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• A new study found that the drug Sunleca (lenacapavir) has been shown to be 100% effective at preventing HIV in females.
• The drug is given via injection two times a year and is manufactured by the U.S. company Gilead.
• Health experts say the potential to reduce the number of new HIV infections is enormous if the drug can be made widely accessible.

Two shots a year of lenacapavir, a drug manufactured as Sunleca by the U.S. company Gilead, was shown to be 100% effective in preventing the transmission of HIV in females, according to a new study funded by Gilead and administered by some of its employees.

More than 5,000 females in Uganda and South Africa were part of the research;  2,134 of them were given the injections, and none of them were reported to have HIV.

The other sections of the study cohort were split into two varieties of oral prevention pills — Descovy and Truvada — on a daily basis, and around 2% of them reported HIV infections.

The results of testing in men have not yet been calculated, but experts say the potential to change the rate of new HIV infections is enormous if the pre-exposure prophylaxis (PrEP) drug can be made widely accessible.

Dr. Amit Achhra, MD, an assistant professor of medicine at Yale School of Medicine who specializes in infectious diseases, told Healthline that the future of HIV prevention was “exciting” in this light.

“While we don’t have HIV vaccine yet, injectable HIV PrEP comes close to what one might see as periodic ‘HIV vaccine,’ i.e. periodic shots that have very high efficacy in preventing HIV infection,” Achhra said. “For those who don’t wish to get the shots, very effective oral HIV PrEP pills will remain an effective option. With more HIV prevention options available, we hope the rate of HIV infections will further decline in the future.”

How does lenacapavir prevent HIV transmission?

Approximately 39 million people worldwide live with HIV, and some of the highest numbers of diagnoses are in sub-Saharan Africa.

In 2022, according to the Foundation for Aids Research, 3,100 young women and girls (ages 15 to 24) contracted HIV every week in sub-Saharan Africa.

Lenacapavir, which is used as a treatment for HIV after it has been contracted in the U.S., Canada, and Europe, is among the group of drugs known as capsid inhibitors. These disrupt the protein shells (capsids) of the HIV virus that is essential to replication, which can interrupt the process of multiplying in the body.

Dr. Monica Gandhi, a professor of medicine and the associate division chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/San Francisco General Hospital, told Healthline that lenacapavir is a “first-in-class new HIV medication” with strong potency.

“The formation of a capsid around the virus is very important at multiple stages of the viral life cycle, including during nuclear transport and release,” Gandhi said. “Lenacapavir is so potent that it can be provided just twice yearly (every 26 weeks), which is its advantage over agents for PrEP (daily oral or cabotegravir, which is given once every 8 weeks).”

Does lenacapavir only work in females?

Rates of HIV are 7.7% higher in men who have sex with other men and 9.2% higher for transgender people, according UNAIDS.

According to Gandhi, the pathways to HIV infection work differently in females and males, but a new study should provide encouraging results for males.

“The PURPOSE 2 trial is being conducted in men, transgender women and non-binary individuals and the results are due out later this year, which is when (if favorable), Gilead will apply for regulatory approval,” Gandhi said. “Some drugs can work differently in men and women due to differential tissue levels at the site where transmission can occur (e.g. anal or vaginal mucosa), so it is important to test these preventive agents in both men and women.”

How much do lenacapavir injections cost?

Current reports have lenacapavir running more than $40,000 for the first year, but it’s been suggested that it could be sold for as little as $40, which would instantly create an enormous path to access worldwide.

“If the drug can be more cheaply made than what the company is suggesting, that would be a huge boon for the field, especially in preventing HIV infection in low-and-middle-income countries,” Gandhi said. 

“The drug is likely to be approved in the US even at a higher price point and should have benefits in controlling HIV infection in the US since the latest data from the CDC is that we still need more uptake of PrEP in this country among women and men,” Gandhi added.

“Currently, oral PrEP pills are significantly cheaper than shots, and in fact, the generic version of Truvada oral PrEP pill is available for very cheap, often less than $1 per pill. However, many people have a hard time keeping up with the daily pill,” Achhra said.

“It will therefore be important to have equally cheaper and accessible injectable PrEP options widely available to make a big dent in the HIV epidemic. Of note, it will be equally important for clinics and hospitals administering these shots to reduce their hospital ‘facility fees,’ which are often exorbitant and prevent access to these medications,” Achhra said.

Takeaway

A capsid inhibitor called lenacapavir, sold as Sunleca by the drug maker Gilead, prevented HIV infection in 100% of the cases in a recent study of more than 5,000 females in South Africa and Uganda.

Lenacapavir has been used as a treatment for HIV, but these twice-yearly shots could revolutionize HIV prevention, experts say.

Results of a study of the drug’s efficacy in males have not been published yet, but experts say full access and a cheaper price point would make an enormous difference globally.

• Most food products have a Nutrition Facts label.
• A good rule of thumb for utilizing this label is the 5/20 rule.
• Under this rule, less healthy nutrients should be kept at 5% DV or less.
• Healthier nutrients, however, should be 20% DV or greater.
• Following this guideline can help you make healthier choices about nutrition.

You’ve probably noticed a nutrition label on the back of the package or can for many of your favorite foods.

The Nutrition Facts label provides important information about the number of calories per serving.

It also states the amounts of various nutrients found in the food and their percent daily value (%DV).

But just what does all this mean, and how can you use it to be healthier and lose weight? One good rule of thumb is the 5/20 rule.

What is the 5/20 rule?

Marta Ferraz Valles, MA, RD, LD, an outpatient dietitian at The Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore, explained that the purpose of the 5/20 rules is to provide a general guide for selecting foods that are low in certain nutrients we don’t want, such as sodium, but high in others that we do want, like fiber, based on the %DV.

The %DV indicates the percentage of each nutrient that a serving of the food provides toward daily nutrient goals or limits based on eating a 2000-calorie diet, she added.

Valles further explained that if the %DV is less than or equal to 5%, the food is considered to be low in this nutrient. On the other hand, if the %DV is 20% or more, it is deemed to be high in this nutrient.

“For example, if a food label indicates that the food contains 2% DV of sodium [per serving], that means that the food is low in sodium,” she said.

Valles additionally noted the importance of serving size.

“If the serving size of the previous [sodium] example were 2 tablespoons and a person would eat 1 cup,” then that person would no longer be consuming low amounts of sodium, she remarked.

“Thus, the rule may be helpful as long as individuals eat the serving size indicated in the label,” said Valles.

How can the 5/20 rule help improve your health?

The 5/20 rule can help you make healthy food choices. For example, it can help you decrease the amount of foods you eat that are high in harmful nutrients like saturated fats and sodium while increasing the amount of beneficial ones like vitamins and fiber.

This can help reduce the risk of critical diseases like diabetes and cardiovascular disease.

When it comes to nutrients that you’ll want to limit, keep an eye on your sodium intake. This can help when it comes to blood pressure and your heart.

The 5/20 rule is also helpful if you are working to lose weight, as reducing your calorie intake is often an important component of weight management.

Additionally, the rule can help identify foods low in added sugars and saturated fats (5% or less of DV) and decrease calorie intake from unhealthy sources.

On the other side of the coin, the 5/20 rule can help you improve your intake of vital nutrients like vitamins, fiber, and minerals, which are good for overall health. You’ll want to choose foods with 20% or more DV of these beneficial nutrients.

Putting the 5/20 rule into action

“Generally, individuals want to choose products with less sodium, saturated fat, and added sugars, and with more dietary fiber, calcium, potassium, and iron,” advised Valles. “However, it is important to consult with a registered dietitian, as this does not apply for everyone.”

Valles cited irritable bowel syndrome (IBS) as one example of when you might be advised to alter this recommendation.

“For example, some people with IBS (irritable bowel syndrome) may have more gastrointestinal symptoms, including cramping and diarrhea, if they have too much of certain types of fiber,” she said.

However, others with IBS are advised to increase their intake of certain fibers. So, if you have IBS or other gastrointestinal conditions, it’s important to talk to your doctor or registered dietitian about what types of fiber, and how much, might be best for symptom management.

Valles said that she also tells her patients to use the rule to compare food products so they can select which is the better choice. For example, when choosing between two tomato sauces, you could opt for the one with less sodium and added sugars.

She added, however, that it’s your overall diet that matters most. You might still be able to buy the tomato sauce with higher sodium and sugar if your overall diet is low in these less-desirable nutrients.

Valles concluded by saying that, although the 5/20 rule can be helpful, it’s also important to read the ingredients list.

“Some products may look very healthy when we look at the label (low sodium, low saturated fat, low added sugars, and high dietary fiber), but if we were to read the ingredient list, it may contain highly processed ingredients that we cannot pronounce,” she said.

“In this case, this may not be the healthiest choice, and people should discuss this with their registered dietitian,” said Valles.

Takeaway

The 5/20 rule is a guideline for using the Nutrition Facts label in order to make healthier choices.

Less healthy nutrients — like sodium, added sugar, and saturated fat — should generally be kept at or below 5% DV.

Healthier nutrients — like fiber, calcium, and potassium — should be consumed in larger amounts at or above 20% DV for most healthy adults.

Following this rule can help you lose weight, protect your heart, and generally be more healthy.

However, be aware that this is a general rule of thumb. Certain medical conditions, such as IBS, may require more or less of certain nutrients.

• Environmental pesticide exposure due to industrial agriculture potentially increases cancer risk to a degree similar to smoking.
• In a new study, researchers correlated cancer rates in geographic regions based on pesticide usage.
• The study does not demonstrate causation. More research is needed to understand how environmental pesticides affect cancer risk.

Is pesticide exposure as bad for you as smoking in terms of cancer risk?

Potentially, yes, claims a new scientific study.

The research, published in the journal Frontiers in Cancer Control and Society, found a strong association between the presence of environmental pesticides and several cancers, including leukemia, non-Hodgkin’s lymphoma, bladder, lung, and pancreatic cancer.

The authors used population and geographic data from sources, including the CDC, Department of Agriculture, and US Geological Survey, to investigate the correlation between rates of these cancers and pesticide usage in various regions across the United States.

This type of study, known as an ecological study, is used to identify broad trends but does not demonstrate a causal link, which the study authors readily admit.

The trends identified between pesticides and cancer risk are akin to those you would typically see with smoking.

“We found that every cancer is affected. So, everything is affected by pesticides. And it is very similar to what you see in smoking. If you increase how much you smoke, you increase your risk for every cancer, even when some of those are more affected than others. And that is exactly what happened here,” Isain Zapata, PhD, an Assistant Professor of Research and Statistics at the Rocky Vista University and Senior Author of the study, told Healthline.

Loren Lipworth, ScD, a Professor of Medicine and Associate Director of the Division of Epidemiology at Vanderbilt University Medical Center who wasn’t affiliated with the research, told Healthline that, due to its design, we need to be cautious about interpreting this study’s findings.

“The conclusions that can be drawn from this type of study are that there may be some etiologic clues, there may be some signals of associations between various types of cancer and pesticide use patterns at this large ecologic population level, but in terms of individual-level data, the study does not provide that,” she said.

Mapping the potential link between pesticides and cancer

The study is the first comprehensive examination of the effects of pesticides on cancer risk across large geographic regions and populations in the United States.

Researchers used reporting data for sixty-nine different pesticides to create geographic regions. Essentially, they carved out areas of the US used for agriculture based on reported pesticide usage.

For example, the Midwest, the country’s leading region for corn production, has the highest presence of environmental pesticides. Meanwhile, the Great Plains region, from northern Texas to North Dakota, has the least.

Once the authors established these geographic regions, they then looked at rates of cancer in these areas. 

They hypothesize that cancer risk is likely tied to the amount of pesticide use and different kinds of agricultural production since pesticide usage also varies based on activity. For example, California, the nation’s largest vegetable producer, would likely have different cancer outcomes than the Midwest, where corn is the predominant crop.

Zapata told Healthline that this methodology gives a more holistic impression of how exposure can occur, noting that individuals are rarely ever exposed to a single pesticide but rather a “cocktail” of different contaminants in the real world.

“You’re going to be exposed to the pesticides that might be floating around from the farms that are close to where you live. There might be industrial residues that are unique to the agricultural activity of that area,” he said.

Specific pesticide outcomes

Sixty-nine nationally reported pesticides were included in the study. Individually, many were linked to different cancer outcomes.

• Atrazine is used to control grasses. The study found that it was consistently a top contributor for increased risk of all cancers and colon cancers.
• Glyphosate is commercially available as a weed killer named Roundup and is associated with an increased risk of all cancers, colon cancer, and pancreatic cancer.
• Dicamba is commonly used in corn and soybean agriculture. It was linked to an increased risk of colon cancer and pancreatic cancer.
• Dimethomorph is a fungicide. It was identified in regions with a high risk of leukemia and non-Hodgkin’s lymphoma.

Despite these findings, Zapata told Healthline that the goal of their study is not to stop pesticide usage.

“We aren’t trying to tell the Midwest, OK, you cannot grow corn anymore,” he said.

“We need to eat. We need to have products derived from agriculture. And to have the efficiency that we need to be economically sustainable, we need to use those chemicals. So it becomes a cost-benefit, risk-benefit approach,” said Zapata.

Strengths and weaknesses of the study

The study authors controlled for major confounding factors, including smoking, socioeconomic factors, and the area of agricultural land. However, when using population data, not all confounding factors can be accounted for.

To be clear, even in a region with high rates of cancer and pesticide usage, the study’s nature doesn’t allow one to be attributed to the other. It does, however, provide a signal that more research is needed.

“There’s no causal inference that can be drawn between individuals or a group of people’s actual pesticide exposure and their individual cancer risk,” said Lipworth.

The study doesn’t differentiate between groups of people, such as farm workers who may have direct exposure to pesticides, and members of the surrounding community whose exposure could vary based on proximity and other factors. 

“It’s really important that we have person-level exposure assessment. There are people who are occupationally exposed, and there are farmers, but in the same area, there are people living with farmers who are exposed in a different way. So, personal level exposure assessment is really critical for us to understand this type of scientific association,” said Lipworth.

The bottom line

A national population study has found a broad association between environmental pesticide usage and various forms of cancer.

Across different US geographic regions, sixty-nine different pesticides were associated with increased risk of colon, pancreatic, lung, and other cancers.

The design of the study only shows association, not causation. More research is needed to better understand how environmental pesticide exposure affects cancer risk on a personal level.

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 …

• A new state-by-state report ranking women’s healthcare has been released.
• It finds that the overturning of Roe v. Wade has made getting reproductive care difficult.
• Also, women are dying from preventable cancers like breast and cervical cancer.
• Women living in states with worse healthcare can self-advocate to get better care.
• However, legislation will be necessary to close the gaps.

A new report prepared by The Commonwealth Fund states that women’s health and reproductive care in the United States is in a “perilous place,” and there are growing disparities in these areas.

They note that more women than ever are dying from preventable causes, and there are large differences in maternal mortality and breast and cervical cancer deaths.

Additionally, women’s life expectancy is at its lowest since the year 2006.

Their state-by-state analysis further draws attention to the fallout from the Supreme Court’s historic decision overturning Roe v. Wade, which made it increasingly more difficult for women to obtain needed reproductive healthcare.

Dobbs v. Jackson Women’s Health Organization has also created a climate where contraception and in vitro fertilization (IVF) are at risk, says the report.

They further discuss the impacts of state-level post-pandemic policies that have left millions of low-income women either without health insurance or with gaps in their coverage.

Additionally, these losses in coverage have left the providers who serve these low-income women in danger of closing their offices.

The 2024 State Scorecard on Women’s Health and Reproductive Care, their first effort to examine women’s healthcare in all 50 states and the District of Columbia, is part of an ongoing series of reports on how well state healthcare systems are fulfilling their missions.

It uses 32 measures to gauge each state’s performance in terms of healthcare access and affordability, health care quality and prevention, and health outcomes.

Where healthcare for women ranks highest and lowest

According to the report, Massachusetts, Vermont, and Rhode Island are some of the best-performing states in terms of healthcare access, quality, and outcomes.

Other top-ten states, ranked from higher to lower, were Connecticut, New Hampshire, Maine, the District of Columbia, Minnesota, Hawaii, and New York.

On the other end of the spectrum, Mississippi, Texas, and Oklahoma ranked the worst on these measures.

Other states among the bottom ten, from lower to higher, were Nevada, Arkansas, Georgia, Alabama, Arizona, Tennessee, and Wyoming.

Among the notable findings of the report is the fact that all-cause mortality for women of reproductive age is highest in southeastern states. At the high end of the spectrum was West Virginia, with an all-cause mortality rate of 203.6 per 100,000. At the low end was Hawaii, with 70.5 per 100,000.

The highest rates of maternal mortality were found in the Mississippi Delta region, which includes Arkansas, Louisiana, Mississippi, and Tennessee. Vermont, California, and Connecticut had the lowest mortality rates.

Another salient finding was that deaths from breast and cervical cancer, which are deemed to be preventable with proper screening and healthcare, were highest in southern states.

The authors of the report noted that northeastern states generally have higher screening rates and the lowest mortality while southern states have lower screening rates and higher mortality rates.

What to do if you live in a state where quality care is less accessible

Nicole Levine, MD, who is a physician focusing on preventive care, nutrition, and lifestyle medicine as well as the founder of Health Strive, said one step you can take is to seek out your local nonprofits and community organizations who provide healthcare.

She also suggests becoming active in lobbying for better healthcare policies.

Additionally, you can make use of telehealth services when care is not available near where you live or travel to other states when necessary healthcare services are denied.

“By taking these steps, the gap in access to high quality healthcare can be closed, she said.

However, she noted that narrowing the gaps between the states and improving women’s health outcomes will involve “more access to comprehensive healthcare and legislation that supports it.”

Rachel Goldberg, a Licensed Perinatal, Infertility, and Eating Disorder Therapist at Rachel Goldberg Therapy, seconded the idea of self-advocacy, making many of the same suggestions as Levine.

“The report also highlights how policy decisions, such as the lack of Medicaid expansion, abortion restrictions, and fertility limitations, directly impact women’s health outcomes,” she added. “This underscores the need for more advocacy and policy changes, which require significant resources and effort.”

Goldberg suggests that increasing awareness through social media, sharing personal stories, and engaging celebrities in the discussion are some grassroots ways to highlight the inequities in women’s health care among the various U.S. states and the District of Columbia.

Takeaway

A new report from The Commonwealth Fund details which states provide the highest and lowest quality healthcare for women.

Massachusetts, Vermont, and Rhode Island are some of the best, while Mississippi, Texas, and Oklahoma rank as the worst.

Some of the important issues identified include higher all-cause mortality in southeastern states and higher rates of preventable cancers like breast and cervical cancer in southern states.

Experts say self-advocacy is an important way women can improve health care for themselves.

However, real progress in narrowing the gaps will require legislation to support it.

• A new study indicates that plant-based meats can be good for your heart.
• They were found to be linked with reduced cardiovascular risk factors.
• However, another says ultra-processed plant-based foods appear to increase risk.
• The discrepancy may lie in whether foods are high in sodium, saturated fat, and sugar.
• It’s important to read labels on processed plant-based foods to avoid these.

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.

Why is plant-based meat better for your heart?

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).”

Why do recent studies seem to contradict each other?

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.

What should you look for when buying plant-based meats?

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.

Takeaway

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.

• Some people report that GLP-1 anti-obesity medications like Wegovy have helped improve their rheumatoid arthritis.
• Body fat and higher BMIs have been associated with a higher risk of developing rheumatoid arthritis.
• Health experts say more research is needed to understand the connection.

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.”

The connection between obesity and rheumatoid arthritis

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.

Emerging “obesity first” approach may help treat rheumatoid arthritis

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.

Will GLP-1 drugs be used to treat rheumatoid arthritis?

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:

• What are the anti-inflammatory effects of GLP-1s, and how do they impact those with autoimmune disease?
• What type of autoimmune disease patient would benefit from this type of treatment, and what kind of effect can be expected?
• What is the effect of these medications on the microbiome, and how does that impact autoimmune disease?
• How much weight loss (if any) is needed to see an impact?
• Are the benefits of GLP-1s in RA patients solely from weight loss?

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.

• People online are spreading misinformation with claims that low protein diets are better for longevity and weight loss.
• Experts say adequate protein intake can promote satiety and the development of muscle mass, which are important factors for weight loss. 
• A mix of plant-based and animal-based protein sources is best for a healthy diet. 

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.

The link between low protein diets and weight loss

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. 

Low protein intake: health benefits and risks  

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. 

Healthy protein types 

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: 

Animal Proteins: Meat, poultry, fish, eggs, and dairy

“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. 

Plant Proteins: Beans, lentils, tofu, tempeh, nuts, seeds, and whole grains

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.

Processed Proteins: Protein bars, shakes, and other supplements

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. 

Takeaway 

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.

• Kim Kardashian stated on a podcast that she uses Saran Wrap to help her psoriasis.
• She learned of the remedy from a dermatologist after other home remedies failed.
• Experts say occlusion therapies like Saran Wrap help psoriasis medications work better.
• Occlusion therapy also helps to soften plaques and reduce inflammation.
• Some other effective home remedies include colloidal oatmeal baths and sunlight.

While Kim Kardashian is known for being carefully styled and groomed in her work as a reality star, model, businesswoman, and actress, she recently revealed that her life isn’t always perfect — especially when it comes to her skin.

The 43-year-old star of FX’s “American Horror Story: Delicate” spoke on the July 16, 2024, episode of the SHE MD podcast about her experience living with psoriasis, a skin disorder in which the immune system speeds up skin cell growth leading to the formation of plaques and scales on the skin.

The National Psoriasis Foundation notes that this autoimmune condition can also cause symptoms like itching, burning, and stinging.

The shapewear mogul told hosts Mary Alice Haney and Dr. Thaïs Aliabadi and their guest, rheumatologist Dr. Daniel Wallace, that she initially thought she was having a reaction to a new dress that she was wearing.

Then, her mother, Kris Jenner, who also has the condition, looked at her legs and exclaimed, “Oh my God, you have psoriasis?”

Kardashian further stated that a cortisone injection helped keep symptoms at bay for a while, but they returned five years later and haven’t abated since.

Speaking of how miserable psoriasis makes her, the reality star said, “One day I’ll just have an itch attack, and I’ll scratch it, and it’ll all start bleeding, and I just can’t take it.”

As for keeping her symptoms under control, she said, “I’ll do anything,” noting that she has tried numerous home remedies that have been recommended to her, including tar tea, herbs, a celery juice cleanse, and various creams and soaps.

However, the remedy that she said works best is something that most people likely already have in their kitchens: Saran Wrap.

The actress said she was given the idea by her dermatologist, Dr. Harold Lancer of Beverly Hills, who told her to apply a prescription cream to the rash, followed by “putting Saran Wrap around it and sleeping on it.”

While she said the unconventional method made her “[sound] like the Tin Man,” Kardashian added that it does work to take away the rash.

Does Saran Wrap really work for psoriasis relief?

When asked about using Saran Wrap to help relieve itchy, painful psoriasis symptoms, Dr. Amy Huang, board-certified dermatologist with Medical Offices of Manhattan and contributor to Labfinder, confirmed that it does indeed work.

“Yes, we also use occlusion therapy for many other dermatologic conditions, including eczema,” she added.

Huang explained why it works. It helps any psoriasis medications that are used under the plastic wrap work better.

“Applying medication under occlusion increases penetration of the medication into the skin, especially in areas where the psoriasis can be quite thick,” she said.

Dr. Anju Methil, a dermatologist and medical consultant with ClinicSpots, added that occusion therapy also helps loosen scales, soften plaques, and reduce inflammation.

She did say, however, that there is limited research dealing with Saran Wrap specifically.

“[B]ut occlusive dressings have shown promise,” she said.

Other home remedies that may help treat psoriasis symptoms

Methil said that one thing she advises is using fragrance-free moisturizers.

“Regular use can significantly improve skin comfort during flare-ups,” she said.

Another measure she suggested is using colloidal oatmeal baths, which have anti-inflammatory and anti-itching properties.

Additionally, Methil discussed using controlled sunlight exposure.

“Sunlight can be beneficial for some psoriasis patients, but discuss appropriate amounts with your doctor to avoid sunburn,” she advised.

Caylee Clay, RDN CDN CYT — who is a dietitian-nutritionist specializing in psoriasis and other autoimmune diseases as well as the author of “Gain Control Over Your Psoriasis: A Science Based Treatment Plan using Lifestyle and Intuitive Eating” and the founder of Autoimmune Eats — said one remedy that she applies to her own psoriasis is to rub on a “glob” of Vicks Vaporub with a bit of apple cider vinegar and then wrap with Saran Wrap.

“This works because the menthol in Vicks is naturally antimicrobial and is known to accelerate wound healing,” she said. “Apple cider vinegar, with the mother, is both naturally antibacterial due to its acidity, plus it’s also a probiotic.”

According to Clay, psoriasis plaques have an altered microbiome. Combining these two products may help restore it to balance.

“Another popular home remedy for psoriasis is taking a bath with Epsom salt,” she added. You can also add a splash of apple cider vinegar or several drops of tea tree oil to your bath.

After soaking, Clay advises lightly rubbing your psoriasis patches with a washcloth to remove any thickened skin gently. Then, moisturize well.

Finally, she suggests that applying walnut oil, which is rich in anti-inflammatory omega-3 fatty acids, can help soothe your skin.

“A few minutes after applying it, add a moisturizer,” she concluded, “as walnut oil alone can be drying.”

Takeaway

In a recent interview, Kim Kardashian revealed that she uses Saran Wrap to help manage her psoriasis symptoms.

Experts say using occlusive therapies like Saran Wrap over your psoriasis medication can improve the treatment’s effectiveness by aiding its penetration into your skin.

Other popular home remedies recommended by psoriasis experts include fragrance-free moisturizers, colloidal oatmeal baths, sunlight exposure, Vicks VapoRub and vinegar, Epsom salt soaks, and walnut oil.

• While GLP-1 medications like Ozempic, Wegovy, and Zepbound can help with weight loss, they may also cause nutrient deficiencies.
• While taking a GLP-1 drug, it is important to consider getting adequate protein, vitamin B12, vitamin D, iron, and calcium.
• Experts share how to manage these deficiencies with diet and lifestyle changes.

Losing weight on GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound may increase your risk of developing nutrient deficiencies because these medications cause people to significantly reduce their food intake.

“If the reduced quantity they are eating is not nutrient-dense, then they may not get all the vitamins and minerals they need,” Rekha B. Kumar, MD, associate professor of clinical medicine at Cornell and Chief Medical Officer at Found, told Healthline.

Also, if you experience side effects from GLP-1 drugs, like vomiting or diarrhea, you may not absorb all the nutrients from the food you are consuming.

However, Tara Schmidt, lead dietitian for the Mayo Clinic Diet, said nutrient deficiencies develop over weeks or sometimes even months.

“Most deficiencies are likely to occur with long-term inadequate intake, such as an overly restrictive diet, malnutrition, or avoidance of entire food groups,” she told Healthline.

While there is still not enough data on nutrient deficiencies specific to people on GLP-1 drugs, experts say these are the five most common nutrient deficiencies people can experience and what they can do to avoid them.

Protein

Not consuming enough protein can lead to loss of lean body mass, weakness, edema, hair loss, and skin changes.

While recommendations vary by age, sex, exercise frequency, and health, the Dietary Guidelines for Americans recommends that most adults should consume around 50 grams of protein per day.

However, for people living with obesity who are on treatment to lose weight, such as those who have undergone bariatric surgery, their doctor may recommend as much as 60 to 75 g/day of protein.

Kumar encourages her patients who take GLP-1 medications to prioritize eating protein, healthy fats, and vegetables “because they will feel full easily and get their required nutrition.”

Foods high in protein include:

• Eggs
• Nuts
• Chicken breast
• Cottage cheese
• Greek yogurt
• Milk
• Lentils

Vitamin D

Vitamin D helps the body build and maintain strong bones. The recommended amount of Vitamin D for adults ages 19 to 70 years is 600 international units (IU).

If you’re not getting enough vitamin D, your body may show the following signs:

• Muscle pain
• Muscle weakness
• Fatigue
• Bone pain
• Tingly sensation in hands or feet

Some foods high in vitamin D include:

• Fatty fish, including trout, salmon, tuna, and mackerel
• Beef liver
• Egg yolks
• Cheese 
• Milk

Vitamin D helps the body absorb calcium.

Calcium

Calcium helps the body function in several ways, including allowing the muscles to move and nerves to communicate messages from the brain to the body.

It also helps blood vessels circulate blood and releases necessary hormones in the body. Adults need about 1,000mg to 1,2000 mg of calcium per day.

Foods high in calcium include milk, yogurt, and cheese.

“For those who wish to avoid dairy, tofu, soymilk, broccoli, some mushrooms, and fortified orange juice are other options, but do not all contain both nutrients,” said Schmidt.

Vitamin B12

Vitamin B12 helps keep blood and nerve cells healthy and helps make DNA. It also prevents anemia.

Some signs of a B12 deficiency include fatigue, headaches, pale or yellow skin, and difficulty concentrating.

Recommended amounts of B12 for adults is 2.4 micrograms (mcg).

Vitamin B12 is naturally found in meat, fish, poultry, eggs, and dairy.

“For those who follow a vegan diet, this can pose a challenge, so selecting fortified products like cereal, meat substitutes, and nutritional yeast can be helpful,” said Schmidt.

Iron

Iron helps the body grow and develop. It also helps the body make hemoglobin in red blood cells, which carry oxygen from the lungs to the body, as well as myoglobin, which provides oxygen to muscles. Iron also makes some hormones.

Adult men need 8mg of iron per day. Adult women need 18mg until they reach 51, and then 8mg after that.

Some signs of low iron include:

• Tiredness
• Weakness
• Shortness of breath
• Pale or yellow skin
• Rapid heartbeat
• Headaches
• Brittle nails

Sources of iron include:

• Clams and oysters
• Lean beef and poultry
• Legumes and lentils
• Whole grains
• Fortified breakfast cereals
• Spinach and kale

“Because iron from plants is not as well absorbed, it’s a good idea to pair the iron source with a source of vitamin C; think spinach salad with strawberries, a lean cut of beef with bell peppers, or iron-fortified cereal with melon,” said Schmidt.

Tips to avoid a nutrient deficiency while taking weight loss drugs

While taking a GLP-1 weight loss medication, consider the following tips to help ensure you get adequate nutrients.

Think about what you drink

Food and beverage choices should provide adequate calories, protein, and hydration in a smaller volume of food, “as overeating while on a GLP-1 may cause nausea or vomiting,” said Schmidt.

Adjust your food intake

When starting a GLP-1 or as the dose increases, Schmidt suggested eating soft, blended, or liquid meals to help tolerate symptoms. Consider overnight oats, smoothies, Greek yogurt, soft fruit, and protein shakes, which can provide protein, vitamins, minerals, fiber, and/or hydration.

Avoid empty calories

Foods and drinks that provide empty calories, meaning high calories with low nutritional value, should be avoided. These include items like sugary beverages, sweets, alcohol, and ultra-processed snack foods. “Intake of these items may replace nutrient-dense foods the body needs,” said Schmidt.

Take a multivitamin

Kumar said your doctor may recommend a multivitamin or supplemental. She sometimes recommends that her female patients take a prenatal or bariatric supplement if they have significantly reduced their food intake.

“If someone has reduced fluids and feels cramps, I encourage water intake and suggest a magnesium supplement,” she said.

Self-monitor your habits

Keeping track of habits like how well you hydrate, how much of nutrients like protein you’re consuming, how many calories you’re eating, and how much exercise you’re getting helps increase self-awareness and provides motivation for realistic change, said Schmidt.

Get help

If you think your diet may be inadequate, talk with your doctor and a registered dietitian about ways to ensure you get healthy amounts of nutrients.