• Stressing out about finding ways to relax can increase anxiety, leading to feeling “stresslaxed.”
• Health experts say there are several ways you can avoid or overcome feeling “stresslaxed.”
• Chronic stress can increase a number of health risks, including high blood pressure, heart attack, and stroke.

Recognizing you are stressed and need to relax is a good step toward helping yourself.

However, when finding ways to de-stress adds more stress to your life, you may end up feeling “stresslaxed,” a counterproductive effect that can lead to a vicious cycle of increased anxiety and worry.

“This term refers to the phenomena or experience of people who are in an anxious or stressed state trying to calm down and feel more relaxed by forcing themselves to take a break or unwind,” Dr. Michael Schirripa, psychiatrist, podcast host, and author of the upcoming novel Mindhunt, told Healthline.

When people force themselves to relax, they can become more anxious, and they may worry more about how well or efficiently they are actually able to relax.

The clinical term for “stresslaxed” is relaxation-induced anxiety, said Deborah Serani, Psy.D., professor at Adelphi University and author of the award-winning book, “Living with Depression.”

“Research suggests that if you already struggle with generalized anxiety or overthinking, you may be more prone to stresslaxing. Other evidence says individuals with stresslaxing struggles may also experience panic attacks in addition to their stress and anxiety. And then there are others who may become depressed because they can’t relax freely,” she told Healthline.

Does the brain resist forced relaxation?

In many ways, the brain resists forced relaxation, particularly the part of the brain called the amygdala, which is always searching for danger.

“We need to remember that our brains are always ‘on’ and are actually designed to be worried. After all, that anxiety can keep us alive as we are always aware of potential dangers that may threaten us,” Schirripa said.

People who live with anxiety, worry, and ruminations have difficulties with cognitive control, meaning they find it hard to put certain thoughts “on hold,” said Serani.

“Along a different line, there are some people who may need to stay busy because subconsciously, being calm, having space, and experiencing ease may give rise to negative thoughts or memories of traumatic experiences,” she added.

Why is it hard for some people to relax?

Schirripa said people find it difficult to relax due to external pressures and internal dynamics.

External pressures, such as work, study, family, and other commitments, can make people feel like they are constantly “switched on” to the outside world and are at the beck and call of others.

“They can then feel obligated to meet the demands of these outside influences, and as such, this can lead to a perception that they are not allowed to actually have any downtime or a space to relax that is just for themselves,” Schirripa said.

Serani noted that work time and leisure time no longer have definitive boundaries.

“Long ago, the workday ended at 5 pm and the weekends were for rest and relaxation, and on Sundays, stores were closed, which helped to make home time and relaxation easier to do. These predictable guidelines just don’t exist anymore,” she said.

Furthermore, technology, access, and other modern conveniences have blurred the lines of work and play, leading to what sociologist Dalton Conley of Princeton University coined “Weisure” (the merging of work and leisure activities).

“So, it becomes very hard to carve out relaxation time,” Serani said.

Internal dynamics that affect the ability to relax include feeling the drive to keep active and not giving oneself permission to slow down and relax.

“Sometimes people worry that if they are relaxed, that they will be bored or, alternatively, by slowing down and relaxing, there can be a fear that they will need to focus too much on the thoughts or feelings going on inside them,” said Schirripa.

Are there long-term consequences of not being able to properly relax?

Chronic stress has been connected to high blood pressure, which can lead to heart attacks and strokes, fatigue, ulcers, headaches, backaches, difficulty concentrating, and irritability.

“Depression and anxiety can surge, as can social, relational, and interpersonal difficulties when you don’t stop and smell the roses,” said Serani.

Not being able to properly switch off and relax can “reset” the nervous system to function at an overly stimulated level, added Natalie Christine Dattilo, PhD, clinical psychologist, founder of Priority Wellness, and instructor at Harvard Medical School.

“Over time, this can make it more difficult to elicit a relaxation response,” she told Healthline. “I meet with people who tell me they feel agitated, on edge, and anxious ‘from the neck down,’ but don’t describe feeling mentally anxious at all…which for me is an indication that we need to actively reset their default activation state through intentional relaxation practice.”

Strategies to help you relax

When trying to relax, Dattilo said first realize that relaxation is not as passive an activity as people have been led to believe, and it doesn’t come naturally to some people.

“I think one of the main reasons some people find it hard to relax is because it’s actually a skill we need to practice on a regular basis in order to fully experience its beneficial effects,” said Dattilo.

Often, people confuse relaxation with “zoning out.”

“This can certainly give our brain a break, but the real goal of relaxation is to ‘downshift’ our nervous system,” Dattilo said.

Downshifting happens through an active process designed to elicit the “relaxation response,” the physiological opposite of the fight-or-flight response.

“It counteracts the negative effects of stress and returns our nervous system to a homeostatic balance,” she said. 

Triggering the relaxation response can be done through visualization, muscle relaxation, massage, breathing techniques, meditation, prayer, and yoga.

Try the following tips to set relaxation in motion.

• Set boundaries between work and home life. “Also, consider powering down from technology early each night. Make self-care a priority and learn how to manage this every day,” said Serani.
• Practice the Benson Relaxation Method, which involves sitting in a comfortable position, closing your eyes, intentionally relaxing all the muscles, beginning at your feet and working up to your head, breathing slowly, for 20 minutes. “This will likely feel a little challenging or forced at first, so maybe start with 5 minutes and gradually work your way up,” said Dattilo.
• Focus on a “done” list to recall what you’ve already accomplished. “Thinking about the to-do list perches you in the future, keeping you from being in the moment,” said Serani. “Highlighting your done list will aid in celebrating your finished chores and encourage relaxation. A done list helps you linger in the past.”
• Engage in 5-minute meditation. “Studies show that even 5 minutes of deep breathing, silence, and restfulness can enhance mental and physical functioning,” Serani said. If you can go for more time meditating, consider a guided meditation with an app, or simply rest, nap, or enjoy some solitude, she said.
• Feed your senses and ground yourself by using the “5,4,3,2,1 Technique” to reduce anxiety so you can relax more readily. “Ask yourself to find 5 things you can see, 3 things you can hear, 4 things you can touch, 2 things you can smell, and 1 thing you can taste,” said Serani.

• Many Americans 60 years and older still take aspirin for the primary prevention of cardiovascular disease, even though guidelines have changed.
• Aspirin can put individuals at an increased risk of bleeding and anemia and is not right for everyone.
• In the last five years, guidelines for aspirin and primary CVD prevention have shifted, but many Americans still appear unaware of them.

Older adults are still likely to take a daily, low dose aspirin for the primary prevention of cardiovascular disease, even though doing so carries significant risks.

Using aspirin to ward off heart attack and stroke used to be a no-brainer. Doctors previously recommended it for both primary and secondary prevention of cardiovascular disease.

However, following the results of three major aspirin trials in 2018, guidance around aspirin has shifted. It is generally no longer recommended for individuals who have not had a heart attack or stroke. However, it is still recommended for patients who have already experienced a cardiovascular event and are trying to prevent another from occurring.

Aspirin no longer carries a blanket recommendation because of the potential risks it carries, particularly bleeding risk and anemia. 

Both the American Heart Association and the United States Preventive Services Taskforce have changed their guidelines in recent years to indicate that aspirin isn’t right for all patients and does carry risks. Despite these changes, new data reveals that many Americans who should not be taking daily aspirin still are, particularly those at the highest risk for harm.

In a research letter published in the Annals of Internal Medicine, researchers found that 18.5 million Americans aged 60 or older, about one in three, were still using aspirin for primary prevention of CVD. Many of them, about 3.3 million, were doing so without medical advice.

“This practice was supported by evidence prior to 2018. It naturally takes some time for new data to percolate and reach physicians and patients and for these to translate into changes in management. Potentially, there may also be a component of lack of awareness and hesitancy to change medical management,” Mohak Gupta, MD, a Cardiology Fellow at Houston Methodist Hospital and First Author of the letter, told Healthline.

Older Americans continue to take aspirin

Gupta’s research utilized self-reported health data between 2012 and 2021. The sample of 186,425 American adults is a snapshot of the US population, representative of roughly 150 million people. More than half the participants were women, and about one-third were non-white.

Compared to ten years ago, fewer adults are using aspirin for the primary prevention of CVD, but the number is still high. The number of adults without CVD who reported using aspirin was 14.4%, down from 20.6% in 2021.

However, when stratified by age, a different picture emerges: for adults 70 and older, 38% are still using aspirin. That’s important because bleeding risks become more prominent with age.

“The older adults are the most vulnerable since they are at higher risk of bleeding. They take more medications, and that can have more drug interactions with aspirin potentially causing more risk of bleeding,” Parul M. Goyal, MD, an Associate Professor of Medicine and Director of Medicine for Seniors at Vanderbilt University Medical Center who wasn’t affiliated with the study, told Healthline.

The study authors write that their findings have real-world implications: despite changing regulations, there is a disparity or knowledge gap about these changes among patients, particularly older ones. Patients and healthcare providers must have serious conversations about the risks and benefits of daily aspirin use.

“Doctors should engage in risk-benefit discussions with patients using aspirin for primary prevention, especially for adults 60 years of age and older, and discontinue aspirin where appropriate– such as in older patients, those at high bleeding risk,” said Gupta.

Why recommendations for daily aspirin use have changed

A trio of studies in 2018 represented a seismic shift in the perception of aspirin for primary CVD prevention. Those studies, the ASCEND trial, the ASPREE trial, and the ARRIVE trial, looked at the risks and benefits of aspirin in different patient populations, including those with diabetes and the elderly. The trials highlighted the potential danger of bleeding events, especially in otherwise healthy individuals, and helped to reshape aspirin recommendations.

In 2019, the American Heart Association issued updated recommendations for aspirin, indicating that while aspirin is still “well established” for secondary prevention of CVD, using it for primary prevention is “controversial.”

Three years later, in 2022, the United States Preventive Services Taskforce updated its own recommendations from 2016. 

“The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults 60 years or older,” said the statement.

“When we’re talking about primary prevention patients, there’s a little bit more risk-benefit consideration. Are we more likely to prevent that first heart attack or stroke, or are we more likely to actually cause a major bleeding episode using aspirin?” Donald Lloyd-Jones, MD, past President of the American Heart Association and Professor of Preventive Medicine at Northwestern University’s Feinberg School of Medicine, told Healthline.

“In secondary prevention, it’s crystal clear: you should be on aspirin, period,” he added.

Aspirin and bleeding risk: what to know

Aspirin is a blood-thinner, meaning that it has anticoagulant or antiplatelet properties, which make it difficult for blood to clot. These properties are useful for preventing heart attack and stroke but can cause other health issues, namely increased bleeding risk.

“The kind of bleeding that led to the change in guidelines was all kinds of bleeding. So it is falling and hitting your head, but it’s a lot of spontaneous bleeding in the stomach,” Eleanor Levin, MD, a Clinical Professor of Cardiovascular Medicine at Stanford Medicine, told Healthline.

For older adults, falling can be a serious health concern. When combined with an increased bleeding risk due to aspirin, you have a potentially fatal mixture.

“You have to consider again, in older people at risk of falls and head trauma, and increased intracranial bleeding, that if they haven’t had a stroke before, that you’re putting them at risk for bleeding,” said Levin.

A 2023 study based on the ASPREE trial also found that a daily low dose aspirin put patients ages 65 years and older at a 20% higher risk of anemia.

Anemia is a condition in which your body doesn’t produce enough healthy red blood cells to transport the necessary amount of oxygen, leading to shortness of breath, dizziness, and headaches.

Experts contacted by Healthline said that patients and doctors should have an informed conversation about the risks and benefits of taking aspirin for the primary prevention of CVD. 

Lloyd-Jones also cautioned that if you have been taking aspirin, even if you’re doing so without medical advice, you should consult a doctor before stopping. Doing so can lead to an increased risk of cardiovascular events.

“This paper should not make anyone stop any medication. It should make people talk to their doctor about why they are taking aspirin,” he said.

The bottom line

Many older Americans continue to take a daily low-dose aspirin for the primary prevention of cardiovascular disease, even though it may put them at increased risk of bleeding.

In the past five years, recommendations have changed around taking aspirin to prevent CVD in individuals who have never had a heart attack or stroke previously.

Experts say that patients should have a detailed conversation about the risks and benefits of taking aspirin as primary prevention for CVD to identify if they would be a good candidate.

Dr Shreya Singhal is a junior doctor working in West London, as well as being a keen backpacker. She has worked in Infectious Diseases and General Practice and shares her top tips for people looking to travel this summer. With lots …

• This month, the Supreme Court preserved access to the abortion pill nationwide and to emergency abortions in Idaho.
• Meanwhile, in Texas, where abortion bans are among the strictest in the U.S., a new study found an uptick in infant mortalities following a 2021 ban on abortion.
• Senate Bill 8 (SB 8) bans abortion if a fetal heartbeat can be detected with no emergency exemptions.
• Access to quality prenatal care can be lifesaving no matter where you live, but it is particularly crucial in states like Texas.

Earlier this month, the U.S. Supreme Court unanimously voted to preserve access to the abortion pill mifepristone.

On June 27, Supreme Court justices temporarily ruled in favor of pregnant people seeking emergency abortions in Idaho, which could be lifesaving.

Meanwhile, in states like Texas, where abortion bans and restrictions are among the strictest in the nation, infant mortality rates have jumped following the state’s 2021 ban on abortion.

A new report shows that Senate Bill 8 (SB 8), the Texas law that banned abortions after a fetal heartbeat can be detected, may have caused the uptick in fetal deaths. 

The law, which went into effect September 21, 2021, provided no exemptions for congenital anomalies and banned abortions as early as five or six weeks, which is before most people know they are pregnant. 

The study, published in JAMA Pediatrics on June 24, suggests that pregnant people were forced to keep their pregnancies even when the fetuses had potentially lethal fetal congenital anomalies. The researchers estimated that SB 8 led to 216 extra infant deaths that would not have occurred if the ban hadn’t gone into effect.

Prior research has found that states with abortion restrictions record more infant deaths than states that permit the procedure.

The Supreme Court’s decision to preserve emergency abortions could help reduce the number of infant deaths in Idaho, but in Texas, these preventable mortalities rest in the hands of SB 8.

“Pregnant people deserve comprehensive access to abortion care no matter the circumstances. The only way to ensure people can access the care they need, in emergency situations or any other circumstances, is to repeal all abortion bans and restrictions,” said Destiny Lopez, acting co-CEO of the Guttmacher Institute, in a statement shared with Healthline in response to the Supreme Court’s June 27 ruling.

Texas abortion ban led to an increase in infant deaths

The new JAMA report is thought to be the first to look specifically at how SB 8 contributed to infant deaths. 

Jessie Hill, a law professor at Case Western Reserve University who specializes in reproductive rights, told Healthline she’s not surprised the increase in infant deaths was a consequence of SB 8.

“I think it was an entirely foreseeable result of Texas’s near-total abortion ban,” she said.

Researchers from the Johns Hopkins Bloomberg School of Public Health first calculated the number of infant deaths in the U.S. and Texas between 2018 and 2022. There were 102,391 infant deaths in the country, 10,351 of which occurred in Texas.

They then analyzed monthly death certificate data between 2021 and 2022 and found that the number of infant deaths, or deaths in babies under 12 months old, increased by 12.9 percent in Texas — from 1,985 to 2,240. 

The increase recorded in the rest of the U.S., for comparison, was just 1.8 percent. 

To better understand the impact of SB 8, the research team then zeroed in on the number of infant deaths recorded between March and December 2022, which is the time period in which the first pregnancies happened with SB.8 in effect.

Based on the researchers’ estimates, the law led to 216 excess infant deaths, which is a 12.7% increase in infant deaths.

Why abortion bans may cause more infant deaths

According to the researchers, abortion bans like SB 8 prevent people from ending pregnancies, including ones with severe fetal abnormalities that are diagnosed later in pregnancy.

Congenital malfunctions are the leading cause of infant mortality in the U.S. — they account for 1 in 5 infant deaths, past data from the Centers for Disease Control and Prevention (CDC) shows.

An increase in infants born with congenital malfunctions, some of which are deadly, would then lead to an increase in infant deaths. 

“Despite amazing advances in neonatal intensive care, pediatric surgery, and other advanced treatments, when it comes to congenital anomalies, some conditions are so severe that they cannot be fixed,” Arianna Cassidy, MD, a maternal fetal medicine physician in the UCSF Department of Obstetrics, Gynecology & Reproductive Sciences, told Healthline.

For example, babies with congenital anomalies that are born prematurely may not be big enough to receive the treatments they need to survive, Cassidy said.

And for infants with congenital anomalies that are candidates for surgery, the surgeries themselves come with risks. 

“Each surgery has risks, such as developing an infection or having another complication, which could be fatal,” says Cassidy, noting that there are many ways complications from surgery for anomalies could lead to an increase in infant deaths.

It’s also believed that abortion restrictions might lead to pregnant people being exposed to potential risks, including financial and emotional stress, that might lead to complications.

More studies are needed to better understand why the infant deaths occurred, the researchers stated.

Access to quality prenatal care could be lifesaving

The findings of the JAMA study highlight the severe health consequences — to both the infant and their families — that occur when abortions are prohibited. 

Past evidence revealed that infant mortality disproportionately affects Black women and that having an infant die leads to significant trauma and, potentially, criminalization.  

Hill believes it’s irrational to make pregnant people carry nonviable pregnancies to term and give birth only to watch the babies die shortly thereafter.

“This report further demonstrates the profound cruelty of abortion bans like Texas’s,” Hill said. 

To Cassidy, the findings are chilling, especially when you consider the ripple effect this kind of law can have.

“It’s the suffering and death of infants, but also suffering of women and families, the sadness and loss in entire communities, the moral injury of physicians and other healthcare providers, and the cost of prolonged hospital stays,” she said.

Hill hopes the findings will make people question whether states that ban abortions are genuinely motivated by an interest to preserving life. 

“If the state truly wants to protect infants, it has many means to do so, such as increasing access to prenatal care and health care generally,” Hill said. 

Takeaway

This month, the Supreme Court ruled in favor to preserve access to the abortion pill mifepristone nationwide, as well as access to abortion in emergency situations in Idaho.

In Texas, however, the strictest abortion bans in the nation remain upheld. A new report found that SB 8, the Texas law that banned abortions after a fetal heartbeat can be detected, may have caused an uptick in infant deaths.

The ban likely prevented people from ending pregnancies, including ones with severe, life-threatening fetal abnormalities that typically get diagnosed later in pregnancy.

• Evidence from a large U.S. study indicates that multivitamin supplements do not improve mortality risk.
• Individuals taking a multivitamin supplement actually had a slightly higher mortality risk than those who did not.
• Multivitamins are taken by roughly one in three US adults, but their health benefits are not well established.

Daily multivitamins are some of the most popular supplements in the United States, but they may not actually make you healthier.

An estimated one-third of US adults take a multivitamin. Consumer spending on them amounts to about 8 billion dollars annually, roughly one-seventh of all dollars that go towards supplements. Of course, the appeal of getting all your necessary vitamins and minerals in one pill per day is alluring. Adults report taking multivitamins to maintain health and fitness and to prevent chronic disease. 

However, evidence, or, more accurately, a lack of evidence, has been mounting for some time that daily multivitamins may not provide consumers with any real protective benefit when it comes to chronic conditions like heart disease and cancer.

In fact, for healthy individuals, a multivitamin may provide no benefit at all. 

In a large study involving nearly 400,000 US adults without a history of chronic diseases over a follow-up period of more than 20 years, those taking a daily multivitamin showed no improvement in mortality risk compared to those who did not.

In fact, those who were taking the supplement demonstrated a slightly increased (4%) mortality risk. The average age of participants was 61.5.

The findings, from researchers at the National Cancer Institute, were published in JAMA Network Open.

Erikka Loftfield, PhD, a researcher in the Division of Cancer Epidemiology & Genetics at the National Cancer Institute, and first author of the study, told Healthline, “To date, there has been insufficient evidence to determine the benefits and harms of MV use…Leveraging data from three large and geographically diverse US cohorts with repeat assessments of MV use and extended follow-up for mortality outcomes, we aimed to evaluate the association of MV use with leading causes of chronic disease-related death.”

No mortality benefit from multivitamin

Loftfield and her team utilized three separate cohorts for their study, totaling 390,124 generally healthy US adults, with follow-up data of about 20 years.

The study’s size and length are two of its greatest strengths. However, it is observational in nature, meaning that, unlike a controlled trial, it does not demonstrate causality between two events — in this case, taking a multivitamin and death. Instead, it helps to form a picture of any associations between these events at a large scale in the real world.

Part of the difficulty of conducting a study of this nature is the sheer volume of data to sort through and the potential for confounding. For example, the study discusses two distinct problems they had to control for in their data: the “sick user effect” and the “healthy user effect.”

There is a concern that health outcomes related to multivitamin use are misleading because of the demographics using them. The “sick user effect” refers to the possibility that individuals who are sick may more frequently use multivitamins due to their health condition.

On the other hand, the “healthy user effect” is the opposite: individuals who already live a healthy lifestyle may be more inclined to use a multivitamin as part of their routine than those who are less health conscious. Without proper controls in place, these effects could lead a researcher to two opposing conclusions about the effects of multivitamins on mortality risk.

Loftfield told Healthline that they were able to control for these distinct effects, by adjusting for lifestyle factors like smoking, diet, and physical activity. They also excluded individuals with major chronic diseases, including cancer, at baseline to account for the “sick user effect.”

Ultimately, after controlling for all these factors, they found that those taking a multivitamin did not have a lower risk of all-cause mortality than those who did not. Nor did they observe any benefits related to specific health outcomes, including cancer, heart disease, and stroke.

The findings are in line with prior research, including recommendations made by the US Preventive Services Task Force in 2022 and 2014, which said there was little to no benefit in taking them.

Dr. Parul M. Goyal, MD, an Associate Professor of Medicine and Director of Medicine for Seniors at Vanderbilt University Medical Center who wasn’t affiliated with the study, told Healthline the results were not surprising.

“The patients that they enrolled are all patients without any chronic medical conditions. Essentially, they’re all healthy patients. Typically, if you are a healthy individual, and you are exercising, you’re eating a regular diet, you’re consuming your fruits and vegetables, you are getting your regular intake of vitamins and supplements,” she said.

Goyal notes that there are some individuals who would likely benefit from a multivitamin supplement, including those with anemia, diabetes, and postmenopausal women. She encourages patients to speak with their healthcare professional before taking a multivitamin.

Do dietitians recommend taking a multivitamin supplement?

Healthline spoke to two registered dietitians to hear their recommendations about eating a healthy diet and taking multivitamin supplements.

“My recommendations for patients are always personalized. In my practice at the Cleveland Clinic, a recommendation to take or skip a multivitamin is based on many factors, including the patient’s current health, dietary pattern, other supplements being taken, and personal health goals. An MVI is not insurance [from] an unhealthy dietary pattern,” said Kristin Kirkpatrick, MS RD, a registered dietitian at the Cleveland Clinic and co-author of Regenerative Health.

Alyssa Kwan, MS, RD, a Clinical Dietitian in Cardiology at Stanford Medicine, told Healthline, “I do not generally recommend a multivitamin for those following a healthy diet and eating well-balanced meals…I will only recommend one if patients are not nutritionally meeting their nutrient needs or have a poor diet at baseline. Maybe their appetite is really poor or they are just not able to meet everything via diet alone, then I would recommend supplementing with a multivitamin.”

Like Kirkpatrick, Kwan also cautions that a multivitamin should not be taken to cover unhealthy “choices of foods that are not nutritionally dense.”

The bottom line

In a large observational study involving nearly 400,000 US adults over 20 years, taking a daily multivitamin did not lower mortality risk overall, nor for specific chronic conditions like cardiovascular disease and cancer.

Multivitamins are among the most popular supplements on the market, taken by roughly one in three US adults. Despite their popularity, their health benefits are not well established.

Experts interviewed by Healthline say that if you eat a healthy diet, taking a multivitamin is not recommended. Always speak with your healthcare provider before starting or stopping taking a nutritional supplement.

• People who were treated with the GLP-1 drug liraglutide and did an exercise program lost weight and body fat but were able to preserve their bone health.
• Both liraglutide and exercise helped people maintain weight loss, but exercise minimized the loss of bone density.
• Other research shows that certain types of exercise can strengthen bones, even in people not trying to lose weight.

Losing weight can help people who are living with obesity or overweight and reduce their risk of type 2 diabetes, sleep apnea, heart disease, and other health issues. But weight loss can also lead to bone loss.

This is a concern as more people are taking GLP-1 receptor agonists such as Ozempic, Wegovy, and Zepbound to help them lose weight.

“Bone mineral density should be a serious consideration, given that we reach our peak bone mass by age 30 and then start to lose bone mass as we move beyond our 30s,” said Jennifer Sacheck-Ward, PhD, a professor of prevention and wellness at George Washington University’s Milken Institute School of Public Health.

“If taking GLP-1 receptor agonists accelerates this loss, then we will have more individuals who are at increased risk of serious fractures, and at younger ages,” she told Healthline.

New research, though, suggests that exercise can help preserve bone health in people being treated with a GLP-1 drug.

In the study, researchers found that people who were treated for a year with liraglutide (sold under the brand names Saxenda and Victoza) and did a program of moderate- to-vigorous-intensity exercise had similar changes in bone mineral density as those who didn’t undergo any treatment.

This was despite people in the combination liraglutide and exercise group losing more weight than people treated with liraglutide alone or exercise alone.

The study was published June 25 in JAMA Network Open.

GLP-1 drugs and bone density

The study was carried out from 2016 through 2019 in Denmark. It included 195 people ages 18 to 65 who were living with obesity but not diabetes. The average age of participants was 43, and nearly two-thirds were female.

Participants first followed a low calorie diet for 8 weeks, which provided 800 calories per day.

In general, adults not trying to lose weight need around 1,600 to 3,000 calories per day, although this varies depending on factors such as age, sex, size and activity level.

Next, researchers randomly assigned people to one of four groups for 52 weeks: a moderate- to vigorous-intensity exercise program, daily injections of liraglutide, a combination of exercise and liraglutide, or the non-treatment (placebo) group.

Participants underwent DEXA scans to measure bone mineral density in their hip, lower spine and forearm. These scans were done before people started the low-calorie diet and again at the end of the 52-week treatment period.

On average, participants lost 29 pounds while on the 8-week low calorie diet. During the 52-week treatment period, people in the placebo group regained weight and lost 15 pounds overall.

Those in the exercise and liraglutide groups maintained their weight loss (25 to 30 pounds overall), and people in the combination group lost additional weight (37 pounds overall).

The combination group also had larger amounts of fat loss compared to the other groups.

In addition, the groups saw different changes in bone mineral density. In the combination exercise and liraglutide group, bone mineral density in the hip and lower spine was similar to the placebo group — meaning this group maintained bone health.

The liraglutide group saw a greater decrease in bone mineral density in the hip and lower spine compared to the exercise group. This suggests that exercise can help prevent bone loss.

Also, both the exercise and combination groups saw an increase in bone mineral density in the forearm.

One limitation of the study is that researchers excluded people over age 65 and those with other chronic health conditions. Thus, the researchers write that the results may not apply to people with diabetes or older adults.

Exercise is recommended for better bone health

Spencer Nadolsky, DO, an obesity and lipid specialist and medical director of WeightWatchers, said loss of bone mineral density is always a concern when intentionally losing weight.

But “I wouldn’t be concerned about GLP-1 medicines causing more than expected losses in bone densities with the amount of weight lost,” he told Healthline. 

“Having said that, I always recommend resistance training for those who are trying to intentionally lose weight in order to minimize bone loss,” he said. 

This is particularly true for people using a GLP-1 drug because they are so effective at helping people lose weight, he said. He also pointed out that newer GLP-1 drugs, such as semaglutide and tirzepatide, are even more effective at promoting weight loss.

The new study’s results fit with other research showing that exercise can help preserve bone health in people who lose weight by cutting calories. In particular, heavy resistance or high impact exercise may have the largest effect on bone health.

Sacheck-Ward said the new study shows that there is a healthy way to lose weight with the use of GLP-1 drugs while preserving bone health.

However, she still has some concerns, “given the reality that the majority of Americans do not engage in the amount of physical activity recommended by the Physical Activity Guidelines for Americans,” she said.

She also pointed out that people in the exercise group lost a similar amount of weight as those in the liraglutide group — but the exercise group maintained their bone mineral density. 

“This should be a serious consideration, especially given the natural loss of bone mass as we progress past our 30s and 40s and with bone fractures posing a significant risk for mortality in older age,” she said.

“Why not choose exercise then, without the side effects [of a GLP-1 drug], and with the bigger bang for our buck on many aspects of our health?” she said.

Takeaway

In a new study, participants followed an 8-week low-calorie diet to lose weight. This was followed by 52 weeks of one of four interventions: treatment with the GLP-1 drug liraglutide, an exercise program, a combination of liraglutide and exercise, or a placebo group.

The combination group lost the most weight and body fat over the course of the study but had similar changes in bone mineral density to those who didn’t undergo treatment.

Both exercise and liraglutide alone led to similar amounts of weight loss, but the liraglutide group had larger amounts of bone loss. Other research shows that certain types of exercise can strengthen the bones.

• The FDA has granted accelerated approval to a novel drug for the treatment of a rare autoimmune disease that damages the liver.
• Primary biliary cholangitis (PBC) occurs when the immune system attacks the bile ducts, leading to liver damage and other serious health outcomes.
• Treatment options for PBC are limited and frequently not well-tolerated by patients.

The U.S. Food and Drug Administration(FDA) has just approved a first-in-class drug for the treatment of a rare autoimmune liver disease.

On June 10th, the FDA granted accelerated approval to the drug Iqirvo (elafibranor) to treat primary biliary cholangitis (PBC).

PBC is a rare autoimmune liver condition in which the small bile ducts in the liver are inflamed and damaged, causing bile and toxins to build up.

As the bile collects in the liver, it damages the surrounding tissue, which can lead to severe health problems like cirrhosis of the liver and destruction of the bile ducts.

Prior treatment options for PBC were limited and frequently not well-tolerated by patients. The definitive treatment for PBC requires a liver transplant. Experts say the approval of Iqirvo will meet a currently unmet need and help to expand options for patients.

“This is an exciting time for new therapies for the treatment of PBC. I am optimistic that the approval of elafibranor will allow more patients with PBC to have an improved prognosis as there will be additional options to provide for second line therapy to help achieve biochemical remission,” Aparna Goel, MD, a Clinical Associate Professor of Medicine, specializing in gastroenterology and hepatology at Stanford Medicine, told Healthline.

How does Iqirvo work?

Iqirvo helps to treat PBC through several pathways, including promoting bile acid transportation, modulating bile production, and decreasing inflammation.

“Iqirvo is the first treatment advance for PBC in 8 years and is the very first in a new class of medicines called PPARs. PPARs are designed with the aim of targeting the underlying PBC disease,” a representative for Ipsen Biopharmaceuticals, the developer of Iqirvo, told Healthline.

The FDA granted the drug accelerated approval following a promising phase 3 trial, the results of which were published in the New England Journal of Medicine in November, 2023.

That trial involved 161 patients who had inadequate response to or unacceptable side effects with ursodeoxycholic acid, the current primary treatment for PBC. 

“First line treatment for PBC is ursodeoxycholic acid. This has been the standard of care for many years. However, at least 60% of patients are either intolerant to or have an incomplete response to ursodeoxycholic acid,” said Goel.

About 67% of the patients in the trial received Iqirvo, while the rest received a placebo. After 52 weeks, half the individuals taking Iqirvo achieved a “statistically significant treatment benefit,” compared to only 4% of those taking the placebo.

Patients taking Iqirvo did experience some side effects during the trial. The most common side effects included abdominal pain, diarrhea, nausea, and vomiting.

Rhabdomyolysis, a serious and potentially fatal muscle-wasting disease, occurred in one individual taking Iqirvo.

“It will be important to monitor for any signs of muscle injury (rhabdomyolysis ) and kidney function as patients are started on this medication. As with any new medication, the long-term safety and efficacy will need to be carefully monitored,” said Goel.

What to know about the autoimmune disease primary biliary cholangitis

PBC is a rare autoimmune disease. According to the latest statistics from the National Institutes of Health (2014), PBC affects about 58 in every 100,000 women and 15 in every 100,000 men in the United States. However, like other rare diseases, the exact number of people who have PBC isn’t entirely clear. Like other autoimmune conditions, PBC is also far more common in women than in men.

Overall, women account for about 80% of all cases of autoimmune disease.

In individuals with PBC, the immune system mistakenly attacks the bile ducts of the liver, causing inflammation and damage. Bile is an acidic fluid formed in the liver that is used in digestion. It is transported by the bile ducts to other organs like the small intestines where it can be used to break down food material. 

Damaged bile ducts can not effectively transport bile, a condition known as cholestasis. As bile builds up in the liver, it can cause scarring (fibrosis), which can lead to irreversible, advanced cirrhosis. A patient may eventually require a liver transplant due to chronic liver damage.

PBC can be hard to diagnose as it begins with mild symptoms, including tiredness and itchy skin. As it progresses, other more severe symptoms like abdominal pain and joint pain may develop. In its final stages, highly visible symptoms may occur like darkening of skin color, the presence of fatty deposits under the skin, and jaundice. 

The cause of PBC is still not well understood, but is believed to be the result of a combination of genetic and environmental factors that lead to the development of an autoimmune condition.

“Several environmental triggers have been associated with ‘activating’ the disease including toxins, viruses and several bacteria. As knowledge of the disease increases, appropriate recognition and testing of the disease is also increasing which is likely to change the prevalence estimates,” said Goel.

The bottom line

This month, the FDA granted accelerated approval to Iqirvo (elafibranor) for the treatment of primary biliary cholangitis (PBC).

PBC is a rare autoimmune disease in which the bile ducts are damaged, leading to inflammation and scarring of the liver.

Current treatment options for PBC are limited and often not well-tolerated. Experts say the new medication is promising, but will need to be monitored for continued safety.

• Certain types of medications can make people more prone to heat-related illness.
• These include diuretics, beta-blockers, anticholinergics, and antipsychotics.
• They can cause dehydration, a lack of sweating, and problems regulating temperature.
• It’s important to keep cool and drink plenty of water during hot weather.
• If you experience symptoms of heat-related illness, seek medical assistance right away.

While the hotter summer months can represent fun in the sun for many of us, a heatwave can turn deadly for others, especially if they are using certain types of medications.

Medications that are commonly used to treat high blood pressure, heart conditions, allergies, and mental health disorders, among others, may put you at risk for being sensitive to high temperatures.

If you aren’t careful, you could develop heat exhaustion or heat stroke. Heat stroke, which is the more serious of the two, can lead to permanent disability or even be fatal. Both require immediate first aid.

Medications that can make you more sensitive to heat

Sazan Sylejmani, PharmD, an experienced Pharmacy Manager and owner of Westmont Pharmacy, told Healthline there are four important types of medications that can increase your sensitivity to heat.

The first of these is diuretics, which are medications that increase how much you urinate. You might also have heard them referred to as “water pills” since they help eliminate fluid retention in your body.

Diuretics are often used to treat high blood pressure and other cardiovascular conditions since they can reduce the amount of fluid in your blood vessels, leading to less pressure against their walls.

According to Sylejmani, some common examples of diuretics are furosemide and hydrochlorothiazide.

Another type of medication that can make you more sensitive to heat is beta-blockers.

Since they help the heart beat more slowly and with less force, these medications are most often used to treat irregular heartbeat and high blood pressure, but they have a range of other applications, including the treatment of anxiety disorders.

Some common examples, per Sylejmani, include metoprolol and propranolol.

A third type of medication he mentioned was anticholinergics.

These drugs work by blocking the action of acetylcholine, making them useful in treating conditions like overactive bladder, incontinence, and chronic obstructive pulmonary disease.

Oxybutynin and benztropine are examples of anticholinergics.

Finally, Sylejmani spoke about antipsychotics.

Antipsychotic medications are used to treat schizophrenia and other mental health conditions since they are capable of targeting certain neurotransmitters in the brain.

He listed risperidone and olanzapine as two medications belonging to this class.

How these medications can put you at increased risk

Dr. Paunel Vukasinov, who is with Medical Offices of Manhattan and is a contributor to LabFinder, explained that the ways these medications put you at risk during hot weather really comes down to three things.

“These medications can impact the body’s ability to regulate temperature, impact the body’s ability to sweat, or lead to worsening dehydration,” he said.

When it comes to diuretics, which cause you to shed excess fluid, if you are also sweating a lot, he said this “can worsen [dehydration] by further removing sodium and water from the body which can lead to complications including low blood pressure and even passing out.”

Sylejmani added that the problem with beta-blockers is they reduce the heart’s ability to pump blood. This can impair your body’s natural ability to dissipate heat and cool itself.

Regarding anticholinergics, Vukasinov said they affect your ability to sweat.

“[T]he core body temperature can rise, which can be further exacerbated by hot weather conditions,” he stated.

Sylejmani further explained that antipsychotics can interfere with our body’s ability to regulate its own temperature, putting people at risk.

How to minimize your risk during a heatwave

“By understanding the interplay between medications and hot weather, patients can better manage their health and minimize risks associated with extreme heat,” said Sylejmani.

He suggests taking the following steps in order to play it safe when temperatures soar:

• Stay hydrated. Drink plenty of fluids, especially water. If you’re taking medication, talk with a healthcare professional for an individualized fluid intake recommendation. “Avoid alcohol and caffeine as they can further dehydrate you,” said Sylejmani.
• Wear lightweight, loose-fitting clothing. This will allow air to reach your body and evaporate your sweat, allowing you to cool off.
• Stay in cool, shaded, or air-conditioned areas as much as possible. If you don’t have an air conditioner at home, the U.S. Centers for Disease Control and Prevention suggests checking with your local health department to see if there are shelters in your area. Malls or public libraries can also be safe spaces to seek refuge from the heat.
• Monitor yourself for signs of heat-related illness. These include excessive sweating, confusion, dizziness, or headaches. “[S]eek medical attention if symptoms appear,” Sylejmani advised.
• Consult with your doctor about adjusting your medication. “They might adjust dosages or advise timing the medication differently to reduce risks,” he said.

Takeaway

When temperatures rise during the summer, it can put people who use certain medications at risk.

Medications like diuretics, beta-blockers, anticholinergics, and antipsychotics, in particular, may be problematic.

These types of medications can cause dehydration, lack of sweating, or problems with regulating body temperature, which puts people at risk for heat exhaustion and heat stroke.

Experts say it’s important to keep your environment cool, drink lots of fluids, and seek medical assistance if you experience any of the warning signs of heat-related illness, including excessive sweating, confusion, dizziness, or headaches.

You may also need to speak with your physician about making adjustments to your medication during the hotter months of the year.

• People are chewing ‘Facial Fitness Gum’ in the hope it will give their jaws a more chiseled and defined appearance. 
• Chewing gum companies claim it allows them to tighten muscles. However, there’s little evidence to suggest it works. 
• Experts say excessive chewing could actually make your jaw appear more square-like and bulky 
• Aesthetic options are one way to achieve noticeable results; however, teen boys should remember that their bone structure is likely to change as they age. 

Facial fitness gum is the latest in a long line of bizarre beauty trends gaining popularity on social media platforms like TikTok, and companies are capitalizing on the craze.

Brands like Rockjaw, Jawz Gum, and Stronger Gum are claiming their products can help “build the most attractive jawline” and “tone and tighten 57+ facial and neck muscles, anytime, anywhere.”

They claim that chewing these products is akin to a facial workout, as facial fitness gum is tougher than regular gum. 

The popularity of these products, particularly among teen boys, is related to the “mewing” trend, which involves placing your tongue on the roof of your mouth to tighten the jaw muscles. 

It’s also associated with “looksmaxxing,” the process of “maximizing” your looks so they more closely align with conventional beauty standards.

However, health experts say there’s little evidence to suggest that facial fitness gum actually works.

Why chewing gum isn’t likely to change the appearance of your jawline

Dr. Kieren Bong, cosmetic doctor and founder of Essence Medical Cosmetic Clinic, isn’t surprised by these claims but isn’t sold on their effectiveness. 

“As a doctor, I find the claim that chewing gum defines the jawline oversimplified. While chewing gum can engage the jaw muscles, any resulting definition is likely minimal and varies between individuals,” he explained. 

“It’s unsurprising that this claim is trending, given the public’s fascination with easy, noninvasive beauty solutions promoted on social media,” Bong added. “However, it’s essential to rely on scientifically backed methods for significant changes in appearance rather than quick fixes with limited evidence.” 

Likewise, Dr. Joel Kopelman, a facial plastic surgeon at Kopelman Aesthetic Surgery, says these claims should be approached with skepticism. 

“Facial aesthetics are complex, and significant changes typically require more than just chewing gum,” he said. 

The reasoning behind facial fitness gum? 

“The trend is built on the concept that repetitive chewing motions can strengthen the muscles of the jaw and face, particularly the masseter muscles,” Kopelman explained. “Proponents argue that increased muscle tone in this area can create a more chiseled appearance.” 

Bong compared it to how other parts of the body become more defined with regular exercise but notes that the impact on overall jawline definition is likely minimal.

Limited research supports the effectiveness of facial fitness gum

Research on the effectiveness of chewing gum for a more defined jawline is limited and inconclusive. 

Bong said most scientific studies focus on chewing gum’s general benefits, such as improved concentration, stress relief, and oral health, rather than its impact on facial aesthetics. 

“Relying on chewing gum alone is not supported by robust scientific evidence and may lead to unrealistic expectations,” he said. 

Kopelman agreed. 

“Research in this area is sparse, and most of the claims are anecdotal rather than based on robust scientific data,” he said. “Strengthening the masseter muscles through chewing might result in some hypertrophy, but it’s unlikely to produce the dramatic changes some might expect.” 

Ultimately, Kopelman said the primary reason chewing gum is unlikely to yield a more defined jawline is that facial aesthetics are influenced by a combination of bone structure, skin quality, and fat distribution, not just muscle tone.

“While chewing gum might strengthen the masseter muscles, it won’t change the underlying bone structure or significantly reduce facial fat,” he said. 

Additionally, he warned that excessive chewing can lead to overdeveloped masseters, which might not be aesthetically desirable and can sometimes lead to a more square or bulky jaw rather than a defined one.

How to achieve a more defined jawline 

Both experts agreed that chewing gum is unlikely to give you a defined jaw, but what are there more effective ways to achieve this result? 

Kopelman said lasting and significant changes in facial aesthetics often require more than simple at-home remedies.

However, there are a few things you can do. 

You shouldn’t underestimate the importance of a healthy diet and exercise.

“Maintaining a healthy diet and regular exercise routine can reduce overall body fat, including facial fat, contributing to a more defined jawline,” Kopelman said. 

Taking good care of your skin is another way to achieve a tauter appearance. “Proper hydration and skin care routines can improve skin elasticity and firmness, contributing to a more defined look,” says Bong. 

These habits may trigger subtle changes. However, it’s difficult to achieve noticeable results without aesthetic interventions. 

Kopelman says noninvasive treatments like Ultherapy or radiofrequency can help tighten the skin around the jawline. 

Meanwhile, the strategic use of dermal fillers can enhance the jawline by adding volume and definition.

A popular choice is Botox.

“Botox injections can slim the jawline by reducing the size of the masseter muscles, especially in individuals with hypertrophic masseters,” Kopelman explains. 

While aesthetic treatments are the most effective option, they are likely not the right choice for teen boys whose features are still developing. 

It’s also important to note that the legal age for dermal fillers and Botox in the United States is 18. 

Takeaway 

Very limited research supports the claim that chewing gum gives you a more chiseled jawline.

In fact, experts say excessive chewing could have the opposite effect, making your jaw appear more square or bulky. 

Facial exercises and aesthetic treatments are effective ways to add definition to your jawline. However, it’s important for teen boys to remember that their bone structure is likely to change as they age.

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

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

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

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

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

The study was published June 21 in JAMA Network Open.

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

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

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

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

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

Intermittent fasting vs. diabetes drugs

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

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

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

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

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

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

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

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

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

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

Improvements in blood sugar and weight

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

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

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

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

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

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

Longer and more diverse studies needed

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

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

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

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

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

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

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

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

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

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

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

Intermittent fasting offers a simpler approach

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

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

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

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

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

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

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

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

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

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

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

Takeaway

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

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

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