HealthLine Health News

chabybucko/Getty Images Most food products have a Nutrition Facts label. A good rule of thumb for utilizing this label is the 5/20 rule. Under this rule, less healthy nutrients should be kept at 5% DV or less. Healthier nutrients, however, should be 20% DV or greater. Following this guideline can help you make healthier choices about nutrition. You’ve probably noticed a nutrition label on the back of the package or can for many of your favorite foods. The Nutrition Facts label provides important information about the number of calories per serving. It also states the amounts of various nutrients found in the food and their percent daily value (%DV). But just what does all this mean, and how can you use it to be healthier and lose weight? One good rule of thumb is the 5/20 rule. What is the 5/20 rule? Marta Ferraz Valles, MA, RD, LD, an outpatient dietitian at The Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore, explained that the purpose of the 5/20 rules is to provide a general guide for selecting foods that are low in certain nutrients we don’t want, such as sodium, but high in others that we do want, like fiber, based on the %DV. The %DV indicates the percentage of each nutrient that a serving of the food provides toward daily nutrient goals or limits based on eating a 2000-calorie diet, she added. Valles further explained that if the %DV is less than or equal to 5%, the food is considered to be low in this nutrient. On the other hand, if the %DV is 20% or more, it is deemed to be high in this nutrient. “For example, if a food label indicates that the food contains 2% DV of sodium [per serving], that means that the food is low in sodium,” she said. Valles additionally noted the importance of serving size. “If the serving size of the previous [sodium] example were 2 tablespoons and a person would eat 1 cup,” then that person would no longer be consuming low amounts of sodium, she remarked. “Thus, the rule may be helpful as long as individuals eat the serving size indicated in the label,” said Valles. How can the 5/20 rule help improve your health? The 5/20 rule can help you make healthy food choices. For example, it can help you decrease the amount of foods you eat that are high in harmful nutrients like saturated fats and sodium while increasing the amount of beneficial ones like vitamins and fiber. This can help reduce the risk of critical diseases like diabetes and cardiovascular disease. When it comes to nutrients that you’ll want to limit, keep an eye on your sodium intake. This can help when it comes to blood pressure and your heart. The 5/20 rule is also helpful if you are working to lose weight, as reducing your calorie intake is often an important component of weight management. Additionally, the rule can help identify foods low in added sugars and saturated fats (5% or less of DV) and decrease calorie intake from unhealthy sources. On the other side of the coin, the 5/20 rule can help you improve your intake of vital nutrients like vitamins, fiber, and minerals, which are good for overall health. You’ll want to choose foods with 20% or more DV of these beneficial nutrients. Putting the 5/20 rule into action “Generally, individuals want to choose products with less sodium, saturated fat, and added sugars, and with more dietary fiber, calcium, potassium, and iron,” advised Valles. “However, it is important to consult with a registered dietitian, as this does not apply for everyone.” Valles cited irritable bowel syndrome (IBS) as one example of when you might be advised to alter this recommendation. “For example, some people with IBS (irritable bowel syndrome) may have more gastrointestinal symptoms, including cramping and diarrhea, if they have too much of certain types of fiber,” she said. However, others with IBS are advised to increase their intake of certain fibers. So, if you have IBS or other gastrointestinal conditions, it’s important to talk to your doctor or registered dietitian about what types of fiber, and how much, might be best for symptom management. Valles said that she also tells her patients to use the rule to compare food products so they can select which is the better choice. For example, when choosing between two tomato sauces, you could opt for the one with less sodium and added sugars. She added, however, that it’s your overall diet that matters most. You might still be able to buy the tomato sauce with higher sodium and sugar if your overall diet is low in these less-desirable nutrients. Valles concluded by saying that, although the 5/20 rule can be helpful, it’s also important to read the ingredients list. “Some products may look very healthy when we look at the label (low sodium, low saturated fat, low added sugars, and high dietary fiber), but if we were to read the ingredient list, it may contain highly processed ingredients that we cannot pronounce,” she said. “In this case, this may not be the healthiest choice, and people should discuss this with their registered dietitian,” said Valles. Takeaway The 5/20 rule is a guideline for using the Nutrition Facts label in order to make healthier choices. Less healthy nutrients — like sodium, added sugar, and saturated fat — should generally be kept at or below 5% DV. Healthier nutrients — like fiber, calcium, and potassium — should be consumed in larger amounts at or above 20% DV for most healthy adults. Following this rule can help you lose weight, protect your heart, and generally be more healthy. However, be aware that this is a general rule of thumb. Certain medical conditions, such as IBS, may require more or less of certain nutrients.

Sunleca (lenacapavir) has been shown to be 100% effective at preventing HIV in females. andreswd/Getty Images A new study found that the drug Sunleca (lenacapavir) has been shown to be 100% effective at preventing HIV in females. The drug is given via injection two times a year and is manufactured by the U.S. company Gilead. Health experts say the potential to reduce the number of new HIV infections is enormous if the drug can be made widely accessible. Two shots a year of lenacapavir, a drug manufactured as Sunleca by the U.S. company Gilead, was shown to be 100% effective in preventing the transmission of HIV in females, according to a new study funded by Gilead and administered by some of its employees. More than 5,000 females in Uganda and South Africa were part of the research;  2,134 of them were given the injections, and none of them were reported to have HIV. The other sections of the study cohort were split into two varieties of oral prevention pills — Descovy and Truvada — on a daily basis, and around 2% of them reported HIV infections. The results of testing in men have not yet been calculated, but experts say the potential to change the rate of new HIV infections is enormous if the pre-exposure prophylaxis (PrEP) drug can be made widely accessible. Dr. Amit Achhra, MD, an assistant professor of medicine at Yale School of Medicine who specializes in infectious diseases, told Healthline that the future of HIV prevention was “exciting” in this light. “While we don’t have HIV vaccine yet, injectable HIV PrEP comes close to what one might see as periodic ‘HIV vaccine,’ i.e. periodic shots that have very high efficacy in preventing HIV infection,” Achhra said. “For those who don’t wish to get the shots, very effective oral HIV PrEP pills will remain an effective option. With more HIV prevention options available, we hope the rate of HIV infections will further decline in the future.” How does lenacapavir prevent HIV transmission? Approximately 39 million people worldwide live with HIV, and some of the highest numbers of diagnoses are in sub-Saharan Africa. In 2022, according to the Foundation for Aids Research, 3,100 young women and girls (ages 15 to 24) contracted HIV every week in sub-Saharan Africa. Lenacapavir, which is used as a treatment for HIV after it has been contracted in the U.S., Canada, and Europe, is among the group of drugs known as capsid inhibitors. These disrupt the protein shells (capsids) of the HIV virus that is essential to replication, which can interrupt the process of multiplying in the body. Dr. Monica Gandhi, a professor of medicine and the associate division chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/San Francisco General Hospital, told Healthline that lenacapavir is a “first-in-class new HIV medication” with strong potency. “The formation of a capsid around the virus is very important at multiple stages of the viral life cycle, including during nuclear transport and release,” Gandhi said. “Lenacapavir is so potent that it can be provided just twice yearly (every 26 weeks), which is its advantage over agents for PrEP (daily oral or cabotegravir, which is given once every 8 weeks).” Does lenacapavir only work in females? Rates of HIV are 7.7% higher in men who have sex with other men and 9.2% higher for transgender people, according UNAIDS. According to Gandhi, the pathways to HIV infection work differently in females and males, but a new study should provide encouraging results for males. “The PURPOSE 2 trial is being conducted in men, transgender women and non-binary individuals and the results are due out later this year, which is when (if favorable), Gilead will apply for regulatory approval,” Gandhi said. “Some drugs can work differently in men and women due to differential tissue levels at the site where transmission can occur (e.g. anal or vaginal mucosa), so it is important to test these preventive agents in both men and women.” How much do lenacapavir injections cost? Current reports have lenacapavir running more than $40,000 for the first year, but it’s been suggested that it could be sold for as little as $40, which would instantly create an enormous path to access worldwide. “If the drug can be more cheaply made than what the company is suggesting, that would be a huge boon for the field, especially in preventing HIV infection in low-and-middle-income countries,” Gandhi said.  “The drug is likely to be approved in the US even at a higher price point and should have benefits in controlling HIV infection in the US since the latest data from the CDC is that we still need more uptake of PrEP in this country among women and men,” Gandhi added. “Currently, oral PrEP pills are significantly cheaper than shots, and in fact, the generic version of Truvada oral PrEP pill is available for very cheap, often less than $1 per pill. However, many people have a hard time keeping up with the daily pill,” Achhra said. “It will therefore be important to have equally cheaper and accessible injectable PrEP options widely available to make a big dent in the HIV epidemic. Of note, it will be equally important for clinics and hospitals administering these shots to reduce their hospital ‘facility fees,’ which are often exorbitant and prevent access to these medications,” Achhra said. Takeaway A capsid inhibitor called lenacapavir, sold as Sunleca by the drug maker Gilead, prevented HIV infection in 100% of the cases in a recent study of more than 5,000 females in South Africa and Uganda. Lenacapavir has been used as a treatment for HIV, but these twice-yearly shots could revolutionize HIV prevention, experts say. Results of a study of the drug’s efficacy in males have not been published yet, but experts say full access and a cheaper price point would make an enormous difference globally.

Deli meats sliced at the counter have been linked to a Listeria outbreak that led to two deaths and 28 hospitalizations. GMVozd/Getty Images The U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) announced a recall of over 200,000 pounds of Boar’s Head products on July 26 amid a Listeria outbreak. Deli meats sliced at the counter have been linked to the outbreak, which led to two deaths and 28 hospitalizations, according to the CDC.  You should avoid unheated deli meat if you are pregnant, age 65 or older, or have a weakened immune system. The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced a nationwide recall of Boar’s Head deli meats on July 26 that may be contaminated with Listeria monocytogenes. The recall includes 207,528 pounds of Boar’s Head liverwurst and other deli meat products. A widespread Listeria outbreak in the United States has resulted in two deaths and 28 hospitalizations across 12 states. The outbreak has been linked to meat sliced at deli counters, not prepackaged deli meats, according to a July 2024 investigation notice from the Centers for Disease Control and Prevention (CDC). The CDC warns that Listeria is a bacteria that causes a foodborne illness called listeriosis, which is particularly dangerous for pregnant people and other high risk groups. The affected individuals span from the Midwest to the East Coast, with lab samples collected between May 29 and July 5. In interviews, most people reported eating deli-sliced meats, particularly turkey, liverwurst, and ham.  Despite the Boar’s Head recall, the CDC’s investigation into this outbreak is ongoing to determine whether other products sliced or prepared at delis are contaminated with Listeria. Who is most at risk after Listeria exposure? Dr. Brian Labus, PhD, MPH, an assistant professor in the Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, cautioned that certain individuals face a higher risk of severe illness from Listeria. He told Healthline that while most people consuming contaminated food may experience mild gastrointestinal symptoms that resolve quickly without treatment, high risk groups are particularly vulnerable. Populations at high risk for serious Listeria infections include:  pregnant people and newborns individuals aged 65 or older those with weakened immune systems  Symptoms typically appear within two weeks of consuming contaminated food but can manifest as soon as the same day or as late as 10 weeks later.  Labus said pregnant people who contract the bacteria “often have a very mild illness,” such as fever, muscle aches, or tiredness, “but that illness can lead to [pregnancy loss], premature delivery, or serious [life threatening] infections of the newborn.” Non-pregnant individuals may also experience fever, muscle aches, and tiredness, along with additional symptoms like headaches and confusion, according to the CDC.  Labus warns that older adults and people with weakened immune systems can develop dangerous Listeria infections that enter the bloodstream or brain. This is “a very serious invasive infection that usually requires hospitalization and kills about one out of every six people infected [with invasive listeriosis],” he said. Why is deli meat causing listeria? Deli meats sliced at the counter carry a higher risk of bacterial contamination, like Listeria, compared to pre-packaged deli meats.  “The difference is the risk of cross-contamination,” said Labus. He explained that while both types of deli meats can arrive from the manufacturer already contaminated with Listeria, pre-packaged options minimize this risk by avoiding direct contact with other products. Slicing meats at the deli can transfer Listeria from contaminated meats to other foods. Equipment and surfaces used for slicing can harbor bacteria, causing contamination of other items prepared in the same area. This significantly raises the risk of bacteria being present in deli counter food products. “This is why it is so important that we keep Listeria from entering these foods in the first place,” Labus stressed, emphasizing the need for vigilance in food manufacturing and handling practices.    If you suspect that you have purchased any deli products that may be contaminated, throw them away immediately to ensure your safety and well-being.  Is it safe to eat meat from the deli? According to Labus, consumers face challenges when purchasing deli meats because there are no visible signs of Listeria or other foodborne pathogens. “This is why we have a robust food protection system in the country,” he said. He explains that the food industry and regulators collaborate to ensure that food is prepared and handled safely, including a zero-tolerance policy for Listeria in the food supply. Labus said the problem is that Listeria “thrives in low-temperature, high-salt conditions — the exact conditions we generally use to prevent bacterial growth in food.” In other words, refrigeration doesn’t prevent or kill Listeria.  So, for those at higher risk of severe illness, such as pregnant women, the CDC recommends avoiding deli meats altogether or heating them to an internal temperature of 165°F or until steaming hot before consumption.   Additionally, ready-to-eat products like deli salads, soft cheeses, and cut melons can also become contaminated with Listeria.  Therefore, the CDC advises high risk individuals to choose safer foods, such as: heated meats hard cheeses homemade deli-style salads (potato, tuna, chicken)  fresh melon and other fruit cut at home Is sliced deli meat healthy? Kiran Campbell, RDN, a registered dietitian nutritionist and medical nutrition advisor at Dietitian Insights, explained that deli meats are considered ultra-processed foods.  “While not all ultra-processed items are harmful,” she noted, ultra-processed meats may indeed pose health risks.  Processed deli meats tend to be high in sodium, saturated fat, and preservatives, contributing to issues like heart disease, diabetes, and certain cancers, she said.  Campbell also highlighted that the World Health Organization (WHO) classified processed meats as Group 1 carcinogens, meaning there is convincing evidence that processed meats cause cancer in humans. Every 50 grams of processed meat consumed daily might increase colorectal cancer risk by about 18%. If you decide to eat deli meats, Campbell advised choosing single-source options like sliced chicken, turkey breast, or roast beef instead of varieties like bologna, salami, and head cheese that contain mixed meats and animal byproducts. She also recommends selecting: minimally processed deli meats with fewer additives products lower in sodium and saturated fat  organic and grass-fed options, which may be more nutritionally dense meats raised without antibiotics   options without added nitrites or nitrates, often labeled “uncured”  However, uncured meats typically use ingredients like celery powder, which still contain natural nitrates. It’s unclear if natural nitrites are actually safer. Ultimately, while it may take more effort, cooking and cutting lean meats at home is usually the safest and healthiest option for sliced meats. Takeaway A multi-state Listeria outbreak in the United States has resulted in 2 deaths and 28 reported illnesses in July 2024.  The CDC has linked these cases to deli-sliced meats, but the specific products involved in the outbreak have yet to be identified. High risk groups — particularly pregnant individuals, people ages 65 or older, or those with weakened immune systems — are advised to either avoid deli-sliced meats altogether or ensure that all deli meats are heated to a high internal temperature of 165°F to kill bacteria before consumption.

Environmental pesticide exposure due to industrial agriculture may potentially increase the risk of cancer as much as smoking, a new study suggests. ArtMarie/Getty Images Environmental pesticide exposure due to industrial agriculture potentially increases cancer risk to a degree similar to smoking. In a new study, researchers correlated cancer rates in geographic regions based on pesticide usage. The study does not demonstrate causation. More research is needed to understand how environmental pesticides affect cancer risk. Is pesticide exposure as bad for you as smoking in terms of cancer risk? Potentially, yes, claims a new scientific study. The research, published in the journal Frontiers in Cancer Control and Society, found a strong association between the presence of environmental pesticides and several cancers, including leukemia, non-Hodgkin’s lymphoma, bladder, lung, and pancreatic cancer. The authors used population and geographic data from sources, including the CDC, Department of Agriculture, and US Geological Survey, to investigate the correlation between rates of these cancers and pesticide usage in various regions across the United States. This type of study, known as an ecological study, is used to identify broad trends but does not demonstrate a causal link, which the study authors readily admit. The trends identified between pesticides and cancer risk are akin to those you would typically see with smoking. “We found that every cancer is affected. So, everything is affected by pesticides. And it is very similar to what you see in smoking. If you increase how much you smoke, you increase your risk for every cancer, even when some of those are more affected than others. And that is exactly what happened here,” Isain Zapata, PhD, an Assistant Professor of Research and Statistics at the Rocky Vista University and Senior Author of the study, told Healthline. Loren Lipworth, ScD, a Professor of Medicine and Associate Director of the Division of Epidemiology at Vanderbilt University Medical Center who wasn’t affiliated with the research, told Healthline that, due to its design, we need to be cautious about interpreting this study’s findings. “The conclusions that can be drawn from this type of study are that there may be some etiologic clues, there may be some signals of associations between various types of cancer and pesticide use patterns at this large ecologic population level, but in terms of individual-level data, the study does not provide that,” she said. Mapping the potential link between pesticides and cancer The study is the first comprehensive examination of the effects of pesticides on cancer risk across large geographic regions and populations in the United States. Researchers used reporting data for sixty-nine different pesticides to create geographic regions. Essentially, they carved out areas of the US used for agriculture based on reported pesticide usage. For example, the Midwest, the country’s leading region for corn production, has the highest presence of environmental pesticides. Meanwhile, the Great Plains region, from northern Texas to North Dakota, has the least. Once the authors established these geographic regions, they then looked at rates of cancer in these areas.  They hypothesize that cancer risk is likely tied to the amount of pesticide use and different kinds of agricultural production since pesticide usage also varies based on activity. For example, California, the nation’s largest vegetable producer, would likely have different cancer outcomes than the Midwest, where corn is the predominant crop. Zapata told Healthline that this methodology gives a more holistic impression of how exposure can occur, noting that individuals are rarely ever exposed to a single pesticide but rather a “cocktail” of different contaminants in the real world. “You’re going to be exposed to the pesticides that might be floating around from the farms that are close to where you live. There might be industrial residues that are unique to the agricultural activity of that area,” he said. Specific pesticide outcomes Sixty-nine nationally reported pesticides were included in the study. Individually, many were linked to different cancer outcomes. Atrazine is used to control grasses. The study found that it was consistently a top contributor for increased risk of all cancers and colon cancers. Glyphosate is commercially available as a weed killer named Roundup and is associated with an increased risk of all cancers, colon cancer, and pancreatic cancer. Dicamba is commonly used in corn and soybean agriculture. It was linked to an increased risk of colon cancer and pancreatic cancer. Dimethomorph is a fungicide. It was identified in regions with a high risk of leukemia and non-Hodgkin’s lymphoma. Despite these findings, Zapata told Healthline that the goal of their study is not to stop pesticide usage. “We aren’t trying to tell the Midwest, OK, you cannot grow corn anymore,” he said. “We need to eat. We need to have products derived from agriculture. And to have the efficiency that we need to be economically sustainable, we need to use those chemicals. So it becomes a cost-benefit, risk-benefit approach,” said Zapata. Strengths and weaknesses of the study The study authors controlled for major confounding factors, including smoking, socioeconomic factors, and the area of agricultural land. However, when using population data, not all confounding factors can be accounted for. To be clear, even in a region with high rates of cancer and pesticide usage, the study’s nature doesn’t allow one to be attributed to the other. It does, however, provide a signal that more research is needed. “There’s no causal inference that can be drawn between individuals or a group of people’s actual pesticide exposure and their individual cancer risk,” said Lipworth. The study doesn’t differentiate between groups of people, such as farm workers who may have direct exposure to pesticides, and members of the surrounding community whose exposure could vary based on proximity and other factors.  “It’s really important that we have person-level exposure assessment. There are people who are occupationally exposed, and there are farmers, but in the same area, there are people living with farmers who are exposed in a different way. So, personal level exposure assessment is really critical for us to understand this type of scientific association,” said Lipworth. The bottom line A national population study has found a broad association between environmental pesticide usage and various forms of cancer. Across different US geographic regions, sixty-nine different pesticides were associated with increased risk of colon, pancreatic, lung, and other cancers. The design of the study only shows association, not causation. More research is needed to better understand how environmental pesticide exposure affects cancer risk on a personal level.

TikTok’s new sunbathing trend encourages people to chase high UV index readings to achieve a tan, which can lead to wrinkles and increase the risk of skin cancer. Catherine Falls Commercial/Getty Images TikTok’s latest harmful trend encourages people to chase high UV index readings to achieve a tan. Being outside for long periods of time when the UV index is high can put you at risk for skin cancer and premature aging. Experts explain the purpose of the UV Index Scale and how to stay safe in the sun. Getting a tan is something many people strive for during summer months, and TikTok users are following the advice of influencers pushing “UV Index Tanning.” This is a dangerous trend that encourages people to go in the sun during high ultraviolet (UV) index readings to achieve a tan. While these influencers are misinformed and spreading harmful health information, many of their videos are getting millions of views. “Targeting a high UV index is opposite of what people should be doing,” Morgan Rabach, MD, a board certified dermatologist and co-founder of LM Medical, told Healthline. In fact, the UV Index Scale was created by the United States Environmental Protection Agency (EPA) to help people make smart, healthy choices about sun exposure, not as a means to garner a tan. The indexes range from 0-11 and indicate the following: 0-2: Low exposure and no protection needed 3-7: Moderate to high exposure and protection needed 8 and above: Very high to extreme exposure and extra protection needed “Now tweens are targeting the highest indexes to get tan fast, seeking outside time when the index is at its highest moments 8 and above,” said Rabach. The higher the UV index, the higher the risk for skin cancer The reality is the higher the UV index reading, the less time it takes for the skin to get burned and the greater the risk of harm from UV exposure — that includes harm to the skin and eyes. “If it’s a UV Index higher than 6, your risk of sunburn and sun cancer is much higher,” Monalisa Tailor, MD, primary care doctor at Norton Medical Group, told Healthline. “High UV index is not how we want to get a tan.” Over 33,000 sunburns land people in the emergency room each year, according to the National Cancer Institute. Moreover, sunburns, especially those that occur in youth, increase the risk of developing skin cancer like melanoma in the future. Experiencing five or more blistering sunburns between the ages of 15 and 20 increases melanoma risk by 80% and nonmelanoma skin cancer risk by 68%. “We are currently seeing a rise in skin cancers in individuals who were born in the 1980s-1990s. It was not common practice when they were younger to wear sunscreen unless they were at the beach or the pool,” said Tailor. Not using sunscreen regularly has increased this group’s risk of skin cancers later in life, she added. “Skin biopsies hurt. There are so many sensory nerves on the skin. The more we avoid a skin biopsy for the future, the better we will feel,” said Tailor. In addition to cancer concerns related to tanning, she said people should also be concerned about the sun’s ability to cause wrinkles and early signs of skin aging. Sun exposure can lead to wrinkles, too In addition to skin cancer, sun exposure in childhood can affect the way skin ages for the rest of your life. For instance, according to the EPA, up to 90% of skin changes that are often thought to be the cause of aging are actually caused by the sun. Over time, getting too much sun can make skin thick, wrinkled, and leathery. When the sun causes the skin to prematurely age, this is called photoaging, photodamage, solar damage, or sun damage. What is happening to the skin? When exposed to UV light, the skin’s DNA changes at a cellular level, and it may take many years before damage to the skin is noticed. Dark patches on the face, called melasma, and freckles are also caused by the sun. The sun can also affect the eyes. UV light ages eye structures, causing corneal damage, cataracts, and macular degeneration, which causes blurred or reduced vision.  How to protect yourself while in the sun Getting sun has benefits, such as stimulating the production of Vitamin D, which may help decrease the risk of certain cancers, such as colon and ovarian. It can also boost the mood-enhancing hormone serotonin and may help some people with skin conditions like eczema and psoriasis. But protecting yourself from the sun is key to reaping its benefits without all the potential harm. While spending time in the sun, consider the following: Stay outside for less than 30 minutes with a UV index between 3 and 5. Wear a water-resistant, broad-spectrum sunscreen with an SPF of at least 30. The numbers in SPF refer to the amount of time it would take to burn your skin. “So, an SPF of 30 would take you 30 times longer to burn than if you weren’t wearing sunscreen, and an SPF 50 would take you 50 times longer to burn,” said Rabach. However, this varies depending on the person. Reapply sunscreen. Regardless of the SPF number, apply enough sunscreen 30 minutes before going outside and reapply it every two hours. “Sometimes, people use the higher SPFs and think they are protected longer, which is true, but it causes them to not reapply, and they wind up getting burned,” Rabach said. Wear protective clothing like a hat, UV shirts or jackets, and sunglasses. Use tinted sunscreens and bronzers to get a tanned look rather than staying in the sun for extended hours.

The FDA has approved vonoprazan (Voquezna), a new daily treatment for heartburn associated with GERD in adults. andreswd/Getty Images The FDA approved vonoprazan (Voquezna) as a daily treatment for heartburn associated with non-erosive gastroesophageal reflux disease (GERD) in adults. GERD is a condition in which acidic stomach contents flow backward into the esophagus. In non-erosive GERD, the esophagus is not damaged by stomach acid. This approval provides an alternative treatment to proton pump inhibitors such as Prevacid, Prilosec, and Nexium. Adults with a certain type of heartburn now have another option for finding relief from their condition. On July 18, the Food and Drug Administration approved Phathom Pharmaceuticals’ medication vonoprazan (Voquezna) as a daily treatment for heartburn associated with non-erosive gastroesophageal reflux disease (GERD) in adults. GERD is a condition in which acidic stomach contents flow backward into the esophagus. In non-erosive GERD — also known as NERD — the esophagus is not damaged by the stomach acid. However, it can cause symptoms such as heartburn. An estimated 45 million American adults have non-erosive GERD, according to Phathom Pharmaceuticals’ release. The FDA’s decision is based on a phase 3 clinical trial that evaluated the efficacy and safety of Voquezna as a treatment for this condition. The trial found that Voquezna significantly reduced heartburn episodes in adults with non-erosive GERD, with “an established safety profile,” Colin W. Howden, MD, professor emeritus at the University of Tennessee College of Medicine, said in the release. “Today’s approval of Voquezna provides physicians with a novel, first-in-class treatment that can quickly and significantly reduce heartburn for many adult patients,” he added. Effectiveness and safety of Voquezna Voquezna, which is taken by mouth, is a type of drug known as a small-molecule potassium-competitive acid blocker (PCAB). This group of medicines blocks the secretion of acid in the stomach. The drug is also approved in the United States to treat erosive esophagitis (known as erosive GERD), in which the stomach acid damages the lining of the esophagus, and for treating Helicobacter pylori infection, in combination with antibiotics. The four-week clinical trial for Voquezna included more than 700 adults with non-erosive GERD who experienced heartburn at least four days per week. Participants were randomly assigned to take Voquezna 10 mg, Voquezna 20 mg, or a non-acting placebo. The company said in its release that, on average, people taking Voquezna had a greater percentage of heartburn-free days (45%) than those taking the placebo (28%). In addition, the average percentage of 24-hour heartburn-free days was higher in the Voquezna group (48%) than in the placebo group (17%). The most common adverse reactions reported by patients taking Voquezna included abdominal pain, constipation, diarrhea, nausea, and urinary tract infection. Some patients who took Voquezna during a 20-week extension phase of the trial also reported upper respiratory tract infection and sinusitis. Results from the study were published May 13 in Clinical Gastroenterology and Hepatology. Patient information and full prescribing information for Voquezna are available. How Voquezna compares to proton pump inhibitors With the FDA approval of Voquezna, “we now have a new medication to treat patients with non-erosive GERD,” said Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, Calif. “This also allays many of the concerns that people have about being on long-term proton pump inhibitors.” Proton pump inhibitors (PPIs) relieve symptoms of GERD by reducing the production of acid in the stomach. They include lansoprazole (Prevacid 24 HR), omeprazole (Prilosec) and esomeprazole (Nexium). Long-term use of proton pump inhibitors may increase the risk of bone fracture, kidney disease, or a deficiency of certain nutrients such as magnesium and vitamin B12. While Voquezna works differently from proton pump inhibitors, it does reduce stomach acid. Because of this, the prescribing information for Voquezna warns of the possibility of similar long-term side effects as proton pump inhibitors. Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., pointed out that most of the side effects of proton pump inhibitors appear with long-term use. “So I would not be surprised if the side effects of [Voquezna] surface many years from now,” he told Healthline. “So that is something to be concerned about.” “While this [approval] gives me one more tool in my toolbox for managing this disease — which is good — I encourage people to be cautious about it since it is a new medication,” Farhadi said. However, Bedford said vonoprazan “has been around for 5 to 10 years now [for other uses], so I think that’s adequate time for us to know if there would be some long-term issues.” Overall, Bedford thinks Voquezna will improve the quality of life of people who respond well to the drug, including those who don’t benefit from proton pump inhibitors. Farhadi said one advantage of Voquezna is that it “starts faster and lasts longer” than proton pump inhibitors. This may allow people to take the drug on an as-needed basis rather than daily. “Let’s say you’re about to go out and have a big dinner, and you know that would bring on discomfort,” Bedford told Healthline. “You might want to take one of these pills an hour or two before to prevent that from occurring.”  “While it doesn’t provide immediate relief, typically the relief from this medication is within one day,” he said. “I’m not sure that can be said for proton pump inhibitors.” Takeaway The Food and Drug Administration approved Phathom Pharmaceuticals’ medication vonoprazan (Voquezna) as a daily treatment for heartburn associated with non-erosive gastroesophageal reflux disease (GERD) in adults. GERD is a condition in which acidic stomach contents flow backward into the esophagus. In non-erosive GERD, the lining of the esophagus is not damaged by the stomach acid, but heartburn can still occur. Voquezna increased the number of heartburn-free days in patients compared with a non-acting placebo. The main side effects of Voquezna were abdominal pain, constipation, diarrhea, nausea, and urinary tract infection.

A new report details which states provide the highest and lowest quality healthcare for women. South Agency/Getty Images A new state-by-state report ranking women’s healthcare has been released. It finds that the overturning of Roe v. Wade has made getting reproductive care difficult. Also, women are dying from preventable cancers like breast and cervical cancer. Women living in states with worse healthcare can self-advocate to get better care. However, legislation will be necessary to close the gaps. A new report prepared by The Commonwealth Fund states that women’s health and reproductive care in the United States is in a “perilous place,” and there are growing disparities in these areas. They note that more women than ever are dying from preventable causes, and there are large differences in maternal mortality and breast and cervical cancer deaths. Additionally, women’s life expectancy is at its lowest since the year 2006. Their state-by-state analysis further draws attention to the fallout from the Supreme Court’s historic decision overturning Roe v. Wade, which made it increasingly more difficult for women to obtain needed reproductive healthcare. Dobbs v. Jackson Women’s Health Organization has also created a climate where contraception and in vitro fertilization (IVF) are at risk, says the report. They further discuss the impacts of state-level post-pandemic policies that have left millions of low-income women either without health insurance or with gaps in their coverage. Additionally, these losses in coverage have left the providers who serve these low-income women in danger of closing their offices. The 2024 State Scorecard on Women’s Health and Reproductive Care, their first effort to examine women’s healthcare in all 50 states and the District of Columbia, is part of an ongoing series of reports on how well state healthcare systems are fulfilling their missions. It uses 32 measures to gauge each state’s performance in terms of healthcare access and affordability, health care quality and prevention, and health outcomes. Where healthcare for women ranks highest and lowest According to the report, Massachusetts, Vermont, and Rhode Island are some of the best-performing states in terms of healthcare access, quality, and outcomes. Other top-ten states, ranked from higher to lower, were Connecticut, New Hampshire, Maine, the District of Columbia, Minnesota, Hawaii, and New York. On the other end of the spectrum, Mississippi, Texas, and Oklahoma ranked the worst on these measures. Other states among the bottom ten, from lower to higher, were Nevada, Arkansas, Georgia, Alabama, Arizona, Tennessee, and Wyoming. Among the notable findings of the report is the fact that all-cause mortality for women of reproductive age is highest in southeastern states. At the high end of the spectrum was West Virginia, with an all-cause mortality rate of 203.6 per 100,000. At the low end was Hawaii, with 70.5 per 100,000. The highest rates of maternal mortality were found in the Mississippi Delta region, which includes Arkansas, Louisiana, Mississippi, and Tennessee. Vermont, California, and Connecticut had the lowest mortality rates. Another salient finding was that deaths from breast and cervical cancer, which are deemed to be preventable with proper screening and healthcare, were highest in southern states. The authors of the report noted that northeastern states generally have higher screening rates and the lowest mortality while southern states have lower screening rates and higher mortality rates. What to do if you live in a state where quality care is less accessible Nicole Levine, MD, who is a physician focusing on preventive care, nutrition, and lifestyle medicine as well as the founder of Health Strive, said one step you can take is to seek out your local nonprofits and community organizations who provide healthcare. She also suggests becoming active in lobbying for better healthcare policies. Additionally, you can make use of telehealth services when care is not available near where you live or travel to other states when necessary healthcare services are denied. “By taking these steps, the gap in access to high quality healthcare can be closed, she said. However, she noted that narrowing the gaps between the states and improving women’s health outcomes will involve “more access to comprehensive healthcare and legislation that supports it.” Rachel Goldberg, a Licensed Perinatal, Infertility, and Eating Disorder Therapist at Rachel Goldberg Therapy, seconded the idea of self-advocacy, making many of the same suggestions as Levine. “The report also highlights how policy decisions, such as the lack of Medicaid expansion, abortion restrictions, and fertility limitations, directly impact women’s health outcomes,” she added. “This underscores the need for more advocacy and policy changes, which require significant resources and effort.” Goldberg suggests that increasing awareness through social media, sharing personal stories, and engaging celebrities in the discussion are some grassroots ways to highlight the inequities in women’s health care among the various U.S. states and the District of Columbia. Takeaway A new report from The Commonwealth Fund details which states provide the highest and lowest quality healthcare for women. Massachusetts, Vermont, and Rhode Island are some of the best, while Mississippi, Texas, and Oklahoma rank as the worst. Some of the important issues identified include higher all-cause mortality in southeastern states and higher rates of preventable cancers like breast and cervical cancer in southern states. Experts say self-advocacy is an important way women can improve health care for themselves. However, real progress in narrowing the gaps will require legislation to support it.

Can TikTok’s popular Morning Shed trend really help improve your skin health and quality of sleep? Hernandez & Sorokina/Stocksy United The Morning Shed is a growing trend on TikTok.  It involves starting your day by shedding layers of beauty and wellness products you apply before bed. Experts say the trend could cause skin irritation and disrupt sleep. If you’re trying it for yourself, it’s best to test the products during the day first. A new trend is growing in popularity on TikTok, and this one is said to improve both the quality of your skin and your sleep.  The Morning Shed trend sees proponents starting their day by “shedding” the many layers of beauty and wellness products they have applied the night before.  The idea behind the trend is “the uglier you go to bed, the prettier you wake up.” The Morning Shed encourages people to apply products like skin care serums, face masks, moisturizing patches, mouthguards, and eye masks so they can wake up looking fresh and glowy.  So, is the Morning Shed worth the effort? Can layering yourself in products before bed really improve the quality of your skin and sleep?  Morning Shed: risks and benefits for your skin Sophie Momen, PhD, a consultant dermatologist at the Cadogan Clinic, describes the trend as “quite excessive and time-consuming.”  She says it’s another example of intensive skin care regimens.  “Preparing to sleep with all these agents is very time-consuming and largely unnecessary,” Momen says. “Drenching the skin in heavy serums and products may block pores and lead to breakouts, while around the delicate eye area, it may cause the formation of milia,” she says.  Momen also notes that sleeping with active ingredients on the skin that are only designed for a short duration of time may lead to skin discoloration, irritation, and dry skin. Additionally, she says most serums and creams will absorb after a certain amount of time and if their intended duration of use is 10 minutes, then it’s unlikely that there will be any additional benefits or absorption after this period of time. That said, Momen believes one or two of the techniques could provide some benefit.  “For instance, the lips may benefit from an intense overnight hydration with a lip mask, and sleeping in silk turbans is also beneficial to reduce friction, frizziness, and hair breakage,” she explains.  How the Morning Shed trend may affect your sleep quality   Jeff Kahn, a sleep expert and CEO and Co-Founder of Rise Science, says performing certain activities or following specific routines while sleeping can have unique impacts on health due to the body’s natural restorative processes during sleep. “When it comes to sleep masks specifically, most of the research we have on whether or not they improve sleep are in hospital settings,” he says. “What we know from these studies is that patients wearing sleep masks tend to report better sleep quality, suggesting that sleep masks can be an effective, noninvasive way to improve sleep in hospital settings,” he says.  The main benefit of wearing a sleep mask may be its ability to block out light.  “Research shows exposure to light during sleep can impair sleep quality as well as overall health, so wearing a sleep mask can help mitigate these effects by blocking out ambient light and supporting melatonin production,” Kahn explains.  Some proponents of the trend claim that mouthtaping or wearing a mouthguard also helps them sleep better. What does Kahn think?  He says a mouthguard might be useful if teeth grinding is disrupting your sleep.  “Teeth grinding is more likely to occur during sleep and can cause mini arousals during sleep you may not even be aware of,” he explains.  “This nocturnal grinding can lead to significant dental issues and is often accompanied by other sleep disturbances, making a mouthguard a key intervention.”  So mouthguards and eye masks may be useful if getting a better night’s sleep is your goal. But they may not be beneficial for everyone as some people may find wearing an excess of products uncomfortable.  Kahn notes that experiencing this kind of discomfort while you sleep can interfere with the natural progression of sleep stages and trigger the body’s stress response, increasing arousal and leading to frequent awakenings.  Additionally, he says adopting new routines to maximize sleep can be anxiety-inducing for some people. In turn, he says this can make it hard to get to sleep.  Tips to get the most out of your Morning Shed routine If you’re planning to add the Morning Shed trend to your routine, Kahn says it’s essential to try out anything that has the potential to be uncomfortable or anxiety-provoking during the daytime, either while you’re awake or during a short nap.  “This will help you acclimate to sensations or make adjustments without the pressure of needing a full night’s rest,” he explains.  As for your skin? “Avoid thick layers of products if you have oily skin or are prone to blackheads, as this can lead to breakouts,” says Momen.  “For dry skin, using agents like hyaluronic acid, peptides, and ceramides overnight can provide hydration,” she adds.  Whatever your skin type, be sure to avoid anything that might cause irritation. “I would avoid leaving acids on overnight that aren’t intended for overnight use. The same goes for layering active ingredients like retinol, as this may cause sensitivity,” Momen suggests.  If beauty is the goal, Kahn says getting enough restorative sleep is one of the most reliable techniques there is.  Takeaway  The Morning Shed is an elaborate bedtime beauty routine. It requires a lot of effort, and it does not guarantee that it will improve skin health or sleep quality. In fact, it could disrupt your sleep, making you appear tired. If you want to give it a go, it’s best to familiarise yourself with some of the products during the day to ensure they don’t cause irritation or discomfort.

The overall risk of bacterial infection from being tattooed is low, but tighter regulations on tattoo ink could help prevent adverse events. Francesco Carta fotografo/Getty Images Many types of sealed tattoo inks were found to contain harmful bacteria, according to a new study. Multiple species of bacteria were detected, more than half of which were linked to possible disease risks. While the overall risk of bacterial infection from tattoos remains low, experts call for tighter regulations on tattoo ink. Tattoos are increasingly common and generally considered safe in sterile environments with licensed professionals using high-quality materials. Tattoo needles penetrate the skin to deposit ink into the epidermis, which is why safe tattooing practices are key to reducing the risk of adverse events. With proper aftercare, the risk of infection from a new tattoo is minimal. However, the long-term risks associated with tattoo ink are less known. Some tattoo inks may contain potentially harmful ingredients that could be toxic to health. In a recent study, scientists tested 75 inks used for tattoos and permanent makeup. Of these, they identified bacteria in 26 samples — more than one-third of the inks. The research was published July 2 in Applied and Environmental Microbiology. “I’m very surprised to see such a high level of bacterial contamination in tattoo inks despite sterility claims,” said Margaret Schwarz, MD, a board certified dermatologist at Noted Dermatology, not involved in the study. “We often think of needle contamination as the source of infections. I wouldn’t have considered the ink itself,” she told Healthline. Can you get a bacterial infection from a tattoo? The skin serves as a barrier to help protect against pathogens. Anything that penetrates the skin to create an open wound increases the risk of infection. This includes tattoos. As one paper explains, “Tattooing is an invasive procedure causing damage to the skin, which is the barrier against external aggression such as chemicals and microorganisms.” According to the authors of the latest study, around 0.5–6% of people with tattoos experience an infection after being tattooed. The overall risk of infection from being tattooed is a relatively small percentage. However, given that 10–20% of people in industrialized countries now have a tattoo, a 0.5–6% infection rate is significant. For context, there are around 333.3 million people in the United States, so conservatively, that’s around 33.3 million tattooed people. If 6% developed an infection, that would be close to 2 million infections. However, the exact causes of post-tattoo infections could be linked to other factors, such as insufficient aftercare and poor hygiene. Infections could also result from tools used in tattooing, like needles, which haven’t been properly sterilized. This is why getting tattoos from licensed professionals in sterile environments is important. Additionally, bacterial infections resulting from tattoos are not severe and are easy to treat. However, at the other end of the scale, some infections be life threatening, such as: Bacteremia: Bacteria in the blood. Endocarditis: An infection of the heart’s inner lining. Septic shock: When blood pressure drops dangerously low after an infection. Should you worry about bacteria in tattoo ink? Previously, experts believed the two main risk factors for tattoo-related infections were inadequate hygiene at the tattoo studio and poor aftercare. Despite this, a 2010 study and a 2011 study each identified aerobic bacteria in tattoo ink. Aerobic bacteria require air to survive, while anaerobic bacteria die in contact with oxygen. This makes anaerobic bacteria more challenging to culture and, therefore, study. The latest research is the first to look for aerobic and anaerobic bacteria in tattoo ink.  The scientists tested 75 samples of unopened, sealed tattoo inks manufactured by 14 companies and available for sale in the U.S.  More than one in three of the inks contained bacteria. The researchers found 34 bacterial isolates, 19 of which they referred to as “possibly pathogenic strains.” Two of the bacterial species were isolated under anaerobic conditions, which included:  Cutibacterium acnes: Linked to acne and eye infections. Staphylococcus epidermidis: An organism commonly found on the skin that can cause infections in immunocompromised individuals. Two ink samples contained Staphylococcus saprophyticus, a common cause of urinary tract infections, and C. acnes. With one-third of inks containing bacteria, why aren’t post-tattoo infections more common? “Not all bacteria cause infections, and many people have strong immune systems that can fend off these pathogens,” Schwarz explained. “But the risk is still significant, and it’s crucial to take preventive measures.” “Regulations on tattoo inks and the tattooing process can help ensure safer practices and reduce the risk of infections,” she continued. “Enhanced oversight would benefit both tattoo artists and clients.” Hannah Kopelman, MD, a dermatologist and expert in cutaneous oncology and hair loss, not involved in the recent research, agreed. ​​”The high prevalence of bacteria in these studies does highlight the need for better regulation and quality control in the tattoo industry,” she told Healthline. Other possible health risks of tattoos Bacterial infections are one of the more common issues associated with tattoos, but there are other potential concerns, including: allergic reactions granuloma: noncancerous cluster of white blood cells and other tissue keloids: raised areas around the tattoo caused by scar tissue hepatitis B or C: if needles are infected Also, another recent study concluded that tattoos may be a risk factor for malignant lymphoma — a cancer that starts in the lymph system and spreads around the body. The study included 11,905 people, and the authors conclude that “tattooed individuals have a 21% increased risk of overall lymphoma relative to nontattooed individuals.”  Interestingly, they also found that people who had a tattoo removed by laser treatment had an even higher risk of malignant lymphoma. This, the scientists believe, may be caused by harmful compounds that are produced as the tattoo is broken down. However, the authors report several limitations to their findings and call for more research to explore this relationship. What to know about tattoo safety While there are some risks associated with tattoos, they can be minimized by good planning. “My advice is to research thoroughly and select a reputable tattoo artist and studio. It’s crucial to ensure that the studio follows strict hygiene practices, such as using sterile equipment and disposable needles,” Kopelman said. She also noted the importance of discussing any allergies or skin sensitivities before the procedure. “It’s essential to look for certification and proper licensing, which indicate adherence to health and safety regulations,” she explained. “The studio should be clean and organized, with all equipment sterilized or disposable.” Kopelman advised checking reviews and asking for recommendations from previous customers.  “Word of mouth can also be great advice,” agreed Schwarz. “Look for someone who uses single-use, sterilized needles. They should also use high quality, reputable ink brands. Don’t be afraid to ask questions before you get your ink!” Aftercare is also important, Kopelman said. This often includes: Keeping the tattooed area clean and moisturized. Avoiding exposure to direct sunlight. Refraining from submerging the tattoo in water — like swimming pools or hot tubs — during the healing process. Avoiding touching the tattoo with dirty hands. Resisting picking any scabs that form.  The takeaway A new study found bacteria in over one-third of 75 sealed tattoo and permanent makeup ink samples. They identified both aerobic and, for the first time, anaerobic bacteria, which could be harmful to health. Anyone who is considering a tattoo should carry out thorough research into the business before taking the plunge.

Your risk of developing a nutrient deficiency can increase while you are taking GLP-1 drugs like Ozempic, Wegovy, and Zepbound. Anna Stills/Getty Images While GLP-1 medications like Ozempic, Wegovy, and Zepbound can help with weight loss, they may also cause nutrient deficiencies. While taking a GLP-1 drug, it is important to consider getting adequate protein, vitamin B12, vitamin D, iron, and calcium. Experts share how to manage these deficiencies with diet and lifestyle changes. Losing weight on GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound may increase your risk of developing nutrient deficiencies because these medications cause people to significantly reduce their food intake. “If the reduced quantity they are eating is not nutrient-dense, then they may not get all the vitamins and minerals they need,” Rekha B. Kumar, MD, associate professor of clinical medicine at Cornell and Chief Medical Officer at Found, told Healthline. Also, if you experience side effects from GLP-1 drugs, like vomiting or diarrhea, you may not absorb all the nutrients from the food you are consuming. However, Tara Schmidt, lead dietitian for the Mayo Clinic Diet, said nutrient deficiencies develop over weeks or sometimes even months. “Most deficiencies are likely to occur with long-term inadequate intake, such as an overly restrictive diet, malnutrition, or avoidance of entire food groups,” she told Healthline. While there is still not enough data on nutrient deficiencies specific to people on GLP-1 drugs, experts say these are the five most common nutrient deficiencies people can experience and what they can do to avoid them. Protein Not consuming enough protein can lead to loss of lean body mass, weakness, edema, hair loss, and skin changes. While recommendations vary by age, sex, exercise frequency, and health, the Dietary Guidelines for Americans recommends that most adults should consume around 50 grams of protein per day. However, for people living with obesity who are on treatment to lose weight, such as those who have undergone bariatric surgery, their doctor may recommend as much as 60 to 75 g/day of protein. Kumar encourages her patients who take GLP-1 medications to prioritize eating protein, healthy fats, and vegetables “because they will feel full easily and get their required nutrition.” Foods high in protein include: Eggs Nuts Chicken breast Cottage cheese Greek yogurt Milk Lentils Vitamin D Vitamin D helps the body build and maintain strong bones. The recommended amount of Vitamin D for adults ages 19 to 70 years is 600 international units (IU). If you’re not getting enough vitamin D, your body may show the following signs: Muscle pain Muscle weakness Fatigue Bone pain Tingly sensation in hands or feet Some foods high in vitamin D include: Fatty fish, including trout, salmon, tuna, and mackerel Beef liver Egg yolks Cheese  Milk Vitamin D helps the body absorb calcium. Calcium Calcium helps the body function in several ways, including allowing the muscles to move and nerves to communicate messages from the brain to the body. It also helps blood vessels circulate blood and releases necessary hormones in the body. Adults need about 1,000mg to 1,2000 mg of calcium per day. Foods high in calcium include milk, yogurt, and cheese. “For those who wish to avoid dairy, tofu, soymilk, broccoli, some mushrooms, and fortified orange juice are other options, but do not all contain both nutrients,” said Schmidt. Vitamin B12 Vitamin B12 helps keep blood and nerve cells healthy and helps make DNA. It also prevents anemia. Some signs of a B12 deficiency include fatigue, headaches, pale or yellow skin, and difficulty concentrating. Recommended amounts of B12 for adults is 2.4 micrograms (mcg). Vitamin B12 is naturally found in meat, fish, poultry, eggs, and dairy. “For those who follow a vegan diet, this can pose a challenge, so selecting fortified products like cereal, meat substitutes, and nutritional yeast can be helpful,” said Schmidt. Iron Iron helps the body grow and develop. It also helps the body make hemoglobin in red blood cells, which carry oxygen from the lungs to the body, as well as myoglobin, which provides oxygen to muscles. Iron also makes some hormones. Adult men need 8mg of iron per day. Adult women need 18mg until they reach 51, and then 8mg after that. Some signs of low iron include: Tiredness Weakness Shortness of breath Pale or yellow skin Rapid heartbeat Headaches Brittle nails Sources of iron include: Clams and oysters Lean beef and poultry Legumes and lentils Whole grains Fortified breakfast cereals Spinach and kale “Because iron from plants is not as well absorbed, it’s a good idea to pair the iron source with a source of vitamin C; think spinach salad with strawberries, a lean cut of beef with bell peppers, or iron-fortified cereal with melon,” said Schmidt. Tips to avoid a nutrient deficiency while taking weight loss drugs While taking a GLP-1 weight loss medication, consider the following tips to help ensure you get adequate nutrients. Think about what you drink Food and beverage choices should provide adequate calories, protein, and hydration in a smaller volume of food, “as overeating while on a GLP-1 may cause nausea or vomiting,” said Schmidt. Adjust your food intake When starting a GLP-1 or as the dose increases, Schmidt suggested eating soft, blended, or liquid meals to help tolerate symptoms. Consider overnight oats, smoothies, Greek yogurt, soft fruit, and protein shakes, which can provide protein, vitamins, minerals, fiber, and/or hydration. Avoid empty calories Foods and drinks that provide empty calories, meaning high calories with low nutritional value, should be avoided. These include items like sugary beverages, sweets, alcohol, and ultra-processed snack foods. “Intake of these items may replace nutrient-dense foods the body needs,” said Schmidt. Take a multivitamin Kumar said your doctor may recommend a multivitamin or supplemental. She sometimes recommends that her female patients take a prenatal or bariatric supplement if they have significantly reduced their food intake. “If someone has reduced fluids and feels cramps, I encourage water intake and suggest a magnesium supplement,” she said. Self-monitor your habits Keeping track of habits like how well you hydrate, how much of nutrients like protein you’re consuming, how many calories you’re eating, and how much exercise you’re getting helps increase self-awareness and provides motivation for realistic change, said Schmidt. Get help If you think your diet may be inadequate, talk with your doctor and a registered dietitian about ways to ensure you get healthy amounts of nutrients.

Shannen Doherty believed a lapse in her health insurance caused her breast cancer diagnosis to be delayed. Neilson Barnard/Getty Images for Hallmark Channel Actor Shannen Doherty recently passed away at age 53 after many years of treatment for breast cancer, which had spread to her bones and brain. The “Charmed” and “Beverly Hills, 90210” star said in a lawsuit that a lapse in health insurance delayed doctors diagnosing her with breast cancer. Annual screening mammograms are recommended for women starting at age 40. These can detect breast cancer in earlier stages when it is easier to treat. Actor Shannen Doherty recently passed away at age 53. Her cause of death was breast cancer. “On Saturday, July 13, she lost her battle with cancer after many years of fighting the disease,” according to a statement from the “Charmed” and “Beverly Hills, 90210” star’s publicist Leslie Sloan. Doherty was diagnosed with breast cancer in 2015. She received chemotherapy and radiation therapy and underwent a mastectomy. Two years later, she announced she was in remission. But she revealed in 2020 it had returned as stage 4 breast cancer. The cancer later metastasized, or spread, to her brain and bones. In 2023, she underwent brain surgery for her cancer. Doherty said a lapse in her health insurance in 2014 caused a delay in doctors diagnosing her with breast cancer, reports the Los Angeles Daily News. The actress settled a lawsuit against her former business management firm, which she accused of mismanaging her money and failing to pay her medical insurance premiums. Earlier detection improves survival from breast cancer Breast cancer is the second most common cancer among women in the United States, according to the Centers for Disease Control and Prevention. In 2021, around 272,000 women in the United States are diagnosed with breast cancer, and around 42,000 women die from breast cancer, the CDC reports. Detecting breast cancer at an early stage, when it is easier to treat, can improve the chances of long-term survival. “A screening mammogram is probably the best tool we have at improving survival for breast cancer,” said Christopher McGreevy, MD, a breast cancer surgeon and Associate Chief of Breast Surgery at Hackensack University Medical Center. “It’s been shown in numerous studies that screening mammograms increase the chance of a woman surviving breast cancer,” he told Healthline. The 5-year survival rate for stage 1 breast cancer — cancer that has not spread beyond the initial site — is over 99%, according to the National Cancer Institute. The survival rate drops to 32% once the cancer has spread to distant parts of the body. People whose breast cancer is detected earlier “may also potentially avoid additional treatments such as chemotherapy, and they generally have more options for surgery,” said McGreevy. Monica M. Yepes, MD, associate director of breast imaging at the Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, said most guidelines recommend that females with average breast cancer risk get a screening mammogram every year starting at age 40. One exception is the U.S. Preventive Services Task Force (USPSTF), which recommends screening mammograms every other year starting at age 40. However, “we know that two years is too long, especially in the 40 to 50-year age group, because the younger patients are the ones that have the more aggressive cancers,” Yepes told Healthline. Why screening is vital for people with higher risk When should people who are at an increased risk of breast cancer start screening? It depends on their specific situation. “If their risk is based off of a genetic mutation, then we would definitely start screening earlier,” said McGreevy, “and their screening would involve a little bit more, such as including additional things such as MRIs.” “For women whose increased risk is solely based off of family history, when they should start their screening depends upon the age at which their family members were diagnosed with breast cancer,” he said. Yepes said many patients don’t know they have a higher risk of breast cancer until they start screening mammograms at age 40. That’s why “the American College of Radiology recommends that every woman should identify their risk factors and their lifetime risk of developing breast cancer as early as age 25,” she said. “So if they do need to start early screening, they’re prepared for it.” Risk assessments can be done with a primary care doctor, an OB-GYN, or through a referral to a specialist. Doctors use risk assessment tools to determine a person’s breast cancer risk based on their personal medical and reproductive history, as well as their family history of breast cancer. In addition, “genetic testing allows us to identify mutations in genes,” said Tran Ho, DO, FSSO, a breast surgical oncologist at El Camino Health in the San Francisco Bay Area. “Most commonly, you may hear about BRCA1 and BRCA2, genes which can have mutations linked to an increased risk of breast cancer.” While many physicians will discuss breast cancer risk with patients in their 20s, Ho encourages women to be proactive about their health. “If patients find that their physician isn’t bringing it up, they should feel empowered to mention it to their doctor,” she told Healthline. “This might even mean asking their doctor to refer them to someone who would be able to review their history and calculate their breast cancer risk.” Health disparities in breast care Yepes said certain groups have a higher risk of having breast cancer and of having very aggressive breast cancers. For example, “there is a subtype of breast cancer called a triple-negative breast cancer that is very common in African American women,” she said. Yepes also pointed out that minority females dying of breast cancer have a 127% higher risk of dying before the age of 50 compared to their white counterparts. In addition, people without health insurance and certain racial and ethnic groups are much less likely to be up to date with recommended screenings, according to the 2024 AACR Cancer Disparities Progress Report released in May. In 2021, 53% of American Indian and Alaska Native women and 67% of Asian women were up to date with breast cancer screening, compared to 76% of non-Hispanic white women, the report showed. The report also found that women under age 65 without health insurance were half as likely to be up to date with breast cancer screening compared to women under age 65 who had private insurance. Yepes said these disparities are due to a number of factors, including a higher genetic risk of having cancer or a more aggressive cancer, socioeconomic factors and a lack of knowledge about the importance of breast cancer screening. Lack of access to the healthcare system can also prevent women from being up to date with screenings. This includes living in areas without adequate healthcare, not having insurance or being underinsured, lack of transportation, being unable to take time off from work, and other barriers. Since 2010, the Affordable Care Act has required most private health insurance plans to cover the cost of women’s preventive healthcare, including mammograms.  If you don’t have insurance or your insurance doesn’t cover breast cancer screening, the National Breast and Cervical Cancer Early Detection Program provides access to breast cancer screening for low-income, uninsured, and underinsured women ages 40-64.  Takeaway Actor Shannen Doherty died July 13 at age 53. Her cause of death was breast cancer. The “Charmed” and “Beverly Hills, 90210” star was first diagnosed with breast cancer in 2015. Two years later, she announced her cancer was in remission, but it returned later as stage 4 cancer. In a lawsuit against her former business management firm, Doherty said a lapse in her health insurance delayed doctors diagnosing her breast cancer. She accused the firm of failing to pay her medical insurance premiums. A screening mammogram can detect breast cancer at an earlier stage when it is easier to treat. In the United States, women with an average breast cancer risk have the option of starting screening mammography at age 40. 

Kim Kardashian recently opened up about her journey living with psoriasis and the home remedies she uses that provide the greatest relief from painful flare-ups. The Hollywood Curtain/Bauer-Griffin/GC Images Kim Kardashian stated on a podcast that she uses Saran Wrap to help her psoriasis. She learned of the remedy from a dermatologist after other home remedies failed. Experts say occlusion therapies like Saran Wrap help psoriasis medications work better. Occlusion therapy also helps to soften plaques and reduce inflammation. Some other effective home remedies include colloidal oatmeal baths and sunlight. While Kim Kardashian is known for being carefully styled and groomed in her work as a reality star, model, businesswoman, and actress, she recently revealed that her life isn’t always perfect — especially when it comes to her skin. The 43-year-old star of FX’s “American Horror Story: Delicate” spoke on the July 16, 2024, episode of the SHE MD podcast about her experience living with psoriasis, a skin disorder in which the immune system speeds up skin cell growth leading to the formation of plaques and scales on the skin. The National Psoriasis Foundation notes that this autoimmune condition can also cause symptoms like itching, burning, and stinging. The shapewear mogul told hosts Mary Alice Haney and Dr. Thaïs Aliabadi and their guest, rheumatologist Dr. Daniel Wallace, that she initially thought she was having a reaction to a new dress that she was wearing. Then, her mother, Kris Jenner, who also has the condition, looked at her legs and exclaimed, “Oh my God, you have psoriasis?” Kardashian further stated that a cortisone injection helped keep symptoms at bay for a while, but they returned five years later and haven’t abated since. Speaking of how miserable psoriasis makes her, the reality star said, “One day I’ll just have an itch attack, and I’ll scratch it, and it’ll all start bleeding, and I just can’t take it.” As for keeping her symptoms under control, she said, “I’ll do anything,” noting that she has tried numerous home remedies that have been recommended to her, including tar tea, herbs, a celery juice cleanse, and various creams and soaps. However, the remedy that she said works best is something that most people likely already have in their kitchens: Saran Wrap. The actress said she was given the idea by her dermatologist, Dr. Harold Lancer of Beverly Hills, who told her to apply a prescription cream to the rash, followed by “putting Saran Wrap around it and sleeping on it.” While she said the unconventional method made her “[sound] like the Tin Man,” Kardashian added that it does work to take away the rash. Does Saran Wrap really work for psoriasis relief? When asked about using Saran Wrap to help relieve itchy, painful psoriasis symptoms, Dr. Amy Huang, board-certified dermatologist with Medical Offices of Manhattan and contributor to Labfinder, confirmed that it does indeed work. “Yes, we also use occlusion therapy for many other dermatologic conditions, including eczema,” she added. Huang explained why it works. It helps any psoriasis medications that are used under the plastic wrap work better. “Applying medication under occlusion increases penetration of the medication into the skin, especially in areas where the psoriasis can be quite thick,” she said. Dr. Anju Methil, a dermatologist and medical consultant with ClinicSpots, added that occusion therapy also helps loosen scales, soften plaques, and reduce inflammation. She did say, however, that there is limited research dealing with Saran Wrap specifically. “[B]ut occlusive dressings have shown promise,” she said. Other home remedies that may help treat psoriasis symptoms Methil said that one thing she advises is using fragrance-free moisturizers. “Regular use can significantly improve skin comfort during flare-ups,” she said. Another measure she suggested is using colloidal oatmeal baths, which have anti-inflammatory and anti-itching properties. Additionally, Methil discussed using controlled sunlight exposure. “Sunlight can be beneficial for some psoriasis patients, but discuss appropriate amounts with your doctor to avoid sunburn,” she advised. Caylee Clay, RDN CDN CYT — who is a dietitian-nutritionist specializing in psoriasis and other autoimmune diseases as well as the author of “Gain Control Over Your Psoriasis: A Science Based Treatment Plan using Lifestyle and Intuitive Eating” and the founder of Autoimmune Eats — said one remedy that she applies to her own psoriasis is to rub on a “glob” of Vicks Vaporub with a bit of apple cider vinegar and then wrap with Saran Wrap. “This works because the menthol in Vicks is naturally antimicrobial and is known to accelerate wound healing,” she said. “Apple cider vinegar, with the mother, is both naturally antibacterial due to its acidity, plus it’s also a probiotic.” According to Clay, psoriasis plaques have an altered microbiome. Combining these two products may help restore it to balance. “Another popular home remedy for psoriasis is taking a bath with Epsom salt,” she added. You can also add a splash of apple cider vinegar or several drops of tea tree oil to your bath. After soaking, Clay advises lightly rubbing your psoriasis patches with a washcloth to remove any thickened skin gently. Then, moisturize well. Finally, she suggests that applying walnut oil, which is rich in anti-inflammatory omega-3 fatty acids, can help soothe your skin. “A few minutes after applying it, add a moisturizer,” she concluded, “as walnut oil alone can be drying.” Takeaway In a recent interview, Kim Kardashian revealed that she uses Saran Wrap to help manage her psoriasis symptoms. Experts say using occlusive therapies like Saran Wrap over your psoriasis medication can improve the treatment’s effectiveness by aiding its penetration into your skin. Other popular home remedies recommended by psoriasis experts include fragrance-free moisturizers, colloidal oatmeal baths, sunlight exposure, Vicks VapoRub and vinegar, Epsom salt soaks, and walnut oil.

GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound can affect people differently. BONNINSTUDIO/Stocksy United Misconceptions about the benefits and risks of GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound are common. Not all GLP-1 drugs are the same, and different medications may affect people differently. Before starting a GLP-1 drug, talk with a healthcare professional about the potential risks and benefits. It likely won’t surprise you to hear that the GLP-1 drugs semaglutide (better known by the brand names Wegovy and Ozempic) and tirzepatide (sold under the brand names Monjouro and Zepbound) were among the top 10 most popular drugs by U.S. spending in 2023. The medications have been heralded has game-changing treatments for diabetes and obesity. But as their popularity has grown, so too have persistent myths and misinformation about them. “The reality is that each of these is prescribed to achieve different health goals, and like any medication, they each come with potential risks that patients should be educated on in order to make informed decisions with their healthcare providers,” says HaVy Ngo-Hamilton, Pharm.D., pharmacist and clinical consultant for BuzzRx. In an effort to clarify common misconceptions, Healthline spoke with experts who helped identify and debunk the eight most common myths currently being shared about GLP-1 drugs. Myth: Taking a GLP-1 drug guarantees significant weight loss  The short answer: “Nothing guarantees weight loss,” says Dr. Mir Ali, MD, a board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center. Ali notes that these drugs certainly have a high success rate for aiding with weight loss, primarily because of their ability to slow stomach emptying, helping people feel fuller longer. In a clinical trial, patients who took weekly 2.4 mg doses of semaglutide lost “clinically significant weight” within 68 weeks. A 72-week trial for tirzepatide suggested that 91% of people who took the maximum 15 mg dose saw a weight reduction of 5% or more. Over half of the participants (57%) lost 20% of their body weight. Those numbers are good, but they are not perfect. Doctors generally recommend patience — to a point. “The FDA has given us guidelines when using these medications, in that we expect at least 5% total body weight loss at 12 weeks,” says Dr. Janese Laster, MD, who is board certified in internal medicine, gastroenterology, obesity medicine, and nutrition. She is also the founder of Gut Theory Total DigestiveCare. If this weight loss doesn’t occur, Laster says a healthcare professional will discuss lifestyle factors, including: Dosing Whether the patient is taking the medication correctly Diet Exercise However, a small percentage of patients won’t respond, which doesn’t mean they did anything “wrong.”  “Obesity already carries a lot of unnecessary societal stigma and shame, so it’s important that patients understand that it is largely out of their control regarding who is a responder or a non-responder,” says Dr. Michael Glickman, MD, the CEO and founder of Revolution Medicine. “It is likely a genetic explanation or…your unique physiology.” Though Mounjaro and Ozempic are approved for the treatment of type 2 diabetes, one 2022 narrative review suggested that individuals living with type 2 diabetes who take these drugs may see less weight loss. Myth: You don’t have to exercise while taking GLP-1 drugs Even the label says otherwise. “If you look at the package insert for Wegovy or Zepbound, the instructions are to use these medications with a ‘reduced calorie diet and increased physical activity,’” Ngo-Hamilton explains. “In reality, the amount of diet and exercise will vary among users, leading to various degrees of weight loss. However, consistent physical activity is vital to achieve and maintain the desired weight loss.” A 2023 article suggested that physical activity is important in helping patients maintain lean muscle mass, which can be lost along with weight. Glickman emphasizes that resistance training is especially critical for these efforts. “If we are not exercising during the weight loss journey, ultimately our metabolism can suffer because patients will lose a significant amount of muscle mass too,” Glickman says. Myth: You don’t need to eat a healthy diet if you’re taking a GLP-1 drug Again, the label suggests the opposite, but social media captions may not. “These medications are not magical, despite what is seen in the media/social media,” Laster says.” Patients will not have success if they do not also make lifestyle and diet changes. Nonadherence to dietary changes is one factor we consider if a patient is not losing weight as we expect on these medications.” Glickman suggests a plant-forward or Mediterranean-style diet, which emphasizes certain fats, lean and plant-based proteins, and leafy greens and deprioritizes ultra-processed and high-sugar foods and drinks. Dietary choices are also important for reducing side effect risk and severity. “Because these medications trigger insulin production, slow the emptying of the stomach, and cause you to feel full faster and for longer periods of time, eating unhealthy foods or larger portions of food may cause negative gastrointestinal side effects, including abdominal pain, nausea, or vomiting,” Ngo-Hamilton says. Myth: Side effects are unbearable (or no big deal) Ultimately, the severity of side effects is relative.  “Unbearable is a subjective term, and individual thresholds for discomfort may vary significantly from person to person, as may the side effects individuals experience while taking the medication,” Ngo-Hamilton says. Backing up, Ngo-Hamilton says common side effects of GLP-1s include: Vomiting Nausea Diahrrea  She says the side effects are often temporary and resolve as the patient adjusts to the medication. Ali says that’s why providers gradually increase doses. “If side effects are an issue, medications to counteract the side effects can be given,” Ali says, adding it’s unusual for a patient to stop taking a GLP-1 for side effects. However, that doesn’t mean none do. “If the side effects aren’t effectively controlled with symptom management and don’t decrease or resolve after three or more months on the medication with dosage increases, you should talk to your doctor about switching to a medication with a different mechanism of action or exploring a different category of weight loss drugs entirely,” Ngo-Hamilton says.  Myth: Using compounded GLP-1 drugs is just as safe as brand-name medications Doctors advise using caution before opting to obtain compounded GLP-1 drugs. “While compounded drugs are certainly an important — and sometimes necessary — option for patients who require access to a drug that is in shortage or otherwise commercially unavailable, these are formulated by specialty pharmacies combining active ingredients they source themselves,” Ngo-Hamilton says. “Unlike the brand name drugs that are clinically tested by the manufacturers for safety and efficacy according to FDA guidelines, compounded drugs are not held to those same standards and are not FDA-approved medications.” Ali suggests discussing options with a healthcare professional and getting their take on compounded GLP-1 drugs and reputable pharmacies. “If you are getting medication…through social media or questionable online sources, you may end up with something that does not work or, worst-case scenario, causes harm,” he says. Myth: Your insurance will cover the cost if you’re a prime candidate Not always. Cost is a barrier for some individuals who would like to go on GLP-1 medication, and not all insurance will help cover it. Medicare does not cover GLP-1s for weight loss. “Insurance coverage will vary by person and by insurance policy, and recently, more insurance plans have opted not to cover the cost of GLP-1 agonists, particularly those that are being prescribed for off-label use,” Ngo-Hamilton says. “For example, when someone doesn’t have type-2 diabetes, their healthcare provider prescribes Ozempic as off-label use for weight management.” A month’s supply of Ozempic can cost about $1,000, similar to Zepbound’s prices. “Prescription discount cards can be a helpful resource for patients whose insurance plans don’t cover these medications,” Ngo-Hamilton says. Myth: All GLP-1 drugs are the same They are similar but not the same. Even Ozempic and Wegovy, though both semaglutide, have some distinctions. “Ozempic and Wegovy are both semaglutides, which stimulate the GLP-1 receptor to reduce appetite and slow stomach emptying,” Ali says. “Ozempic is indicated for diabetes, whereas Wegovy is for weight loss.” The maximum weekly dose of Ozempic is 2.0 mg, while Wegovy’s is 2.4 mg.  Zepbound and Mounjaro have the same weekly dose (15 mg), and the lone distinction between them is that Zepbound is for weight management, and Mounjaro is for diabetes treatment. They are different from semaglutide but possess commonalities.  “Mounjaro and Zepbound are both tirzepatide which affects two receptors, GLP-1 and GIP, again reducing appetite and slowing stomach emptying,” Ali says. Zepbound is “better” than Wegovy for weight loss Some data suggests that patients will lose more weight on Zepbound than Wegovy. Eli Lily-conducted trials (SURMOUNT-3 and SURMOUNT-4) indicated that people taking tirzepatide lost more than a quarter (26.6%) of their body weight in 84 weeks, which is more than the 15% of people taking Wegovy for 68 weeks lost. The timeframe was different for these trials, and Glickman says experiences can vary, too.  “Not every patient tracks perfectly along the average weight loss curve,” Glickman says. “Some patients can be non-responders to one brand and responders to the other. Some patients can also be average responders to one brand and super responders — above average — to the other. It can be a little unpredictable.” Currently, Glickman says that close monitoring is sometimes the best way to determine long-term fit. However, more research in precision medicine may change this strategy. Takeaway Misconceptions about the benefits and risks of GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound are commonly spread. Though these medications can help people lose weight, not everyone responds to them. Diet and exercise are still important factors for sustainable weight loss while taking a GLP-1 medication. Before starting a GLP-1 drug, talk with a healthcare professional about the potential risks and benefits.

Forming healthy habits can help increase the effectiveness of GLP-1 drugs like Wegovy and Zepbound, leading to more weight loss in less time. Ivan Rodriguez Alba/Getty Images Lifestyle choices can either hinder or complement the effectiveness of GLP-1 weight loss drugs like Wegovy and Zepbound. Health experts say there are several research-backed strategies that may help improve weight loss results while taking GLP-1 drugs. These include getting regular exercise, reducing stress, eating a healthy diet, and prioritizing sleep.  GLP-1 drugs like Wegovy and Zepbound have grown in popularity due to their ability to help people lose significant amounts of weight. However, while these drugs are a useful tool for many people, they’re far from a “silver bullet” that guarantees you’ll shed pounds quickly or, in some cases, lose any weight at all. Lifestyle choices can greatly impact the effectiveness of GLP-1 drugs for weight loss. Experts say the following healthy habits can help increase the weight you may lose while taking these medications, as well as maintain the results long-term. Exercise regularly  It probably won’t come as much of a surprise that getting regular exercise is a great way to complement the effects of Wegovy and Zepbound.  A common complaint about these drugs — and dramatic weight loss in general — is that they may cause you to lose muscle mass as well as fat.  “Exercise will help you maintain your muscle mass and prevent muscle loss during weight loss,” said registered dietitian Kim Shapira.  She explained that resistance training, specifically, is a great way to help protect against the loss of muscle mass and promote fat loss, which is essential for your metabolism and weight maintenance.  Kristin Kirkpatrick, dietitian at Cleveland Clinic Department of Wellness and Preventive Medicine, points to a study published in 2021 that supports this idea.  Researchers found muscle mass loss impacts metabolism, cardiovascular health, insulin sensitivity, and even mortality. “This is also a critical factor if/when you choose to reduce the dose or stop the medication completely, as low muscle mass increases the risk of rapid weight gain,” Kirkpatrick says.  Prioritize sleep  Quality sleep might not immediately spring to mind when it comes to weight loss, but it may play a bigger role than you realize.  Feeling tired and irritable can affect your ability to make healthy choices and, on a physical level, your ability to lose weight.  “When a person doesn’t sleep well, meaning they have trouble falling asleep, staying asleep, or waking up feeling unrested, this increases the stress hormone cortisol,” Shapira says. “When cortisol levels are high, it changes the way we metabolize food and disrupts our hormone balance.”  Research suggests that sufficient sleep is essential for maintaining a healthy weight.  A study published in 2022 found that a pattern of sleep duration of less than six hours a night has been associated with a higher body mass index.  The same study cites short sleep duration as a “significant risk factor for weight gain and obesity.”  Eat a healthy diet  While Wegovy and Zepbound can produce dramatic results, the importance of good nutrition should not be overlooked — particularly if you want to maintain weight loss long-term.  GLP-1 medications help regulate the hormones that signal the brain that you’re hungry and help increase feelings of fullness so you’re more likely to eat smaller amounts of food. That said, Shapira says it’s always best to eat a balanced diet full of fiber, vegetables, whole grains, and foods with omega-3 and protein.  Consuming enough protein may be key to preventing weight regain if you decide to stop taking Wegovy or Zepbound.  A 2021 review notes that diets with higher protein intake can provide significant benefits to prevent weight regain.  For Kirkpatrick, making every bite count is key when you’re taking a GLP-1 drug.  “GLP-1 agonist drugs reduce appetite and, consequently, the volume of food intake. A deficient volume of food may increase the risk of malnutrition, so getting a nutritional bang in every bite is critical,” she explains.  Reduce stress  Stress can also impact your ability to lose weight.  “Just like lack of sleep, being stuck in a ‘fight or flight mode‘ increases our cortisol levels, which affects our metabolism, causing insulin resistance and disrupting our hormone health,” Shapira explains.  Several studies have found an association between stress and obesity, including recent research published in January that suggests childhood stress may contribute to an increased risk of heart disease and obesity. “It’s important to practice ways to regulate your nervous system, such as taking deep breaths often or spending some time meditating,” Shapira advises.  Takeaway  Drugs like Wegovy and Zepbound can trigger dramatic weight loss results. However, lifestyle choices can hinder or complement their effectiveness. Health experts say that the best way to increase the effectiveness of GLP-1 weight loss drugs is with healthy strategies like regular exercise, stress reduction, and prioritizing quality nutrition.  Implementing these lifestyle changes now may also help you maintain your weight loss results in the future.

In states with strict abortion laws, many medical residents are unable to receive full-scope reproductive training, which includes abortion care and counseling. jacoblund/Getty Images In states with strict abortion laws, many medical residents are unable to receive abortion training. Some medical students have left states such as these to obtain full-scope OB-GYN training, which includes abortion care and counseling. One healthcare professional in Louisiana faced this dilemma midway through her medical residency. After completing her residency, she left the state to pursue an OB-GYN practice in the Northeast, where abortions are permitted. As states pass sweeping restrictions against abortion, it’s become increasingly clear these bans have far-reaching consequences. Evidence has shown, for example, that abortion restrictions can push families into poverty, worsen pregnant people’s long-term physical and mental health, and cause increases in both maternal and infant deaths. Less known, however, is the impact abortion bans have on the healthcare professionals who care for pregnant individuals. A new report from the University of California San Francisco revealed that the fall of Roe v. Wade, which led to an influx of abortion restrictions in multiple states, has been particularly distressing for obstetrics and gynecology (OB-GYN) residents.  Healthline spoke with one healthcare professional who can attest to this. Due to privacy concerns, this source’s name has been changed to Emily Green for the purpose of reporting and protecting her identity. Green moved to Louisiana in 2020 for her OB-GYN residency at an academic hospital. When considering hospitals to apply to, reproductive justice was at the forefront of her decision — she chose a program that would provide her with the training to be a full-scope OB-GYN. “To me, that includes good training and solid foundation in contraception counseling, in abortion counseling, and in abortion training,” Green told Healthline.  But in June 2022, Roe v. Wade was overturned, and Green, who was halfway through her residency, suddenly found herself smack in the middle of the country’s anti-abortion movement. Green’s experiences, as detailed below, are her own opinions and not those of the larger institutions she’s been a part of. How abortion bans changed medical residency programs Even with Roe v. Wade in place, abortion was hard to come by in Louisiana — there were only three clinics in the state that offered elective abortion and strict laws in place that completely banned the procedure with few exceptions. When the June 2022 Dobbs v. Jackson Women’s Health Organization decision revoked the constitutional right to abortion, Louisiana banned most types of abortion. “I remember exactly where I was because I was scheduled to go on this rotation [for abortion training] in September of 2022,” Green said.  That summer, multiple short-lived protections went into place to keep those three clinics running, causing a lot of back-and-forth about if and when Green would be able to do her training and whether or not her patients could access abortion services.  “You’d tell patients, ‘You have these three options within the state, but tomorrow, I don’t know if they’re accepting new patients,’” Green, who worked with a primarily Medicaid and uninsured population, shared.  There was the added concern of whether she was legally protected as a physician. There was a lot of ambiguity regarding the new bans — of what was or was not permitted — and how well a hospital’s legal counsel could protect physicians. She hustled to stay current with the rapidly changing legislation to ensure that her patients were getting the most accurate information.  Watching this play out was heartbreaking for her. “You come into this profession wanting to help people make decisions about their body and their life that feel safe and healthy for them, and then the ability to do so becomes really challenging,” Green said. Green added that many of her patients already had a lot stacked against them, and seeing them further lose control of their bodies and decisions was very difficult. She said she felt helpless knowing she could not offer patients full-scope care. Many people found scheduling an appointment, which may or may not happen due to changing laws and lengthy wait times, arranging child care, securing transportation, and managing finances overwhelming. The new restrictions disproportionally affected birthing people of color and socially disadvantaged communities, Green said. In medical school, Green read a lot of books about remote places in the United States where abortion was inaccessible. “All of a sudden, it became very real. These stories were no longer just something you were reading about far away. This is what I was working with on a day-to-day basis,” she said.  Residents scrambled to get abortion training  Meanwhile, the clinic Green was slated to do her abortion training was shut down due to the state’s abortion ban. Green specifically chose her program for the abortion training it offered — now, it was unclear if Green would get trained. She struggled with the implications of being in a place where healthcare providers aren’t properly trained to offer abortion care.  “Not only are you affecting women’s ability to access abortion now but it’s really affecting their ability to make their own reproductive decisions down the line,” Green said.  Without proper training, future physicians might not understand how the procedure works and won’t be able to counsel women about evidence-based abortion care.  “You start to lose generations of of people that have that skillset,” Green said. This could create a situation where pregnant people resort to alternatives that aren’t as safe, she said. Fortunately, Green’s program was affiliated with the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning (Ryan Program), which ensures OB-GYN residents get comprehensive contraception and abortion training regardless of where they live, which secured out-of-state abortion training for interested residents.  In 2023, Green traveled to Massachusetts to complete abortion training. Residents grapple with the decision to stay or leave  Green, who recently wrapped up her residency, made the difficult decision to move to a state in the Northeast that has many abortion protections in place.  Although she is looking forward to providing evidence-based reproductive healthcare to her patients, she said this decision has brought on a significant amount of moral distress. If proponents of abortion care leave states like Louisiana, there might be more geographic areas where physicians lack the skillset to perform abortions or the interest and ability to support women through these challenging situations.  Green said it’s hard to move away when you know you could offer a perspective or advice that could be comforting and life changing for females looking to terminate pregnancy.  “The decision to leave in some ways feels like you’re abandoning a patient population you care a lot about and deserves access to this information,” Green said. “I am so grateful and have so much respect for the people in my program who will stay and continue to make sure we can train in the way we need to and provide care in a safe way, especially in states like Louisiana where things are just so restricted,” she shared.  Takeaway In states with strict abortion laws, many medical residents are unable to receive full-scope reproductive training, which includes abortion care and counseling. One healthcare professional in Louisiana faced this dilemma midway through her medical residency and ultimately left the state to pursue an OB-GYN practice where abortions are permitted. The future of medical residency programs for aspiring OB-GYNs in states where abortions are banned or restricted remains uncertain.

Combining GLP-1 drugs like Ozempic with SGLT2 diabetes medications may help reduce the risk of heart attacks, stroke, and kidney disease, new research suggests. Alexandr Muşuc/Getty Images Two classes of diabetes drugs may also improve cardiovascular and kidney disease outcomes in people with or without diabetes. In a meta-analysis involving more than 70,000 patients with diabetes, SGLT2 inhibitors reduced the risk of heart attack, stroke, and kidney disease progression. When paired with a GLP-1 drug, the benefit increased. Two classes of diabetes drugs show health benefits far beyond improving blood sugar. When used together, their effects are even more evident. For individuals with type 2 diabetes, SGLT2 inhibitors lower blood sugar by preventing the kidneys from reabsorbing glucose; the excess sugar is instead excreted through urine. But they do more than that. Large trials suggest that SGLT2 inhibitors reduce the risk of kidney disease, heart attack, and stroke not only in patients with type 2 diabetes, but also, those without. If you’ve been following the trajectory of another well-known class of diabetes drugs, this might sound familiar. The health benefits of GLP-1 drugs, the class of diabetes and obesity medications that includes Ozempic, Wegovy, Mounjaro, and Zepbound, have also grown to include improving outcomes for cardiovascular disease, heart failure, and chronic kidney disease. New research published this week in The Lancet Diabetes & Endocrinology now indicates that both classes of drugs used together may yield even more protective benefits than individually. “What we found was clear and additional benefits of SGLT2 inhibitors when used in combination with GLP-1 receptor agonists, benefits on cardiovascular disease, benefits on kidney disease progression, and also no increased risk of side effects or safety issues when used in combination,” Brendon Neuen, PhD, a Clinical Associate Professor of Medicine at Royal North Shore Hospital in Sydney, Australia, and co-author of the study told Healthline. Robert A. Gabbay, MD, PhD, Chief Scientific and Medical Officer for the American Diabetes Association, lauded the study, saying, “This adds to the growing body of evidence showing the benefit of these two important classes of medicines and that their benefits can be additive.” Gabbay and the ADA were not involved in the research. Kidney and CVD benefits of SGLT2 inhibitors Neuen and his team conducted a meta-analysis of 12 randomized, double-blind, placebo-controlled trials — the “gold standard” for research trials. The analysis included data from more than 70,000 patients with diabetes. A small cohort of those patients, about 3,000 (4.2%), were being prescribed a GLP-1. The researchers were curious whether or not the cardiovascular and kidney protective effects of the SGLT2 inhibitors would persist across the available data, and how the addition of a GLP-1 would alter those effects. Not only did the protective benefits of the SGLT2s persist with or without the presence of a GLP-1, but when the two were paired, the benefits were even greater. The study examined a myriad of serious health issues that are known comorbidities of type 2 diabetes. These outcomes include the risk of major cardiovascular events (heart attack and stroke), hospitalization for heart failure, or death from cardiovascular disease. Chronic kidney disease progression was also explored, which the team defined as a 40% or more decline in eGFR (a standard measurement of kidney functioning), kidney failure, or death due to kidney functioning. Compared to a placebo, an SGLT2 by itself reduced the risk of heart attack and stroke by 11% and hospitalization for heart failure or cardiovascular death by 23%. The effects on kidney disease progression were even more pronounced: an SGLT2 yielded a reduced risk of 33% compared to a placebo. For each outcome, the addition of a GLP-1 resulted in an additional small reduction in risk. For cardiovascular disease-related hospitalizations and kidney disease progression, a GLP-1 further reduced risk by about 2%. For major cardiovascular events, a GLP-1 nearly doubled the protective effects, reducing risk by an additional 10%. Safety and tolerability were also consistent when an SGLT2 was used individually or paired with a GLP-1, meaning there was not an increased number of adverse events when the drugs were used together. “These data provide the strongest evidence that we have yet that using these two medications in combination is not only safe but highly effective and is likely to improve clinical outcomes for people with type 2 diabetes who have cardiovascular kidney disease,” said Neuen. A new era of diabetes management The study is likely to grab the attention of doctors and healthcare organizations who are still evaluating and creating guidelines for these two relatively novel classes of drugs. The FDA  first approved SGLT2 inhibitor, Invokana (canagliflozin), in 2013. GLP-1 drugs have been available for nearly 20 years, but have only recently taken the industry by storm due to blockbuster drugs like Ozempic and Zepbound capturing the attention of the public. “In the new era of diabetes management where we have available medications such as GLP-1 receptor agonists and SGLT2 inhibitors, the goal is to understand which patient could benefit most from which treatment or treatment combination,” Mona Mashayekhi, MD, PhD, an Assistant Professor of Medicine in Diabetes, Endocrinology and Metabolism at the Vanderbilt University Medical Center who wasn’t affiliated with the study, told Healthline. For patients with type 2 diabetes who are at risk for or already have comorbidities like kidney disease, heart failure, or cardiovascular disease, it appears there is a new world of potential in these drugs. Even for patients without diabetes, the benefits of GLP-1s and SGLT2s are a promising development. “These medications are now recommended in people with heart failure and kidney disease, even if they do not have diabetes, because they have clear and important, clinically important benefits in preventing kidney failure and heart failure outcomes,” said Neuen. The bottom line In a meta-analysis involving more than 70,000 patients with diabetes, SGLT2 inhibitors improved outcomes for cardiovascular events like heart attack and stroke, hospitalizations, and kidney disease progression. When an SGLT2 inhibitor was paired with a GLP-1 (the class of drugs that includes Ozempic and Mounjaro), there was an even greater reduction without any additional safety issues. Experts told Healthline that the findings will help to better inform doctors about treating patients with certain comorbidities, including kidney disease and heart disease.

Walmart has begun stocking a handful of Charlotte’s Web CBD products at over 800 locations. Jakub Porzycki/NurPhoto via Getty Images More than 800 Walmart stores in the United States now carry topical CBD products. Cannabidiol or CBD is a non-psychoactive chemical found in cannabis that may help with a variety of conditions including inflammation, pain, and anxiety. There is some scientific evidence to support the therapeutic benefits of CBD. More than 800 Walmart stores across five states will now carry CBD products on their shelves. Charlotte’s Web, one of the biggest names in cannabidiol (CBD) and other hemp-derived botanical products, announced that some of their products are now available in select Walmart stores as of June 26. In total, 827 stores in Texas, Pennsylvania, California, Illinois, and Florida began stocking a handful of CBD topicals from Charlotte’s Web, including a balm stick, cream, and cooling gel — all of which contain 1,000mg of concentrated CBD isolate. CBD is a non-psychoactive chemical component of marijuana that is touted for a wide variety of conditions, including inflammation, chronic pain, insomnia, and anxiety. However, it has only ever been approved by the FDA for epilepsy.  Even so, CBD has become more and more pervasive in recent years, showing up in products from sodas and gummies to lotions and oils.  CBD topicals may help with pain, inflammation, and other skin conditions. “We are proud to introduce CBD topicals at Walmart, reflecting Charlotte’s Web’s dedication to setting new standards of excellence in the CBD industry, ensuring every Walmart shopper can experience the transformative benefits of our meticulously crafted products,” said Bill Morachnick, CEO of Charlotte’s Web, in a statement. Wesley Raup-Konsavage, PhD, an Assistant Professor of Pharmacology at Penn State University who has extensively researched CBD and other cannabinoids, told Healthline, “Given the widespread availability of CBD products, it was really only a matter of time until a large chain started selling these products.” Despite their popularity and anecdotal reports of therapeutic effects, experts contacted by Healthline said that the data is still unclear for many of the claims made about CBD. “It is important to note that, in many ways, the public is getting ahead of the science. We still do not have good data to support the use of CBD or other cannabinoids for treating conditions outside of a few select areas,” said Raup-Konsavage. Is topical CBD effective for muscle soreness? Topical CBD products, including lotions, balms, and sticks, are popular because they may help mitigate inflammation and muscle soreness; they’re often marketed for post-exercise relief. CBD is also generally considered safe. However, topical CBD products are some of the least studied, so it’s unclear what, if any, therapeutic effects they might have. Most research has been conducted on CBD that is consumed orally. Available studies on topical CBD and muscle soreness are small. “Little research has been done on the topical delivery of CBD; however, this does have potential to be of benefit for joint pain and other forms of local pain,” said Raup-Konsavage. A 2023 study involving 21 college-age participants found that topical CBD did not improve muscle soreness. A randomized, double-blinded, placebo-controlled study (considered the “gold standard”) involving 28 participants that was published this month also found that CBD did not impact muscle recovery and soreness. “For many people, transdermal delivery isn’t that effective a way to get the active ingredient into the body,” Paul Armentano, the Deputy Director of the National Organization for the Reform of Marijuana Laws (NORML), told Healthline. Drugs are metabolized by the body in different ways, so the “route of administration, or how you take them, matters. With a wide variety of CBD products on the market that can be consumed in different ways, from drinks to vapes to lotions, it is hard to be certain if the dose you are getting is the same as what is printed on the label. “CBD itself is therapeutic in a number of different ways. That doesn’t mean a shot of CBD in your espresso is therapeutic,” said Armentano. The science behind the health benefits of CBD Although CBD topicals might not have the best track record, CBD does have scientific backing for other health conditions. Currently, there is only one FDA-approved drug containing CBD, Epidiolex, which is indicated for seizures associated with two rare but severe forms of epilepsy. In the United Kingdom and some European countries, Sativex, which is derived from both THC (a psychoactive chemical found in cannabis) and CBD, is approved for multiple sclerosis-related spasticity, which is when an individual’s muscles may feel stiff and rigid or spasm uncontrollably. Sativex is not approved or legal in the United States. Outside of the narrow FDA approval, CBD may help with conditions including inflammation, chronic pain, anxiety, and insomnia. The strength of the scientific evidence for these conditions varies. “The anti-inflammatory and analgesic activities of CBD are the most widely researched, and there is some good evidence that CBD can be an effective treatment. There is some evidence that CBD may reduce anxiety as well, although these data are far more limited,” said Raup-Konsavage. Is CBD legal? In 2018, the US government effectively legalized many CBD products through legislation known as the “Farm Bill.” The bill allows for cannabis or hemp plants to be grown legally so long as they do not contain more than 0.3% THC. In reality, CBD products are still in a legal gray area that can vary from state to state. “If the CBD in question is derived from a plant that the federal law classifies as hemp…then that end product containing the CBD is considered a federally legal product. If the CBD was sourced from a plant that contained a greater amount of THC than three-tenths of 1%, then that end product would not be considered to be a legal product,” said Armentano. The CBD market is also generally unregulated so long as manufacturers do not make therapeutic claims about the product.  “We don’t know a whole lot about how these products are produced. There’s not a whole lot of oversight with regard to the consistency of the product from batch to batch, or their purity, or their labeling, or even the marketing,” said Armentano. The bottom line More than 800 Walmart stores across five US states are now carrying a variety of topical CBD products. Cannabidiol, or CBD, is a non-psychoactive chemical found in cannabis that is believed to have therapeutic properties. CBD is only FDA-approved for the treatment of seizures. There is some scientific evidence to support the use of CBD for other conditions, including inflammation, pain, and anxiety.

A common ultrasound screening technique used to assess the risk of endometrial cancer may be less effective in Black females, a new report suggests. MoMo Productions/Getty Images A new report found that a common screening technique used to assess the risk of endometrial cancer may be less effective in Black people. Pelvic transvaginal ultrasonography misses a significant percentage of cancer risk cases in Black females. The most accurate way to detect endometrial cancer in Black females is through a tissue biopsy. A new report found that a common screening technique used to assess the risk of endometrial cancer (EC) may be less effective in Black people. The study, published in JAMA Oncology in June, discovered that pelvic transvaginal ultrasonography (TVUS) led to false negatives in a portion of Black females who actually had EC. TVUS, which uses sound waves to produce a picture of the inside of the pelvis, is routinely recommended to females experiencing postmenopausal bleeding, which is a symptom of EC.  If the TVUS reveals that the individual has a thicker endometrial thickness (ET), they should also get a tissue biopsy to screen for EC. Some Black females with EC have a relatively thin endometrial thickness — as a result, they don’t get a biopsy, and the cancer is missed.  With EC, early detection is crucial.  “Since we know that ultrasound assessment is not always accurate in Black women, other screening modalities are essential for early cancer detection, including symptom awareness and advocacy,” Elena Ratner, MD, MBA, a gynecologic oncologist at Yale Cancer Center and Smilow Cancer Hospital, told Healthline.  Many cancers were missed on ultrasounds in Black females The report evaluated the health data of 1,494 Black individuals who underwent pelvic ultrasonography with an ET measurement before a hysterectomy. Of the group, 210 had EC. In addition, 78% had fibroids, 71% had vaginal bleeding, and 57% had pelvic pain.  Of the 210 who had EC, about 11% had an ET that was below the diagnostic threshold for detection (4 mm). The study found that roughly 9.5% of cancers detected in Black females were detected below the threshold of 4 mm, and 3.8% were in people who had an ET less than 3 mm.  An estimated 11.5% of the cancers would have been missed because the people had a relatively thin ET. The findings suggest the most accurate way to identify EC in Black females is through a tissue biopsy. Diana Pearre, MD, a board certified gynecologic oncologist at The Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center in Burbank, CA, says that the lead researcher of the study, Dr. Kemi Doll, has significantly added to the scant research that’s been done surrounding health inequities in the diagnosis and treatment of endometrial cancer.  “The main takeaway I believe she wants us to understand is that we cannot rely simply on the image we see on an ultrasound report to determine whether to biopsy a patient with postmenopausal bleeding,” Pearre said. Why TVUS may be less reliable for detecting cancer in Black people In many patient populations, TVUS is an effective way to measure ET and provide a risk assessment for EC. “It is often used to determine whether patients should get a biopsy of the internal lining of the uterus and make sure there are no cancerous or precancerous changes in the lining,” Amer Karam, MD, a gynecologic surgeon with Stanford Medicine, says. However, the procedure doesn’t appear to be as reliable in Black females.  Prior research has shown that Black females with postmenopausal bleeding are less likely to get an endometrial biopsy.  A study published in 2019 revealed that Black females are more likely to get false negative transvaginal ultrasounds compared to white females.  “In publications, ultrasound findings of being below a certain endometrial thickness threshold rule out the possibility of endometrial cancer. In Black women, that does not appear to be the case,” Ratner said. According to Karam, the majority of studies examining the accuracy of TVUS have been conducted in mostly white patients. The researchers of the new report suspect that the decreased visibility of the cancers in Black females and the increased prevalence of fibroids may make the cancer harder to detect via TVUS alone. “One other factor not examined in the current study is the higher prevalence of aggressive types of endometrial cancer that present with thinner linings among Black patients,” Karam said. Biopsies can help detect a greater percentage of cancers Pearre suspects that many physicians will be surprised to see these new findings. “I hope they take this study into account and refer patients to gynecologists when they report bleeding regardless of how thick the inner lining of their uterus is,” Pearre said. The researchers suggest that a tissue biopsy should always be done to provide an accurate diagnosis of EC. According to Pearre, endometrial sampling is the cornerstone of EC diagnosis. “If a patient reports bleeding after menopause or even heavy bleeding prior to menopause, endometrial sampling is probably the next best strategy in their workup,” Pearre said. The bottom line: A new report found that a common screening technique used to detect endometrial cancer risk may be less effective in Black people. Pelvic transvaginal ultrasonography misses a significant percentage of cancer risk cases in Black females. The most accurate way to detect endometrial cancer in Black females is through a tissue biopsy.

Delaying the onset of type 2 diabetes for 4 years or more after a prediabetes diagnosis can help reduce your risk of heart disease, stroke, and death. Hobo_018/Getty Images People who delayed the onset of type 2 diabetes for 4 years or more had a lower long-term risk of death and diabetes complications. Participants in the study were all diagnosed with prediabetes and elevated blood sugar not high enough to be considered type 2 diabetes. Lifestyle programs of healthy diet and physical activity have been shown to reduce the risk of developing type 2 diabetes. People with prediabetes who were able to delay the onset of type 2 diabetes for 4 years or more through healthy diet and exercise had a lower long-term risk of death and diabetes complications, a new study shows. Prediabetes means your blood sugar level is higher than normal but not high enough to be considered type 2 diabetes. It is sometimes known as impaired glucose tolerance or borderline diabetes. “This study underscores the importance of efforts to improve health and reduce the risk for diabetes because that will make a big difference later on,” said Peter Senior, PhD, director of the Alberta Diabetes Institute at the University of Alberta. “There’s a big difference between getting diabetes at the age of 85 and getting it at 45,” he told Healthline. “If you get it at 45, you could be looking at a lot of years of life lost.” Senior was not involved in the new study, which was published July 9 in PLoS Medicine.  Delaying diabetes gives long-term health benefits In the new study, researchers examined health outcomes for 540 people with prediabetes who participated in an earlier study conducted in China known as the Da Qing Diabetes Prevention Study. In this study, people were randomly assigned to a control group or to one of three intervention groups. The intervention groups involved a 6-year program of healthy eating, regular exercise, or both. Researchers followed participants for an average of 30 years after the interventions. In the new analysis, researchers found that people who delayed their diabetes diagnosis for at least four years after their initial prediabetes diagnosis had a lower risk of dying from any cause or from having a cardiovascular event such as coronary heart disease, stroke, or heart failure. They also had a lower risk of diabetes-related eye, kidney, or nerve problems when compared to people who developed diabetes at an earlier age. In addition, people who delayed their diabetes diagnosis for at least 6 years had a lower risk of dying due to cardiovascular disease compared to those who were diagnosed with diabetes earlier. There was no protective effect for people who delayed their diabetes diagnosis for fewer than 4 years. “This suggests that a longer diabetes-free time may lower the risk of long-term adverse outcomes,” the authors wrote in the paper. “Taking action, including but not limited to lifestyle intervention, to prolong the diabetes-free time in people with prediabetes may be crucial.” Healthy eating and physical activity lowered diabetes risk Senior pointed out that the original Da Qing study and the U.S. National Diabetes Prevention program both showed that it is possible to prevent people from developing diabetes. The National Diabetes Prevention Program is a lifestyle change program that focuses on healthy eating and physical activity. Research showed that people with prediabetes who joined this program reduced their risk of developing type 2 diabetes by 58%. “We’ve also learned over the years that if you have diabetes and you’re able to keep your blood sugars in target, that that’s going to be beneficial over the long run,” said Senior. So, “if you have someone who has diabetes and you work with them intensively, even if it’s just for 5 or 10 years, that will set them up for better long-term health decades later, compared to those who are left to fend for themselves.” However, if you delay getting your blood sugar under control, you may not see the same kind of long-term health benefits as someone who started earlier. Senior compares it to saving for retirement, where it’s best to start setting aside money when you are 20 rather than waiting until you’re 50. Only in this case, you are accumulating health benefits. The new study, he said, extends this thinking to earlier, before people get diabetes. “If we intervene with lifestyle changes, that means a person’s diabetes is delayed,” he said. “And even if you do develop diabetes later, you’re still going to be at an advantage over people whose diabetes came on much sooner.” Type 2 diabetes is a complex disease The new study included people who had prediabetes, so they had a higher risk of developing type 2 diabetes. One public health approach would be to identify people like this who are at higher risk of diabetes and focus intensive interventions on them. This is the approach used by the National Diabetes Prevention Program. “But if the intervention is healthy eating and healthy lifestyle, there’s no harm in those,” said Senior. “So let’s recommend them for everybody, maybe with extra coaching for those who are at highest risk [of diabetes].” Although healthy eating and regular exercise can lower the risk of developing type 2 diabetes, Senior cautioned against seeing diabetes solely as a “lifestyle disease.” “Behaviors, lifestyle, and the situations people find themselves in will all impact the age at which they get diabetes,” he said.  But genetics also play an important role in the development of diabetes. “There are people who are destined to get diabetes no matter what,” he said. “In their case, it may be more about delaying diabetes until later in life, and that’s still very worthwhile.” Still, “there’s a real risk that we could reinforce stigma about diabetes,” he said. “If somebody gets diabetes, they could be criticized for eating the wrong foods or not doing enough of the right thing.” But “that misunderstands the nature of diabetes,” he said. “There will be people who get diabetes who have been really careful with their lifestyle but got diabetes because of their genetics.” Takeaway Researchers looked at health outcomes for people with prediabetes who participated in an earlier study comparing lifestyle interventions — healthy eating, exercise, or both — to no intervention. People who delayed the onset of diabetes by 4 years or more had a lower risk of dying from any cause or from having a cardiovascular event such as coronary heart disease, stroke, or heart failure. They also had a lower risk of diabetes-related eye, kidney, or nerve problems. Other research has shown that lifestyle programs such as healthy eating and physical activity can reduce a person’s risk of developing type 2 diabetes. However, genetics also play a role in whether someone develops diabetes.

A new real-world study found that people taking Mounjaro lost more weight faster compared to people who took Ozempic. Sandy Huffaker for The Washington Post via Getty Images In a real-world study, Mounjaro showed greater weight loss compared to Ozempic. Patients taking Mounjaro were more likely to hit weight-loss benchmarks and drop more pounds overall. The study is the first to compare the two drugs head-to-head in a real-world setting using healthcare data. Eli Lilly’s Mounjaro trumps Novo Nordisk’s Ozempic in the first real-world comparison of weight loss in patients with obesity. According to a new study in JAMA Internal Medicine, Mounjaro (tripeptide) showed better results across multiple weight-loss benchmarks and overall weight loss compared to Ozempic (semaglutide).  Both are part of a class of drugs known as glucagon-like peptide receptor agonists (GLP-1), which are indicated for the treatment of type 2 diabetes and obesity. GLP-1 drugs work by mimicking natural hormones in the gut and brain that control blood sugar and appetite. They also cause weight loss by slowing digestion and imparting feelings of fullness and satiety. Ozempic and Mounjaro are both FDA-approved for the treatment of type 2 diabetes, but are frequently used “off-label” for obesity. The drugs are sold under different trade names, Zepbound (tirzepatide) and Wegovy (semaglutide), when indicated for the treatment of obesity. Prior trials have shown patients taking Ozempic lost as much as 16% of their total body weight. Mounjaro showed even more impressive results, with some patients losing more than 20%. However, due to differences in how the trials were conducted, they cannot be directly compared. New real-world data now suggests that Mounjaro is, in fact, the more effective of the two for weight loss.  “This data is informative and reinforcing because it supports our experiences in real-world clinical practice — people lose more weight with tirzepatide than with semaglutide,” Beverly Tchang, MD, an endocrinologist, Spokesperson for the Obesity Society, and Assistant Professor of clinical medicine at Weill Cornell Medicine, told Healthline. Tchang wasn’t affiliated with the research. Patients taking tirzepatide 3 times as likely to achieve weight loss of 15% or more The study found that across a one-year time period, patients taking tirzepatide were more than twice as likely to achieve a weight loss of 10% or greater and three times as likely to achieve a weight loss of 15% or greater compared to semaglutide. Total weight loss at various intervals, including three, six, and 12 months, was also greater among those taking tirzepatide. The gap between the two drugs also increased with time. At three months, the average weight loss for tirzepatide was 5.9% compared to semaglutide’s 3.6%. By one year, patients taking tirzepatide lost more than 15% of their body weight, while those taking semaglutide lost about 8%. “As a practicing cardiologist and researcher, having the most timely data to inform patient care is paramount,” Ty Gluckman, MD, Medical Director at the Center for Cardiovascular Analytics, Research, and Data Science (CARDS) at Providence Heart Institute, and an author on the paper, told Healthline. “Because tirzepatide was only approved by the FDA in mid-2022 for type 2 diabetes, the ability to rigorously analyze its use (on- and off-label) for a broad population of patients with overweight or obesity, not just a subset captured in insurance databases, has the power to greatly improve our understanding of how these agents are being used in everyday practice and the effect that they’re having,” said Gluckman. To conduct their study, researchers at Truveta, a healthcare data and analytics company that currently includes 30 health systems across the US, tapped into electronic health records and prescriber data. They identified adults with overweight or obesity who began taking either Ozempic or Mounjaro for the first time between May 2022 and September 2023. They could not have previously been prescribed a GLP-1 drug to be included in the study. In total, more than 40,000 patients met criteria for the study who had taken one of the two drugs. After matching patients taking tirzepatide to characteristically similar individuals taking semaglutide, the total cohort remaining was 18,386. The average age of patients in the study was 52. The cohort was predominantly female (70%) and white (77%). About 12% of the cohort was Black and 2% were Asian. More than half of the patients included in the study were living with type 2 diabetes. Learn more about how to get GLP-1 medications like Mounjaro from vetted and trusted online sources here: How to Get Mounjaro (Tirzepatide) Where to Buy Mounjaro (Tirzepatide) Online How to Get Wegovy for Weight Loss In Person and Online How to Get a Wegovy Prescription Online How to Get Zepbound: What We Know So Far Where to Buy Zepbound Online How to Get Ozempic: Everything You Need to Know Where to Buy Ozempic Online No difference in drug safety Researchers also observed whether either drug resulted in more adverse health events.  GLP-1 drugs are known to be associated with common gastrointestinal effects, including nausea, diarrhea, and vomiting. However, more serious complications have also occurred, including bowel obstruction or ileus, which is potentially fatal. Both Ozempic and Mounjaro resulted in a similar amount of adverse events, according to the study. Moderate-to-severe outcomes that were observed included bowel obstruction, gastroparesis, pancreatitis, and cholelithiasis (gallstones). “Gastrointestinal side effects of these medications have been widely reported as well, but we didn’t find a difference in the rates of moderate to severe gastrointestinal adverse events between the two medications,” Tricia Rodriguez, PhD, a scientist at Truveta Research, and lead author on the paper, told Healthline. The study also yielded some other significant findings. Consistent with other clinical trials, weight loss was greater among patients without type 2 diabetes. The reasons for these effects are still unclear.  Additionally, more than 50% of patients in both the tripeptide group and semaglutide group stopped taking their medication within one year. Researchers theorize that this could be linked to a number of different factors, including the cost and accessibility of the medications or side effects. The study doesn’t conclude why the discontinuation rate is so high but notes that more research needs to be done in this area. The bottom line In a first real-world comparison using healthcare data, Mounjaro (tirzepatide) outperformed Ozempic (semaglutide) across numerous weight-loss benchmarks. Patients taking Mounjaro were two times as likely to achieve a weight loss of 10% or greater and three times as likely to achieve a weight loss of 15% or greater. The safety profile of both drugs was similar in terms of adverse gastrointestinal events during the study period.