• Lifestyle choices can either hinder or complement the effectiveness of GLP-1 weight loss drugs like Wegovy and Zepbound.
• Health experts say there are several research-backed strategies that may help improve weight loss results while taking GLP-1 drugs.
• These include getting regular exercise, reducing stress, eating a healthy diet, and prioritizing sleep. 

GLP-1 drugs like Wegovy and Zepbound have grown in popularity due to their ability to help people lose significant amounts of weight.

However, while these drugs are a useful tool for many people, they’re far from a “silver bullet” that guarantees you’ll shed pounds quickly or, in some cases, lose any weight at all.

Lifestyle choices can greatly impact the effectiveness of GLP-1 drugs for weight loss.

Experts say the following healthy habits can help increase the weight you may lose while taking these medications, as well as maintain the results long-term.

Exercise regularly 

It probably won’t come as much of a surprise that getting regular exercise is a great way to complement the effects of Wegovy and Zepbound. 

A common complaint about these drugs — and dramatic weight loss in general — is that they may cause you to lose muscle mass as well as fat. 

“Exercise will help you maintain your muscle mass and prevent muscle loss during weight loss,” said registered dietitian Kim Shapira. 

She explained that resistance training, specifically, is a great way to help protect against the loss of muscle mass and promote fat loss, which is essential for your metabolism and weight maintenance. 

Kristin Kirkpatrick, dietitian at Cleveland Clinic Department of Wellness and Preventive Medicine, points to a study published in 2021 that supports this idea. 

Researchers found muscle mass loss impacts metabolism, cardiovascular health, insulin sensitivity, and even mortality.

“This is also a critical factor if/when you choose to reduce the dose or stop the medication completely, as low muscle mass increases the risk of rapid weight gain,” Kirkpatrick says. 

Prioritize sleep 

Quality sleep might not immediately spring to mind when it comes to weight loss, but it may play a bigger role than you realize. 

Feeling tired and irritable can affect your ability to make healthy choices and, on a physical level, your ability to lose weight. 

“When a person doesn’t sleep well, meaning they have trouble falling asleep, staying asleep, or waking up feeling unrested, this increases the stress hormone cortisol,” Shapira says. “When cortisol levels are high, it changes the way we metabolize food and disrupts our hormone balance.” 

Research suggests that sufficient sleep is essential for maintaining a healthy weight. 

A study published in 2022 found that a pattern of sleep duration of less than six hours a night has been associated with a higher body mass index. 

The same study cites short sleep duration as a “significant risk factor for weight gain and obesity.” 

Eat a healthy diet 

While Wegovy and Zepbound can produce dramatic results, the importance of good nutrition should not be overlooked — particularly if you want to maintain weight loss long-term. 

GLP-1 medications help regulate the hormones that signal the brain that you’re hungry and help increase feelings of fullness so you’re more likely to eat smaller amounts of food.

That said, Shapira says it’s always best to eat a balanced diet full of fiber, vegetables, whole grains, and foods with omega-3 and protein. 

Consuming enough protein may be key to preventing weight regain if you decide to stop taking Wegovy or Zepbound. 

A 2021 review notes that diets with higher protein intake can provide significant benefits to prevent weight regain. 

For Kirkpatrick, making every bite count is key when you’re taking a GLP-1 drug. 

“GLP-1 agonist drugs reduce appetite and, consequently, the volume of food intake. A deficient volume of food may increase the risk of malnutrition, so getting a nutritional bang in every bite is critical,” she explains. 

Reduce stress 

Stress can also impact your ability to lose weight. 

“Just like lack of sleep, being stuck in a ‘fight or flight mode‘ increases our cortisol levels, which affects our metabolism, causing insulin resistance and disrupting our hormone health,” Shapira explains. 

Several studies have found an association between stress and obesity, including recent research published in January that suggests childhood stress may contribute to an increased risk of heart disease and obesity.

“It’s important to practice ways to regulate your nervous system, such as taking deep breaths often or spending some time meditating,” Shapira advises. 

Takeaway 

Drugs like Wegovy and Zepbound can trigger dramatic weight loss results. However, lifestyle choices can hinder or complement their effectiveness.

Health experts say that the best way to increase the effectiveness of GLP-1 weight loss drugs is with healthy strategies like regular exercise, stress reduction, and prioritizing quality nutrition. 

Implementing these lifestyle changes now may also help you maintain your weight loss results in the future.

Respiratory syncytial virus (RSV) is a major respiratory virus that is common over the winter period, typically November to February. While the symptoms are mild for many, RSV accounts for around 30,000 hospitalisations of children under 5 in the UK annually, and for 20 to 30 infant deaths. In this post, we look at the symptoms, risk factors and who is eligible for the vaccine.

• In states with strict abortion laws, many medical residents are unable to receive abortion training.
• Some medical students have left states such as these to obtain full-scope OB-GYN training, which includes abortion care and counseling.
• One healthcare professional in Louisiana faced this dilemma midway through her medical residency.
• After completing her residency, she left the state to pursue an OB-GYN practice in the Northeast, where abortions are permitted.

As states pass sweeping restrictions against abortion, it’s become increasingly clear these bans have far-reaching consequences.

Evidence has shown, for example, that abortion restrictions can push families into poverty, worsen pregnant people’s long-term physical and mental health, and cause increases in both maternal and infant deaths.

Less known, however, is the impact abortion bans have on the healthcare professionals who care for pregnant individuals.

A new report from the University of California San Francisco revealed that the fall of Roe v. Wade, which led to an influx of abortion restrictions in multiple states, has been particularly distressing for obstetrics and gynecology (OB-GYN) residents. 

Healthline spoke with one healthcare professional who can attest to this. Due to privacy concerns, this source’s name has been changed to Emily Green for the purpose of reporting and protecting her identity.

Green moved to Louisiana in 2020 for her OB-GYN residency at an academic hospital.

When considering hospitals to apply to, reproductive justice was at the forefront of her decision — she chose a program that would provide her with the training to be a full-scope OB-GYN.

“To me, that includes good training and solid foundation in contraception counseling, in abortion counseling, and in abortion training,” Green told Healthline. 

But in June 2022, Roe v. Wade was overturned, and Green, who was halfway through her residency, suddenly found herself smack in the middle of the country’s anti-abortion movement.

Green’s experiences, as detailed below, are her own opinions and not those of the larger institutions she’s been a part of.

How abortion bans changed medical residency programs

Even with Roe v. Wade in place, abortion was hard to come by in Louisiana — there were only three clinics in the state that offered elective abortion and strict laws in place that completely banned the procedure with few exceptions.

When the June 2022 Dobbs v. Jackson Women’s Health Organization decision revoked the constitutional right to abortion, Louisiana banned most types of abortion.

“I remember exactly where I was because I was scheduled to go on this rotation [for abortion training] in September of 2022,” Green said. 

That summer, multiple short-lived protections went into place to keep those three clinics running, causing a lot of back-and-forth about if and when Green would be able to do her training and whether or not her patients could access abortion services. 

“You’d tell patients, ‘You have these three options within the state, but tomorrow, I don’t know if they’re accepting new patients,’” Green, who worked with a primarily Medicaid and uninsured population, shared. 

There was the added concern of whether she was legally protected as a physician.

There was a lot of ambiguity regarding the new bans — of what was or was not permitted — and how well a hospital’s legal counsel could protect physicians.

She hustled to stay current with the rapidly changing legislation to ensure that her patients were getting the most accurate information. 

Watching this play out was heartbreaking for her.

“You come into this profession wanting to help people make decisions about their body and their life that feel safe and healthy for them, and then the ability to do so becomes really challenging,” Green said.

Green added that many of her patients already had a lot stacked against them, and seeing them further lose control of their bodies and decisions was very difficult. She said she felt helpless knowing she could not offer patients full-scope care.

Many people found scheduling an appointment, which may or may not happen due to changing laws and lengthy wait times, arranging child care, securing transportation, and managing finances overwhelming.

The new restrictions disproportionally affected birthing people of color and socially disadvantaged communities, Green said.

In medical school, Green read a lot of books about remote places in the United States where abortion was inaccessible.

“All of a sudden, it became very real. These stories were no longer just something you were reading about far away. This is what I was working with on a day-to-day basis,” she said. 

Residents scrambled to get abortion training 

Meanwhile, the clinic Green was slated to do her abortion training was shut down due to the state’s abortion ban.

Green specifically chose her program for the abortion training it offered — now, it was unclear if Green would get trained.

She struggled with the implications of being in a place where healthcare providers aren’t properly trained to offer abortion care. 

“Not only are you affecting women’s ability to access abortion now but it’s really affecting their ability to make their own reproductive decisions down the line,” Green said. 

Without proper training, future physicians might not understand how the procedure works and won’t be able to counsel women about evidence-based abortion care. 

“You start to lose generations of of people that have that skillset,” Green said.

This could create a situation where pregnant people resort to alternatives that aren’t as safe, she said.

Fortunately, Green’s program was affiliated with the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning (Ryan Program), which ensures OB-GYN residents get comprehensive contraception and abortion training regardless of where they live, which secured out-of-state abortion training for interested residents. 

In 2023, Green traveled to Massachusetts to complete abortion training.

Residents grapple with the decision to stay or leave 

Green, who recently wrapped up her residency, made the difficult decision to move to a state in the Northeast that has many abortion protections in place. 

Although she is looking forward to providing evidence-based reproductive healthcare to her patients, she said this decision has brought on a significant amount of moral distress.

If proponents of abortion care leave states like Louisiana, there might be more geographic areas where physicians lack the skillset to perform abortions or the interest and ability to support women through these challenging situations. 

Green said it’s hard to move away when you know you could offer a perspective or advice that could be comforting and life changing for females looking to terminate pregnancy. 

“The decision to leave in some ways feels like you’re abandoning a patient population you care a lot about and deserves access to this information,” Green said.

“I am so grateful and have so much respect for the people in my program who will stay and continue to make sure we can train in the way we need to and provide care in a safe way, especially in states like Louisiana where things are just so restricted,” she shared. 

Takeaway

In states with strict abortion laws, many medical residents are unable to receive full-scope reproductive training, which includes abortion care and counseling.

One healthcare professional in Louisiana faced this dilemma midway through her medical residency and ultimately left the state to pursue an OB-GYN practice where abortions are permitted.

The future of medical residency programs for aspiring OB-GYNs in states where abortions are banned or restricted remains uncertain.

• Intermittent fasting is an eating strategy that some research suggests could aid in weight loss.
• New research from the University of Illinois Chicago used data to debunk common myths about intermittent fasting.
• Dietitians say commonly believed claims about intermittent fasting often require more nuance. 

While some eating strategies, like the Mediterranean diet, have broad support, others remain the subject of scrutiny and, at times, conflicting (and inaccurate) information.

Researchers at the University of Chicago Illinois believe intermittent fasting is one of them.

In a new article published in Nature Reviews Endocrinology on June 19, they sought to debunk what they concluded are common “myths” about the eating plan. These myths include intermittent fasting’s role in causing unhealthy diets, eating disorders, affecting lean muscle mass, and fertility issues.

Even the term “intermittent fasting” is misleading, says one registered dietitian.

“The diet sounds like it involves fasting intermittently — at irregular intervals — but most protocols require you to fast regularly,” says Destini Moody, RD, a registered dietitian with Garage Gym Reviews.

The new report’s authors included research on two types of intermittent fasting: alternate-day (switching between days of consuming a limited number of calories and days of eating as they please) and time-restricted (eating as desired during a four—to 10-hour window).

While the authors who conducted the latest study concluded both types were safe and that four commonly held ideas were untrue, Healthline spoke with additional health experts to discuss the latest research.

They provided more nuance to better explain the researchers’ reasoning behind their conclusions and expanded on the latest science to help debunk 7 commonly believed myths about intermittent fasting.

Myth: Intermittent fasting affects sex hormones

The authors cited research, including a 2024 study of 90 adults living with obesity, that indicated intermittent fasting did not negatively affect sex hormones. The study also suggested that it may decrease testosterone and increase SHBG levels in people with PCOS, improving the condition.

On the latter point about PCOS, one dietitian says the new research is promising (but cautions it’s early).

“Preliminary findings on using intermittent fasting as a strategy for women with PCOS to regulate hyperandrogenism are promising,” says Allie Echeverria, MS, RD, LD. “Androgens are male sex hormones. Women naturally also have androgens, but women with hyperandrogenism have excessive levels.”

Generally, dietitians and research, including a 2021 review, indicate that calorie restriction that prompts under or malnutrition can harm fertility, specifically estrogen.

Moody says intermittent fasting’s effects on sex hormone levels are “contingent on the fact that the dieter is still taking care to eat sufficient calories within their eating window.”

Moody adds that a sign of undernutrition and eating disorders is the loss of a menstrual cycle, which can be detrimental to reproductive and overall health.

Overall, one dietitian calls the current evidence far from conclusive.

“it is very important to note that there is still very limited evidence on both female and male sex hormones being affected by intermittent fasting,” says Courtney Pelitera, MS, RD, CNSC, a registered dietitian with Top Nutrition Coaching. “Many of the trials completed have small sample sizes, often less than 100 people and during a shorter duration of time.” 

Myth: Intermittent fasting causes excessive muscle mass loss

Researchers cited studies that suggested that people lost the same amount of lean muscle mass regardless of whether they were fasting or following another diet. For instance, a 2022 meta-analysis of randomized trials compared people who restricted calories each day and those using intermittent fasting. The data suggested that 75% of weight loss could be chalked up to fat tissue, while the remaining 25% was lean mass, regardless of the diet strategy.

The new report’s authors added that resistance training and higher protein intake could help lower the odds of lean muscle mass loss. 

“Any healthy weight loss diet that provides adequate protein and strength training will help to preserve lean muscle mass,” says Pelitera.

Myth: Intermittent fasting will affect your diet quality

Authors suggest that intermittent fasting does not cause unhealthy diet quality. Authors cited one review of randomized control trials published in 2024 that indicated that intake of the following indicators of diet quality did not change in people adhering to shorter eating windows (4 to 6 hours) and longer ones (8 to 10 hours):

• Fiber
• Protein
• Cholesterol
• Total fat
• Carbohydrates
• Sugar
• Saturated fat
• Fiber
• Sodium
• Caffeine

What might this mean? It’s currently unclear, Moody says.

“If it means the person had a poor diet prior…then intermittent fasting is unlikely to make their diet worse — it simply changes the time period in which they consume their nutrient-poor diet,” Moody says.

“Furthermore, if the person’s diet is nutritious before IF, one could agree that starting fasting is unlikely to steer them toward poor diet choices,” she says. “While researchers are correct in debunking this myth, it must be stressed that those going into intermittent fasting with a poor diet can’t expect the practice of IF to improve diet quality on its own.”

Myth: Intermittent fasting can cause eating disorders

Of the four claims made by researchers, dietitians arguably stressed the need for the most caution with this one. 

Researchers cited a 2023 systemic review and a 2019 doctoral thesis. The latter followed 86 people for four weeks and suggested that intermittent fasting didn’t cause eating disorders.

The authors suggested that healthy adults who used intermittent fasting tended to report fewer food cravings, binge-eating behaviors, weight concerns, and anxiety about appearance. People with a history of eating disorders were screened out. The authors wrote — and the dietitians we spoke with also noted — that participants generally started from a low risk of developing one in the first place.

“Short-term studies suggesting intermittent fasting doesn’t cause eating disorders are limited in scope,” says Emily Van Eck, MS, RDN. “Eating disorders typically develop over longer periods than these studies cover. The study cited is only four weeks long.”

As for the reports of body image and weight concerns?

“[It] is hardly surprising,” Van Eck says. “The act of following a diet plan eases anxiety about food and body size. Many who later develop an eating disorder were able to stick with some — if not many — diets for a short term before their eating disorder developed.”

Myth: Intermittent fasting can “cure” type 2 diabetes

A 2023 randomized control trial suggested that intermittent fasting might help people with type 2 diabetes achieve remission, which goes against the idea that the disease is chronic and lifelong. However, Van Eck says more research is needed.

“The study mentioned here was only three months long and, therefore, does not provide any significant information about people’s ability to stick to this regimen long term or their ability to improve their blood sugar long term,” Van Eck says.

That said, doctors, health organizations, and dietitians generally agree that weight management is a crucial component of diabetes management (but there’s not enough conclusive evidence to support the idea that it’s a “cure”).

Additionally, IF has shown improvements in reducing insulting resistance and improving insulin sensitivity along with improving blood sugar parameters.

“We know that weight control and weight loss can help with the management of type 2 diabetes,” Pelitera says. “Intermittent fasting often leads to calorie restriction, which results in weight loss. As far as reversing the disease, there are many different things that would factor into this [and it is] far more complicated than a specific eating window. Quality of diet and increased [intake] of fruits and vegetables would be the first place to start. Adequate hydration, fiber, and consistent regular physical activity are going to play major roles as well.” 

Myth: Intermittent fasting can lead to long-term weight loss

A small randomized control trial of 90 people with obesity compared people who did not count calories but followed time-restricted eating from noon to 8 p.m. to a control group who ate for 10 or more hours per day.

Another group of people in the study restricted calories by 25%. Only 77 people completed the one-year study.

The data indicated that the time-restricted plan produced more weight loss than the control but was not more productive than restricting calories in a racially diverse group.

However, dietitians say that more than a one-year assessment period is needed to draw conclusions about the link between long-term weight loss and intermittent fasting. 

“The study cited is small and not very well designed, so one should take the findings with a grain of salt,” Moody says. “That said, it is very possible that IF can lead to long-term weight loss. However, this is the most likely if the fasting is accompanied by comprehensive nutrition education and the supervision/regular counseling of a registered dietitian.”

“If weight loss is to be sustained long term, knowing how to adjust one’s diet to prevent weight regain once IF ceases is critical,” she adds.

Myth: Intermittent fasting is safe for everyone

The new report concludes that intermittent fasting is generally safe, but dietitians emphasize the need for nuance.

Van Eck pointed out that intensive weight loss could increase the risk of all-cause or cardiovascular mortality in people with Type 2 diabetes. 

Moody and Pelitera also advised people living with type 1 or 2 diabetes to seek medical advice, regardless of the recent study that suggested that intermittent fasting could “reverse” type 2 diabetes.

“These patients were in a clinical setting under constant monitoring by scientists where safety could be assured,” Moody says. “Otherwise, dangerous lows in blood glucose and other medication-related dangers can occur.”

Moody also advises against following intermittent fasting if you are:

• Pregnant
• Lactating
• Under 18
• Take prescription medications that require regular food intake
• Have a history of eating disorders

Pelitera does not recommend IF to people with kidney disease or who have other conditions that require appropriate levels of specific nutrients, such as sodium, potassium, and phosphorus.

Takeaway

Intermittent fasting is a dietary plan that involves eating during specific windows.

Several myths are commonly believed about the safety and efficacy of intermittent fasting.

These myths included that intermittent fasting could cause adverse effects on sex hormones (and fertility), muscle mass loss, unhealthy diet, and eating disorders.

Intermittent fasting is not safe for everyone, including people with certain conditions or who are pregnant or lactating.

Intermittent fasting research is still limited and hasn’t been conducted in large populations over a long term. It’s wise to speak with a healthcare professional about whether this diet is best for you before beginning.

• A new survey finds that Americans fall prey to health-related misinformation on TikTok.
• 1 in 11 Americans had health issues after following advice from TikTok.
• Some people think platforms and influencers should be held responsible for posting health-related misinformation.

In 2020, friends and family of Katrine Wallace, PhD, epidemiologist and assistant professor at the University of Illinois Chicago, turned to her for answers about COVID-19.

To help inform and ease fears, she decided to create educational videos on social media.

“I would make a daily update, and my accounts were small at the time, mostly for family and friends. Those started getting shared with other people and before I knew it, my accounts got bigger,” Wallace told Healthline.

Today, her TikTok account has over 280,000 followers, and her Instagram has nearly 90,000. She continues to share public health information about COVID-19 and other health-related topics and debunks misinformation circulating on social media.

“There is a flood of bad information out there that is put out by people trying to sell stuff online, so I try to point people to the CDC or other sources made for lay people like their public health department,” said Wallace.

While she never imagined she would be an “influencer,” knowing that dangerous health misinformation and conspiracy theories exist on social media motivates her to continue to push back.

“I’m giving people the tools to have those conversations with their coworkers, with their family, with their uncle at Thanksgiving who thinks the vaccine has microchips in it,” she said. “Hopefully it has ripple effects and gets the message out there.”

56% of Gen Z users turn to TikTok for health and wellness advice

A new survey of 1,000 Gen Z users by the personal trainer app Zing Coach found that 56% of respondents go to TikTok for health and wellness advice, while for 1 in 3, TikTok is the main source of health knowledge.

“Gen Z isn’t exactly the picture of perfect health — more than half of 18- to 25-year-old Americans are overweight — but it’s not for a lack of desire. Zing’s research shows considerable interest in pursuing health and well-being among the younger demographic,” Walter Gjergja, Chief Wellness Officer at Zing Coach, told Healthline.

“They’re just not as willing or able to pay for a personal trainer or work with a qualified doctor. Instead, they turn to TikTok, Google, and YouTube for advice because it’s fast and free.”

By doing so, he said they expose themselves to misinformation and body confidence issues.

1 in 11 Americans had health issues after following advice from TikTok

Aaron B. Zimmerman, optometrist and associate professor of clinical optometry at The Ohio State University recently treated a patient who embraced a TikTok video that endorsed health benefits of staring at the sun.

“This individual viewed the sun for an extended period of time until it became unbearable, and she suffered permanent damage to her retinas,” he told Healthline. “I suspect that practitioners across disciplines are seeing patients that have experienced harm from questionable content on various forms of media.”

The Zing Coach survey found that 1 in 3 people admitted they don’t double-check the wellness advice they get from TikTok, while 1 in 10 said that a high number of likes or followers is enough to make the influencer trustworthy — regardless of their professional background.

“When we see an account with millions of followers and videos with an endless stream of positive comments from other users, our first thought is that the information shared must be true. However, likes and engagement are by no means an indication of an influencer’s trustworthiness,” said Gjergja.

Ultimately, for many influencers, what they push on social media is a means to a livelihood, and some spread misinformation if it pays well enough, he added.

Additionally, Wallace said the more sexy and compelling a video is, the more it’s going to spread.

“Conspiracy theories get millions of views because people think they have a secret the government doesn’t want them to know,” she said. “The algorithms work in a way that if you’re following people who put out misinformation, then you’re consistently getting bad information, and if you’re getting all your information from there then there is a big percentage of people who are not getting fact-based information.”

3 out of 5 people have seen health-related misinformation or harmful advice on TikTok, but only 1 in 4 call it out

Calling out a dishonest influencer is like screaming into the void, said Gjergja.

“You could leave a message calling out the misinformation. However, it will soon get buried under a stream of comments from loyal fans who staunchly believe everything social media’s popular personalities say,” he said.

The effort of reporting misinformation is often not worth it to people if they don’t think the platform will remove the video, added Wallace.

“There are videos I report that say the vaccine has HIV in it, and it will come back as it doesn’t violate community guidelines. I’ve even had anti-sematic things come back as not violating guidelines,” she said. “[Platforms] get paid whether it’s good or bad information.”

She points to Section 230 of the Communications Decency Act, legislation that passed in 1996, which declares that service providers or individual people are not to be held liable for illegal content posted online by other people.

“The way accountability can start is by changing that legislation because now we have very far outgrown it. It still enables the platforms to do nothing about misinformation,” said Wallace. “Platforms have no incentive to [take action] because they make money the more things go viral and the more they keep engagement going,” said Wallace.

63% of people want TikTok creators held legally accountable for the accuracy of their health advice

Holding people legally accountable for producing content and videos that contain misinformation is tricky because even though they know they are misleading or potentially harming others, they can claim their content is for entertainment reasons, said Wallace.

Banning material is a delicate issue that could violate the First Amendment, said Zimmerman.

“If people are harmed and there is strong evidence of malice by the content generator(s) then perhaps there are legal avenues that can be pursued,” he said.

However, he believes the best approach is for bad health information to be contradicted with evidence-based content produced by reputable individuals and organizations.

66% of Gen Z admitted they only trust health TikToks if they come from a professional

There are qualified experts on TikTok and other social media who aim to offer genuine, honest, and accurate health information.

When taking in medical advice or information, look for those with respected qualifications, such as an MD or PhD, and when taking fitness advice consider those with reputable certifications like those from the International Sports Sciences Association (ISSA) or the National Academy of Sports Medicine (NASM).

“But don’t just believe the words in a self-proclaimed expert’s bio. Whether by reading reviews from past customers, scouring their LinkedIn profiles, looking at their longevity and standing in the wellness industry, or checking a trustworthy directory for their claimed profession, you need to do your research and fact-check their claims before you follow any advice,” said Gjergja.

Consider what type of scientific data they are sharing or backing their claims with.

“When I’m talking about something, I always try to share an article that I’m referring to. I try to make sure that people know it is evidence-based from a reputable source; I’m not saying things with no data to back it up,” said Wallace.

Always check with your doctor before acting on any health advice from people on social media, even if they appear reputable.

• People who delayed the onset of type 2 diabetes for 4 years or more had a lower long-term risk of death and diabetes complications.
• Participants in the study were all diagnosed with prediabetes and elevated blood sugar not high enough to be considered type 2 diabetes.
• Lifestyle programs of healthy diet and physical activity have been shown to reduce the risk of developing type 2 diabetes.

People with prediabetes who were able to delay the onset of type 2 diabetes for 4 years or more through healthy diet and exercise had a lower long-term risk of death and diabetes complications, a new study shows.

Prediabetes means your blood sugar level is higher than normal but not high enough to be considered type 2 diabetes. It is sometimes known as impaired glucose tolerance or borderline diabetes.

“This study underscores the importance of efforts to improve health and reduce the risk for diabetes because that will make a big difference later on,” said Peter Senior, PhD, director of the Alberta Diabetes Institute at the University of Alberta.

“There’s a big difference between getting diabetes at the age of 85 and getting it at 45,” he told Healthline. “If you get it at 45, you could be looking at a lot of years of life lost.”

Senior was not involved in the new study, which was published July 9 in PLoS Medicine. 

Delaying diabetes gives long-term health benefits

In the new study, researchers examined health outcomes for 540 people with prediabetes who participated in an earlier study conducted in China known as the Da Qing Diabetes Prevention Study.

In this study, people were randomly assigned to a control group or to one of three intervention groups. The intervention groups involved a 6-year program of healthy eating, regular exercise, or both. Researchers followed participants for an average of 30 years after the interventions.

In the new analysis, researchers found that people who delayed their diabetes diagnosis for at least four years after their initial prediabetes diagnosis had a lower risk of dying from any cause or from having a cardiovascular event such as coronary heart disease, stroke, or heart failure.

They also had a lower risk of diabetes-related eye, kidney, or nerve problems when compared to people who developed diabetes at an earlier age.

In addition, people who delayed their diabetes diagnosis for at least 6 years had a lower risk of dying due to cardiovascular disease compared to those who were diagnosed with diabetes earlier.

There was no protective effect for people who delayed their diabetes diagnosis for fewer than 4 years.

“This suggests that a longer diabetes-free time may lower the risk of long-term adverse outcomes,” the authors wrote in the paper. “Taking action, including but not limited to lifestyle intervention, to prolong the diabetes-free time in people with prediabetes may be crucial.”

Healthy eating and physical activity lowered diabetes risk

Senior pointed out that the original Da Qing study and the U.S. National Diabetes Prevention program both showed that it is possible to prevent people from developing diabetes.

The National Diabetes Prevention Program is a lifestyle change program that focuses on healthy eating and physical activity. Research showed that people with prediabetes who joined this program reduced their risk of developing type 2 diabetes by 58%.

“We’ve also learned over the years that if you have diabetes and you’re able to keep your blood sugars in target, that that’s going to be beneficial over the long run,” said Senior.

So, “if you have someone who has diabetes and you work with them intensively, even if it’s just for 5 or 10 years, that will set them up for better long-term health decades later, compared to those who are left to fend for themselves.”

However, if you delay getting your blood sugar under control, you may not see the same kind of long-term health benefits as someone who started earlier.

Senior compares it to saving for retirement, where it’s best to start setting aside money when you are 20 rather than waiting until you’re 50. Only in this case, you are accumulating health benefits.

The new study, he said, extends this thinking to earlier, before people get diabetes.

“If we intervene with lifestyle changes, that means a person’s diabetes is delayed,” he said. “And even if you do develop diabetes later, you’re still going to be at an advantage over people whose diabetes came on much sooner.”

Type 2 diabetes is a complex disease

The new study included people who had prediabetes, so they had a higher risk of developing type 2 diabetes.

One public health approach would be to identify people like this who are at higher risk of diabetes and focus intensive interventions on them. This is the approach used by the National Diabetes Prevention Program.

“But if the intervention is healthy eating and healthy lifestyle, there’s no harm in those,” said Senior. “So let’s recommend them for everybody, maybe with extra coaching for those who are at highest risk [of diabetes].”

Although healthy eating and regular exercise can lower the risk of developing type 2 diabetes, Senior cautioned against seeing diabetes solely as a “lifestyle disease.”

“Behaviors, lifestyle, and the situations people find themselves in will all impact the age at which they get diabetes,” he said. 

But genetics also play an important role in the development of diabetes.

“There are people who are destined to get diabetes no matter what,” he said. “In their case, it may be more about delaying diabetes until later in life, and that’s still very worthwhile.”

Still, “there’s a real risk that we could reinforce stigma about diabetes,” he said. “If somebody gets diabetes, they could be criticized for eating the wrong foods or not doing enough of the right thing.”

But “that misunderstands the nature of diabetes,” he said. “There will be people who get diabetes who have been really careful with their lifestyle but got diabetes because of their genetics.”

Takeaway

Researchers looked at health outcomes for people with prediabetes who participated in an earlier study comparing lifestyle interventions — healthy eating, exercise, or both — to no intervention.

People who delayed the onset of diabetes by 4 years or more had a lower risk of dying from any cause or from having a cardiovascular event such as coronary heart disease, stroke, or heart failure. They also had a lower risk of diabetes-related eye, kidney, or nerve problems.

Other research has shown that lifestyle programs such as healthy eating and physical activity can reduce a person’s risk of developing type 2 diabetes. However, genetics also play a role in whether someone develops diabetes.

• More than 800 Walmart stores in the United States now carry topical CBD products.
• Cannabidiol or CBD is a non-psychoactive chemical found in cannabis that may help with a variety of conditions including inflammation, pain, and anxiety.
• There is some scientific evidence to support the therapeutic benefits of CBD.

More than 800 Walmart stores across five states will now carry CBD products on their shelves.

Charlotte’s Web, one of the biggest names in cannabidiol (CBD) and other hemp-derived botanical products, announced that some of their products are now available in select Walmart stores as of June 26.

In total, 827 stores in Texas, Pennsylvania, California, Illinois, and Florida began stocking a handful of CBD topicals from Charlotte’s Web, including a balm stick, cream, and cooling gel — all of which contain 1,000mg of concentrated CBD isolate.

CBD is a non-psychoactive chemical component of marijuana that is touted for a wide variety of conditions, including inflammation, chronic pain, insomnia, and anxiety.

However, it has only ever been approved by the FDA for epilepsy.  Even so, CBD has become more and more pervasive in recent years, showing up in products from sodas and gummies to lotions and oils. 

CBD topicals may help with pain, inflammation, and other skin conditions.

“We are proud to introduce CBD topicals at Walmart, reflecting Charlotte’s Web’s dedication to setting new standards of excellence in the CBD industry, ensuring every Walmart shopper can experience the transformative benefits of our meticulously crafted products,” said Bill Morachnick, CEO of Charlotte’s Web, in a statement.

Wesley Raup-Konsavage, PhD, an Assistant Professor of Pharmacology at Penn State University who has extensively researched CBD and other cannabinoids, told Healthline, “Given the widespread availability of CBD products, it was really only a matter of time until a large chain started selling these products.”

Despite their popularity and anecdotal reports of therapeutic effects, experts contacted by Healthline said that the data is still unclear for many of the claims made about CBD.

“It is important to note that, in many ways, the public is getting ahead of the science. We still do not have good data to support the use of CBD or other cannabinoids for treating conditions outside of a few select areas,” said Raup-Konsavage.

Is topical CBD effective for muscle soreness?

Topical CBD products, including lotions, balms, and sticks, are popular because they may help mitigate inflammation and muscle soreness; they’re often marketed for post-exercise relief.

CBD is also generally considered safe.

However, topical CBD products are some of the least studied, so it’s unclear what, if any, therapeutic effects they might have. Most research has been conducted on CBD that is consumed orally. Available studies on topical CBD and muscle soreness are small.

“Little research has been done on the topical delivery of CBD; however, this does have potential to be of benefit for joint pain and other forms of local pain,” said Raup-Konsavage.

A 2023 study involving 21 college-age participants found that topical CBD did not improve muscle soreness. A randomized, double-blinded, placebo-controlled study (considered the “gold standard”) involving 28 participants that was published this month also found that CBD did not impact muscle recovery and soreness.

“For many people, transdermal delivery isn’t that effective a way to get the active ingredient into the body,” Paul Armentano, the Deputy Director of the National Organization for the Reform of Marijuana Laws (NORML), told Healthline.

Drugs are metabolized by the body in different ways, so the “route of administration, or how you take them, matters. With a wide variety of CBD products on the market that can be consumed in different ways, from drinks to vapes to lotions, it is hard to be certain if the dose you are getting is the same as what is printed on the label.

“CBD itself is therapeutic in a number of different ways. That doesn’t mean a shot of CBD in your espresso is therapeutic,” said Armentano.

The science behind the health benefits of CBD

Although CBD topicals might not have the best track record, CBD does have scientific backing for other health conditions.

Currently, there is only one FDA-approved drug containing CBD, Epidiolex, which is indicated for seizures associated with two rare but severe forms of epilepsy.

In the United Kingdom and some European countries, Sativex, which is derived from both THC (a psychoactive chemical found in cannabis) and CBD, is approved for multiple sclerosis-related spasticity, which is when an individual’s muscles may feel stiff and rigid or spasm uncontrollably. Sativex is not approved or legal in the United States.

Outside of the narrow FDA approval, CBD may help with conditions including inflammation, chronic pain, anxiety, and insomnia. The strength of the scientific evidence for these conditions varies.

“The anti-inflammatory and analgesic activities of CBD are the most widely researched, and there is some good evidence that CBD can be an effective treatment. There is some evidence that CBD may reduce anxiety as well, although these data are far more limited,” said Raup-Konsavage.

Is CBD legal?

In 2018, the US government effectively legalized many CBD products through legislation known as the “Farm Bill.” The bill allows for cannabis or hemp plants to be grown legally so long as they do not contain more than 0.3% THC.

In reality, CBD products are still in a legal gray area that can vary from state to state.

“If the CBD in question is derived from a plant that the federal law classifies as hemp…then that end product containing the CBD is considered a federally legal product. If the CBD was sourced from a plant that contained a greater amount of THC than three-tenths of 1%, then that end product would not be considered to be a legal product,” said Armentano.

The CBD market is also generally unregulated so long as manufacturers do not make therapeutic claims about the product. 

“We don’t know a whole lot about how these products are produced. There’s not a whole lot of oversight with regard to the consistency of the product from batch to batch, or their purity, or their labeling, or even the marketing,” said Armentano.

The bottom line

More than 800 Walmart stores across five US states are now carrying a variety of topical CBD products.

Cannabidiol, or CBD, is a non-psychoactive chemical found in cannabis that is believed to have therapeutic properties.

CBD is only FDA-approved for the treatment of seizures. There is some scientific evidence to support the use of CBD for other conditions, including inflammation, pain, and anxiety.

In this blog post, Jenny, from Hampshire, shares the story of her daughter Layla and her struggle with whooping cough at 3 weeks old.

• Two classes of diabetes drugs may also improve cardiovascular and kidney disease outcomes in people with or without diabetes.
• In a meta-analysis involving more than 70,000 patients with diabetes, SGLT2 inhibitors reduced the risk of heart attack, stroke, and kidney disease progression.
• When paired with a GLP-1 drug, the benefit increased.

Two classes of diabetes drugs show health benefits far beyond improving blood sugar. When used together, their effects are even more evident.

For individuals with type 2 diabetes, SGLT2 inhibitors lower blood sugar by preventing the kidneys from reabsorbing glucose; the excess sugar is instead excreted through urine. But they do more than that. Large trials suggest that SGLT2 inhibitors reduce the risk of kidney disease, heart attack, and stroke not only in patients with type 2 diabetes, but also, those without.

If you’ve been following the trajectory of another well-known class of diabetes drugs, this might sound familiar.

The health benefits of GLP-1 drugs, the class of diabetes and obesity medications that includes Ozempic, Wegovy, Mounjaro, and Zepbound, have also grown to include improving outcomes for cardiovascular disease, heart failure, and chronic kidney disease.

New research published this week in The Lancet Diabetes & Endocrinology now indicates that both classes of drugs used together may yield even more protective benefits than individually.

“What we found was clear and additional benefits of SGLT2 inhibitors when used in combination with GLP-1 receptor agonists, benefits on cardiovascular disease, benefits on kidney disease progression, and also no increased risk of side effects or safety issues when used in combination,” Brendon Neuen, PhD, a Clinical Associate Professor of Medicine at Royal North Shore Hospital in Sydney, Australia, and co-author of the study told Healthline.

Robert A. Gabbay, MD, PhD, Chief Scientific and Medical Officer for the American Diabetes Association, lauded the study, saying, “This adds to the growing body of evidence showing the benefit of these two important classes of medicines and that their benefits can be additive.”

Gabbay and the ADA were not involved in the research.

Kidney and CVD benefits of SGLT2 inhibitors

Neuen and his team conducted a meta-analysis of 12 randomized, double-blind, placebo-controlled trials — the “gold standard” for research trials. The analysis included data from more than 70,000 patients with diabetes. A small cohort of those patients, about 3,000 (4.2%), were being prescribed a GLP-1.

The researchers were curious whether or not the cardiovascular and kidney protective effects of the SGLT2 inhibitors would persist across the available data, and how the addition of a GLP-1 would alter those effects.

Not only did the protective benefits of the SGLT2s persist with or without the presence of a GLP-1, but when the two were paired, the benefits were even greater.

The study examined a myriad of serious health issues that are known comorbidities of type 2 diabetes. These outcomes include the risk of major cardiovascular events (heart attack and stroke), hospitalization for heart failure, or death from cardiovascular disease.

Chronic kidney disease progression was also explored, which the team defined as a 40% or more decline in eGFR (a standard measurement of kidney functioning), kidney failure, or death due to kidney functioning.

Compared to a placebo, an SGLT2 by itself reduced the risk of heart attack and stroke by 11% and hospitalization for heart failure or cardiovascular death by 23%. The effects on kidney disease progression were even more pronounced: an SGLT2 yielded a reduced risk of 33% compared to a placebo.

For each outcome, the addition of a GLP-1 resulted in an additional small reduction in risk. For cardiovascular disease-related hospitalizations and kidney disease progression, a GLP-1 further reduced risk by about 2%. For major cardiovascular events, a GLP-1 nearly doubled the protective effects, reducing risk by an additional 10%.

Safety and tolerability were also consistent when an SGLT2 was used individually or paired with a GLP-1, meaning there was not an increased number of adverse events when the drugs were used together.

“These data provide the strongest evidence that we have yet that using these two medications in combination is not only safe but highly effective and is likely to improve clinical outcomes for people with type 2 diabetes who have cardiovascular kidney disease,” said Neuen.

A new era of diabetes management

The study is likely to grab the attention of doctors and healthcare organizations who are still evaluating and creating guidelines for these two relatively novel classes of drugs. The FDA  first approved SGLT2 inhibitor, Invokana (canagliflozin), in 2013. GLP-1 drugs have been available for nearly 20 years, but have only recently taken the industry by storm due to blockbuster drugs like Ozempic and Zepbound capturing the attention of the public.

“In the new era of diabetes management where we have available medications such as GLP-1 receptor agonists and SGLT2 inhibitors, the goal is to understand which patient could benefit most from which treatment or treatment combination,” Mona Mashayekhi, MD, PhD, an Assistant Professor of Medicine in Diabetes, Endocrinology and Metabolism at the Vanderbilt University Medical Center who wasn’t affiliated with the study, told Healthline.

For patients with type 2 diabetes who are at risk for or already have comorbidities like kidney disease, heart failure, or cardiovascular disease, it appears there is a new world of potential in these drugs. Even for patients without diabetes, the benefits of GLP-1s and SGLT2s are a promising development.

“These medications are now recommended in people with heart failure and kidney disease, even if they do not have diabetes, because they have clear and important, clinically important benefits in preventing kidney failure and heart failure outcomes,” said Neuen.

The bottom line

In a meta-analysis involving more than 70,000 patients with diabetes, SGLT2 inhibitors improved outcomes for cardiovascular events like heart attack and stroke, hospitalizations, and kidney disease progression.

When an SGLT2 inhibitor was paired with a GLP-1 (the class of drugs that includes Ozempic and Mounjaro), there was an even greater reduction without any additional safety issues.

Experts told Healthline that the findings will help to better inform doctors about treating patients with certain comorbidities, including kidney disease and heart disease.

• A new report found that a common screening technique used to assess the risk of endometrial cancer may be less effective in Black people.
• Pelvic transvaginal ultrasonography misses a significant percentage of cancer risk cases in Black females.
• The most accurate way to detect endometrial cancer in Black females is through a tissue biopsy.

A new report found that a common screening technique used to assess the risk of endometrial cancer (EC) may be less effective in Black people.

The study, published in JAMA Oncology in June, discovered that pelvic transvaginal ultrasonography (TVUS) led to false negatives in a portion of Black females who actually had EC.

TVUS, which uses sound waves to produce a picture of the inside of the pelvis, is routinely recommended to females experiencing postmenopausal bleeding, which is a symptom of EC. 

If the TVUS reveals that the individual has a thicker endometrial thickness (ET), they should also get a tissue biopsy to screen for EC.

Some Black females with EC have a relatively thin endometrial thickness — as a result, they don’t get a biopsy, and the cancer is missed. 

With EC, early detection is crucial. 

“Since we know that ultrasound assessment is not always accurate in Black women, other screening modalities are essential for early cancer detection, including symptom awareness and advocacy,” Elena Ratner, MD, MBA, a gynecologic oncologist at Yale Cancer Center and Smilow Cancer Hospital, told Healthline. 

Many cancers were missed on ultrasounds in Black females

The report evaluated the health data of 1,494 Black individuals who underwent pelvic ultrasonography with an ET measurement before a hysterectomy.

Of the group, 210 had EC. In addition, 78% had fibroids, 71% had vaginal bleeding, and 57% had pelvic pain. 

Of the 210 who had EC, about 11% had an ET that was below the diagnostic threshold for detection (4 mm).

The study found that roughly 9.5% of cancers detected in Black females were detected below the threshold of 4 mm, and 3.8% were in people who had an ET less than 3 mm. 

An estimated 11.5% of the cancers would have been missed because the people had a relatively thin ET.

The findings suggest the most accurate way to identify EC in Black females is through a tissue biopsy.

Diana Pearre, MD, a board certified gynecologic oncologist at The Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center in Burbank, CA, says that the lead researcher of the study, Dr. Kemi Doll, has significantly added to the scant research that’s been done surrounding health inequities in the diagnosis and treatment of endometrial cancer. 

“The main takeaway I believe she wants us to understand is that we cannot rely simply on the image we see on an ultrasound report to determine whether to biopsy a patient with postmenopausal bleeding,” Pearre said.

Why TVUS may be less reliable for detecting cancer in Black people

In many patient populations, TVUS is an effective way to measure ET and provide a risk assessment for EC.

“It is often used to determine whether patients should get a biopsy of the internal lining of the uterus and make sure there are no cancerous or precancerous changes in the lining,” Amer Karam, MD, a gynecologic surgeon with Stanford Medicine, says.

However, the procedure doesn’t appear to be as reliable in Black females. 

Prior research has shown that Black females with postmenopausal bleeding are less likely to get an endometrial biopsy. 

A study published in 2019 revealed that Black females are more likely to get false negative transvaginal ultrasounds compared to white females. 

“In publications, ultrasound findings of being below a certain endometrial thickness threshold rule out the possibility of endometrial cancer. In Black women, that does not appear to be the case,” Ratner said.

According to Karam, the majority of studies examining the accuracy of TVUS have been conducted in mostly white patients.

The researchers of the new report suspect that the decreased visibility of the cancers in Black females and the increased prevalence of fibroids may make the cancer harder to detect via TVUS alone.

“One other factor not examined in the current study is the higher prevalence of aggressive types of endometrial cancer that present with thinner linings among Black patients,” Karam said.

Biopsies can help detect a greater percentage of cancers

Pearre suspects that many physicians will be surprised to see these new findings.

“I hope they take this study into account and refer patients to gynecologists when they report bleeding regardless of how thick the inner lining of their uterus is,” Pearre said.

The researchers suggest that a tissue biopsy should always be done to provide an accurate diagnosis of EC.

According to Pearre, endometrial sampling is the cornerstone of EC diagnosis.

“If a patient reports bleeding after menopause or even heavy bleeding prior to menopause, endometrial sampling is probably the next best strategy in their workup,” Pearre said.

The bottom line:

A new report found that a common screening technique used to detect endometrial cancer risk may be less effective in Black people.

Pelvic transvaginal ultrasonography misses a significant percentage of cancer risk cases in Black females.

The most accurate way to detect endometrial cancer in Black females is through a tissue biopsy.