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• The FDA has approved a new colorectal cancer blood test by Guardant Health for Medicare coverage.
• The test, called Shield, looks for “free-floating” fragments of cancer DNA in the bloodstream.
• The Shield test also offers accessibility and convenience at the cost of reduced accuracy.
• The ECLIPSE clinical trial, which preceded the FDA approval, found that the test accurately confirmed 83.1% of colorectal cancer cases.

A new blood test for colorectal cancer was approved this week by the Food and Drug Administration (FDA), making it the first test of its kind to meet requirements for Medicare coverage.

Guardant Health’s blood test, called Shield, is a noninvasive blood test that is touted as a simple, convenient alternative to other forms of colorectal cancer (CRC) screening. 

Colon cancer screening is a notoriously tricky issue: fewer than 60% of adults in the United States ages 45 and 75 receive screening for the disease, despite it being the second-leading cause of all cancer-related deaths. Yet colorectal cancer is highly treatable when detected early.

Hesitancy around colorectal cancer screening may stem from the belief that colonoscopies and stool-based tests are onerous or unpleasant. However, finding a non-invasive colorectal cancer screening test that is both accurate and noninvasive has proved challenging. 

“The persistent gap in colorectal cancer screening rates shows that the existing screening options do not appeal to millions of people,” Daniel Chung, MD, a gastroenterologist at Massachusetts General Hospital and professor of medicine at Harvard Medical School said in a press release from Guardant Health.

“The FDA’s approval of the Shield blood test marks a tremendous leap forward, offering a compelling new solution to close this gap. This decision will help make screening tests more broadly accessible and propel blood-based testing and CRC screening into a new era,” Chung continued.

Can a blood test for colon cancer replace a colonoscopy?

Shield’s greater ease of use comes with a not-insignificant trade-off in screening accuracy.

Medical professionals contacted by Healthline said that the potential for missed diagnoses is concerning and that the test should not be viewed as a replacement for a colonoscopy.

“Most of us look at these types of tests as adjuncts or ‘helper’ tests to get more people screened and then possibly get more colonoscopies if they were positive,” Ben Park, MD, PhD, director of the Vanderbilt-Ingram Cancer Center at Vanderbilt University, told Healthline. Park was not affiliated with the Shield research but disclosed that he is currently engaged in separate clinical trials involving Guardant Health.

“The danger of these types of tests is if they’re negative, they’re not necessarily really negative,” Park said.

There is a shared sense of enthusiasm among doctors about the potential for Shield to get more people screened for colorectal cancer more frequently. But exactly how the test will fit into current recommendations is less clear. 

“The gold standard is still very much the colonoscopy. So, I would be cautious counseling patients that we don’t see this as an equal alternative to colonoscopy,” Christopher Chen, MD, an assistant professor of oncology and director of the Early Drug Development at the Stanford Cancer Institute, Stanford Medicine, told Healthline.

Uri Ladabaum, MD, director of the Gastrointestinal Cancer Prevention Program at Stanford Medicine told Healthline, “Guardant Shield is expected to have substantial net benefit if it extends CRC screening to persons who are unwilling or unable to undergo screening colonoscopy or stool-based screening.”

However, if Guardant Health’s Shield were to substitute for screening colonoscopy or stool-based screening in those willing to use them, this is expected to worsen outcomes,” Ladabaum noted.

Blood test detects colon cancer with 83% accuracy

The approval of Shield arrives on the back of the ECLIPSE trial, the results of which were published in the New England Journal of Medicine in March 2024.

The trial included nearly 8,000 participants between the ages of 45 and 84. Shield is what’s known as a cell-free DNA test (cfDNA test), which looks for “free-floating” DNA molecules that are shed by cancer cells into the bloodstream.

The ECLIPSE trial found that in patients with CRC, confirmed by a colonoscopy, Shield accurately identified the cancer in 83.1% of cases. That means a significant number of participants with CRC (16.9%) received a false negative test result.

“You may not think that sounds like a big number, but when you translate it into the hundreds of thousands of patients who get diagnosed with colon cancer every year in this country alone, that is a significant number,” Park said.

“It could meaningfully risk missing a significant number of diagnoses,” Chen noted.

The concern for doctors is what happens when someone gets a false negative test result who isn’t regularly getting a colonoscopy as well. 

“That’s where the potential danger is where, you know, we could potentially be giving false security or senses of security,” Park said.

The test also doesn’t test for pre-cancerous lesions, only detecting them in about 13% of cases. It is therefore not regarded as a preventive screen, since it only detects cancer that is already present.

Despite these caveats, the test represents a new opportunity to increase screening and adherence for a dangerous, pervasive form of cancer. But its true value will be found in expanding screening as an adjunct to colonoscopy, not replacing it.

The takeaway

A blood test for colorectal cancer, Guardant Health’s Shield, has just been approved by the FDA for Medicare coverage, putting the test in reach of many more people in the U.S. at risk for developing the disease.

The blood test is a convenient, non-invasive alternative to other forms of colorectal cancer screening that are perceived as time-consuming or unpleasant.

Doctors caution that the test should not be viewed as a replacement for the “gold standard” colonoscopy, but rather an adjunct test that can help to accommodate certain patients who might not otherwise be screened.

As we move into autumn, protection from any earlier COVID-19 vaccination you may have had will be starting to wane. For those who are more likely to become seriously ill from COVID-19, the NHS offers a free vaccine in the …

• A new study has linked sugar consumption with signs of biological aging.
• Researchers observed how diet and sugar affected the epigenetic age of Black and white women in midlife.
• Epigenetic age is not the same as chronological age and is indicative of how behavioral and environmental factors affect “wear and tear” on the body at a cellular level.

In one of the first studies to do so, scientists have linked dietary sugar intake to epigenetic (also referred to as biological) aging.

Excess sugar consumption is already known to increase the risk of chronic disease; now, it also appears to speed up signs of aging at a cellular level. The findings were published in the journal JAMA Network Open.

Researchers also examined the impact of a healthy diet on epigenetic markers and found the opposite effect: a higher-quality diet slowed the signs of aging.

The inverse effects also appear to be independent of one another, so diet and sugar consumption should both be evaluated in a dietary context for their effects on health and aging.

“Our findings appear to fit well with the general nutritional epidemiology literature that finds added sugars to be related to chronic diseases such as cardiometabolic conditions and cancer and related processes such as inflammation, all of which track with aging and are one manifestation of wear and tear on our bodies over time,” Dorothy Chiu, PhD, a Postdoctoral Scholar at the UCSF Osher Center for Integrative Health, and first author of the study, told Healthline.

Heidi J. Silver, PhD, RD, a Research Professor of Medicine at Vanderbilt University Medical Center who wasn’t affiliated with the study, told Healthline, “While the current studies do not show cause and effect, improving overall quality of the diet might contribute to slowing age or environmentally-related epigenetic changes.”

Sugar speeds up the body’s epigenetic “clock”

Chiu and her team investigated a cohort of 342 women in midlife. Importantly, the cohort was evenly split among Black (171) and white (171), and composed of individuals from different socioeconomic backgrounds. Prior scientific studies on diet and epigenetics have historically been limited to white individuals, making them hard to generalize to a broader population.

The participants were selected as part of the NGHS study, originally commissioned in the 1980s to study cardiovascular health in white and Black females between the ages of 9 and 19. The same group was then recruited again between 2015 and 2019 when all of the women had entered midlife — the average age being 39.

To assess the role of diet and sugar on epigenetic age, researchers first utilized a number of indices to gauge diet quality. These included the aMED Index, which scores a diet based on how closely it adheres to the Mediterranean diet, and the Alternative Healthy Eating Index.

Researchers then compared scores from these dietary indices to a novel epigenetic clock known as GrimAge2. GrimAge2, like other epigenetic clocks, relies on interpreting DNA methylation, a natural process that affects gene expression.

“DNA methylation (DNAm) is one way genes are modified and are turned on and off. It is used as a reliable indicator of epigenetic age because these patterns in DNAm have been observed to accumulate over time and are related to biological age,” said Chiu.

Researchers anticipated that a higher quality diet would slow signs of epigenetic aging, while sugar consumption would do the opposite. They were right.

However, interestingly, the effects of a healthy diet showed a far more significant response compared to sugar intake.

“Since the authors found a stronger association with diet quality and epigenetic age, it would be wiser to focus on the overall quality of the diet. Reducing added sugars intake would be one way to improve diet quality, especially if those calories are replaced with other ways to increase diet quality,” said Silver.

What is epigenetic age?

Chiu’s research is part of a growing field known as geroscience, which seeks to understand in scientific terms how aging, disease, and biology are all related. One of the important distinctions made in the field is between chronological age and biological or epigenetic age. 

When you celebrate your birthday, that’s representative of your chronological age; one year is the same amount of time for everyone. However, epigenetic age indicates the health of your body at a cellular level, and it doesn’t move at the same rate for everyone. 

Epigenetics refers to the impact that behavioral and environmental factors have on the age of your body.

For example, the epigenetic age of someone who eats healthy and exercises every day may increase more slowly than someone who is sedentary and consumes high amounts of sugar.

Epigenetic changes are also reversible, which means that your behavior, diet, and exercise can affect the aging process for better or worse.

“Epigenetic age reflects modifications of our genetic material or DNA that can result in changes in our gene and protein expression,” said Chiu.

 “These modifications end up turning genes on or off, which can have health implications depending on how the biological functions and physiology of our cells and systems are impacted,” she said.

The bottom line

Among a cohort of Black and white women in midlife, sugar intake and diet quality were predictors of epigenetic aging.

A healthy diet appears to slow the body’s biological “clock,” while consuming sugar does the opposite.

The role of diet in epigenetic aging is part of the growing field of geroscience, which seeks to understand scientifically how biology, diet, aging, and disease are all related.

• Travis and Jason Kelce are collaborating with General Mills to launch a new breakfast cereal.
• The cereal, Kelce Mix, contains a combination of their breakfast favorites.
• However, the brothers have been called out for promoting a cereal that could be unhealthy.
• The brothers responded to the criticism by claiming it was okay in moderation.
• Nutritionists have weighed in, saying children would be better off eating less sugar.

Kansas City Chiefs tight end Travis Kelce and his brother Jason have announced that they are doing a collaboration with General Mills, bringing to market a cereal based on their childhood favorites.

The creation, which is called “Kelce Mix,” drew inspiration from a discussion the pair had on their “New Heights” podcast last year in which the siblings ranked their favorite cereals.

It features a combination of Travis and Jason’s three favorites: Cinnamon Toast Crunch, Lucky Charms, and Reese’s Puffs all in one box.

There will also be four limited edition Kelces’ Pick collectible boxes with these three cereals as well as Honey Nut Cheerios.

However, while Travis Kelce seemed stoked about the deal, calling it a “full-circle moment,” some, like Dr. Calley Means, have had a less rosy outlook on the celebrity endorsement.

Means, the best-selling author of “Good Energy: The Surprising Connection Between Metabolism and Limitless Health” and the founder of TrueMed, recently took to his X account with the blunt advice that “[a]thletes should stop sponsoring food that destroys kids’ metabolic health.”

Jason Kelce soon clapped back via his X account, saying, “I grew up on these products, Calley, and I was a perfectly healthy fit child because I enjoyed them in moderation and when on the go for quick meals when both my parents didn’t have time to cook.”

But is Kelce right? Can these cereals really be a part of a healthy diet?

How unhealthy is Kelce Mix cereal?

Varsha Khatri, RDN, with Prowise Healthcare, noted that, while Kelce Mix combines three familiar breakfast cereals, no specific information detailing ingredients has been made available.

“Nevertheless, such cereals are generally made up of a combination of sweet-tasting grains, man-made flavors and additives that may alter their nutrient content greatly,” she said.

Khatri went on to explain that children’s cereals tend to be made with a lot of sugar, sometimes containing as much as 12-15 grams per serving.

“This is already high since it could be about half the daily recommended sugar intake for children by the American Heart Association, which should not exceed 25g while a child is between ages 2 and 18,” she said.

Khatri additionally remarked that high levels of sugar intake have been associated with conditions like obesity, type 2 diabetes, and dental problems.

Sugary cereals are also problematic because eating large amounts of sugar can increase blood sugar and cause energy crashes, leading to cravings for even more sugary foods.

“This cycle might be extremely injurious to the metabolic health of children due to their still-growing bodies that can highly suffer from what excess consumption of sugar does,” said Vashtri.

What can children eat that’s a healthier alternative?

Lesley Kumar, RD, CNS, a nutrition consultant with Ringside24, suggests that there are several breakfast options that are healthier for your child.

One is plain oatmeal that you’ve prepared yourself.

“Oatmeal is rich in fiber and can be naturally sweetened with fruits like bananas or berries, according to your preferences,” she explained.

Another possibility, per Kumar, is Greek yogurt with fresh fruit, which gives your child a healthy dose of protein and probiotics. “It can also be topped with nuts or seeds for added nutrients,” she suggested.

Nutritious smoothies made by blending fruits, vegetables, and protein source such as Greek yogurt or protein powder are also a great choice, according to Kumar.

However, if you really can’t live without cereal, she advised going for whole grain cereals like Cheerios or bran flakes. These are low in sugar and high in fiber.

“These alternatives offer balanced nutrition without the excessive sugar found in Kelce Mix,” Kumar concluded.

Takeaway

Kansas City Chiefs football players Jason and Travis Kelce are collaborating with the cereal manufacturer General Mills to release a cereal called Kelce Mix.

The cereal includes three of their favorites, including Cinnamon Toast Crunch, Lucky Charms, and Reese’s Puffs.

The announcement hasn’t been without controvery, however, with Dr. Calley Means condemning the cereal as being unhealthy for children’s nutrition.

While the brothers were quick to defend the cereal as being healthy in moderation, nutritionists say breakfast cereals are often high in sugar, which can damage children’s growing bodies.

They say healthier options are foods like oatmeal, Greek yogurt, fruit smoothies, and whole grain cereals that are lower in sugar.

• Dry age-related macular degeneration is an eye disorder that can lead to blindness. It affects millions of Americans.
• A formulation of over-the-counter antioxidant supplements appears to prevent the progression of the disease, even in its advanced stage, known as geographic atrophy.
• There is no cure for AMD, and current pharmaceutical options can be cumbersome and expensive.

A widely available formulation of antioxidant supplements appears to slow the progression of dry age-related macular degeneration (AMD).

Dry AMD is a common eye disorder in individuals aged 55 and over that causes blurred vision, and is a leading cause of legal blindness.

As its name suggests, the condition occurs naturally during aging and is more common in older individuals. It may have little to no effect on vision but may also progress to a more severe, vision-threatening form known as geographic atrophy.

Based on recent estimates, dry AMD is believed to affect nearly 20 million Americans aged 40 and older. However, less than one percent of them have a vision-threatening form of it.

There is no treatment to reverse damage from dry AMD. However, new evidence suggests that a cocktail of over-the-counter antioxidant supplements can slow progression of the disease significantly, even in individuals with geographic atrophy.

55% less disease progression over placebo

In an article published this month in the journal Ophthalmology, researchers from the National Eye Institute found that antioxidant supplementation slowed progression by as much as 55% over three years compared to a placebo.

“These findings are very significant as geographic atrophy affects approximately 5 million people worldwide and, up until recently, we had no treatments to prevent geographic atrophy occurring, slow its expansion, or restore vision to affected areas. The oral supplements have the advantages of a large treatment effect, excellent safety profile, ease of use, and low cost,” Tiarnan D. L. Keenan, BM BCh, PhD, a researcher in the Division of Epidemiology and Clinical Applications at the National Institute of Health’s National Eye Institute, and first author of the study, told Healthline.

Theodore Leng, MD, an Associate Professor of Ophthalmology at Stanford Medicine who wasn’t affiliated with the study, told Healthline, “This study was great because it really confirms some of our suspicions about vitamin supplementation in this specific form of advanced macular degeneration.”

Antioxidant cocktail shows promise

Researchers conducted a post hoc analysis of two major clinical trials that previously investigated the link between antioxidant supplementation and dry AMD progression. Those trials, known as AREDS and AREDS2, honed in on six supplements believed to support eye health and slow disease progression:

• Vitamin C
• Vitamin E
• Copper
• Zinc
• Lutein
• Zeaxanthin

The original studies found that taking this combination of supplements reduced the risk of progression from intermediate to advanced AMD by one-fourth. However, there was nothing to suggest that the supplements would slow progression in individuals whose eyes had already advanced to geographic atrophy, the most extreme form of dry AMD.

Keenan and his team wanted to find out whether the AREDS2 supplement formulation could also help slow disease progression in individuals with the advanced form of the disease.

“Our study shows that the oral supplements have an important role even when geographic atrophy is present,” he told Healthline.

Specifically, they found that over a three year period, the eyes of individuals with geographic atrophy who took antioxidants showed 39.8 microns of disease progression, compared to 73.2 microns in the eyes of those who took a placebo. That’s 55% less progression simply by taking an antioxidant supplement.

Wet vs dry AMD

The vast majority, about 90%, of all cases of AMD are the dry form. However, about 10% of AMD cases may progress to another form, known as wet AMD.

Dry AMD is associated with the presence of large yellow protein deposits under the retina, known as drusen. These deposits damage a small but important area at the back of the eye known as the macula, which allows your eyes to precisely focus on objects in front of you. Dry AMD may progress, but doesn’t always, to geographic atrophy, which can cause permanent loss of vision.

“Imagine you have a camera or a computer screen and you have dead pixels on the screen. That area of dead pixels just expands slowly over time. That’s basically the patient’s experience who has geographic atrophy. They have areas of the retina that are dead or not functional and that area grows in a kind of concentric manner,” said Leng.

Sometimes, wet AMD may develop. Wet AMD or neovascular AMD, is defined by the abnormal presence of blood vessels under the retina that can cause swelling and bleeding. This bleeding and fluid accumulation are where the condition derives its “wet” moniker.

Wet AMD tends to be more severe, progresses more quickly, and always affects the central vision of the macula. It is always considered an advanced stage of AMD.

At this time, AREDS2 antioxidant supplements only appear to be beneficial for dry AMD, not wet.

“Individuals with geographic atrophy should benefit from the AREDS2 formulation supplement. In addition, our previous research has shown that a healthy diet (particularly a Mediterranean-type dietary pattern) and avoiding smoking are strongly associated with slower atrophy growth rates. So a healthy lifestyle is important alongside the supplements,” said Keenan.

The bottom line

A combination of antioxidant supplements known as AREDS2, which includes vitamin A, vitamin C, copper, zinc, lutein, and zeaxanthin, helps slow the progression of dry AMD, even in the advanced stage known as geographic atrophy.

A novel study found that compared to placebo, those taking the antioxidant formulation showed 55% less disease progression.

The supplements are not recommended for wet AMD, a less common but more severe form of AMD.

The sun is shining and most of us will be happy to see the arrival of warmer and drier weather after the wet and cool summer we have had so far. This week’s higher temperatures have triggered a yellow Heat-Health …

• In an eight-week study, a vegan diet showed signs of slowing biological aging compared to an omnivorous diet.
• The Stanford Twin Study recruited identical twins who were subsequently put on opposing diets to study the effects.
• The findings appear consistent with other literature about the anti-aging and protective properties of a vegan diet.

A vegan diet can slow signs of aging at a molecular level in as little as eight weeks, according to new research.

The findings, published July 28 in the journal BMC Medicine, are pulled from the Stanford Twin Study, also the subject of the new Netflix documentary series “You Are What You Eat: A Twin Experiment.” 

Stanford’s experiment asks the question: what happens when pairs of identical twins eat two different, although still healthy, diets?

The eight-week study involved 22 pairs of twins, half of whom (one from each pair) were randomized to a “healthy vegan” diet, while the other half consumed a “healthy omnivorous” diet.

Initial study results, published in November 2023, showed similar results supporting the short-term plant-based diet protocol.

Participants who consumed a vegan diet ate fewer calories, lost more weight, and improved LDL (bad) cholesterol and fasting insulin levels than their omnivorous diet counterparts. 

Does a vegan diet slow down aging?

The research published this week indicates that in addition to these benefits, consuming a vegan diet also improved epigenetic markers associated with aging.

Think of these markers like clocks hidden in your genes: you might be forty years old (your chronological age), but your biological age could be different based on lifestyle factors like diet and exercise influence. 

There is no single unified measure for reading biological age through epigenetics. Instead, the research team employed multiple tests to read these “clocks.”

Scientists can observe patterns in DNA methylation, a natural process that affects gene expression, to estimate biological age using various tests, including GrimAge and DunedinPACE.

“We didn’t really expect much from these clocks, which was the surprising bit because out of all the clocks that we studied, there were about 12 that showed consistent decreases in their epigenetic age,” first study author Varun B. Dwaraka, PhD, head of bioinformatics and principal investigator at TruDiagnostic, told Healthline.

“There was a significant decrease in the vegans, but there was no change in the omnivores,” he said.

Vegan vs. omnivore: Which diet is healthier?

The study was conducted in two phases.

During the first four weeks, participants were provided meals at no cost by the nationwide meal delivery company Trifecta Nutrition (the company was not involved in sponsoring the study). In the second half, participants were responsible for cooking their own meals.

The key for both the vegan and omnivore meal plans is that they both had to be healthy.

“The terms ‘vegan’ and ‘omnivore’ are very broad, and it is quite possible to make poor food choices that would be consistent with these diet patterns,” senior study author Christopher Gardner, PhD, a professor of medicine and a nutrition scientist at Stanford Medicine, told Healthline.

“For example, soda, [some] French fries, and Oreo cookies are all technically vegan,” Gardner noted.

Both groups were instructed to eat diets high in vegetables and fiber while minimizing refined grains and sugars. Researchers utilized the Healthy Eating Index, a validated metric that uses a scoring system to determine the overall quality of an individual’s diet, to gauge the quality of participants’ meals.

By recruiting twins to the study, researchers were able to eliminate one of the largest confounding factors when studying epigenetics: DNA. 

“This was the perfect kind of design because essentially what you’re doing is looking at two genetically identical individuals and then allowing them to have two different diet types and then seeing what the response would be,” Dwaraka said.

“We’ve known in the past that different diets can have different impacts on epigenetic age. But in those interventional trials, it wasn’t really done in a way that controlled for those genetic variances,” he noted.

How do epigenetics affect aging?

The findings go beyond improvements to body composition and cholesterol, demonstrating the role of diet in aging itself.

Epigenetics refers to the way that behavior and environment affect genetics. These changes are not permanent, nor do they directly affect your DNA; instead, like a computer, they affect how the “code” of your DNA is read.

“You can actually read the DNA in a way that formulates different biological processes to occur. So, you can maybe relate this to the idea of having a computer that has the same exact hardware, but based on the software that you’re downloading, you can activate different processes,” Dwaraka explained.

Epigenetic changes can alter gene expression, making you more or less susceptible to various forms of disease. 

So, while you can’t change your DNA itself, you can affect your epigenetics (for better or worse) through day-to-day activities.

“Nutrition and exercise are among the most well‐known environmental epigenetic factors influencing the proper developmental and functional lifestyle, with potential beneficial or detrimental effects on health status,” Myron Szewczuk, PhD, a biomedical and molecular sciences professor at Queen’s University in Ontario, Canada, told Healthline. Szewczuk was not affiliated with the research.

Chronological age changes at the same rate as everyone. Still, your biological age, which refers to the health and functioning of your body on a cellular level, is dynamic and modifiable.

The distinction between chronological and biological age has become an important area of study as the human life span has increased and science has made continual breakthroughs in understanding the human genome.

Long-term effects of a vegan diet on aging are not known

The study, though compelling, may not offer much in the way of practical recommendations for individuals interested in improving their diet.

The study authors say their findings are limited to the eight-week scope and can’t speak to the longer-term effects of either diet, though they do eventually hope to hold a longer trial.

“We cannot say anything beyond just eight weeks because, for example, one of the things that we do know is that a vegan diet without vitamin B12 supplementation can actually have disastrous effects on health,” Dwaraka said.

Despite this caveat, vegan and plant-based diets have been associated with numerous health benefits — but so have omnivorous diets like the Mediterranean diet.

“This is very consistent with the current knowledge that a plant-based diet is associated with benefits for biological aging and other health conditions, such as overall cardiac health,” Alyssa Kwan, a clinical dietitian in cardiology at Stanford Medicine who wasn’t affiliated with the research, told Healthline.

“I think this study, though short term, helps to support evidence for a plant-based diet.”

The takeaway

In an eight-week trial involving identical twins, those who followed a vegan diet showed signs of slowing down the aging process at a molecular level. 

Lifestyle choices including diet and exercise are known epigenetic modifiers, which can make you more or less susceptible to disease.

Although the findings are limited to just eight weeks, other experts say that the study is consistent with other literature on the health benefits of vegan and plant-based diets.

• 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.

• 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.

• 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.