considered safe for people Though virus particles of HPAI have been detected in pasteurized milk, the risk of transmission of HPAI is extremely unlikely, but it may be possible in raw milk. “The FDA does not have any concerns that our milk supply is contaminated and see no health threat or concerns for consumers at this time,” Joseph Lambson, PharmD, Director of the New Mexico Poison and Drug Information Center, and an Assistant Professor at the University of New Mexico College of Pharmacy, told Healthline. “They still highly urge against using raw milk or products that utilize raw milk for the same concerns that they’ve been saying for years and years, which is you’re just at increased risk of infection. And so you can definitely include this highly virulent form of avian flu to that list,” said Lambson. The FDA warns that raw milk can carry dangerous pathogens, including salmonella, listeria, and campylobacter. Commercially available milk undergoes pasteurization, which is a process in which milk is heated and then cooled in order to destroy pathogens. The process has been used on milk for public health purposes for over one hundred years in the United States.  “Pasteurization is required by the FDA if you’re moving milk products from one state to another. They have to follow a specific temperature and time. That should kill the virus. So the inactive virus may be in the milk, but it’s not going to be able to replicate, so you can drink it safely,” said Sylvia Ley, PhD, an Assistant Professor of Epidemiology at Tulane University School of Public Health and Tropical Medicine. Viral fragments may remain in milk after pasteurization but are not considered to pose a risk to consumer health.  Additionally, the FDA and USDA have stated that milk from sick cows is actively being diverted from the food supply. Lambson encourages anyone concerned that they have consumed a contaminated product to contact their poison control center, where they can get medical advice about symptoms to look for and whether or not they should seek medical treatment. “Additionally, it also helps from a surveillance purpose to see if we’re having an increase of exposures,” he said. The bottom line The FDA has discovered the presence of avian influenza in dairy milk. Regulators have cautioned that there is little to no risk of infection in commercial milk due to pasteurization. However, the virus may be present in raw milk. Only two known cases of transmission of the virus are known to have occurred recently in humans.

New research finds that over 50% of Millennial and Gen-Z TikTok users are influenced by diet and nutrition trends on the platform, yet only 2% of nutrition content on the app is accurate. mixetto/Getty Images A new survey found that 57% of Millenial and Gen-Z TikTok users reported being influenced by or frequently adopting nutrition trends they learned about on the platform. However, only about 2% are accurate compared to public health and nutrition guidelines. Experts are concerned about TikTok’s influence, given the potential for misinformation. The fact that fad diets and nutrition advice are widely shared on social media platforms like TikTok is not new news. However, a new survey conducted by MyFitnessPal and Dublin City University suggests the majority of diet and nutrition trends on TikTok are not aligned with public health and nutrition guidelines. Even more concerning is that of the 2,000 Millennial and Gen-Z TikTok users surveyed, 57% of respondents said they had been influenced by or frequently tried nutrition trends they saw on the platform. Yet, only 2.1% of nutrition content on the platform is accurate, according to an AI-based analysis of more than 67,000 videos conducted with Dublin City University that compared TikTok videos against regulated public health and nutrition guidelines. “The latest research conducted by MyFitnessPal, which partnered with Dublin City University, uncovered that there is a tremendous amount of health and nutrition misinformation on TikTok,” says Dr. Joan Salge Blake, EdD, RDN, LDN, FAND, a nutrition professor at Boston University, author of Nutrition & You, and the host of the nutrition & health podcast, Spot On!, who was not involved in the study. How the survey was conducted The new data comes as part of a two-part project. First, MyFitnessPal polled 2,000 Millennial and Gen-Z TikTok users. Of the 57% of people who reported being influenced by TikTok health and nutrition trends, more than two-thirds (67%) said they tried at least one of the viral ideas a few times weekly. Furthermore, 30% of respondents said they tried the TikTok trend despite potential health risks, and 31% reported feeling an adverse effect from a “fad diet” trend. “Every individual has different needs, and when people try to adapt to the same fads or concepts, individuals . . . can create nutrient deficiencies by removing whole food groups, and if they are not getting what they need, they will eventually negatively affect mood, focus, and cognition ,” says Amy Goldsmith RDN, LDN, the founder of Kindred Nutrition. MyFitnessPal also teamed up with Dublin City University to analyze more than 67,0000 videos with nutrition content using artificial intelligence and compared them to regulated health and nutrition guidance. Preliminary findings indicated that only 2.1% was accurate when checked against this guidance. And the 97.9% of content not included was classified as inaccurate, partially accurate, or uncertain because of a lack of scientific evidence supporting the claim. Despite TikTok’s influence, Gen-Z users said they trusted content from qualified registered dieticians over information dispensed by uncredentialed influencers. “Unfortunately, this doesn’t stop them from adopting trends from unqualified people,” worries Emily Van Eck, MS, RD. “That so many people are adopting baseless trends and being harmed by them is unsettling.” Blake shared similar sentiments. “While extremely concerning, these findings support other studies that have identified that unqualified individuals are providing nutrition and health misinformation and disinformation,” Blake says. It’s also in step with TikTok’s broader influence. PEW Research from 2023 indicated that the number of U.S. adults regularly getting their news from TikTok quadrupled in three years, from 3% in 2020 to 14% in 2023. About one-third (32%) of people ages 18 to 29 reported regularly getting their news via TikTok.  Potential limitations of the study While one dietitian is also concerned by the findings, she notes it’s important to acknowledge the manner in which the survey was conducted leaves room for flaws. “It is vital to acknowledge that at this time, we do not have enough evidence to suggest whether — and if so, to what extent — AI can, on its own, determine whether a video or piece of content follows public health and nutrition guidelines,” said Maddie Pasquariello, MS, RDN, who was not involved in the study. Additionally, while bias is an issue on TikTok, especially when influencers are paid to promote certain products, Pasquariello cautions that MyFitnessPal is not unbiased, either. The app dispenses nutrition information. “We could make the deduction that by telling folks not to turn to TikTok, they might turn to MyFitnessPal instead — and, as they suggest, use the “tool” on their website, bringing more people to their platform,” Pasquariello says. “They have as much of a vested interest in keeping eyes and clicks on their website as TikTok does.” A small study of 20 women with an average age of about 22 who self-monitored their diet on MyFitnessPal indicated that experiences varied and that, while it can be useful for some, it could become harmful if used obsessively.  Tips to fact-check the accuracy of TikTok health and nutrition claims Blake says the misformation found on TikTok poses numerous health risks. “Nutrition misinformation can be dangerous if followed without the guidance of a person’s health care provider and the nutrition expertise of an RDN,” Blake says. “Many folks are on medications and have chronic medical issues such as diabetes, heart disease, and high blood pressure for which they must follow a specific diet to meet their nutrition needs. Also, extreme dieting and the promotion of elimination diets that are often promoted via social media can feed into disordered eating and malnutrition, especially among young adults.” However, as the survey indicates, qualified individuals are dispensing information on social media. “Though it’s never where I recommend folks go first for nutrition advice, social media can still be a useful tool for spreading awareness about public health initiatives and evidence-based nutrition advice,” Pasquariello says. “Though they’re few and far between, some influencers and experts know what they’re talking about and are extremely rigorous in the content they put out.” How can you determine who is who? Experts say following these simple tips can help. Consider the source Credentials matter. “Health coaches and nutritionists — and many of the “experts” who grace our podcast feeds — are not required to undergo any training [in many states] to give themselves these titles,” Pasquariello says. “They often fail to properly synthesize research or consider new studies in the context of our understanding of the evidence at large, as they never received training in parsing literature for a lay audience. Their aim is to get views and listens and to make money.” Pasquariello notes that RDs must undergo extensive, science-focused education and hundreds of hours of training under supervision, including work in clinical nutrition and research settings. “Beyond that, they have to stay up to date on the latest research and obtain continuing education credits in order to retain their credentials year to year,” she says. In short, look for RD/RDN in a person’s bio.  “The RDN has also passed a national exam administered by this accrediting body,” Blake says. Starting in 2024, all RDN candidates will be required to hold a master of science degree before taking this national exam.” Do some research Pasquariello suggests fact-checking information, including any studies touted by influencers — even RDs/RDNs. “It’s important that any RD you’re getting nutrition advice from is able to present peer-reviewed science-based information to back up the advice they’re dispensing or claims they’re making,” Pasquariello says. “Optimally, this means randomized, controlled clinical trials and meta-analyses.” Read past the abstract at the top of the study. “So many people who push out nutrition advice online fail to actually read a study in its entirety before making sweeping claims about something that may have appeared in one line of the abstract of a long piece of scientific literature,” Pasquariello says. Additionally, see if there are more recent studies. “This is one of the most important ones, but I think it is the least talked about,” Pasquariello says. “As medical professionals and RDs, we have an obligation to look at any new study in the context of the literature at large. Whenever a new study comes out that seems to upend what we know about a subject or presents an entirely new direction to the research, I like to picture the findings as a tiny dot inside a huge circle. Yes, we should consider new pieces of evidence, but always in the context of everything else in that arena to date.” Spot keywords Pasquariello says some popular buzzwords are red flags, including: Toxic/toxins Poisons Chemicals Quick-fix Cleanse Detox Reset Quick weight loss Never eat X Always do Y “I also grow wary whenever someone mentions supplements, gut health, cortisol, hormone imbalance, gut reset, heal your gut lining, and the like without clarifying explicitly what they mean and in what scenarios,” she says. If you’re judicious, you’ll soon realize just how often these terms are thrown around as vague, eye-catching mentions rather than being fully explained or contextualized.  Do a gut check Van Eck suggests checking in with yourself before following advice found on TikTok. “Keep in mind that one person’s experience is not proof that something is right for you, even if they are an expert,” she says. “Think critically about the tip they are offering.” She suggests asking yourself: Is adopting this trend going to take a considerable amount of time, money, or attention resources from me that might be more significant than the potential benefit?  Does the nutrition hack seem too good to be true? (“It probably is,” Van Eck says.) Do I think that because this person is “thinner,” younger, more toned, or has smoother skin, trying this questionable trend will make me look more like them? “If it seems like they’re showing off their body, they likely feel as if their body is their business card,” Van Eck says. “That is a red flag.” Use evidence-based resources While the information found online can be murky, there are evidence-based resources people can turn to. The experts Healthline spoke with recommended the following: The United States Food & Drug Administration (or applicable governing body in your country) Food and nutrient databases from the U.S. Department of Agriculture National Institutes of Health Center for Disease Control and Prevention (CDC) Additionally, in-person resources, such as through RDs and RDNs or WIC programs, can also assist in the form of accurate information. Takeaway New data from MyFitnessPal indicates that nearly 6 in 10 Gen-Z and Millenial TikTok users are heavily influenced by health and nutrition content found on the platform. However, in a further analysis with Dublin City University, preliminary findings suggested that only 2.1% of the information was accurate compared to regulated health and nutrition guidelines. Experts say it’s best to seek information from RDs and RDNs, who have vast training in nutrition. Fact-checking claims by looking at the actual study, reading past the abstract, and seeking data from additional studies to support or refute the claim made by a person online is also helpful. Seeing an RD or RDN in person or using websites from regulated bodies for information, such as the CDC or FDA, can also help you find more accurate insights and data to support your health.

New research finds that consistently getting good quality sleep can help reduce cardiovascular disease risk. Halfpoint Images/Getty Images A new study found that older adults who maintained good sleep quality over a five-year period had a lower risk of cardiovascular disease. However, even people with good sleep quality only at one point in the study had a lower cardiovascular risk compared to those with ongoing poor sleep quality. The study focused on poor sleep quality, but sleep disorders such as sleep apnea can also increase the risk of cardiovascular disease. Sleep and health are intimately connected, with poor sleep linked to a greater chance of developing obesity, diabetes, heart disease, depression, and anxiety. While research shows the importance of high-quality sleep, many studies have looked at people’s sleep patterns at one point in time. But sleep habits can change over the course of a person’s life, so a single measurement may not always show the whole picture for someone’s health over their lifetime. To gain a better understanding of how changes in sleep patterns affect health, researchers from China examined people’s sleep patterns at two different time points, several years apart. As with earlier research, they found that higher quality sleep was linked to better health — in this case, a lower risk of coronary heart disease and stroke. These benefits were greatest for people who slept well at the start and end of the study. However, even people who had high quality sleep only at one point in time saw a lower risk of cardiovascular disease compared to those with ongoing poor sleep quality. The new study was published April 23 in JAMA Network Open. How sleep quality affects heart health The study included over 15,000 retired workers from China who completed questionnaires and had medical examinations about five years apart. Researchers collected genetic data from some people, which was used to determine their cardiovascular risk. People were excluded from the study if they already had cardiovascular disease or cancer at the start of the study.  Researchers used the questionnaires to determine people’s sleep quality. “Favorable” sleep was based on four factors: bedtime between 10 pm and midnight, sleeping 7 to 8 hours per night, good or fair sleep quality, and napping 60 minutes or less during the day. Researchers found that people with “favorable” sleep patterns at either point in time were less likely to have a cardiovascular disease event (coronary heart disease or stroke) compared to people with poor sleep patterns at both times. Even people who had good sleep at the beginning and worse sleep at the follow-up visit had a lower cardiovascular risk compared to those with ongoing poor sleep. However, people who reported high sleep quality (persistent favorable sleep) at both time points had the lowest cardiovascular risk. This included a 16% lower risk of coronary heart disease and a 34% lower risk of stroke. When researchers took into account the effect of people’s genes, they found that those with a low genetic risk for cardiovascular disease and favorable sleep patterns at both time points had the lowest cardiovascular risk. The lowest-risk group had a 35% lower risk of coronary heart disease and a 52% lower risk of stroke compared to people with high genetic risk and ongoing poor sleep. However, the findings showed that even people with an intermediate or high genetic risk for cardiovascular disease have benefits from good sleep quality, with a 64% lower risk in the good sleep quality group. So, “even with the presence of genetic factors associated with cardiovascular disease, good sleep quality decreased people’s risk of developing cardiovascular disease,” said Cheng-Han Chen, MD, interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, Calif. Sleep patterns are often consistent The results of the new study are similar to earlier research that used survey data to assess people’s sleep quality, said Safia S. Khan, MD, a specialist in sleep disorders and an associate professor in the Department of Family and Community Medicine and the Department of Neurology at UT Southwestern Medical Center in Dallas. However, the new study is one of the first to look at changes in sleep patterns and the risks from cardiovascular disease over time, she told Healthline. In another study that assessed sleep quality at two points in time, researchers followed middle-aged European participants for nine years. They found a lower cardiovascular risk for people with higher-quality sleep patterns and for those who improved their sleep habits over time. These results are similar to the findings in this latest study. The earlier study also showed that many people have consistent sleep patterns, with only 19% of participants changing their sleep patterns over the course of the study. “For middle-aged people and retirees, their sleep patterns are not going to change significantly from year to year,” said Khan. “So essentially, we can assume that these people [in the new study] had the same type of sleep pattern before the survey was conducted.” That means the results of the study are a good indication of the link between cardiovascular outcomes and sleep patterns, she said. Another unique aspect of the study is that it focused on retired older adults, who may have more natural sleep patterns than middle-aged people, who often adjust their sleep habits to their work schedules, the authors wrote.  Sleep is a key part of heart health Although the study fits with earlier research, it has certain limitations. For example, because the participants were all older adults from China, the results may not apply to younger people or those with different racial or ethnic backgrounds. So “we need to have more studies from other regions of the world,” said Khan, “to see if these results can be replicated in those other areas.” In addition, this was an observational study, which means “it doesn’t necessarily show that poor sleep quality causes the cardiovascular condition,” Chen told Healthline, only that there is a link between the two. “It could be that there are other factors, such as depression or stress, that cause both poor sleep quality and cardiovascular disease,” he said. Researchers didn’t take into account all of these other factors. For example, “they didn’t look at other aspects of sleep quality that we consider very important,” said Chen, “specifically, sleep disorders such as sleep apnea, which is a risk factor for cardiovascular disease.” Khan agreed. “We don’t know how many people had sleep apnea, insomnia, restless legs, or other sleep disturbances,” she said. “Or if their spouses had significant sleep apnea or snoring that could be disturbing [people’s] sleep.” Although Khan thinks future studies should take into account these other factors, she said we already know that sleep quality is an important aspect of heart health. The American Heart Association even includes getting healthy sleep as one of its eight essential measures for improving and maintaining cardiovascular health, alongside managing weight, controlling cholesterol, eating better, and staying active. “Whenever I talk to my patients about cardiovascular health and improving their cardiovascular risk factors, I always mention sleep quality and the idea of getting good sleep, as well as asking if they’ve been checked for sleep apnea,” said Chen. Takeaway In a study of over 15,000 retired workers, researchers found that those who maintained good sleep quality over a five-year period had the lowest risk of cardiovascular disease, specifically coronary heart disease and stroke. However, even people who had good-quality sleep at only one point in the study had a lower risk of cardiovascular disease compared to those with poor sleep throughout the study. The study relied on questionnaires to assess people’s sleep quality, which may not be accurate. In addition, researchers didn’t assess other factors that can affect cardiovascular disease risk, such as sleep disorders such as sleep apnea and depression.

New research suggests that people who take antacids may be at greater risk for migraine attacks and severe headaches. ingwervanille/Getty Images A study of more than 11,000 adults suggests an association between migraine attacks or severe headaches and acid-suppressing medications like proton pump inhibitors (PPIs). An estimated 20% of adults in the U.S. have GERD, which can cause heartburn and acid reflux. These types of drugs are widely used to treat them. However, the study does not state that these classes of acid-suppressing medications cause migraine attacks or severe headaches. People who take antacids may be at greater risk for migraine attacks and severe headaches, a new study using data from more than 11,000 people suggests. The study, published in Neurology Clinical Practice, [EMBARGOED UNTIL 4PM EST], identified the potential link between proton pump inhibitors (PPIs) like esomeprazole (Nexium) and omeprazole (Prilosec), antacid supplements, and histamine H2-receptor antagonists (H2RAs) like famotidine (Pepcid AC) or cimetidine. The risk of migraine and severe headache, when compared with people who used no acid-suppression therapy, was 70% higher for those using PPIs, 40% higher for those using H2RAs, and 30% higher for those taking generic antacids. All drugs examined in the study were prescription only. The data did not look at most over-the-counter medications. Some of them were made available at nonprescription strength during the study, but those were not included. Acid reflux, a condition in which stomach acids and contents can return to the esophagus, causing irritation, burping, and burning pain, is an aspect of gastroesophageal reflux disease (GERD). According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 20% of Americans have GERD. Those who are overweight or obese, pregnant, or either smoke or are exposed to secondhand smoke regularly are at the highest risk for GERD, but anyone can develop it. The study used data from adults in the National Health and Nutrition Examination Survey from the years 1999 to 2004. That survey is a cross-sectional analysis that has been continuously conducted since 1999, but only in those first five years did it contain a question about headaches and migraine attacks. The study results are associative, so the results do not suggest that antacids are causing migraine episodes or severe headaches. How are acid reflux and migraine episodes connected? Dr. Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, told Healthline that there’s not one known connection between acid reflux and migraine episodes, but all PPI drugs, H2 blockers, and antacids are known to produce side effects like headache, nausea, and fatigue. “One theory is that it is a problem with the person’s central nervous system or glutamate level, which is one of the pain pathway facilitators, and that might link acid reflux disease and headaches,” Mikhael said. “When acid is overproduced and retained, it causes an inflammatory cascade in the mucosa of the stomach and esophagus.” He noted that several mechanisms could be behind the triggering of the headache or migraine. The first would be the use of PPI, as the class of drugs can interfere with the absorption of magnesium and other vitamins, which then can trigger headaches and worsen migraine episodes. “Another theory is the inflammatory cascade reaction that starts at the GI level can trigger the central nervous system to facilitate the release of the calcitonin gene-related peptides that would trigger migraine,” Mikhael added. Dr. Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, who was also not involved in the study, told Healthline that, in general, high levels of stress could create conditions for GERD or migraine. “In my clinical practice, I see countless patients with increased life stress causing disabling headaches, and many of these patients’ increased life stress also causes disabling GERD,” Segil said. “It is challenging as a neurologist to explain why any stomach acid level-changing medications would cause a change in a patient’s brain to increase or decrease the frequency of headaches or migraines, but it easy as a neurologist to blame increased life stress on causing patients to have migraine headaches and GERD.” Why are proton pump inhibitors so associated with migraine episodes? PPIs are a widely used treatment for GERD that can halt the production of acid and relieve heartburn. They take longer to take effect than H2RAs but tend to have more lasting results, with the intended use being between four and 12 weeks. Mikhael pointed out that PPIs’ effect on magnesium absorption in the body could have a strong role in the development of migraine episodes or severe headaches, and the fact that this class of drug is so often used could be a possible connection. Segil again pointed to stress as a significant factor but noted the connection between strong GERD and headaches. “Proton pump inhibitors are the most potent acid-decreasing medications available and are newer and work better than old H2(histamine) blocking medications and antacids,” Segil said. “Patients with increased life stress would be expected to produce more acid as a stress response, which is what I see in clinical practice. Patients with increased life stress would also be expected to have more frequent headaches,” Segil said. He added, “I am not surprised to see the treatment group requiring the strongest acid-decreasing family of medications, PPIs, to have the most frequent headaches as a comorbidity. I was surprised to see the placebo group in the weakest of the stomach acid-producing medications to have the highest number of migraines, which was 20% of the placebo group versus 22% of the patients taking antacid supplements.” Takeaway A study of more than 11,000 adults suggests an association between migraine attacks or severe headaches and proton pump inhibitors (PPIs) like esomeprazole (Nexium) and omeprazole (Prilosec), antacid supplements, and histamine H2-receptor antagonists (H2RAs) like famotidine (Pepcid AC) or cimetidine. An estimated 20% of adults in the U.S. have GERD, which can cause heartburn and acid reflux; these drugs are widely used to treat them. The study does not state that these classes of acid-suppressing medications cause migraine episodes or severe headaches; it’s an associative finding from existing data.

Can weight loss drugs like Ozempic, Wegovy, and Zepbound really alter your personality? FreshSplash/Getty Images “Ozempic personality” is a side effect reported by some users of popular GLP-1 obesity and diabetes medications. The term refers to a cluster of mental health issues, including increased anxiety, depression, and anhedonia. Experts contacted by Healthline disputed the term and reaffirmed that GLP-1 medications are safe and effective. First, there was “Ozempic face,” then “Ozempic butt,” and now there’s a new side effect known as “Ozempic personality,” being reported among users of the popular drug — but what is it, and is there any scientific backing? Terms like “Ozempic face” and “Ozempic butt” have gained traction among the general public to describe the profound weight loss effects of Ozempic and similar drugs. These drugs (which include Wegovy, Mounjaro, Zepbound, and others) belong to a class of drugs known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs). These medications work by simulating a hormone secreted in the gut that slows digestion, makes you feel more full, and increases feelings of satiety in the brain. The drugs have proven incredibly effective for weight loss, with some patients losing 20% of their body weight.  Such powerful medication has created a whole new vocabulary for how people talk about their experiences, leading to terms like “Ozempic butt.” While these terms are certainly not valid scientific terms, they can potentially be indicators of side effects. The latest term, “Ozempic personality,” which has been reported across social media and has shown up in various media outlets, including the NY Post and The Daily Mail, suggests that patients using GLP-1 drugs may experience changes in their mood and demeanor. Some have gone on to say that the drugs have caused increased anxiety, depression, and even suicidal ideation. It should be noted that, despite these anecdotal reports, a large study recently found no link between GLP-1 medications and suicidal ideation. Furthermore, experts contacted by Healthline refuted many of the claims made about “Ozempic personality” and decried the negative light that it puts on individuals using the drugs. “Whoever is coming up with this stuff really doesn’t get it,” Caroline Apovian, MD, a Professor of Medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, told Healthline. Sun Kim, MD, an Associate Professor of Endocrinology at Stanford Health, told Healthline:  “GLP-1s can change your relationship to food. Food is an integral part of social activity, and when it is less important to you, it can change your social interactions. My patients, especially those who have diabetes or significant comorbidities associated with obesity, are mostly happy with their new lifestyle on GLP-1s. They can worry less about food; they can be more active.” What is ‘Ozempic personality,’ and is it real? While there is no single definition for the term, it encompasses a cluster of symptoms or feelings. The most commonly reported symptoms of “Ozempic personality” are: Worse mood Increased feelings of anxiety and depression Feelings of anhedonia, or lacking an interest in previously enjoyed activities Decreased libido (less interest in sex) These negative feelings are generally attributed to changes in the dopamine or “reward center” of the brain. But it’s not entirely clear how GLP-1 drugs are interacting with dopamine in the brain. Derek Daniels, PhD, a Professor and Chair of the Department of Biological Sciences at the University at Buffalo, has studied the effects of GLP-1 medications on thirst and drinking behavior in animal models. “As we’re getting these signals from the process of eating or drinking, it’s all feeding back to the dopamine systems, making them less responsive to more eating or drinking,” he told Healthline. “Whether the GLP-1 is making an animal feel full faster and then those signals are what’s turning down dopamine or if GLP-1 is acting directly on the dopamine receptors, so that they’re less responsive, I don’t know the answer to that,” said Daniels. But there could be a simpler answer, too: eating less, losing weight, and giving up foods you love is hard. “You’re soothing yourself with all these bad foods and developing obesity, and so now you don’t feel like rewarding yourself with sugary food, and you’re in a bad mood. It’s not the Ozempic that did that. It was the addiction in the first place. That’s how I think people should look at this,” said Apovian. The link between weight loss drugs and addictive behaviors By directly or indirectly affecting the dopamine system, GLP-1 drugs like Ozempic and Wegovy might play a larger role in diminishing cravings of all kinds. “It doesn’t surprise me that there are overall changes in people that are on these drugs. I think some of them are probably subtle, but in animal models, these drugs turn down almost any motivated behavior that we can imagine,” said Daniels. Researchers have looked at the role these medications can play in other addictive disorders, including drugs, alcohol, and tobacco. A review of the medical literature published in 2022 found that GLP-1 drugs resulted in “potent reductions” in alcohol and substance use. The report also states, “individuals suffering from obesity and individuals suffering from addiction have overlapping brain dysregulations, and the anti‐obesity effects of GLP‐1 receptor agonists support the potential usefulness of GLP‐1 receptor agonists for the treatment of substance use disorder and alcohol use disorder.” Another study from that same year found that GLP-1 drugs could also “represent an important step in the development of novel drug therapies for cocaine use disorder.” How to address “Ozempic personality” Experts agreed that they do not like the negative connotations of the term “Ozempic personality,” but that doesn’t mean that individuals using GLP-1 drugs won’t deal with real mental health issues. “I don’t like that headline. I don’t think it’s changing personalities at all. I think it’s changing the way that people are thinking about food,” said Rachel Goldman, PhD, a licensed psychologist in private practice in NYC and clinical assistant professor in the Department of Psychiatry at New York University. Goldman, who works with patients with obesity and those who have undergone bariatric surgery, understands the challenges, both mental and physical, that patients go through during weight loss. “It’s going to help you become healthier. It’s going to help you on this health journey, but depending on what’s going on in your life, it may or may not improve those depressive symptoms. It’s unrealistic to think that just losing weight is going to make everybody happy and healthy.” She encourages anyone taking weight loss drugs who is experiencing mental health issues to address them with a healthcare professional. Daniels adds that it’s also important to see the big picture with any course of treatment:  “These are really promising drugs. I think you have to balance the risks and the benefits of the drug with what you’re trying to treat. Clearly, obesity is a huge health problem that carries all kinds of horrible risks. So, even if there is a downside to  these drugs, you have to take that in the context of all of the upsides.” The bottom line Reports of so-called “Ozempic personality,” have begun appearing on social media and through various news outlets. The term is not a scientific one but characterizes a sense of worsening mental health, including anxiety, depression, and anhedonia in individuals taking GLP-1 medications like Ozempic and Wegovy. Experts interviewed by Healthline expressed their frustration with the negative connotations of the term and reiterated that GLP-1 drugs are safe and effective. Individuals experiencing mental health issues should address them with healthcare professionals.

The risk of AFib may be higher for people under 65 than previously believed. anadorado/Getty Images A new study suggests that atrial fibrillation (AFib) may be more common in people under 65 than shown by previous research. Younger people with AFib also had an increased risk of dying or hospitalization compared to similarly-aged people without AFib. Experts say it is not clear if AFib is increasing among younger people or if doctors are detecting it more often. It may be both. Atrial fibrillation (AFib or AF), a condition involving irregular heart rhythms, is more common in people under the age of 65 than previously thought, a new study shows.  Adults in this age group also had an increased risk of dying and being hospitalized for heart attack, heart failure, or stroke, compared to similarly-aged people without AFib, researchers found. “Common knowledge among cardiologists is that, in people under 65, AFib is extremely uncommon and not detrimental. But there really hasn’t been any data to back that up,” study author Aditya Bhonsale, MD, a cardiac electrophysiologist at University of Pittsburgh Medical Center’s Heart and Vascular Institute, said in a release. The study was published April 22 in the journal Circulation: Arrhythmia and Electrophysiology.  What is AFib? Atrial fibrillation, the most common type of arrhythmia, affected an estimated 5.2 million Americans in 2010, with this expected to grow to 12.1 million by 2030. This condition causes the heart to beat irregularly and sometimes faster than normal, which can lead to symptoms such as feeling lightheaded, tired, or dizzy. You may also feel like your heart is fluttering, beating too quickly or hard, or skipping a beat. Left untreated, AFib can cause heart disease or make your existing heart disease worse. It also increases the risk of complications such as heart failure and stroke. “AFib is typically a disease of older people,” said Bradley Knight, MD, medical director of electrophysiology at Northwestern Medicine Bluhm Cardiovascular Institute in Chicago, who was not involved in the study. “As people get older, they can develop abnormalities in the atrium [of their heart], which can lead to atrial fibrillation.” While the risk of AFib among older adults is well known, this condition was previously thought to be not very common among younger adults.  For example, a 2001 study found that less than 1% percent of American adults younger than 55 years old had AFib, compared to 9% of people 80 years or older. Similar results were seen in a more recent European study. Why reports of AFib risks in younger adults are higher In the new study, UPMC researchers found that AFib was more common in their younger patient population than what was seen in those earlier studies. To determine this, they reviewed medical records for over 67,000 adults who had at least two outpatient visits at a UPMC clinic between 2010 and 2019 related to a diagnosis of AFib. Although the average age of patients with AFib was 72 years old, nearly one-quarter were under 65, with the majority of younger patients being men. Researchers also assessed the risks of hospitalization and dying faced by younger people with AFib. Other research shows that AFib increases the risk of dying early, but many of those studies focused on older adults. After reviewing the 10-year survival for younger patients, researchers found that men with AFib were 1.3 to 1.5 times more likely to die, compared to similarly aged men without AFib. For younger women with AFib, the risk of dying was 1.7 to 2.4 times worse compared to younger women without this condition. Many people in this younger age group had risk factors for cardiovascular disease, including obesity, smoking, high blood pressure, diabetes, and obstructive sleep apnea. Over time, these conditions can lead to physical damage and electrical changes in the heart that result in AFib. Increasing AFib or better detection? Jim Liu, MD, a cardiologist at The Ohio State University Wexner Medical Center in Columbus, who was not involved in the study, said this study highlights that AFib in younger patients is a “serious condition,” especially “as AFib becomes more prevalent in younger adults and is not just isolated to elderly patients.” So is AFib really becoming more common in people under 65 years, or are doctors getting better at detecting this condition? It might be a little bit of both. “We are probably doing a better job at detecting AFib,” Liu told Healthline. For example, “so many people now have personal wearable devices, like smartwatches and other monitors, that can detect AFib.” “However, risk factors for AFib — such as obesity, sleep apnea, diabetes and hypertension — are also increasing in younger patients.” Other risk factors for AFib include consuming large amounts of alcohol and viral infections such as COVID-19. Many of these can be modified to reduce your risk of developing AFib. “It’s important to address the risk factors for AFib,” said Liu. “This means getting conditions like [high blood pressure], sleep apnea, and diabetes under control. It also means losing weight if someone is overweight.” Wearable devices and screening Even though the new study suggests that AFib may be more common in younger people than previously known, Knight said clinical guidelines don’t recommend routine screening of all patients for AFib. “[Screening] may be important in patients with risk factors, particularly older patients, and patients with heart disease or [high blood pressure],” he said, “but I don’t know that we need to screen for it in very young patients [who don’t have symptoms].” However, “[AFib] is being screened for more often due to these wearable devices that are available without a prescription,” he said. Knight thinks these kinds of devices can be useful in managing patients who are already diagnosed with AFib. For example, if someone thinks they are having possible symptoms of AFib, they can use their wearable device to record their heart rhythm and send the recording to their doctor for review.  They could also record their rhythms once a week after a heart-related procedure or a change in their medications to see if their heart is staying within a normal rhythm. “These are very valuable tools, but there is also the problem of false positives,” said Knight. “A lot of young, healthy people are told they have AFib by their device,” but a follow-up with a doctor may show that it was a false positive. He recommends that anyone with heart-related symptoms such as palpitations (fast-beating, fluttering or pounding heart), chest pain, or sudden shortness of breath talk with their doctor or other medical professional. “One of the tests might be for them to wear a long-term heart monitor that will detect any atrial fibrillation that they might have,” said Knight. Takeaway Researchers examined the medical records of over 67,000 people with AFib. Nearly one-quarter of these patients were younger than 65 years old. AFib was previously thought to affect those over 65 years old, with rates increasing with age. However, this study suggests that this condition also impacts younger people. Many younger patients with AFib in the study had risk factors for AFib, such as obesity, high blood pressure, diabetes, and obstructive sleep apnea.

New research suggests that low dose aspirin may help enhance your immune system and lower your risk of colorectal cancer. andreswd/Getty Images Aspirin has been shown to protect against colorectal cancer. A new study says it may do this by enhancing the body’s ability to detect cancer cells. Aspirin is not right for everyone and may be most beneficial for those with CVD risk. Your lifestyle choices can also influence your risk for colorectal cancer. Early detection through regular screenings can make colorectal cancer easier to treat. Studies have shown that taking aspirin may reduce the risk of colorectal cancer. Additionally, other studies suggest that aspirin use may also improve colorectal cancer outlook. One thing that remains unclear, however, is just how aspirin protects against colorectal cancer. The main protective mechanisms are thought to be the inhibition of the enzymes that maintain proinflammatory signals, such as prostaglandin‐endoperoxide synthase 1 (COX-1) and prostaglandin‐endoperoxide synthase 2 (COX-2). But, there are several other interrelated mechanisms that have not yet been elucidated. According to new research published on April 22, 2024, in the journal Cancer, one of these mechanisms may be that it enhances certain aspects of the immune system. Aspirin may enhance the immune system’s function To learn more about how aspirin might protect against colorectal cancer, Italian researchers looked at tissue samples from 238 people who had surgery for colorectal cancer. They identified that 12% of these patients were aspirin users. They then compared tissue samples from cancer patients who had used aspirin with those who hadn’t. In those who used aspirin, there was less cancer spread to the lymph nodes and higher infiltration of immune cells into tumors. Further, when the researchers exposed colorectal cancer cells to aspirin in their lab, they saw greater expression of a protein called CD80 on certain immune cells. This amplified their ability to signal to other immune cells that proteins associated with cancerous cells were present, according to the study authors. They also found higher CD80 expression in the healthy rectal issue of those patients with rectal cancer. This finding suggests that aspirin creates an environment where the immune system is on the lookout for cancer cells. The principal investigator on the study — Dr. Marco Scarpa MD, PhD, of the University of Padova — further noted in a press release that absorption of aspirin in the rectum tends to be less than in the rest of the colon. “Thus, if we want to take advantage of its effects against colorectal cancer, we should think of how to guarantee that aspirin reaches the colorectal tract in adequate doses to be effective,” he said. Limitations of the study The researchers wrote that one of the primary limitations of the study was the fact that it was retrospective and observational, meaning that they were looking back in time to see what had already happened. According to the authors, this made it impossible to analyze how long people had been taking aspirin prior to their cancer diagnoses. Additionally, the researchers noted that aspirin use was self-reported and, in some instances, people may have taken aspirin in the past, but it was obscured by the fact that they had stopped using it before entering the hospital for cancer treatment. Kubanych Takyrbashev, MD, Health & Wellness Advisor at NAO, who was not involved in the study, commented that since it was not a controlled clinical trial — a study in which one group receives the treatment that’s being studied and another comparison group receives a sham treatment — this can also introduce confounding variables and biases. Confounding variables are uncontrolled variables that could also be causing the observed effect. Biases could tip the balance in favor of a false result. “Furthermore,” said Takyrbashev, “the mechanisms underlying aspirin’s potential effects on the immune system’s response to cancer cells would require further elucidation through in-depth molecular and cellular studies.” Risks to consider before taking low dose aspirin “Before considering aspirin as a preventive measure against cancer or any other condition, individuals should be aware of the potential risks and side effects associated with its use,” said Takyrbashev. Long-term aspirin use can increase your risk of gastrointestinal bleeding, ulcers, and other complications, he said. This is especially true in people who have a history of gastrointestinal issues or bleeding disorders. “Additionally, aspirin can interact with other medications and might not be suitable for everyone,” said Takyrbashev, “so individuals must consult with a healthcare professional before initiating aspirin therapy.” How to reduce your overall risk of colorectal cancer Chris McDermott, a Certified Advanced Practice Registered Nurse with Intercoastal Consulting & Life Care Planning, who was not involved in the study, said, “Beyond aspirin, lifestyle choices play a vital role.” First of all, it’s important to get regular screenings in order to detect precancerous polyps early, he said. The U.S. Department of Health and Human Services recommends that you get regular screening for colorectal cancer between the ages of 45 and 75. However, if there is a history of colorectal cancer in your family, they suggest that you get screened even sooner. According to the agency, early detection can make the disease easier to treat. In lieu of a colonoscopy, in which a doctor uses a scope to look directly inside your colon and rectum, you may be able to simply provide a stool sample for analysis if you are at average risk of developing colorectal cancer. McDermott added that eating a diet rich in fiber, fruits, vegetables, and whole grains is also important. Getting regular exercise, moderating your alcohol consumption, and avoiding smoking can also reduce your risk. Finally, you should check whether anyone in your family has had the disease. “Genetic factors matter, so be aware of your family’s cancer history,” McDermott concluded. Takeaway Studies have shown that taking low dose aspirin on a regular basis can help protect against colorectal cancer. A new study has found that one way it might provide this benefit is by enhancing the immune system’s ability to detect cancerous cells. Experts say aspirin is not for everyone since the risks may outweigh the benefits. Patients at risk for CVD are good candidates. However, if you have a history of gastrointestinal issues or bleeding disorders, it may not be right for you. Other ways to reduce your risk include eating a healthy diet, exercising, drinking only in moderation, and avoiding smoking. It’s also important to know your family’s medical history and get screened for colorectal cancer following the recommended schedule.

Actor Jennifer Stone may be best known for playing the role of Harper Finkle in the hit Disney series ‘Wizards of Waverly Place,’ but today she’s enjoying a second career as an ER nurse – all while managing living with type 1 diabetes. Image Provided by Medtronic Actor Jennifer Stone shares her journey of living with type 1 diabetes. Stone’s diagnosis inspired her to become a registered nurse. The actor juggles working as a nurse and acting. While Jennifer Stone is best known for playing Selena Gomez’s best friend on Disney’s Wizards of Waverly Place, she is also a nurse people encounter when they find themselves in the emergency room. “I get recognized pretty frequently between the red hair and my weird voice. It’s kind of a giveaway. Even during the pandemic, when I was in full PPE – mask, gown, gloves, completely covered head to toe – people would recognize me. I was very surprised by that,” she told Healthline. “No one wants to go to the ER, and so if I can bring somebody a little bit of joy when they’re having a rough day, I look at it as such a gift,” she said. Why getting diagnosed with type 1 diabetes can take time for some adults When she was 20 years old, Stone started having blurry vision, feeling extremely tired and gained 60 pounds in three months. “Obviously, I knew something was wrong, so I started going to the doctor,” she said. “I had symptoms for type 1 and type 2 diabetes, so I really confused a lot of doctors…some doctors said type 2 cause I was older, and some said type 1.” After four years of visiting different doctors and receiving different diagnoses, she was finally diagnosed with type 1 diabetes. “I got a good doctor with a good system, which for a diabetic, is vital,” Stone said. Dr. Andrew Welch, an endocrinologist at UC Health, said that even though in the United States, children and teenagers are almost twice as likely to be diagnosed with type 1 diabetes compared to adults, there is an increasingly recognized and significant risk of developing type 1 diabetes as a young adult and even into later adulthood. “In fact, there was a higher overall number of new diagnoses of type 1 diabetes in adults than children in the United States because there are more adults than children,” he told Healthline. “Many adults do not get the appropriate testing for type 1 diabetes since they are assumed to have type 2 diabetes leading to delays in diagnosis and appropriate care.” Stone’s diabetes diagnosis inspired her to become a nurse During her four-year journey, Stone was in and out of doctor offices and hospitals trying to figure out her condition, she had good and bad experiences with healthcare providers. “I was in this place where I already had taken a break from acting for my health and I wanted to get a college degree, I was ready to transfer from a community college to a four-year for psychology, but with this whole experience it just really inspired me…I had a lot of really great experiences with nurses,” she said. She entered nursing school and graduated in 2019. During school, she worked in different spaces, but the variety of treating everything from a cold to a heart attack, and intensity of emergency medicine resonated with her most. “I like the multi-tasking. I like the chaos. I like the collaboration. Nursing is like that in general, but in the emergency room especially, because we don’t yet know what’s going on, and we’re in the diagnostic space where you really have to work with a group,” said Stone. Collaborating is what she likes most about acting, too. “I love collaborating with a group of people for a common goal, and I really feel that while [on set] and in the emergency room,” she said. Managing type 1 diabetes, acting, and nursing Over the past seven years of living with type 1 diabetes, Stone tried many different treatment options. She currently uses the reusable smart insulin pen, InPen, by Medtronic. “Constantly be open with your endocrinologist about what’s on the horizon,” she said. “I would encourage my fellow diabetics to not get complacent with what they’re using because [technology] is constantly changing and evolving. Talk to your endo and see what’s best for you so you can live your best life.” Dr. Kathleen Dungan, an endocrinologist at The Ohio State University Wexner Medical Center, said treatment for type 1 diabetes continues to get better with more effective insulins, insulin delivery systems that closely resemble a healthy pancreas and more effective glucose monitoring devices that reduce the need for people to poke their fingers. “People who are fortunate to be able to access the latest technology in particular are much less likely to be hospitalized for severe complications and have overall better glucose levels,” Dungan told Healthline. “Better glucose levels will translate to fewer chronic complications and deaths in the long run.” However, she noted that the condition is still a challenging disease that demands lots of attention to stay healthy both physically and mentally. Stone knows this well and prioritizes self-care. “I remember a diabetes educator saying ‘you can never have a drink’ and I remember thinking I’m not even 21 yet,” Stone said. “The biggest thing I’ve learned is that I have to have balance in all things. I have to have balance in sleep, in exercise, in my diet, in everything, and how much I’m working and stress.” She also does not consider her condition disabling but rather a challenge she didn’t have before. “[It’s] made me a more well-rounded person. It’s made me stronger, and it’s forced me, in the best way, to take care of myself more,” said Stone. Feeling her best allows her to continue acting while working three 12-hour shifts per week. “So I have four other days that I can focus on acting, my other passion,” she said. Stone wants to help lift others living with type 1 diabetes When Stone was first diagnosed with type 1 diabetes, she felt alone and isolated. Her mom’s college roommate was the only person she knew living with the condition. Since her diagnosis, she has connected with others who have type 1 diabetes. “I’ve seen other people deal with similar challenges that I deal with, and they come out better for it or more productive or capable; it’s so inspiring to me,” she said. “My hope is to make others feel less alone in their diagnosis and to make people feel more empowered and capable despite their diagnosis.” While she aims to accomplish this with people in both her personal and professional life, she said sometimes her patients inspire her too, especially because diabetes, like other chronic conditions, is constantly evolving. “I can do the exact same thing one week, and everything is perfect, and I reach that unicorn 100 blood sugar, and then the next week, maybe my hormones are surging, or I’m stressed, and it throws everything off kilter,” said Stone. “So I’m constantly learning from patients or other diabetics about what is working for them and the tweaks they make to help them adjust to the weeks where the sky is the wrong shade of blue.”

Agustin Vai/Getty Images A prostate cancer biomarker test that utilizes 17 genetic markers has demonstrated a high degree of accuracy in screening for serious cancer. The test also significantly reduced unnecessary biopsies for individuals with indolent, low-grade prostate cancer. The results are exciting, but questions remain as to whether the test would perform in a more racially diverse population. Researchers have identified 17 unique genetic markers that are overexpressed by high-grade prostate cancers, which can be screened for accurately using a urine test. Experts say the test can help doctors identify serious cancers while also reducing unnecessary biopsies.  Prostate cancers are graded according to a Gleason score. The higher the grade the more likely the cancer will spread quickly and grow. This new test could potentially help with diagnosing and treating cancer earlier and with fewer invasive measures. Improving PSA tests for prostate cancer The health benefits of screening for prostate cancer with a standard prostate-specific antigen (PSA) blood test have historically come with the tradeoff: the potential for unnecessary, invasive procedures, such as prostate biopsies. However, innovations in the realm of prostate cancer biomarker tests are helping to improve diagnostic accuracy alongside PSA testing. The results of one such biomarker test, known as the MyProstateScore 2.0 (MPS2), which were published this month in JAMA Oncology, indicate that the test is highly accurate for detecting high-grade cancers. Researchers found that the test had a 95% sensitivity for prostate cancer of grade group 2 or greater, and 99% for grade group 3 or greater. “It does look impressive and exciting. I definitely think this is moving the field in the right direction, which will be helpful for patients in the long term,” Geoffrey Sonn, MD, an Associate Professor of Urology at Stanford Medicine who wasn’t affiliated with the research, told Healthline. However, questions remain about whether the test could be accurately applied to a racially diverse population, a limitation that the authors acknowledge in the research. Adam Murphy, MD, MBA, an Associate Professor of Urology at the Northwestern University Feinberg School of Medicine, called the research, “a good addition to the literature,” but noted that there were clear limitations regarding race. Murphy wasn’t affiliated with the research. “It’s hard to know how it performs in other ethnic minority groups,” said Murphy. Experimental test was between 95-99% accurate To develop the test, researchers sequenced nearly 60,000 genes, eventually identifying 54 markers of prostate cancer. They found 17 of these markers were further stratified to indicate high-grade cancer. Research and guidelines on prostate cancer screening have increasingly focused on identifying these high-grade cancers to help with early detection and treatment. “Prostate cancer differs from many other cancers in that there’s a subset of low-grade prostate cancers that really do not behave like cancer. They don’t spread or metastasize, and thus they pose minimal risk of harm,”Jeffrey Tosoian, MD, MPH, an Assistant Professor of Urology and Director of Translational Cancer Research at Vanderbilt University Medical Center, and lead author of the paper, told Healthline. “We set out to improve upon existing tests through two mechanisms. One is that we identified markers that are specific for higher-grade cancers,” Tosoian said. “The other was the breadth of markers. We were able to use newer technology that allows us to capture seventeen, plus a reference gene, so eighteen genes with a single test.” The study included 743 men with an average age of 62, and a PSA score of 5.6. The test had a 95% sensitivity among men who had a grade group 2 or greater cancer; this sensitivity improved to 99% in men with a grade group 3 or greater cancer. In practical terms, that means the test accurately identified 95 out of 100 and 99 out of 100 incidences of cancer, depending on the grade of the cancer. “Most cancers won’t express all of these different markers. Most will only express a subset of them. And so by having more markers in a single test, it’s likely to pick up more of the higher grade cancers that exist in the population,” said Tosoian. Reducing false positives for prostate cancer Another major finding of the study was the expected number of unnecessary biopsies that utilizing the test avoided.  PSA testing is known to result in false positives, which can lead to anxiety and stress, so doctors have sought out other tests, such as biomarker tests, to improve accuracy. PSA is naturally secreted in the body, whether or not cancer is present, so an elevated PSA does not indicate cancer by itself. However, due to an elevated PSA level, a doctor might be inclined to order additional testing, including a biopsy. “For a long time, someone would get a PSA blood test and if it was abnormal, they would just go straight to having a biopsy done of their prostate, which leads to lots and lots of procedures that are uncomfortable at best,” said Sonn. In the case of the MPS2 test, however, researchers found that utilization of the test could have reduced the rate of unnecessary biopsies by an estimated 35-42%. That is a significant improvement over other biomarker tests, which have been found to avoid between 15-30% of unnecessary biopsies. “The aim would be that MPS2 can preserve the proven benefits of PSA screening in terms of early detection of high grade cancers that can be effectively treated, while significantly reducing the potential harms of false positive testing,” said Tosoian. Accuracy unclear in minority racial groups Despite the findings, a major limitation of the study is whether the test would be accurate in other ethnic groups. Only 12.8% of participants in the study self-identified as Black.  Prior research has found that different ethnic groups express variance in PSA levels; that is, depending on your ethnicity, your baseline PSA level could be higher or lower than a white individual, which can affect a doctor’s decision to pursue additional screening. A study from 2022 found that Black men have higher baseline PSA levels than White or Hispanic men, but that current PSA guidance does not account for ethnicity. “One problem is that they tend to use a one-size-fits-all approach,” said Murphy. Furthermore, there are also established disparities in the use of screening measures, such as MRI, among ethnic groups. A study from 2021 found that Black and Hispanic patients were significantly less likely than white patients to undergo an MRI after an elevated PSA score. It isn’t just that Black people “are at higher risk of prostate cancer and the thresholds need to be oftentimes lowered for when you wanna do a biopsy,” said Murphy.“If you are Asian or Hispanic, the thresholds that are used for the general population are mainly derived for white men. “But because they have lower risk, the thresholds are probably higher.” The bottom line A prostate cancer biomarker test that utilizes genes indicating high-grade prostate cancer appears highly accurate. Experts believe the test could improve screening for high-grade prostate cancer screening, while simultaneously reducing unnecessary biopsies. However, questions remain as to whether the test can be accurately applied to non-White ethnic groups.

GLP-1 drugs like Ozempic and Wegovy can help most people lose weight, but they don’t work for everyone. Johnér/Offset Images GLP-1 medications like Ozempic and Wegovy have gained popularity for their ability to help people lose significant weight. Despite the rates of success, about 15% of people will not see clinically relevant weight loss. Doctors say there are several reasons why GLP-1 medications may not work for you, but there are alternative options available. Ozempic and Wegovy have been called game-changers for people living with obesity or overweight. One 2021 clinical trial indicated that 86.2% of more than 800 participants achieved “clinically significant” weight loss after taking 2.4 mg weekly doses of semaglutide (sold under the brand names Ozempic and Wegovy) for 68 weeks. As promising as those numbers look, they also mean that 13.8% of people did not see clinically significant weight loss.  Doctors say it’s essential for patients to understand they could fall into either camp — responder or non-responder— even though the data suggests it’s more likely a person will respond. “As in any other category of medication, one type of prescription is not going to be the best fit for every patient,” says Dr. Meghan Garcia-Webb, MD, who is triple board certified in internal medicine, lifestyle medicine, and obesity medicine. “It’s also important that patients don’t pin all their health success on one medication.”  The reasons patients end up in the non-responder category can vary — and sometimes, there is more than one factor. 5 reasons you may not lose weight on drugs like Ozempic or Wegovy. Dr. Michael L. Glickman, MD, explains that “success” on a GLP-1 medication is considered a body weight loss of more than 5% after three months of treatment. “However, ideally in clinical practice, we hope to achieve at least 10-15% [bodyweight loss], which can lead to more meaningful metabolic health,” says Glickman, a triple board certified family medicine, lifestyle medicine, and obesity medicine physician and the founder of Revolution Medicine. “It can be a little unpredictable how someone will respond to a weight loss medication. Based on studies, every medication has a subgroup of ‘non-responders.’” Why? These are the five reasons health experts say they see the most. Lifestyle changes Though sometimes an overlooked footnote, trials for semaglutide (like this one of more than 1,900 adults published in 2021) included lifestyle intervention for both the placebo and medication group.  “To see the best response to a GLP-1 medication, patients should generally follow the six pillars of Lifestyle Medicine,” Glickman says. Those pillars are: Eating a plant-forward diet Regular exercise Managing stress Avoiding substance use Maintaining strong social relationships with family and friends Are these novel? No, but Glickman says they’re essential for people whether they’re trying to lose weight or not and can impede the effectiveness of anti-obesity medication. A 2023 study pointed out another reason exercise is essential for people on weight loss drugs: When people lose weight, they can lose muscle mass. Exercise can help mitigate that loss and its associated risks, such as injury. Not taking medication as prescribed Taking the correct dose regularly is important for success.  “If the medication is not taken as prescribed, such as missing doses or not following instructions on timing or dosage, it may not work effectively,” says Dr. Yoshua Quinones, MD, a board certified internist with Medical Offices of Manhattan and contributor to LabFinder.  The reasons for this issue vary, from poor education on how to take the medication to forgetfulness. Additionally, research suggests that people are more likely to lose weight if the drug is taken long-term. A 2022 trial indicated that people regained two-thirds of their weight within a year of stopping 2.4 mg weekly doses of semaglutide. On a similar note, Quinones says people may not see weight loss at all if they start and then immediately stop. “GLP-1 agonists often require a certain duration of treatment before their full benefits are achieved,” he says. “Premature discontinuation or non-adherence to the prescribed regimen could result in unmet therapeutic goals.” Remember that the trials followed patients for over a year — 68 weeks. A 2021 trial indicated that being a responder by week 20 was predictive of successful body weight loss of 15%, with more than 96% of those participants going on to lose weight.  In a Reuters report with analysis from pharmacy benefits manager Prime Therapeutics, only 32% of people said they were still taking Ozempic and Wegovy after one year.  Not everyone can afford to stay on the drugs long-term. The monthly cost of drugs like Wegovy can be around $1,000. Insurance programs, including Medicare, do not always cover weight-loss drugs, and legislation to expand Medicare coverage to include anti-obesity medications has stalled, according to a Scientific American report. Even if people can afford the drugs, shortages have plagued patients.  Besides access – an important factor — patients may experience side effects like GI discomfort. For some, these side effects are enough to stop taking the medications altogether. “The medication side effects often resolve with time, but if they are severe enough, some patients may decide it’s just not worth seeing what happens,” Garcia-Webb says. “The entire goal of these medications is to improve people’s health and quality of life, not require them to use all their sick leave.” Other medical issues A person may have other medical issues that are undiagnosed or going untreated or undertreated. “Some medical issues — hypothyroidism, sleep apnea, chronic insomnia, to name just a few — can interfere with weight loss efforts and should be treated prior to starting a weight medication,” Garcia-Webb says. Additionally, a person may have an eating disorder.  “For patients who have an obesity issue and binge eating disorder, sometimes the binge eating will correct itself with the GLP-1 agonist, but not always,” Garcia-Webb says. A 2024 review indicated that small pilot studies suggest GLP-1s can reduce some eating disorders, but researchers said more rigorously collected data is needed. Insulin resistance Ozempic is designed to treat people with diabetes and help them lower their A1C. However, research, like a 2022 narrative review, indicates that people may lose less weight on GLP-1 medications. “When there is already a pre-established metabolic disease, it becomes more of an uphill battle to reverse those abnormalities, especially if they have been established for a long time,” Glickman says. The response is physiological.  “In patients with type 2 diabetes, the ability of their bodies to respond to GLP-1  and stimulate insulin secretion is reduced,” Quinones explains. “Usually, GLP-1 aids in controlling blood sugar levels by stimulating the pancreas to release insulin after meals. However, this response may be less potent than in individuals without diabetes. This weakened response to GLP-1 can make it challenging to manage blood sugar levels in patients with diabetes and may require alternative treatment methods or adjustments in medication dosage.” Medication interference  People taking a GLP-1 drug with other medications may see less weight loss. “Patients may also have a harder time losing weight if they are on certain medications at the same time as a GLP-1 that can promote weight gain, such as certain antidepressants and beta blockers,” Glickman says. Garcia-Webb agrees and encourages people to speak with their providers about other medications they are taking before starting a GLP-1 medication and if they do not experience weight loss. What to do if you don’t experience weight loss on a GLP-1 medication Importantly, patience is critical when taking a medication like Ozempic or Wegovy. “Ideally, give the medication at least 12 weeks to see an effect,” Garcia-Webb says. However, if you’re not seeing the needle move by that point or have concerns, experts say you have options. Speak with your doctor Experts stressed the importance of having an open dialogue with your doctor, whether the weight is coming off or not.  “Seeking guidance from a healthcare provider is essential,” Quinones says. “They can evaluate individual factors affecting effectiveness and suggest necessary adjustments, like altering doses or exploring alternative treatments.” Garcia-Webb meets with patients at least once a month when increasing doses and more if the person has significant side effects. She encourages people to find providers who have regular follow-up plans. Lifestyle tweaks Collect some data on yourself. “Are you optimizing your lifestyle changes, like stopping when full, eating mainly whole, unprocessed foods, cooking your own meals instead of eating takeout or delivery, drinking enough water, sleeping seven to hours a night, and exercising consistently?” Garcia-Webb suggests asking yourself. If not, Quinones says adjusting habits, like managing portion sizes, can help. Additionally, stress can play into habits, from eating to sleep. “Addressing emotional and psychological aspects is crucial,” he says. “Seeking assistance from a therapist, counselor, or support group can address issues such as emotional eating or stress management, thereby enhancing overall well-being and weight management progress.” Manage side effects Side effects can go away with time. However, Garcia-Webb says people can take some steps to mitigate and manage them, including: Eating small, frequent meals. Avoiding greasy foods, which sit in the stomach longer and may make GI issues like nausea and reflux worse. Speaking with your doctor about over-the-counter and prescription medications that may help you manage side effects, potentially only on a short-term basis. Switch to a different medication Ozempic and Wegovy are not the only options for people. Zepbound was approved in 2023 for the treatment of obesity and overweight, as well as specific underlying conditions. A 2023 trial indicated that people who were living with obesity or overweight without diabetes experienced a mean bodyweight reduction of 21% by 36 weeks. Mounjaro, which uses the same ingredient (tirzepatide) and is made by the same company (Eli Lilly), is for people with diabetes. Quinones says switching from Wegovy to Zepbound may be worth trying. The two drugs have distinctions. “Wegovy, derived from semaglutide, acts as a GLP-1 receptor agonist, mimicking the GLP-1 hormone to reduce appetite by increasing insulin secretion and signaling feelings of fullness to the brain,” he says. “In contrast, Zepbound, a form of tirzepatide, operates as a dual agonist for both the glucose-dependent insulinotropic polypeptide (GIP) and the GLP-1 receptor, promoting insulin secretion and sensations of satiety. Both GIP and GLP-1 agonists are hormones naturally produced in our gastrointestinal system.” Quinones says some people may experience more weight loss on Zepbound, including people not responding to Wegovy. Takeaway While many people will respond to Wegovy and Ozempic for weight loss, up to about 15% of people will not respond to the drugs. The reasons vary, from the need to make lifestyle tweaks like diet and exercise to metabolic issues and side effects from other medications. GLP-1 medications are best if taken long-term, but shortages, price, and side effects like GI discomfort are potential barriers for some. Additionally, other medical issues may hamper weight loss. It’s important to discuss issues you are having with your doctor and that providers make plans for follow-ups. Your doctor may be able to help you manage side effects. They may also refer you to specialists to treat other conditions and work with you to find medications for conditions like depression that do not typically list weight gain as a side effect. Other drugs, like Zepbound, may be more effective for some patients. 

A new study found people takeing the GLP-1 Zepbound had fewer symptoms of sleep apnea. River Rock Photos/Getty Images People with obesity who received the weight-loss drug Zepbound had fewer obstructive sleep apnea events, or episodes of stopped breathing during sleep. The research by drug maker Eli Lilly included people who used a CPAP machine to treat their obstructive sleep apnea, and those who didn’t. Experts say the breathing-related benefits seen in these studies are due to weight lost by people receiving Zepbound over the course of a year. People with obesity experienced relief from obstructive sleep apnea — or episodes of stopped breathing during sleep — while taking anti-obesity drug Zepbound (tirzepatide), drugmaker Eli Lilly announced Apr. 17. The results come from two yearlong clinical trials of over 400 adult patients with obstructive sleep apnea, the most common type of sleep-related breathing disorder, one that affects millions of Americans and often goes undiagnosed. In people with obstructive sleep apnea, the upper airway becomes blocked, which causes brief pauses in breathing while asleep. This can lead to daytime fatigue, headaches and other short-term symptoms, as well as an increased risk of cardiovascular disease, diabetes and mental health changes. The results of the studies have not been published in a peer-reviewed journal, but will be presented at the American Diabetes Association’s 84th Scientific Sessions in June, the company said. However, the results “are significant enough to warrant utilizing medications to help people lose weight, so that their sleep apnea improves,” said Christine Ren-Fielding, MD, division chief of bariatric surgery at NYU Langone and director of the NYU Langone Weight Management Program. She was not involved in the new studies. Zepbound linked to improved sleep apnea Tirzepatide, sold under the brand name Zepbound, was approved by the Food and Drug Administration (FDA) for chronic weight management in November 2023. The agency previously approved the drug under the brand name Mounjaro for the treatment of type 2 diabetes. Like Novo Nordisk’s Ozempic and Wegovy, tirzepatide belongs to a class of drugs known as GLP-1 receptor agonists. Tirzepatide also targets another hormone known as GIP, making it a dual-acting drug. Participants in the new studies had obesity and moderate-to-severe obstructive sleep apnea, which means having 15 or more episodes per hour of stopped breathing during each night. People with central sleep apnea were excluded from the study. This form of sleep apnea occurs when the brain doesn’t properly send signals to the muscles that control breathing. One of the new studies involved people who were unwilling or unable to use a continuous positive airway pressure (CPAP) machine, a commonly prescribed device for treating sleep apnea. Participants were randomly assigned to receive either weekly injections of tirzepatide or an non-acting placebo. After one year, people receiving tirzepatide had an average of 27.4 fewer apnea events per hour, compared to an average reduction of 4.8 events per hour for those in the placebo group. The other study included people who were using a CPAP machine and planned on continuing to use it throughout the study. Half of the participants received tirzepatide and the other half received a placebo. In the tirzepatide group, people had an average of 30.4 fewer apnea events per hour, compared to an average reduction of six events per hour in the placebo group. In both studies, participants lost around 20% of their body weight How obesity is linked to obstructive sleep apnea Current treatments for sleep apnea target the symptoms of this condition — stopped breathing — but tirzepatide addresses the underlying cause, blockages in the airway that result in breathing pauses during sleep. There is a strong correlation between gaining weight and the risk of developing obstructive sleep apnea, explained Ren-Fielding, due to fat deposits in the neck and tongue. This can lead to the tongue blocking the flow of air during sleep, especially when lying on your back. As a result, people are woken repeatedly throughout the night. Over time, obstructive sleep apnea “can cause serious cardiac disease and serious neurologic problems, in terms of mental awareness and falling asleep easily during the day,” Ren-Fielding said. In addition, “sleep apnea can worsen obesity,” she said, “because people who get a terrible night’s sleep may use sugary products or caffeinated products to keep themselves awake during the day, which can lead to weight gain.” Marijane Hynes, MD, associate clinical professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C., who was not involved in the new research, said the improvements in sleep apnea symptoms among people who received Zepbound were due to them losing weight. “For many, but not all, patients, weight loss helps improve sleep apnea,” she told Healthline. For example, “a 10% weight loss decreases obstructive sleep apnea by [around] 11 events per hour.” Other treatments that lead to significant weight loss — such as bariatric surgery and endoscopic sleeve gastroplasty — can also relieve sleep apnea symptoms. “With surgical weight loss, within a few months of the surgery, we see that patients no longer need their CPAP device, and they’re sleeping better and feeling better,” said Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, Calif. These benefits remain as long as they keep the weight off. “Obstructive sleep apnea is primarily due to obesity, so if they are able to maintain the weight loss, they will keep the beneficial effects — resolving sleep apnea, and improving diabetes and high blood pressure, etc,” said Ali, who was not involved in the new research. Will insurance cover Zepbound for sleep apnea? Another possible effect of the new studies will be changes in the labeling of Zepbound by the FDA, said Ren-Fielding, “allowing people with sleep apnea to be prescribed this medication.” Most participants in the two studies would have already been eligible for Zepbound for chronic weight managment. But many insurers have been hesitant to cover this drug — and other GLP-1s — when used solely for weight loss. This is partly due to the high cost of the drug. The list price for Zepbound is about $1,000 a month, although people with insurance coverage for the drug will likely pay less. Eli Lilly also offers a savings card that allows people without insurance to get the drug for $550 a month. In its release, Eli Lilly said it plans to submit an application to the FDA and to regulatory agencies in other countries seeking approval of the drug for treating sleep apnea in people with obesity. This approval “would add another indication to the medication to make it easier for people to get it covered by insurance,” said Ali. In addition, “it’s good to have more evidence to be able to say to patients, ‘If you lose weight, all these things will improve,’” he said, including sleep apnea symptoms. Takeaway In two clinical trials, people with obesity who received weight-loss drug Zepbound saw a greater average reduction in sleep apnea events over the course of a year, compared to people who received a non-acting placebo. One study included people who were being treated for obstructive sleep apnea with a continuous positive airway pressure (CPAP) machine. The other study included people who were unwilling or unable to use this commonly prescribed device for treating sleep apnea. Experts say the apnea-related benefits were due to the weight lost by participants while on Zepbound. In both studies, people taking the drug lost about 20% of their body weight over a year.

Actress Olivia Munn is talking about undergoing treatment after a breast cancer diagnosis. Valerie Macon/AFP via Getty Images Actress Olivia Munn revealed that she had been diagnosed with bilateral breast cancer last year. In a new interview she talks about how her treatment involved medically-induced menopause. This typical treatment duration period is 5 years. Actress Olivia Munn is talking about her recovery from breast cancer and how her treatment has led to medically-induced menopause. Munn was diagnosed with bilateral breast cancer last year. “You realize cancer doesn’t care who you are; it doesn’t care if you have a baby or if you don’t have time,” the actress told People. “It comes at you, and you have no choice but to face it head-on.” After her diagnosis, Munn said she had a lymph node dissection, a nipple delay procedure and a double mastectomy.  The cancer diagnosis came as a surprise to Munn since an earlier mammogram found she was clear and she had also tested negative for the BRCA cancer gene, which is associated with an increased risk of breast and ovarian cancer. Part of her treatment involves ovarian suppression, which has led to medically-induced menopause. How breast cancer treatment can lead to menopause symptoms Medically induced menopause involving ovarian suppression is an approach that can be used to treat premenopausal patients who are diagnosed with hormone receptor-positive breast cancer.   This treatment is used because hormones can impact the chances of breast cancer recurrence. These types of cancers have proteins that bind to hormones like estrogen or progesterone, which can encourage the cancer to grow. “Usually ovarian suppression is achieved by a hormonal injection that temporarily causes the ovaries to stop estrogen production and is often combined with oral endocrine therapies,” Dr. Melissa Accordino, a breast cancer specialist at Columbia’s Herbert Irving Comprehensive Cancer Center, stated. “The decision to proceed with ovarian suppression is made based on various characteristics of an individual’s cancer (such as stage, grade, overall aggressiveness, along with other features) and is a decision made between the healthcare team and the individual patient.” Patients who are treated with ovarian suppression and endocrine therapy are typically treated for at least 5 years, but sometimes longer based on the individual’s cancer characteristics and experience with the medication, Accordino added. “For more aggressive breast cancers that have a higher risk of recurrence, it is recommended to add an injection (a GnRH agonist) that prevents the production of estrogen from the ovaries and puts women into medically induced menopause,” Dr. Mariya Rozenblit, a medical oncologist at the Smilow Cancer Hospital, explained. What is bilateral breast cancer? Munn was diagnosed with bilateral breast cancer, a rare type of breast cancer that is present in both breasts. It makes up only 1-3% of breast cancers. “Every breast cancer is unique, and it’s important to correctly categorize the type of breast cancer an individual has in order to figure out the right treatment for that individual; one of the ways that doctors classify breast cancer is based on molecular subtype which accounts for hormone receptors (estrogen receptor and progesterone receptor), human epidermal growth factor (HER2), and other molecular markers,” said Accordino. Luminal B breast cancer, which is Munn’s diagnosis, makes up about 15-20% of all breast cancer cases, and is hormone receptor-positive and can be either HER2 positive or negative. “Luminal B tumors are a type of hormone receptor-positive tumors that tend to be a bit more faster growing,” Dr. Maryam Lustberg, the director of the Center for Breast Cancer at Yale Cancer Center and Smilow Cancer Hospital, stated. “They are still very much driven by estrogen-based pathways as luminal A tumors but are sometimes treated with more intensive type of systemic therapies including maximal estrogen suppression, targeted therapies and sometimes chemotherapy.” Symptoms of medically-induced menopause While everyone experiences different symptoms during cancer therapy, there are typical side effects of ovarian suppression. “The symptoms of medically induced menopause are similar to those experienced during natural menopause, although they can often be more severe due to the abrupt reduction in hormone levels,” said Dr. Francisco Esteva, the chief of hematology & medical oncology at Northwell Lenox Hill Hospital. Common symptoms include: hot flashes night sweats vaginal dryness mood swings decreased libido “Other systemic effects may include bone density loss, changes in cholesterol levels, and increased risk of cardiovascular diseases,” Esteva noted. Takeaway Olivia Munn was recently diagnosed with bilateral breast cancer and part of her treatment is medically-induced menopause.  This type of treatment is for premenopausal patients with hormone receptor-positive breast cancer. The typical duration period for this treatment is 5 years.

Hundreds of fake online retailers are selling counterfeit weight loss drugs like Wegovy and Ozempic. d3sign/Getty Images A firm has announced the takedown of over 250 websites selling fake GLP-1 drugs like Ozempic. High prices and shortages make sites like these appealing to consumers. Experts say counterfeit drugs can pose health risks since it’s impossible to know what’s in them. It is important to verify the legitimacy of any online pharmacy that you use. According to reporting by Reuters, the CEO of cybersecurity firm BrandShield, Yoav Keren, told the news outlet that they have removed over 250 websites selling fakes of popular GLP-1 receptor agonist medications like Ozempic and Wegovy. GLP-1 drugs are used to increase insulin sensitivity and stimulate insulin secretion, as well as reduce blood sugar in patients with type 2 diabetes. They are also capable of inducing weight loss in those with obesity. However, they can be expensive without insurance. For example, a carton of Ozempic can cost around $1,000 at most U.S. pharmacies. Additionally, some products, like Wegovy, which is specifically approved for obesity treatment, are still experiencing shortages due to high demand. Unfortunately, these factors create an opportunity for purveyors of fake prescription drugs to come in and take advantage of consumers. Keren told Reuters that his organization works on behalf of drug makers like Lilly and Novo to ferret out these sellers. Once BrandShield has collected evidence that the websites are selling counterfeit drugs, they contact the companies hosting these sites to get them taken down. When it can, it also turns over the information to law enforcement agencies. Keren also noted that social media sites were popular venues for promoting fake drugs. In fact, out of 3,968 listings removed in 2023, nearly 60% were found on Facebook. Why fake drug websites are so dangerous Catherine Rall, a Registered Dietitian with Happy V, said the biggest danger with buying from fake drug websites is you simply don’t know for sure what you are getting. “Any time you’re taking an unregulated drug, you’re taking a huge risk since it could literally contain anything,” she said. “The best case scenario, outside of the unlikely idea that someone is selling Ozempic at below-market prices, is that you get an inert placebo,” said Rall. “There’s also a huge risk that you’re putting something dangerous into your body.” According to Nancy Mitchell, a registered nurse and a contributing writer at Assisted Living Center, one risk is that you’ll receive products laced with heavy metals and harmful toxins. “Every year, hundreds of people show up in the ER with severe allergic reactions or lead poisoning that they acquired from some unknown generic source,” she said. The Food and Drug Administration further points out that since most GLP-1 drugs are injected, there is a risk of infection since the sterility of the needles can’t be confirmed. Novo Nordisk, the maker of Ozempic, further notes that there is no way to confirm the efficacy of fake diabetes medications. This could be dangerous for people who need them to control their blood sugar. How to know if you are buying real medications online Dr. Eldad Einav, an obesity medicine specialist at Drugwatch, said that people often get fooled by fake drug websites because they copy real online pharmacies. “These fake sites often use deceptive tactics to appear genuine, such as copying branding and logos of reputable pharmaceutical companies,” he said. Consumers may also be enticed by discount pricing and promises of quick results. In order to determine whether an online pharmacy is legitimate, Einav suggests the following: Use reputable online pharmacies. “Look for verified contact information, secure payment methods, and accreditation from regulatory authorities,” he advised. Verify the medication’s authenticity. “Research the medication’s appearance, packaging, and manufacturer before purchasing,” Einav said. Compare it with the product that is being offered. Companies like Novo Nordisk may offer photos of real and fake products that you can view for comparison. Beware of suspiciously low prices. Deep discounts may mean that the product is counterfeit or expired, he explained. Consult a healthcare professional. A doctor or pharmacist can help you verify whether a website is real in addition to instructing you on how to use medications safely, said Einav. Look for accreditation. “Look for verified seals or certifications on the website,” he said. The National Association of Boards of Pharmacy provides a database of accredited pharmacies. Ensure prescription requirements. According to Einav, if medications are sent to you directly without the need for a prescription from a licensed physician, this is a tell-tale sign that they aren’t a legal pharmacy. Verify pharmacy credentials. Finally, before you make your purchase, verify that the pharmacy has an active license in the state where it dispenses medications. “If in doubt about a pharmacy’s legitimacy, refrain from using its services,” he concluded. Takeaway Working on behalf of drug makers, the cybersecurity firm BrandShield announced that it has orchestrated the shutdown of more than 250 counterfeit websites selling fake GLP-1 drugs like Ozempic. Fake pharmacies are dangerous to consumers, according to healthcare professionals and government agencies, because it’s not possible to know exactly what is in the products they are selling. Risks range from the products simply not being effective to them containing life-threatening contaminants. Experts say it is important to verify the credentials of any online website that you use to purchase your medications. If you are in doubt about its legitimacy, it is best to not use it.

More Americans say they are not getting enough sleep. Guido Mieth/Getty Images New Gallup polling data suggests that more people aren’t getting enough sleep. Women in particular say they are in need of more sleep with just 36% saying they feel well rested. Experts say that these trends are cause for concern and action.  New Gallup polling data suggests that Americans are in need of more sleep. The new data found that more than half of individuals surveyed or 57% said they would feel better if they got more sleep. The last time Gallup conducted a similar poll was 2013, where the results were almost flipped with 56%  feeling that they got enough sleep at that time. Experts say sleep data is a “little scary” Dr. Mark S. Aloia, PhD,  an associate professor of medicine at National Jewish Health and head of sleep and behavioral sciences for Sleep Number, says that the data is cause for concern. “These data [points] are quite compelling and, honestly, a little scary from the perspective of someone who studies sleep and the consequences of getting too little sleep. The results show a dramatic change from 10 years ago and the data 10 years ago were already alarming,” Aloia said. All told, approximately 20% of respondents shared that they’re getting less than five hours of sleep per night, with 53% placing their daily sleep schedule in the 6-7 hour range. Additionally, only 26% of people said that they got the suggested 8 hours a night. Why are Americans getting less sleep? Gallup’s analysis found a correlation between stress levels and less sleep. The study authors reported that stress levels among Americans have been increasing steadily in recent decades. Stress levels have risen since 2003 when 33% of respondents saying they commonly experience stress in their daily lives to 49% in 2023.   Gallup found that as people’s stress levels have increased their sleep has suffered. They report that 63% of people who say they need more sleep also say they are frequently experiencing stress. Dr. Tiffany Yip, PhD, a professor of psychology at Fordham University, says this data suggests that we should be thinking more about how we can increase our sleep while reducing stress. “Stress is pretty inevitable,” Yip said. “I think the challenge and the take-home here is for people to think about the stressors that they encounter, and how they present themselves when they go to bed at night…Sort of thinking about ways in which maybe we can start to leave the stress of the day behind.” Dr. Raj Dasgupta, MD, an associate program director for internal medicine residency at Huntington Health and chief medical advisor for Sleep Advisor, says that stress can take a major toll on sleep schedules. “The different stresses that individuals have to go through, in my opinion, correlates with difficulty in having good sleep, which is one of the key things about insomnia,” Dasgupta said. “In some individuals, insomnia can be initiated from that acute stressing event.” Men vs. women: who gets more sleep? The report also found key differences for men and women getting enough sleep. While nearly half of men or 48% say they feel they get enough sleep, for women that number was less, with just 36% reporting they feel well rested. Additionally, for women between the ages 18 and 49, just 27% felt they were getting enough sleep.  Aloia says that medicine needs to do a better job when it comes to meeting the needs of women when it comes to sleep health.  “These are differences we must attend to in a thoughtful and diligent manner. For years we did not face gender differences in the right way in medicine,” Aloia said. “These results suggest that women, and particularly younger women, need support around their sleep health.” Experts also said that Americans from certain races and ethnicities may face specific stressors that affect sleep leading to disparities among certain groups. “The most consistent disparities there fall between Black and white Americans, although there’s also evidence of disparities for Asian groups and Latin/a groups as well, with similar patterns, shorter sleep duration and poor sleep quality relative to white Americans,” Yip said. “My research is trying to understand why that is, and what are the drivers that I focus on, in particular, is the stress that relates to discrimination.” How to be better rested The good news is that experts agree that there are tangible steps you can take to get better sleep. Dasgupta says that one tool that he encourages people to use is a sleep journal or log. Other techniques include reducing screen time at night, optimizing your bedroom, and trying to sleep at consistent times. “I think that we’ve all had a night out of nowhere, where I’m like, ‘Why can’t I sleep tonight?’ And maybe you could kind of piece it together. like, ‘Wait a minute, I didn’t work out the last three days,’ or ‘You know what, I went to this restaurant and had that meal, and got heartburn,” Dasgupta said. Aloia, meanwhile, is honed in on the need for continued conversations at the intersection of sleep and stress.  “The take away for me is that we must prioritize sleep and our mental health. The two are intricately connected. We have years of research tying sleep with mental health and it is time we make both clear priorities in our healthcare system and in our personal lives,” Aloia said. “And, as friends, family members, employers, care providers, etc. it is time for us to support one another around both of these critical health issues.” Takeaway A new report from Gallup finds most Americans say they need more sleep. Experts say rising stress levels may be behind change in sleep patterns.

New research suggests that GLP-1 drugs like Ozempic and Wegovy are not likely to increase the risk of thyroid cancer. Jaap Arriens/NurPhoto via Getty Images There has been a concern that GLP-1 drugs might increase thyroid cancer risk. However, a new study indicates that any increase in risk is probably quite low. This is likely because these drugs have a high specificity for the GLP-1 receptor. People can reduce their risk by focusing on lifestyle factors like smoking and diet. It is also important to get regular screenings and avoid unnecessary radiation exposure. Glucagon-like peptide 1 (GLP-1) agonist drugs — which include medications like Ozempic (semaglutide), Victoza (liraglutide), and Trulicity (dulaglutide) — have been life changing for many people. When used regularly, they can help those with type 2 diabetes produce more insulin and achieve better blood sugar control. They can also help people lose weight, especially when coupled with lifestyle changes like healthy diet and exercise. One downside, however, is that they have not been recommended for use in those with a personal or family history of either medullary thyroid cancer or multiple endocrine neoplasia. Previous studies, starting with rodent studies conducted in the premarketing phase, have raised concerns about whether GLP-1 receptor agonists could increase a person’s risk for cancer. In response, these medications have been required to carry a black box warning regarding the potential risk. However, a new study published on April 10, 2024, in BMJ indicates these concerns may be unfounded. According to this study, treatment with GLP-1 receptor agonists was not linked with any substantial increase in risk for thyroid cancer in people who were followed up on average for 3.9 years. The study authors did acknowledge that a small increase in risk could not be ruled out, but it would be no greater than a 31% increase in relative risk. In other words, no more than 0.36 excess cancers per 10,000 person-years would occur compared to the background incidence of 1.46 per 10,000 person-years in those who had used a different type of diabetes medication. Connection between GLP-1 drugs and thyroid cancer risk found to be low The study was performed using healthcare and administrative data from Denmark, Norway, and Sweden. Study participants, who were between the ages of 18-84, were selected based on their use of either a GLP-1 receptor agonist or a dipeptidyl peptidase 4 (DPP4) inhibitor, another type of diabetes medication. Those taking dipeptidyl peptidase 4 inhibitors were selected as the comparator group since these drugs are not believed to increase thyroid cancer risk. The researchers also carried out a similar analysis using another class of diabetes medications called “sodium-glucose cotransporter 2 (SGLT2) inhibitors.” Their analysis started when people initially began using a GLP-1 medication and continued until people were diagnosed with cancer, left the study, or the study follow-up period ended. On average, the GLP-1 group was followed for 3.9 years, and the DPP4 group was followed for 5.4 years. It was found that 76 out of 145,410 developed thyroid cancer in the GLP-1 group, an incidence rate of 1.33 events per 10,000 person-years. On the other hand, 184 out of 291,667 people in the DPP4 group went on to be diagnosed with thyroid cancer, which corresponds to an incidence rate of 1.46 events per 10,000 person-years. What makes these findings different from previous studies? Dr. Kristopher M. Day, founder of Pacific Sound Plastic Surgery, who was not involved in the study, said, “The recent findings that GLP-1 drugs, such as Ozempic, do not increase the risk of thyroid cancer, differ from previous studies primarily because of advancements in research technology, including more precise analytic tools, and a better understanding of the drug’s pharmacodynamics.” According to Day, these developments allow for a more nuanced examination of the drug’s effects on the body. This can lead to clearer, more accurate results, he noted. “A significant aspect could also be the longitudinal follow-up in recent studies, offering insights into the long-term impacts of these drugs, which wasn’t as prevalent or detailed in earlier research,” added Day. Why GLP-1 drugs like Ozempic and Wegovy may not increase cancer risk Day said the reason that GLP-1 drugs like Ozempic and Wegovy might not lead to an increased risk of thyroid cancer really comes down to their specific mechanism of action. They target the glucagon-like peptide-1 receptor, he said, which plays a crucial role in glucose metabolism but has minimal interaction with thyroid function. “This specificity reduces the likelihood of unintended effects on thyroid cells, which could potentially initiate cancerous changes,” said Day. “Additionally, these drugs’ therapeutic window may contribute to their safety profile, ensuring effectiveness without reaching levels that could harm other bodily systems,” he added. How people can reduce their risk for thyroid cancer “From a practitioner’s standpoint, advising patients on reducing their risk of thyroid cancer requires a focus on lifestyle factors that are within their control,” said Dr. Mark Anton, founder of OC Breast Surgery, who was not involved in the study. “Encouraging a diet that supports thyroid health, advising on the avoidance of unnecessary radiation exposure, and recommending regular screenings, especially for those with a family history of thyroid issues, are critical steps,” he advised. Anton also stressed the importance of understanding and communicating the last research findings related to the safety of GLP-1 drugs. This can help lessen people’s concerns and foster a proactive, informed approach to health and wellness, he said. Takeaway It was originally feared, based on preliminary research, that GLP-1 drugs might increase the risk for thyroid cancer. However, a new study indicates that any increase in risk is probably quite low. The reason is that GLP-1 drugs mainly affect the GLP-1 receptor and don’t tend to impact thyroid function. To reduce your risk of developing thyroid cancer, it’s important to eat a thyroid-healthy diet, including adequate iodine. Avoiding unnecessary radiation exposure and getting regular screenings, especially if there is a family history of thyroid issues, can also help.

A new study looks at the most common complications of AFib. Getty Images Lifetime risk of AFib has increased with 1 in 3 people at risk for the condition at some point during their lives. The CDC estimates that 12.1 million U.S. adults will have atrial fibrillation by 2030. A new study finds that the most common complication related to AFib is heart failure. The risk of atrial fibrillation, the most common type of heart arrhythmia, has increased with one in three people expected to develop the disease in their lifetime. Now a new study finds that the most frequent complication of this disease is heart failure rather than stroke. With these increasing numbers more strategies are needed to prevent either heart failure or stroke in people with atrial fibrillation, according to the study authors. Heart failure twice as common as stroke for people with AFib The study was published in The BMJ, on April 17 and examined 3.5 million people in Denmark from 2000 to 2022 who had no history of atrial fibrillation at age 45 or older. Researchers found 362,721 people with a new diagnosis of atrial fibrillation, almost evenly split between men (54%) and women (46%), and followed them until heart attack, heart failure, or stroke. From 2000 to 2010, the lifetime risk of atrial fibrillation was 24%; from 2011 to 2022, that risk increased to 31%, with men and people who had a history of stroke, heart attack, heart failure, diabetes, or chronic kidney disease seeing a larger increase. And among people found to have atrial fibrillation, the lifetime risk of heart failure was 41% — twice the lifetime risk of stroke (21%) and four times that of heart attack. The Centers for Disease Control and Prevention (CDC) estimates that 12.1 million U.S. adults will have atrial fibrillation by 2030. Nicklas Vinter, MD, PhD, Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University in Denmark, is one of the study’s authors and told Healthline that the study’s findings underline the need for testing new treatments and medications that can help minimize heart failure and stroke risks in people with atrial fibrillation. “Heart failure was the major complication after atrial fibrillation in our study, but the international guidelines for the management of atrial fibrillation mainly focus on stroke prevention. The high lifetime risk of heart failure encourages greater attention to prevent heart failure after atrial fibrillation,” Vinter said. What causes AFib? There are four chambers in the heart — two atria and two ventricles — and atrial fibrillation occurs when those chambers don’t function properly due to abnormal electrical activity, which causes the atria and ventricles to contract at different speeds. Advanced age, high blood pressure, hyperthyroidism, diabetes, binge drinking, and a history of underlying heart disease are all factors that can contribute to the development of atrial fibrillation, Paul Drury, MD, board certified cardiologist and associate medical director of electrophysiology at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who was not involved in the study, told Healthline. “The exact cause of atrial fibrillation is unknown; however, we know that there are multiple risk factors for developing atrial fibrillation. Non-modifiable risks include age and gender. Simply, being male and getting old puts you at risk for AFib,” Drury said. “Risk factors that are modifiable include obesity, hypertension, diabetes, sleep apnea, alcohol intake and congestive heart failure. By treating these conditions, we can often lower the lifetime risk of developing atrial fibrillation.” Drury also pointed out that with certain conditions like hyperthyroidism or mitral valve disease “treatment of the underlying condition can resolve the AFib.” Why are cases of AFib on the rise? “People are generally living longer, and we know age is a risk factor. Also, obesity, [hypertension] and diabetes are more prevalent which also increases risk,” Drury said. Additionally, certain conditions such as obesity and diabetes that are linked to AFib are becoming more common. “Another reason is increased detection,” Drury said. “The increased usage of ‘smart’ watches and other home health monitoring devices have detected a number of asymptomatic or minimally symptomatic cases of AFib that would have not otherwise been detected.” Nikhil Warrier, MD, board-certified cardiac electrophysiologist and medical director of electrophysiology at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, told Healthline that the United States has the highest prevalence of atrial fibrillation globally. Those with European ancestry have the highest risk of developing it, he said, but African Americans are more likely to develop serious complications from it. “The prevalence of [AFib] is increasing as a function of our population aging as age remains an independent risk factor for the development of [AFib.] Emerging studies also point to the fact that social determinants of health are drivers of cardiovascular disease,” Warrier said. “Specifically, adverse social determinants of health have been consistently associated with incident [AFib], [AFib treatment, and outcomes. Diet also plays a critical role in mitigating obesity which is a risk factor for [AFib], as access to healthy food resources can directly encourage an active lifestyle and a healthier diet.” How is AFib treated? Both Drury and Warrier said treatment for atrial fibrillation is a lifelong process and often requires a combo of approaches. “This includes first and foremost, managing stroke risk. This is done with medications to thin the blood, or a small device implanted in the heart to prevent blood clots,” Drury said. “Treatment is also needed to slow or regulate the heart rate in [AFib.] This can be done with either medications, an invasive procedure called an ablation, or a combination of the two. In some cases, a pacemaker can also be used.”   Additionally, lifestyle modifications to diet, sleep, exercise, and alcohol or tobacco intake are important to help manage any development of or complications from atrial fibrillation. “Based on observational studies, the Mediterranean diet along with abstinence from smoking or alcohol intake have been shown to reduce [cardiovascular] risk in patients with [AFib]. This goes to the heart of preventing or mitigating [cardiovascular] risk,” Warrier said. “Once patients develop [AFib] and are symptomatic, medical intervention or oftentimes procedural interventions are needed to reduce burden of [AFib] and for maintenance of normal rhythm.” Takeaway The risk of developing atrial fibrillation, a common form of heart arrhythmia, rose from one in four to nearly one in three over the last decade, a Danish study found. For those who receive a diagnosis of atrial fibrillation, the most common complication is heart failure, followed by stroke. As people are living longer and more methods for detecting the condition are developed, it is expected that these numbers will continue on pace to rise. Medication, diet changes, abstaining from alcohol or smoking, and other lifestyle modifications can help mitigate the effects of atrial fibrillation.