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• A study compared 5:2 intermittent fasting, done with meal replacements, to diabetes medications for the treatment of type 2 diabetes.
• People who did intermittent fasting lost more weight and saw greater improvement in blood glucose control.
• The 5:2 intermittent fasting diet involves eating 25% of your usual calories on two nonconsecutive days each week, and eating regularly the rest of the week.

A new study finds that intermittent fasting with low-calorie meal replacements may be an effective way for people with type 2 diabetes to lose weight and control blood sugar levels, compared to standard diabetes medication.

For people with type 2 diabetes, especially those with a recent diagnosis, losing weight may help improve their blood glucose (sugar) levels and reduce the need for diabetes drugs such as metformin.

However, maintaining weight loss with diet alone can be challenging.

In the new study, researchers found that combining these two dietary interventions may make it easier.

The study was published June 21 in JAMA Network Open.

Researchers found that people recently diagnosed with type 2 diabetes who did intermittent fasting using meal replacements lost more weight over 16 weeks compared to people who received standard diabetes medication.

Those who did intermittent fasting also saw greater improvements in their hemoglobin A1c (HbA1c or A1C) levels, a measure of blood glucose control.

Michael J. Wilkinson, MD, a cardiologist and assistant professor of medicine at UC San Diego Health, said the results seen in the study with intermittent fasting and meal replacements were impressive.

However, he pointed out that this was not simply a study of intermittent fasting. On the two fasting days per week, participants consumed a lower-calorie meal replacement, which ensured they ate fewer calories.

“The content of what was supplied in those meal replacements is important to the results,” said Wilkinson, as is the nutrition and exercise counseling that all participants received throughout the study. This combination of [approaches] may explain why people saw greater changes in weight and HbA1c compared to other studies, he said.

Intermittent fasting vs. diabetes drugs

The new study included 405 adults in China who were overweight or had obesity and were recently diagnosed with type 2 diabetes. Almost two-thirds of participants were men, the average age was 46 years old and the average HbA1c level was 7.9%. 

An HbA1c level of 6.5% or higher is in the diabetes range. Most people with diabetes aim to keep their HbA1c below 7%.

Researchers randomly assigned participants to be treated with a diabetes medication — either metformin (Glucophage) or empagliflozin (Jardiance) — or to follow an intermittent fasting plan for 16 weeks. Overall, 332 people completed the 16-week treatment.

All participants received guidance every 4 weeks from nutritionists and research staff about eating healthy and exercising regularly.

Researchers continued to monitor participants for 8 weeks after the treatment period. This included measuring HbA1c, body weight, waist and hip circumference, blood pressure and other metabolic markers.

People assigned to the intermittent fasting plan fasted for two nonconsecutive days per week, and mostly ate their usual foods and amounts on the other days — what’s known as 5:2 intermittent fasting.

To control the amount of calories and nutrients that people ate on fasting days, researchers provided participants with prepackaged meal replacements. People ate about one-quarter of their usual calories on those days — 500 calories for women and 600 calories for men.

Vicky Pavlou, RDN, a registered dietitian and doctoral student at the University of Illinois Chicago told Healthline that the approach used in the study is not a “true” 5:2 intermittent fasting diet.

Participants also ate a meal replacement for dinner on their non-fasting days and were asked to count their calories. Usually, people are allowed to eat whatever they want on non-fasting days, she said, which is simpler and easier to stick with.

“In general, the point of intermittent fasting is to give people really simple instructions,” she said, “as an alternative to counting their calories, which can be burdensome for people.”

Improvements in blood sugar and weight

Researchers found that after 16 weeks, people following the intermittent fasting diet had greater improvements in certain measures.

People who did intermittent fasting lost an average of 21 pounds over 16 weeks, versus 12 to 13 pounds for those receiving one of the diabetes medications.

The intermittent fasting group also saw significant reductions in waist and hip circumference and systolic and diastolic blood pressure.

In addition, in the intermittent fasting group, HbA1c decreased by 1.9%, compared to a decrease of 1.6% in the metformin group and a decrease of 1.5% in the empagliflozin group.

According to the American Diabetes Association, people with type 2 diabetes who maintain an HbA1c of 6.5% or lower for at least 3 months are considered to be in diabetes remission.

In the new study, 80% of people in the intermittent fasting group met this target at the end of 16 weeks, with 77% still at that level after the 8-week follow-up. A longer follow-up would be needed in order to confirm that they met the American Diabetes Association’s definition of remission.

Longer and more diverse studies needed

Wilkinson said one of the strengths of the study is its duration, although he thinks additional studies are needed with an even longer follow-up.

“With drugs like metformin and empagliflozin, the expectation is that these are long-term, maybe lifetime, therapies,” he said. “So if we’re comparing those to 5:2 intermittent fasting with meal replacement, the expectation is that it’s a long-term intervention.”

For that to work, “we need to have a better understanding of the long-term adherence and also the long-term safety [of intermittent fasting],” he said.

In particular, the meal replacements would need to provide all the necessary vitamins, minerals and other nutrients, he said. Studies might also need to monitor people’s health and body composition — such as lean muscle mass — to see if long-term use of meal replacements is safe, he added.

Pavlou said if you are only replacing one meal with a meal replacement — versus using them for every meal — it is less of a concern that someone would fall short on their nutrients.

In addition, the meal replacements she uses in the clinic are designed to provide a full range of nutrients and to be safe for regular use over several months. Still, people prescribed meal replacements long-term are regularly monitored by their doctor, she said.

Another concern that Wilkinson raised about the new study is that participants were all diagnosed with diabetes within the past year and had not used diabetes medications in the 3 months leading up to the study. So the results may not apply to other groups of patients.

Colette Knight, MD, chair of the Inserra Diabetes Institute at Hackensack University Medical Center echoed some of his concerns.

“This study focuses on the newly diagnosed patient with diabetes — a group where lifestyle intervention can be very helpful,” she told Healthline. “This [approach] is not for the 20-year diabetic patient.”

In addition, “we need to look at a more diverse population of patients with a longer duration of diabetes,” she said. 

Also, more studies are needed in order to know “what happens when you add this restrictive diet to known diabetes medications that also promote weight loss,” she said.

Intermittent fasting offers a simpler approach

Around 11% of Americans have diabetes, with type 2 diabetes accounting for 90-95% of all cases, according to the Centers for Disease Control and Prevention. 

Risk factors for type 2 diabetes include being overweight or having obesity, having a family history of type 2 diabetes, being physically inactive, and being older than age 45.

Lifestyle changes such as healthy eating and exercise are recommended for people with type 2 diabetes, even for those who are taking a diabetes medication. Diet and exercise alone, though, may not be enough to help people lower their blood glucose level.

Intermittent fasting, though, is designed to make it easier for people to cut back on calories while still getting enough nutrients in their diet.

“There is some research suggesting that intermittent fasting can be an effective strategy for managing type 2 diabetes and prediabetes,” said Knight. “Some studies have also shown that intermittent fasting can lead to improvements in glycemic control, weight loss and other metabolic parameters in individuals with these conditions.”

Similarly, research shows that including meal replacements as part of a lifestyle intervention, without intermittent fasting, can lead to greater weight loss and decreases in HbA1c, compared to other diets or to diabetes education.

In spite of the benefits seen in the new study and past research, there is not yet general agreement among doctors about which people might benefit most from intermittent fasting, Knight said. In addition, “just this one approach may not be enough,” she said.

Other types of intermittent fasting and time-restricted eating methods are also available, which gives people more options. These include:

• 16/8 time-restricted eating: This involves fasting for 16 hours each day and restricting eating to an 8-hour window.
• Eat Stop Eat: This involves fasting for 24 hours once or twice a week.

“Each has its own advantages and disadvantages,” said Knight. “The best approach for individuals with diabetes depends on their individual preferences, lifestyle and health status.”

Knight recommends that people with diabetes talk to their doctor before starting any intermittent fasting regimen, to ensure it is safe and appropriate for their specific needs.

Takeaway

Researchers randomly assigned people recently diagnosed with type 2 diabetes to 16 weeks of treatment with a diabetes medication or intermittent fasting with meal replacements.

Those in the intermittent fasting group saw greater improvements in their hemoglobin A1c, a measure of blood glucose control, and weight loss, compared to the diabetes medication groups.

Experts say additional research is needed, with longer follow-up and a more diverse population. This includes testing intermittent fasting in people who have had diabetes longer and those taking diabetes medications.

• A recent study focusing on people who recently experienced an episode of low back pain shows that walking can be hugely beneficial.
• Regular walking significantly reduced the risk of future episodes and healthcare visits.
• It also improved their quality of life, sleep, and mood.

Low back pain is incredibly common and notoriously difficult to treat. A new study, however, finds that a simple, cost-effective, highly accessible intervention can make a real difference: walking.

A new paper, which was published in The Lancet on June 19, found that people with low back pain who walked regularly were significantly less likely to experience pain that limited their activity. They also reported improved quality of life.

Participants who walked regularly were half as likely to need time off work or require medical treatment than people in the control group.

Low back pain is incredibly common

Healthline contacted Dr. Tash Pocovi, lead author of the study and a postdoctoral fellow at Macquarie University, Australia.

“​​Working in physiotherapy, it’s incredible to see just how prevalent low back pain is,” she said, “with reports that 620 million people globally reported experiencing low back pain in 2020.”

She explained that, while most scientists focus on treatment, fewer are focusing on prevention. This is important because “7 in 10 people who recover from an episode of low back pain will have a new episode in the next 12 months.”

“While it’s not considered a life-threatening disease, we can see the very serious impacts it can have on people’s lifestyle, ability to work, and overall quality of life,” Pocovi said.

For their study, the scientists recruited 701 people who had recently experienced an episode of low back pain. 

Split into two groups, one acted as the control, and the other embarked on a personalized walking program with six education sessions with a physiotherapist over 6 months. The scientists followed up the participants for 1–3 years.

They found that those in the walking group experienced pain that limited their activity less often than those in the control group. Also, there was a longer gap before they had a recurrence: an average of 208 days compared with 112 days.

Pocovi told Healthline that she was not surprised that walking benefited these people because the intervention “helped get people moving, reduced their fear, and gave them strategies and confidence to self-manage their condition — all of which we know are important.”

However, she was surprised “how much the intervention could impact people’s lives aside from improving their low back pain management.”

“While we were able to reduce the recurrence of low back pain requiring care-seeking by over 40%, we also had patients who reported improved sleep, mood, positive lifestyle changes, and improved management of other chronic health conditions,” she explained. 

“It was very pleasing to see the positive, overall health implications of this intervention,” Pocovi said.

How people with back pain can benefit from walking

We asked Pocovi how much walking might benefit people who experience low back pain.

In their study, the walking plan was individualized based on factors including age, physical ability, preferences, and available time. 

“We gave them a rough guide of gradually building up to 30 minutes, five times a week,” she told us. “After 3 months, most of the people who took part were walking 3 to 5 days each week for an average of 130 minutes per week.”

“We want to see the public walking more, even if this is done independently. However, if you are struggling to get started, you may consider reaching out to a health professional to help.”

Healthline spoke with Neel Anand, MD, an orthopedic spine surgeon and director of the Cedars-Sinai Spine Center in Los Angeles, CA, who was not involved in the study. He added a note of caution:

“While walking is a great total-body cardiovascular exercise that can be especially helpful for people experiencing back pain episodes, be sure not to go too far or for too long if you’re in moderate to severe pain, and make sure that the walking surface is even, without too much uphill or downhill variation to start.”

Why is low back pain so common?

To help make sense of the high prevalence of low back pain, Healthline spoke with Thomas Pontinen, MD. Pontinen, who was not involved in the study, is a double board-certified anesthesiologist, interventional pain management specialist, and chronic pain expert.

Our evolutionary past, he explained, is one of the reasons. “Human beings evolved from animals with horizontal spines.” As we evolved to walk on two legs, “the spine had to adapt.” 

“It is incredibly likely that a lifetime spent using a vertical spine, as we do, will eventually come with drawbacks since the spine has to support most of our weight and all the pressures of movement through life,” Pontinen said.

Other factors, Pontinen told us, include general wear and tear of the discs between the vertebrae with age, injuries, poor posture, a sedentary lifestyle, and obesity.

How to reduce the risk of back pain

Healthline asked Dr. Joel S. Beckett, a board-certified neurological spine surgeon how individuals can reduce their risk of experiencing low back pain.

Beckett, who was not involved in the recent study, practices at DISC Sports & Spine Center in Marina del Rey, CA. He provided these tips:

• Maintain a healthy weight.
• Engage in regular physical activity that includes strengthening and stretching exercises to maintain good core strength.
• Practice good posture.
• Use proper techniques when lifting heavy objects. 
• Avoid prolonged sitting.

In line with the results of the recent study, he told us that “standing and walking is the best activity for our back.”

Takeaway

According to a recent study, walking regularly can reduce the risk of low back pain returning, improve quality of life, and reduce the need to visit healthcare specialists. 

Taking regular walks also improved sleep and mood, and improved the management of other chronic health conditions.

However, as Anand told us, it’s important to wait for the “green light” from your doctor, but “contrary to what some might think, staying immobile or being on ‘bed rest’ after the acute phase of a back pain episode might do more harm than good.”

• GLP-1 drugs have gained popularity over the last few years for their remarkable ability to help people lose weight.
• Doctors are beginning to examine other benefits of this class of drugs, which may help you to live longer.
• In addition to treating diabetes and obesity, research suggests these drugs can also help reduce the risk of a number of additional health issues, such as cancer and cardiovascular disease.

You may not be familiar with GLP-1 agonists, but there’s a good chance you’ve heard of the brand names attached to this class of drugs: names like Wegovy, Ozempic, Mounjaro, and Zepbound.

GLP-1 agonists are drugs that act like your natural GLP-1 hormone, which is a hormone that your body produces when you eat. One of its many functions is to give you the feeling of satiation — or fullness — which is a message to stop eating.

While they can help manage diabetes, these drugs have skyrocketed in popularity due to their ability to help treat obesity, and with good reason. Obesity is a leading risk factor for many diseases that can lead to early death. By treating obesity early, these risks can be reduced and thus increase lifespan.

However, more recent research suggests that these drugs may also help reduce the risk of a number of other health conditions.

While this research is still in its early days, findings suggest these drugs may help people live longer, healthier lives by reducing their risk of the following health conditions.

Cardiovascular disease

“Obesity increases one’s risk of all aspects of cardiovascular diseases including developing blockages in the arteries, having heart attacks and strokes, heart failure, arrhythmias, hypertension, and even increasing the risk of diabetes, which can further contribute to cardiovascular diseases,” said Dr. Janet Wei, a cardiologist with the Barbra Streisand Women’s Heart Center in Los Angeles, CA, in an interview with Healthline.

“I think these drugs are a very big deal. We know how difficult it is to lose weight. Bariatric surgery has a very good track record, but of course, not everyone wants to get surgery,” Wei added.

In the realm of cardiovascular health, there’s enough evidence of GLP-1 agonists’ effectiveness that the FDA approved Wegovy earlier this year to help prevent cardiovascular death, although only for a select population.

“The current class of GLP-1 receptor agonists has been shown in clinical studies to be much more effective for weight loss than traditional lifestyle modifications such as diet and exercise,” Dr. Cheng-Han Chen, board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, told Healthline.

“There is no question that GLP-1 receptor agonists, as they become more popular, have the potential to decrease the tremendous burden of many chronic diseases on our society,” Chen said.

Cancer

“Obesity is a well-established risk factor for several types of cancer, including but not limited to breast cancer (particularly postmenopausal), colorectal cancer, endometrial cancer, esophageal adenocarcinoma, kidney cancer, pancreatic cancer, liver cancer, and gallbladder cancer,” Dr. Wael Harb, board certified hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA, told Healthline.

“Treating obesity can potentially reduce the risk of these cancers. Weight loss has been associated with a decreased risk of several obesity-related cancers. By reducing excess body fat, individuals can lower chronic inflammation and insulin resistance, normalize hormone levels, and improve overall metabolic health, all of which contribute to a lower cancer risk,” Harb explained.

“Given that GLP-1 drugs like Wegovy, Ozempic, and Mounjaro are effective in promoting weight loss and improving metabolic health, it is plausible to hypothesize that these medications could reduce the risk of obesity-related cancers,” said Harb.

Beyond treating obesity to indirectly reduce the risk of cancer, researchers have found some evidence that GLP-1 drugs can help improve the functionality of your body’s natural killer (NK) cells.

“NK cells play a crucial role in the body’s immune response to tumors by recognizing and destroying malignant cells. If GLP-1 drugs can indeed restore or enhance NK cell functioning, this could theoretically enhance the body’s ability to detect and eliminate cancer cells, thereby reducing cancer risk,” said Harb, noting that more comprehensive research is still needed.

Neurological issues

Other research — some older and some newer — has been conducted to study whether GLP-1 drugs might provide benefits for people with Alzheimer’s disease and Parkinson’s disease, respectively.

However, in an interview with Healthline, Dr. Clifford Segil, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, advised caution regarding these diseases.

“Neuroprotection remains an elusive statement, and multiple different types of medications have made claims of being neuroprotective. In the year 2024 there does not remain any pharmaceutical drug, vitamin, mineral or technique that has been proven to slow down neurodegeneration and prevent neurology diseases common in aging,” said Segil.

“I would be extremely concerned decreased food intake would worsen the overall health of Alzheimer’s Dementia patients who often have weight maintenance as an issue because they forget to eat,” Segil added.

But that doesn’t mean GLP-1 agonists don’t have any potential to help in the realm of neurology.

Other research has shown that these drugs might be useful for treating alcohol use disorder.

Excessive alcohol use causes 178,000 annual deaths in the United States each year, according to the CDC.

“The use of GLP-1 medication as a treatment for alcohol use is extremely promising, and in clinical practice, I have found it has helped an immense amount of patients. The early satiety with food decreased eating, and the early satiety to drinking has also been noted,” said Segil.

Takeaway

GLP-1 medications may help reduce the risk of several major causes of death, but it’s also important to remain appropriately cautious at this early stage.

“We need longer monitoring to ensure this is a safe medication for a more general population to take, but what we know so far certainly appears game-changing for a high risk cardiovascular group,” said Wei.

“I hope that future trials looking at GLP-1 agonists do a better job of recruiting a diverse population, and certainly more women,” Wei added.

“Other medications have had unexpected adverse effects, which post-marketing surveillance has noted. As the use of GLP-1/GIP medications surge in the US, post-marketing surveillance will hopefully identify unexpected adverse effects as it is designed to,” said Segil.

• U.S. Surgeon General Dr. Vivek Murthy called on Congress to put a warning label on social media platforms.
• Social media contributes to the mental health crisis among children and teens, Murthy said.
• Other actions would also be needed, including social media legislation aimed at protecting the safety and health of young people.

U.S. Surgeon General Vivek Murthy, M.D, is calling for Congress to put a warning label on social media platforms, stating that social media poses a harm to the mental health of children and teens.

“The mental health crisis among young people is an emergency — and social media has emerged as an important contributor,” Murthy said in an op-ed in The New York Times June 17.

Murthy cited research published in JAMA Psychiatry showing that teens who spend more than three hours a day using social media have double the risk of mental health problems, including depression and anxiety.

Other research found that 46% of adolescents said social media made them feel worse about their bodies, while 32% said social media negatively affected their grades in school.

American teens spend an average of 4.8 hours a day on social media platforms like TikTok, Instagram, and YouTube, according to a 2023 Gallup poll. Over half reported using social media for at least four hours per day, the poll shows.

What a warning label can do

A warning label, which would require congressional action, “would regularly remind parents and adolescents that social media has not been proved safe,” Murthy wrote in The New York Times.

Joseph Trunzo, PhD, a professor of psychology at Bryant University, said the Surgeon General’s proposal is a good move.

“I’m in support of anything we can do to raise awareness of the potential dangers of social media, particularly for our youth,” Trunzo told Healthline. However, “it’s hard to say how much impact this is going to have.”

Similar labels appear on tobacco and alcohol products. Tobacco studies show that warning labels increase people’s awareness of the harms of smoking and change behavior, Murthy said.

In 1965, Congress voted to require that cigarette packages distributed in the United States carry a warning that said that cigarette smoking “may be hazardous to your health.”

Smoking rates have dropped since then. In 1954, 45% of Americans were smokers; by last year it had dropped to 12%, Gallup data shows.

However, the tobacco warning label was “coupled with a huge public health campaign and other significant efforts to get people to reduce or quit smoking tobacco,” said Trunzo.

“So I don’t think a warning label, by itself, is going to solve the problem,” he said, “but it’s certainly a step in the right direction.”

Concerns of how social media can affect mental health

Murthy has previously raised concerns about the potential harms of social media to the mental health of children and teens. But his recent call for warning labels is the most urgent to date.

In May 2023, he issued an advisory that said that we don’t have enough information to show that social media is safe and “there is growing evidence that social media use is associated with harm to young people’s mental health.”

The advisory called on policymakers and technology companies to take steps to protect the safety and health of children and teens. It also suggested ways for parents and young people to support healthy social media use.

While his op-ed this week took a stronger stance, Murthy acknowledged that “a warning label would not, on its own, make social media safe for young people.”

He urged schools to become phone-free environments and suggested parents create phone-free zones around meals, bedtime, and social gatherings to protect their child’s sleep and in-person social connections. 

And he recommended that parents limit their child’s social media use until after middle school.

“This is much easier said than done, which is why parents should work together with other families to establish shared rules, so no parents have to struggle alone or feel guilty when their teens say they are the only one who has to endure limits,” Murthy wrote in The New York Times.

The end of push notifications and infinite scroll ?

Murthy called on Congress to pass legislation to protect young people from online abuse, harassment, and exposure to violent or sexual content. 

These laws should also restrict social media features that encourage excessive use of the apps, he wrote — like push notifications, infinite scroll, and autoplay.

“Social media platforms are designed to keep eyes on the screen,” said Trunzo, “to make sure that people continue to use their platform.”

New York state’s legislature passed a bill earlier this month that would block social media platforms from showing suggested posts — fed by the algorithm — to people under the age of 18. Instead, feeds for minors would default to chronological order. A minor could still get posts the algorithm suggests if they have parental consent.

Platforms would also be blocked from sending suggested post notifications to minors between midnight and 6 a.m. without consent from their parents.

Gov. Kathy Hochul is expected to sign the bill into law, AP News reported.

Other states have taken different approaches. Florida Governor Ron DeSantis signed a bill in March that prohibits children under 14 years from obtaining their own social media account, and requires parental consent in order for 14- and 15-year-olds to have their own account.

In the op-ed, Murthy also called on tech companies to share their data on the health effects of the platforms with the public and researchers, as well as to allow independent audits of their platform.

“While the platforms claim they are making their products safer, Americans need more than words,” Murthy wrote. “We need proof.”

Takeaway

In an op-ed in The New York Times, Surgeon General Dr. Vivek Murthy called on Congress to put a warning label on social media platforms, warning of the dangers to the mental health of children and teens.

Research shows that teens who use social media more often have a greater risk of mental health problems, including depression, anxiety and negative body image. On average, U.S. teens spend 4.8 hours a day on social media, Gallup research shows.

Murthy said a warning label will not, by itself, protect the mental health of children and teens. Other steps are needed, including phone-free zones in schools and at home, and legislation to limit the negative impact of social media on young people.

• New research finds that using GLP-1 drugs like Ozempic before bariatric surgery can help improve the health of people with extreme obesity.
• Extreme obesity is defined as having a body mass index (BMI) of 70 or more.
• In 2022, there were nearly 280,000 metabolic and bariatric surgeries in the United States.

People with extreme obesity can reduce their risk of complications from bariatric or metabolic surgery by taking GLP-1 drugs before the procedures, according to a study presented over the weekend at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting. The results of the study haven’t yet been published in a peer-reviewed scientific journal.

Extreme obesity, which is defined as having a body mass index (BMI) of 70 or more, presents patients and doctors with complications during and after weight-loss surgery compared to patients with lower BMIs. The research presented at the ASMBS meeting suggests that GLP-1 drugs like Ozempic, Wegovy, Zepbound, or Mounjaro can be the most effective way to lose that weight before undergoing such surgeries.

Taking multiple types of weight loss drugs was most effective

The study documented 113 patients with a BMI greater than 70 who attempted to lose weight ahead of metabolic and bariatric surgery with either medically supervised diet and exercise, one GLP-1 medication (mostly semaglutide), or multimodal therapy involving more than one GLP-1.

Patients were treated for an average of 72.9 days.

People taking multiple medications had the greatest percentage of total body weight loss (13.1%), followed by single GLP-1 therapy (8.14%) and diet and exercise (5.95%). BMI reductions were greatest in people who were treated for six to 12 months with combination drug therapy.

Who should be taking GLP-1 drugs before surgery?

John Morton, MD, professor of surgery (bariatric, minimally invasive) at the Yale School of Medicine and Yale Medicine bariatric surgeon, told Healthline that people considering such surgery should ultimately consult a healthcare professional in advance to determine what those risks are and how much weight they ultimately need to lose.

Morton was not involved in the study.

“I look for two things. One, their motivation: Why do they want to lose weight? I ask them that, and I also ask them how much weight they want to lose,” Morton said. “And to the degree that they’re fairly accurate with their weight-loss goals, then that tells me how ready they are and also if their motivations are appropriate—in other words, to improve their health or to interact more with their families or be more productive at work. I think the main takeaway from this study is we have a lot of options for people who have extra weight and you should go to accredited centers to help figure out what’s the best path forward.”

What are the risks of bariatric surgery?

Around 42% of adults in the United States have obesity, according to the Centers for Disease Control and Prevention, putting them at risk for inflammation, cancer, and type 2 diabetes.

Researchers have linked obesity to many health complications, some of which can be life threatening if not treated:

• type 2 diabetes
• heart disease
• high blood pressure
• certain cancers (breast, colon, and endometrial)
• stroke
• gallbladder disease
• fatty liver disease
• high cholesterol
• sleep apnea and other breathing problems
• arthritis
• infertility

In 2022, there were nearly 280,000 metabolic and bariatric surgeries in the United States. Morton said this type of surgery has risks but is overall quite safe.

“It has one of the safest safety records in surgery,” Morton said. “The mortality rate from bariatric surgery is less than hip or knee replacement or removal of a gallbladder.”

Morton added that losing 5-10% of total body weight can help with diabetes, blood-pressure or cholesterol issues, and 15% percent can help with problems like sleep apnea or fatty liver. But people with severe obesity need to lose more to counter the potential health problems that they face.

“If you want to reduce your risk from cancer associated with obesity, then you probably have to lose 25% of your total body weight,” Morton said. “Bariatric surgery affords you the most weight loss. And again, the risk is quite low. You do need to take into account the risk of doing nothing. And the risk of doing nothing carries significant risk. People who carry extra weight who are obese reduce their lifespan on the order of 10 to 15 years.”

Mir Ali, MD, board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Healthline that patients with BMI in the 60s or 70s have high risks for surgery because anesthesia can be difficult to configure, and moving a patient with that level of BMI during surgery can be complicated.

Ali was not involved in the study.

“The higher their BMI, the higher their risk,” Ali said. “But also recovery is harder when the patient is extremely large. So there’s a lot of different factors that go into play. So these medications can be used to have somebody lower their weight and reduce their surgical risks to some extent.”

“There’s no set number, it’s very much dependent on the patient, their body habitus, their age, general health, other risk factors,” Ali said. “We can have a pre-op evaluation by different specialists; they could see the anesthesiologist ahead of time to see if they’re acceptable [as far as] risks for their airway for the anesthesia. So it just depends on the patient. If they have more heart or lung factors, we might have them lose more weight.”

Takeaway

A study presented over the weekend suggested that for people with extreme obesity taking GLP-1 agonists like Ozempic or Wegovy before bariatric or metabolic surgery was the most effective method of losing weight to reduce surgical or recovery complications.

Extreme obesity is defined as having a body mass index of more than 70; it can lead to multiple health conditions and make anesthesia difficult to assess for bariatric surgery.

Experts say meeting with a doctor to tailor the appropriate plan for pre- and post-surgical approaches is ultimately the best plan for each patient.

• Musician Kevin Jonas announced he has undergone treatment for basal cell carcinoma.
• Basal cell carcinoma is the most common form of skin cancer.
• About 1 in 5 people will develop the condition at some point in their life.

Kevin Jonas, the 36-year-old member of the pop group the Jonas Brothers, has announced that he has undergone treatment for basal cell carcinoma.

Basal cell carcinoma is one of the most common forms of skin cancer. The American Cancer Society reports that about 5.4 million cases of basal and squamous cell skin cancers are diagnosed each year.

In a post on Instagram this week, Jonas revealed he was having the skin cancer removed at a physician’s office that day.

“Today, I’m having a basal cell carcinoma removed from my head,” Jonas said in the video. “Yes that is an actual little skin cancer guy that has started to grow and now I have to get surgery to remove it. So here we go.”

After undergoing the procedure, Jonas is seen in his car heading home.

“Make sure to get those moles checked, people,” he said.

How to ID basal cell carcinoma

Basal cell carcinoma is often skin-colored unlike other forms of skin cancer like melanoma.

There are various forms of basal cell carcinoma, and it’s unclear which type Jonas has been diagnosed with. He has shared that the affected area was on his forehead.

Krista M. Rubin, MS, FNP-BC, a nurse practitioner at the Mass General Cancer Center’s Center for Melanoma, says that the condition can show itself in many different forms.

“Basal cell cancer (BCC) typically presents as a slow growing, flesh-colored, smooth bump with a ‘pearly’ or shiny appearance.  The lesion may have rolled borders and often have visible blood vessels. BCC may be described as ‘a sore that won’t heal’. On dark skin, BCC can look like a shiny or pearly brown or black bump.  There are different subtypes of BCC that have different characteristic appearances, but they all have something in common; they appear as a change in the skin,” Rubin said.

According to experts like Karen Connolly, MD,  a dermatologic surgeon at Memorial Sloan Kettering Cancer Center,  basal cell carcinoma rarely metastasizes to the point of being life-threatening but removing the cancer can lead to issues.

“The bigger concern with basal cell is that it tends to appear in areas where you get sun exposure, so the head and neck area,” Connolly said. “Those areas that are always exposed, are the highest risk locations to develop a basal cell so people can get them on areas that are functionally and cosmetically really important, and that can be problematic.”

Connolly said one sign you may have a basal cell carcinoma is if you have an area of skin that just won’t heal. 

“Patients can check their own skin and there are certain basal cells that would be hard for a layperson to diagnose, but then, certain ones, If someone has a non-healing area, or pimple-like growth that just doesn’t seem to go away or is new,” Connolly said. “If they have an area that just continues to bleed and then heal, and then bleed again, those are the types of signs that people can notice at home and know that they have to go get evaluated, too.”

Min Deng, MD, dermatologist and director of Mohs micrographic surgery at MedStar Health as well as an associate professor of dermatology at Georgetown University, says that it’s particularly important to get checked if you’ve been previously diagnosed with this form of skin cancer before, to see your medical provider regularly.

“Once an individual has developed a basal cell cancer, there’s about a 44% risk, almost half of patients will develop another one within three years,” Deng said. “Once somebody has developed one, usually we recommend they get a full skin check at least once a year with a dermatologist

Deng also says that skin cancer can affect people of different skin tones, not just people with lighter skin.

“Everybody gets sun, including patients with darker skin tone. And the number of patients I’ve had come in, thinking they were coming in for one thing, and then lo and behold, it’s a skin cancer, and they typically are larger by the time they do come in, or they’re in more complex areas where they require larger surgery,” Deng said. “Everybody can get skin cancer. If you have skin, it has the potential to develop skin cancer.”

Deng says that she is hopeful that Jonas’ public announcement could have a positive effect on the awareness and treatment of skin cancer,

“I think sometimes, especially in my younger patient population, a lot of them have never gone through a medical procedure or a surgical procedure,” Deng said. “I think people also delay it…because the most sun-exposed area on our bodies is probably our face and that’s also where people are probably least likely to want a biopsy until they have to, until it’s bigger, or it’s really obvious. My hope is that this brings more awareness to how common it is.”

How basal cell carcinoma is treated

There is a broad range of treatments for basal cell carcinoma. There are traditional surgical options, minimally invasive options, radiation treatments, topical creams, pill-based interventions, and electrodesiccation and curettage, a process where the skin cancer is burned and scraped off. 

Radiation and pharmacological options are generally limited to those who are not viable candidates for surgery due to risk of complications.

How to prevent skin cancer

The best advice to reduce your risk of skin cancer is to avoid intense sun exposure. This means using and applying sunscreen with at least SPF 30 or higher that protects against both UVA and UVB rays, according to the American Academy of Dermatology. If you’re going outside you can also wear comfortable clothing that covers at-risk areas on your head, shoulder, and back. Experts also recommend avoiding going outside when the sun’s rays are the strongest from 10 a.m. to 2 p.m.

Takeaway

Pop star Kevin Jonas shared that he had a type of skin cancer called basal cell carcinoma that had to be removed. Basal cell carcinoma is one of the most common forms of skin cancer.

• A new study showed drinking beet juice daily may improve heart health among postmenopausal women.
• Beet juice stimulates the production of nitric oxide, which promotes better blood flow and circulation.
• When looking for beet juice, choose 100% juice with no additives.

A new study suggests that drinking beet juice daily may enhance blood vessel function more effectively than a placebo. When adopted as a daily habit during postmenopausal years, this improvement may significantly reduce the risk of heart disease in postmenopausal women.

The findings were published this week in Frontiers in Nutrition.

Drinking beet juice daily may help blood vessels

Participants consumed two 2.3-ounce bottles of concentrated beet juice, followed by one bottle every morning for 7 days. After several weeks, they consumed beet juice without nitrate.

To measure vascular function, researchers analyzed blood vessel expansion when participants were and were not drinking the beet juice with nitrate.

Results showed that drinking the beet juice with nitrate daily improved blood flow in comparison to the nitrate-free beet juice.

However, the researchers found that neither treatment stopped the decline in blood vessel function after tissue damage had occurred in postmenopausal women.

The results also suggest that certain protective benefits of beetroot juice nitrate on blood vessels disappear within 24 hours after the last dose. Consistent daily or even more frequent intake of nitrate-rich beetroot juice might be necessary to maintain the protective effects on endothelial function.

This was a small, short-term study. Larger, long-term studies are needed to find the best dose and timing of nitrate intake to promote blood vessel function and heart health in postmenopausal women.

Jocelyn Delgado Spicuzza, PhD, of the Huck Institutes of Life Sciences at the Pennsylvania State University and first author on the study, explained how beet juice can help post-menopausal women.

“Consuming nitrate through plants is a secondary pathway to increase the availability of nitric oxide in the body, a molecule responsible for widening blood vessels to accommodate blood flow and oxygen delivery to organs such as the heart,” Delgado Spicuzza said in an emailed response. “Since estrogen is no longer sufficient to stimulate nitric oxide production in the body naturally following menopause, dietary nitrate can be converted to nitric oxide through the entero-salivary pathway to help maintain healthy blood vessel functioning.”

John Higgins, MD, sports cardiologist at UTHealth Houston, explained that in pre-menopausal women, estrogen has a protective effect on vascular function.

“Postmenopausal women have a higher risk of cardiovascular disease because they lose the protective effect of estrogen on vascular function and nitric oxide production which normally keeps the arteries flexible, fluid, and resistant to plaque formation,” said Higgins. “Other effects of age include postmenopausal women [who] are less active in general and gain weight, both of which are unhealthy.”

Higgins was not involved in the study.

The health benefits of beet juice

Nitrate-rich beet juice promotes the production of systemic nitric oxide and improves endothelial function in older, healthy, and high heart disease-risk populations, Higgins explained.

In addition, it may help:

• lower blood pressure
• reduce LDL or “bad” cholesterol
• improve exercise stamina
• improve muscle strength in people with heart failure
• prevent or reduce fatty deposits from forming in your liver
• support overall health during chemotherapy

Beet’s protective cardiovascular effects

The study showed drinking beet juice specifically impacted blood vessel function. Higgins pointed out that beet juice can help protect cells called endothelial cells that line arteries, veins and capillaries.

Beet juice directly targets and improves abnormal endothelial function by stimulating the production of nitric oxide. Through a chain reaction, your body changes nitrates found in beet juice into nitric oxide, which helps with blood flow and blood pressure, Higgins added.

“The vascular endothelium is an important barometer of health and wellness yet is often not discussed because it is out of sight,” Higgins stated. “Abnormal endothelial function is associated with detrimental medical conditions including diabetes, hypertension, cardiovascular disease and some cancers.”

What to look for when buying beet juice

When shopping for beet juice in the store, paying attention to the ingredients is important.

“Look for a good fresh organic beetroot juice with 100% juice and little to no additives, natural juices are generally better than powdered,” said Higgins.

You can also check to make sure there are no added sugars.

Takeaway

Frequent beet juice consumption could boost heart health among postmenopausal women.

Beet juice improves blood vessel function by increasing the amount of nitric oxide in the body. 

• The FDA is issuing a warning about an ongoing investigation of Diamond Shruumz brand mushroom chocolates and candies.
• The products have been linked to 10 reported hospitalizations due to severe symptoms including seizures and loss of consciousness.
• Consumers are urged not to eat the products and immediately discard them.

The Food and Drug Administration (FDA) has issued a warning for Diamond Shruumz brand products, which are marketed as “microdose chocolate” infused with a proprietary blend of mushrooms. Consumers are urged not to eat the products and immediately discard them.

There have been 12 reported illnesses associated with the products, the majority of them requiring hospitalization for serious symptoms including seizures, loss of consciousness, vomiting, and abnormal heart rate.

The FDA and U.S. Centers for Disease Control and Prevention (CDC), in conjunction with America’s Poison Centers, are currently investigating the Diamond Shruumz products, which include chocolates, gummies, and other confections. However, they say they still haven’t determined the causes of the illnesses.

Healthline contacted Diamond Shruumz regarding the FDA investigation but did not receive a response.

Mushroom-infused chocolates cause loss of consciousness

 At the beginning of June, poison centers across the United States started receiving calls from individuals who consumed various Diamond Shruumz products, which are available nationwide. States reporting illnesses include Pennsylvania, South Carolina, Alabama, Indiana, Kentucky, and more. The majority of cases, four of the 12, occurred in Arizona.

Steven Dudley, PharmD, DABAT, Director of the Arizona Poison and Drug Information Center, has been working closely with local area hospitals, the FDA, and CDC throughout the investigation. 

“We were aware of four patients over the weekend of June 1 who were all exposed to these Diamond Shruumz products… Any time you get four of anything, you raise the alarm and ask: is there something bigger going on here?” he told Healthline.

Symptoms involving the products have been severe, with 10 out of 12 of them requiring hospitalization.

The most common symptoms associated with the Diamond Shruumz products are:

• Seizures
• Central nervous system depression (loss of consciousness, confusion)
• Agitation
• Abnormal heart rates
• Hyper- and hypotension
• Nausea
• Vomiting

“The most concerning of these are the seizures and the loss of consciousness. In some of these patients, you have a severe decrease in your consciousness, so the next question is, can you be so severely sedated that your breathing is affected?” said Dudley.

There have been no deaths associated with the products at this time. Dudley also notes that the majority of illnesses have been “quick on, quick off” so the illness is usually not long-lasting. Despite severe symptoms, patients have recovered quickly following medical intervention.

What are “microdose chocolates”?

Diamond Shruumz markets their products as “the leading form of microdosing.” Microdosing refers to the practice of small amounts of psychedelic drugs, including psilocybin mushrooms and MDMA for therapeutic benefit. Despite using the term, Diamond Shruumz products don’t actually contain psilocybin or other scheduled drugs. 

The products are instead made with a “proprietary blend of nootropic and functional mushrooms,” including lion’s mane, reishi, and chaga. However, there can be other ingredients present as well, since the full list of ingredients is not disclosed on their website. Proprietary blend is a designation allowed under the FDA that allows the producers of supplements to protect their formulas.

“Typically, when we talk about microdosing, especially with mushrooms, we’re thinking more of psilocybin-containing or other hallucinogenic mushrooms.  But that’s what’s so peculiar about this brand. They are marketing this microdosing type of strategy, yet they do not contain any of the psilocybin or any other type of the hallucinogenic mushrooms,” Joseph Lambson, PharmD, DABAT, Director of the New Mexico Poison and Drug Information Center, and an Assistant Professor at the University of New Mexico College of Pharmacy, told Healthline.

Diamond Shruumz even makes the lab testing of their products freely available on their website to show that they do not contain illicit psychoactive drugs nor other mycotoxins, including those of the deadly amanita muscaria. 

Despite not containing psychedelic drugs, the products are clearly intended to convey to potential consumers that they will have “an experience.”  

The FDA warns that the products will likely appeal to children and teenagers.

Why are people getting sick?

It’s unclear at this time why consumers of Diamond Shruumz products are getting sick. 

“Hopefully we will have some answers fairly soon,” said Dudley. “We’re working in coordination with the federal agencies to get these products tested.”

Both experts contacted by Healthline said that it is too early to tell if this is a product contamination issue or if a component of the proprietary formula is to blame.

“We just don’t know what’s inside of these products currently,” said Lambson.

What should you do if you’ve bought Diamond Shruumz products?

“At this point in time, the recommendation is to stay away from these products. Please not use these products because there’s clearly something going on here,” said Dudley.

The FDA warning encourages consumers to:

• Not consume any of the affected products
• Discard any products around the home
• Look after children and teenagers to ensure these products are not being consumed

“If anyone is having any symptoms or has any questions or concerns about one of the Diamond Shruumz products, they can call their local poison control center at 1-800-222-1222. This is applicable to healthcare professionals as well, both to receive guidance on how to manage these patients, but also to help with reporting purposes to support the FDA’s current investigation,” said Lambson.

The bottom line

A variety of Diamond Shruumz mushroom-infused confections, including chocolates and gummies, have been reportedly associated with severe effects including seizure and loss of consciousness.

The FDA is urging consumers not to eat these products and to immediately discard them.

If you have consumed one of these products and are feeling ill, you should contact the poison control system at 1-800-222-1222 or a healthcare provider.

• Interest in raw milk is soaring, and some states are moving to legalize its sale.
• This potential change in legislation challenges the long-standing advice to pasteurize milk, a process that eliminates harmful bacteria and guards against severe foodborne illnesses.
• False and misleading information about the health benefits and risks of raw milk are commonly shared online.

Got milk? Perhaps, but is it pasteurized?

Interest in raw milk is growing in popularity. In fact, Delaware, Iowa, and Louisiana recently passed or took steps to pass legislation to legalize its commercial sale. The moves come at an interesting time, as federal officials warn of high levels of bird flu virus in raw milk, even after five weeks of refrigeration. 

The effort to loosen the reigns on raw milk sales also goes against gold-standard public health guidance to pasteurize milk to prevent foodborne illness — a practice that took hold in the 1880s and is credited with lowering potentially dangerous diseases, including tuberculosis.

Why is interest in raw milk growing — and why now?

“Raw dairy evangelists repeat the claims that due to the lack of pasteurization and homogenization, it contains more nutrients, intact enzymes, probiotics and that even people with lactose intolerance can tolerate raw milk,” Emily Van Eck, MS, RD, a registered dietitian at Emily Van Eck Nutrition & Wellness, said. “These claims go directly against well-established science and norms in the food industry.” 

That’s the short answer, but the long one is complex. Dietitians believe it generally comes down to tales as old as time: money and social influence, especially in the digital age. 

Raw vs. pasteurized milk: differences and health risks

Raw milk is unpasteurized milk.

“It’s often framed as fresh, natural, unprocessed, and ‘safe’ despite the increased risk of foodborne illness,” Cara Harbstreet, MS RD LD of Street Smart Nutrition, said. “Raw milk is not necessarily organic. It also does not necessarily have to come from cows, as goats and sheep can also produce raw milk for human consumption.”

Incorrect information has given “pasteurization” a negative connotation. 

“Pasteurized milk is raw milk that has undergone a heated process that kills harmful microbial colonies,” Kathleen Garcia-Benson, RDN, a registered dietitian with Top Nutrition Coaching, said. “It is a food safety management tool integrated into the Standard Milk Ordinance in 1924 as a means of reducing foodborne illness, which can be life-threatening.”

The pasteurization process involves heating the milk at a specific temperature (usually 161 degrees Fahrenheit) for at least 15 seconds before cooling it rapidly back to 39 degrees. 

“Because it has not been treated with heat to rid it of microorganisms, [raw milk] consumption can spread dangerous pathogens, including bacteria, that can result in serious disease or death,” Maddie Pasquariello, MS, RDN, said.

Why interest in raw milk is growing despite health risks 

Despite more than a century of mainstream acceptance of pasteurization’s health and safety benefits, raw milk is trending.

“Trending practices in nutrition go together like peanut butter and jelly,” Garcia-Benson said. “Every few months, a new topic of interest grabs hold of people’s attention — and wallets.”

Experts Healthline spoke with cited:

• Financial gain
• Social media
• The desire to eat “more naturally.”
• Lack of trust in systems

The wallet point is what Pasquariello points to as the primary driver of the raw milk trend.

“It almost always goes back to money,” she said. “For some who are spreading this disinformation — information that is meant to intentionally misinform — content around raw milk is clickbait/rage bait designed to boost likes and comments, ultimately helping these creators’ videos/content appear more highly in their communities’ algorithms. This earns them money and clout.”

Others make money more directly (or hope to).

“For example, brands selling raw milk may pay them to create content, whether or not they disclose such contractual agreements,” Pasquariello said. “Their sales, on the whole, benefit from increased traffic, increased follower numbers, and, importantly, from people developing fear for conventional foods/foods they normally buy every day at the grocery store, for instance. The more you begin to fear foods that are completely safe for consumption, the more you’ll fall victim to these conspiracy theories.”

Social media is a common denominator.

“Wellness influencers often post personal and compelling testimonials in engaging videos that often go viral,” Harbstreet said. “Many of these influencers run lifestyle accounts with large followings, giving raw milk the illusion of safety and legitimacy since negative experiences are rarely, if ever, shared publicly.”

That illusion includes the idea that raw milk is better because it’s “not processed” through pasteurization.

“The desire for less processing in food overall and the increased interest in homemaking on social media has also played a role in the trending of raw milk,” Garcia-Benson added.

Finally, data suggests trust in government and its institutions has reached record lows. A 2023 PEW Research report indicated that fewer than two in 10 Americans reported trusting the government in Washington to do the right thing “just about always” or “most of the time.” 

“These claims gain more traction in our current era where those vulnerable to fear-mongering and who get into ‘natural medicine’ are increasingly distrustful of our governmental institutions, like the FDA, who regulate milk production to keep the public safe,” Van Eck said.

Raw milk: Fact vs. fiction

“Food freedom” is a buzzword being clouted by raw milk proponents.

“Everyone has the right to make informed decisions about their health, but there are real, avoidable consequences of choosing raw milk, which comes down to weighing risks and benefits (or in this case, the risks, as there really aren’t any benefits,” Pasquariello said.

The experts who talked with Healthline feel that true informed consent involves the correct information. They helped clear up the following common myths about raw milk and pasteurization that are currently being shared.

Myth: Pasteurization decreases milk’s nutritional value

This myth has consistently been debunked by data and dietary experts alike.

“There is no significant decrease in the vitamin or mineral content during pasteurization, including the B vitamins influencers claim we lose when we pasteurize milk,” Pasquariello said.

Research published in 2014 indicated that B12 resisted pasteurization when heated for 16 seconds. 

“There is also no reason to fear any of the processes that happen during pasteurization — many people cite ‘protein denaturation’ as a way to spread fear,”  Pasquariello added. “Protein denaturation is a vital part of digestion whenever you eat food so that your body can use the building blocks of proteins, amino acids, for various cellular functions. Not only is it not something to fear, it is a requirement for health.”

Myth: People who are lactose intolerant can drink raw milk safely

Van Eck said there’s no truth to this common claim, either.

“Lactose is lactose is lactose,” she said. “The idea came from the false statement that raw milk contains lactase, which is the enzyme we need to break down lactose. People intolerant to lactose have less or less functional lactase.”

Fermented dairy is a safer, more easily-digested bet for people who are lactose intolerant “because there is less lactose since it’s partially broken down by the bacteria in the fermented milk,” Van Eck said.

Harbstreet explained that, for the same reason, consuming raw milk doesn’t prevent someone from becoming lactose intolerant. She also pointed out that “advocates for raw milk often attempt to discredit a small study from 2014.” 

The study was small (16 people) and suggested that raw milk didn’t reduce symptoms of lactose malabsorption. 

“It’s worth noting that although this is an older, and very small, pilot study, the authors acknowledged the significant limitations,” Harbstreet said. “They also noted that their study design and participant feedback could support the design of future studies. However, at this point, no further studies have been published to expand on this hypothesis.”

Myth: Consuming raw milk protects against illness

Quite the opposite, experts say.

“Raw milk puts people at a higher risk of getting sick from salmonella and e. Coli,” Garcia-Benson said. “Even in the cleanest of dairy farms, cross-contamination can occur, especially because of the close location of the udder to the excrement of the cow.”

Pasquariello echoed these sentiments, stressing that claims that animal living conditions can reduce pathogens, rendering raw milk safe, aren’t true.

“The conditions the animals live in won’t affect the bacterial content of their stomachs or whether that content is safe for humans,” Pasquariello said.

Experts don’t consider drinking organic raw milk to be an effective harm-reduction measure, either.

“Pathogens can still be borne by organic milk and pose a problem for humans,” Pasquariello said.

Regarding bird flu, 2024 research suggested that lab mice given raw milk from cows with the infection had higher virus levels in respiratory organs.

Takeaway

Interest in raw milk is growing. However, raw milk isn’t pasteurized, a heating process designed to kill bacteria that could cause foodborne illnesses like typhoid.

Pasteurization has been used for more than a century.

Dietary experts say raw milk’s current growing popularity is due to interest in financial gain from influencers and brands, social media, a desire to consume healthier food, and distrust in government agencies.

However, claims that raw milk is more nutritious or free of pathogens are false. Regarding the latter, it’s the opposite: Raw milk, including organic raw milk, is more susceptible to containing pathogens.

Experts recommend consuming pasteurized milk, stressing it’s the safer option and offers plenty of nutrients, like protein and calcium.

• Trichophyton mentagrophytes is a fungus that causes ringworm in people and in cats, dogs and other pets.
• A subtype of this fungus can be acquired through sexual contact, according to the CDC.
• In some parts of the world, this fungus is drug-resistant, but in the US, it still responds well to common antifungals.

A sexually transmitted ringworm caused by a certain fungus has been reported for the first time in the United States.

“Healthcare providers should be aware that Trichophyton mentagrophytes type VII is the latest in a group of severe skin infections to have now reached the United States,” study author Avrom Caplan, MD, a dermatologist and assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine, said in a release.

What is Trichophyton mentagrophytes type VII?

T. mentagrophytes is a common type of fungus that can cause ringworm in people, as well as in cats, dogs and other pets. 

“It is one of the most common causes of ringworm, a contagious fungal infection of the skin, hair and nails,” said Bindu Balani, MD, an infectious disease specialist with Hackensack University Medical Center, who was not involved in the new research.

It can also cause athlete’s foot, jock itch, and barber’s itch, she told Healthline.

T. mentagrophytes genotype VII is a specific type of this fungus that can be sexually transmitted, according to the Centers for Disease Control and Prevention.

Cases of T. mentagrophytes genotype VII have been reported in other parts of the world, including in Southeast Asia and Europe.

First U.S. case of sexually transmitted fungus

In a report released June 5 in JAMA Dermatology, Caplan and his colleagues describe the first documented case in the United States of this sexually transmitted fungus.

The case involved a man in his 30s from New York City who developed an itchy rash on his genitals, buttocks, and limbs after returning from a trip to England, Greece, and California.

The man “reported multiple male sexual partners while traveling, none with a similar infection, and visited a sauna 2 months prior to developing skin lesions,” the researchers write.

Genetic tests confirmed that the fungus causing the rash was T. mentagrophytes genotype VII.

The man was treated for 4 weeks with the antifungal medication fluconazole with no response. He was then treated with the antifungals terbinafine and itraconazole, both of which improved his symptoms.

Dr. Aniruddha Hazra, MD, an infectious diseases physician and associate professor of medicine at UChicago Medicine, who was not involved in the new research, said this type of rash may look like jock itch or ringworm, typically a patch or patches of dry, scaly skin.

The researchers said this type of infection may also cause a rash that looks more like an eczema flare than a ringworm infection with the characteristic circular pattern on the skin.

While the infection is not fatal, it can cause permanent scarring, they added.

Standard antifungal drugs work

Balani said fungal infections of the skin are generally treated with topical antifungal creams, lotions or gels, although oral antifungal medications may be needed for more severe infections or for infections that affect the hair or nails.

However, she pointed out that “in some cases, Trichophyton mentagrophytes type VII can be resistant to standard antifungal treatments.”

Even though T. mentagrophytes genotype VII can be difficult to treat and the infection may take months to clear up, Hazra said in the United States, this fungus still responds well to treatment.

“People who are concerned about STIs should be aware of this, especially when thinking about a rash that may not be improving,” he said, “but our usual antifungals are readily effective against it.”

Balani agrees that people shouldn’t be overly concerned about this infection: “With just one known case [in the United States], there’s no evidence this is widespread, or that this is something the public needs to worry about,” she said.

However, “if people are having itchy eruptions in areas like the groin, and it’s not improving or is resistant to the usual fungal treatments, they may want to see a healthcare professional,” she said.

People may also want to see a healthcare professional if the rash appears in the weeks following sexual activity, or after travel to Southeast Asia or Europe, where this fungus has been increasingly diagnosed, she said.

The only way to diagnose T. mentagrophytes genotype VII is through fungal sampling/scraping, she said.

“If diagnosed with this particular fungus, I also recommend getting screened for other sexually transmitted infections,” she said.

In addition, you should seek medical care if “you have a rash accompanied by symptoms affecting the entire body, rather than just the skin, such as a fever, muscle aches, nausea & vomiting, etc.,” Balani said.

Tips for preventing fungal infections

Balani offered the following general tips for dealing with fungal infections of the skin:

• Keep the affected area clean and dry to prevent the fungus from growing.
• Wash your hands often, especially after touching animals or soil.

• Avoid sharing personal items, including towels, combs, and brushes.
• Wear shoes in public places. This will help protect your feet from infection.

Takeaway

In a recent case study, researchers describe the first reported case of a sexually transmitted ringworm caused by a certain fungus, Trichophyton mentagrophytes type VII.

The case occurred in a man from New York City who traveled to England, Greece and California. After he returned home, he developed a rash on his genitals, buttocks, and limbs.

Cases of this fungus have occurred in Southeast Asia and Europe, with some reports of drug resistance. However, in the United States, this fungus still responds well to frontline antifungal medications.