As our world becomes increasingly interconnected and the climate changes, the UK faces challenges that we might associate with more exotic destinations. One such challenge is the potential introduction of invasive mosquito species, particularly the tiger mosquito (Aedes albopictus). This …
How you can help us resist the tiger mosquito’s conquest of Europe Read More »
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.
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.
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.
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.
The Best and Worst States for Women’s Healthcare Read More »
While one recent study indicates that plant-based ultra-processed foods might increase the risk of heart disease and early death, a systematic review and meta-analysis, including 12 controlled trials, published in the Canadian Journal of Cardiology suggests that plant-based meat alternatives (PBMAs) might be an exception, actually helping to improve cardiovascular health.
According to the study, while the nutritional profiles of various PBMAs vary widely, overall, they have characteristics that make them heart-healthy.
The researchers also found studies showing that PBMAs could improve certain cardiovascular risk factors, including total cholesterol, LDL, apolipoprotein B-100 (a form of LDL implicated in inherited forms of high cholesterol), and body weight.
They did note, however, that more studies are needed to conclude what the effects on heart health will be long-term.
Commenting on the study, John Higgins, MD, sports cardiologist at UTHealth Houston, explained that plant-based meat has less saturated fat and more fiber per serving than regular meat.
Saturated fat is significant because it raises low-density lipoprotein cholesterol (LDL), which is often thought of as being the “bad” cholesterol. High levels of LDL can lead to clogged arteries. Polyunsaturated fat, however, has the opposite effect.
Fiber, especially the soluble variety, binds with cholesterol, helping to shuttle it out of the body.
However, he noted that there are other potential factors at work as well. PBMAs can lead to a lowering of trimethylamine N-oxide (TMAO), which is a molecule that may be a risk factor for heart disease.
“Also, cardiovascular harm from traditional meat and egg yolks is not only due to high cholesterol in both and additionally high saturated fats in red meat,” said Higgins, “but also both elevate plasma levels of toxic metabolites of the intestinal microbiome including trimethylamine N-oxide (TMAO).”
Michael O. McKinney, MD, a physician, and nutritionist with Health Outlook, told Healthline that the apparent contradiction between this study and another recent study, which found that plant-based ultra-processed foods (a category that can include plant-based meat) reside in “the ingredients as well as the general nutritional profile” of these foods.
“[E]ven though many ultra-processed foods have unhealthy additives like high levels of sodium, sugar and unhealthy fats, plant-based meats developed for health do not contain these components,” he explained.
However, McKinney added that plant-based meats can be divided into two categories: those with whole ingredients and those heavily processed with artificial additives. So, some plant-based meats may be healthier than others.
McKinney advises paying close attention to the ingredient list to choose the plant-based meat that is healthiest for your heart.
“Opt for products with whole food ingredients instead of added sugars,” he said.
He also recommends looking for products that have less sodium in order to keep your blood pressure in check.
McKinney further noted that some plant-based meats can actually be high in saturated fat if they are made with coconut or palm oil.
Additionally, he suggests looking at the fiber content since it is also good for heart health.
Finally, McKinney recommends avoiding added sugars. “These are unnecessary and unhealthy, as some processed foods may contain sugars to enhance taste,” he said.
Higgins additionally explained that a diet with regular meat can also be good for your heart if you opt for leaner choices.
“In fact, the Mediterranean diet is also considered heart healthy and includes occasional red meat as well as more frequent lean chicken and fish,” he said.
You can also substitute plant-based foods like fruits, vegetables, whole grains, and nuts in place of meat. These foods can help lower your cholesterol and reduce your risk of heart disease, said Higgins.
A new study has found that plant-based meats can be healthier for your heart than regular meat.
However, another recent study found that ultra-processed plant-based foods — including plant-based meats — can actually increase heart disease risk.
Experts say the seeming contradiction may be explained by the fact that many ultra-processed foods contain high amounts of sodium, sugar, and unhealthy fats.
Plant-based meats designed with health in mind do not contain these ingredients.
When selecting plant-based meats, check the label for their sodium, saturated fat, sugar, and fiber content.
Alternatively, a diet rich in whole plant-based foods with occasional lean meat can also be good for your heart.
Why Most Plant-Based Meat Alternatives Are Healthier Than Real Meat Read More »
The weight-loss benefits of GLP-1 medications like Ozempic, Wegovy, and Zepbound are widely known.
However, as more and more people take these medications, there appear to be other benefits, such as reducing one’s risk of heart disease, stroke, kidney disease, and colon cancer.
Recently surfacing are anecdotal accounts of GLP-1 medications also helping people with rheumatoid arthritis (RA) manage their pain and experience a decrease in flare-ups.
“It is well established that autoimmune patients with obesity fare worse than those without. [They] have higher symptoms and less response to traditional therapies,” Dr. Elizabeth Ortiz, rheumatologist and clinical advisor at WellTheory, told Healthline. “I have seen patients lose weight and then require less immunosuppressant therapy for their condition.”
According to a systematic review and meta-analysis of cohort studies, there is a positive association between levels of body fat and the risk of developing RA. Additionally, higher BMI (in middle age and in early adulthood) and waist circumference were associated with a higher risk of RA.
Obesity has been associated with worse autoimmune and inflammatory symptoms and with less favorable response to standard therapy for RA, added Ortiz.
“In addition to keeping autoimmune patients from feeling their best in the short term, the combination of obesity and autoimmunity can have a major impact on health in the long term,” she said. “Those with rheumatoid arthritis and other autoimmune diseases carry a higher risk of cardiovascular disease than those without these conditions. Our best defense against this is tight control of autoimmune inflammation and all other cardiovascular disease risk factors, such as obesity.”
Because of this, she said managing obesity should be a part of a holistic care plan for anyone with RA or another autoimmune disease.
Dr. Fatima Cody Stanford, associate professor of medicine and pediatrics at Harvard Medical School, said by reducing weight, patients may experience less joint pain and inflammation, improved mobility, and reduced disease activity.
“Moreover, weight loss can improve overall health, reduce comorbidities such as cardiovascular disease and diabetes, and enhance the effectiveness of RA medications,” Stanford told Healthline.
Treating obesity first to help with other conditions has been coined the “obesity first” approach. Stanford said it is an emerging and promising strategy because addressing obesity directly can have a broad range of positive effects on multiple chronic conditions.
“By targeting obesity first, healthcare providers can potentially improve or even resolve associated conditions like type 2 diabetes, hypertension, and dyslipidemia,” she said. “This holistic approach recognizes obesity as a root cause rather than a consequence, aiming to improve overall patient health and simultaneously reduce the burden of multiple chronic diseases.”
However, Ortiz believes it is too early to take an “obesity first” approach for autoimmune disease. While a proportion of patients with autoimmunity may have positive results by solely focusing on obesity, she said this will not be the case for everyone.
“The biologic triggers for any particular individual’s autoimmune disease are complex and personal, and taking an ‘obesity first’ approach without also addressing the underlying autoimmune disease may expose patients to unnecessary risk from poorly controlled inflammation,” she said.
As the complex relationships between obesity, metabolic health, and chronic diseases deepen, Stanford said it’s clear that collaboration between obesity medicine physicians, endocrinologists, rheumatologists, cardiologists, and primary care providers is needed to create comprehensive treatment plans that address the root causes of these conditions.
“As new therapies and strategies emerge, they offer hope for improved quality of life and outcomes for patients struggling with obesity and associated chronic diseases,” she said. “Continued research and innovation will be key in advancing these efforts and providing evidence-based care.”
Given the anti-inflammatory properties that GLP-1 drugs provide and their effects on the immune system, Standford said these medications could be promising in the context of autoimmune diseases. She anticipates more research regarding their potential benefits.
“Preliminary research has suggested that GLP-1s may modulate immune responses and reduce inflammation, which could benefit conditions like RA, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD),” said Stanford. “Further research is needed to understand the mechanisms involved and to evaluate their efficacy and safety in these contexts.”
Ortiz agreed. She said those treating autoimmune diseases don’t want to turn to GLP-1 drugs without a better understanding of how and why autoimmune patients may benefit from them.
For instance, key questions that need to be answered include:
Understanding the effects of GLP-1 drugs on a person with an autoimmune disease like RA who is not overweight or obese needs further research.
“As we continue to discover [GLP-1s] biologic effects on inflammation and our immune systems and continue to accrue data in people using them for obesity and diabetes, we may find they are a useful tool against autoimmunity, aside from their impact on obesity,” said Ortiz.
Any positive impact would have to be weighed against potential risks of using these medications, such as the risk of muscle loss, as muscle loss can lead to osteoporosis, a condition often associated with autoimmune diseases, she noted.
Overall, more time is needed to determine whether or not GLP-1 drugs can be used to control autoimmunity and inflammation in those with or without obesity and how best to utilize the medications for these purposes.
“What is likely to be addressed more quickly is how these medications can be utilized as a supplement to standard autoimmune therapy to improve metabolic syndrome and decrease an autoimmune patient’s cardiovascular risk,” said Ortiz.
Ozempic and Wegovy May Help Reduce Rheumatoid Arthritis Symptoms Read More »
A high protein diet has long been recognized for its weight loss and health benefits. However, misinformation is spreading on social media platforms like TikTok and Reddit that a low protein diet is best.
Proponents claim that we need less protein than previously thought and that reducing your intake could trigger weight loss.
One recent example is a TikTok video that was posted by dietitian @endocrinenutritionist. In the video, she claimed the most compelling argument for a low protein diet is that human breast milk contains just 6% protein and that in the first six months of life, humans double in size.
“Theoricatallicy, that should be all the protein we need,” she said.
Furthermore, she also claimed that the reason we think animal protein is better than plant-based protein is because of “amino acid studies that were done back in the early 1900s on rats.”
However, this particular influencer’s claims are not true.
For example, the nutritional content of breast milk contains 1% protein, not 6%, and a study conducted on older community-dwelling men in 2020 found that low protein intake was associated with a modest increase in risk of all-cause and cause-specific mortality among older men.
Yet a growing number of influencers online are spreading misinformation like this about the benefits and risks of nutrition trends.
Kelsey Costa, registered dietitian and science communications officer at Examine, says there has been renewed interest in the notion that restricting protein intake or certain essential amino acids might extend life span.
“Studies in rodents have also shown that cutting down on protein, without cutting calories, might extend the life span of these animals. However, the evidence is limited and based on animal studies,” she said.
Therefore, these results are not necessarily applicable to humans. Moreover, Costa said any potential benefit of long-term protein restriction is likely offset by an increased risk of sarcopenia, an age-related and progressive loss of muscle and strength.
Dietitian and author of How Not to Eat Ultra-Processed, Nichola Ludlam-Raine, said the shift in popularity from high protein diets to low protein diets reflects a broader understanding of balanced nutrition beyond just macronutrient focus.
However, she said the claim that low protein diets may be better for weight loss is nuanced.
“High protein diets are known to promote satiety, preserve muscle mass during weight loss, and increase thermogenesis,” Ludlam-Raine explains. “On the other hand, lower protein diets could potentially lead to weight loss due to reduced calorie intake if protein-rich, calorie-dense foods are replaced with fruits, vegetables, and whole grains.”
Crucially, though, Ludlam-Raine said that a low protein diet might not be sustainable for everyone as protein is critical for maintaining muscle mass and overall metabolic health.
Similarly, Costa explained how low protein intake may make weight loss difficult in the long term.
“A very low protein diet may initially result in weight loss, likely due to resulting calorie restriction overall, like any other highly restrictive diet,” she said. “But without adequate protein intake, this calorie restriction can result in the loss of both body fat and muscle mass.”
“The loss in muscle mass may ultimately decrease metabolism and lead to further weight regain when the diet is stopped,” she added.
Weight loss aside, you might be wondering how a low protein diet affects overall health and longevity.
Ludlam-Raine said that reduced intake of some proteins, such as red meat, may be linked to increased life span, but this is likely due to the heart health benefits rather than the reduction in protein.
“It’s important to remember that protein is essential for life, with a minimal requirement of at least 0.8g of protein per Kg of body weight a day,” she notes.
Another potential benefit may be disease prevention, especially for some people with pre-existing conditions.
“Lower protein intake has been associated with reduced risks of certain diseases, such as kidney disease (in those with uncontrolled diabetes) and some cancers in certain people – particularly those who may eat a lot of processed red meat,” Ludlam-Raine explains.
“However, these benefits largely depend on the quality and source of the proteins, as well as the overall diet composition,” she points out.
There are also notable risks with eating a low protein diet.
“Inadequate protein can lead to muscle atrophy, particularly in older adults,” says Ludlam-Raine.
It can also cause nutrient deficiencies. “Proteins are essential for providing certain vitamins and minerals, and a low protein diet may result in deficiencies in nutrients like B12, iron, and zinc,” she explains.
Additionally, a weakened immune function may be another by-product of low protein intake.
“Proteins are crucial for the immune system, and insufficient intake can impair the immune response,” Ludlam-Raine explains.
As is often the case with nutrition, how much of a specific nutrient you need is highly individual.
“The recommended daily intake of protein varies by age, sex, and activity level,” says Ludlam-Raine.
“Generally, 0.8 grams of protein per kilogram of body weight is sufficient for most adults, while athletes and older adults may require more, around 1.0 to 2.0 grams per kilogram.”
The kind of protein you eat matters, too.
Protein sources can be divided into:
“These are complete proteins containing all the essential amino acids that we need.
“They are beneficial for muscle mass maintenance and overall health due to essential nutrients such as vitamin B12 and calcium as well as iodine, but should be consumed in moderation in comparison to plant-proteins,” says Ludlam-Raine.
While some plant proteins may be incomplete, Ludlam-Raine said they can be “combined to provide all essential amino acids (think beans on toast).”
“They are generally lower in saturated fat and therefore can be beneficial for heart health and weight management,” she said.
While convenient, Ludlam-Raine says many of these are technically classed as ultra-processed and should not replace whole foods. She recommends choosing healthier versions of protein supplements that don’t contain added sugar.
To ensure adequate protein intake, Ludlam-Raine recommends including protein at every meal and choosing protein-based snacks.
“It’s a good idea to mix plant and animal protein sources to ensure a variety of amino acids and other nutrients,” she adds.
Eating a very low protein diet isn’t beneficial for health or achieving sustainable weight loss.
For most people, it’s best to eat around 0.8 grams of protein per kilogram of body weight.
Including both animal-based and plant-based protein sources will provide the most benefit.
Can a Low Protein Diet Really Help You Lose Weight? Read More »
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.
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.
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.”
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.
Kim Kardashian Says She Sleeps in Saran Wrap for Psoriasis Relief: Does It Work? Read More »
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.
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:
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:
Some foods high in vitamin D include:
Vitamin D helps the body absorb 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 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 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:
Sources of iron include:
“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.
While taking a GLP-1 weight loss medication, consider the following tips to help ensure you get adequate nutrients.
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.
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.
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.
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.
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.
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.
5 Common Nutrient Deficiencies You Can Develop on Drugs Like Wegovy and Zepbound Read More »
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.
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 Dr. Christopher McGreevy, MD, a breast cancer surgeon 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.
Dr. 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.
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, 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.”
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.
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.
Shannen Doherty Believed a Lapse in Health Insurance Delayed Her Breast Cancer Diagnosis Read More »
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.
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:
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.
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.
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.
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:
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.
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.
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.
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.
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.
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.
8 Common Myths About Weight Loss Drugs Like Wegovy and Zepbound Debunked Read More »
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.
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.
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.”
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.
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.
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.
4 Ways to Increase Weight Loss on Wegovy, Zepbound Read More »
