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• Non-motor symptoms like depression and anxiety are often experienced years before a Parkinson’s disease diagnosis.
• 62-year-old Veronica Brown shares her journey with Parkinson’s disease.
• Brown found relief from deep brain stimulation years after taking medication.

For more than a decade, Veronica Brown was experiencing chronic fatigue, depression, and debilitating anxiety without knowing what was causing the symptoms.

“I stopped traveling, and I used to be a travel agent,” she said.

While she didn’t know it at the time, Brown was experiencing non-motor symptoms of Parkinson’s disease during what is called the prodromal or hidden stage of the disease.

Alessandro Di Rocco, MD, a neurologist at Northwell Lenox Hill Hospital, explained that the brain starts to lose specific brain cells that produce dopamine years before motor symptoms like tremors, slowing of movements, and stiffness appear.

“Many people can trace back a few years before they experienced a tremor or motor symptoms and see that they experienced changes in mood, depression, and anxiety. Some people might experience constipation, but it’s so common that it’s hard to connect to Parkinson’s disease,” he told Healthline.

In 2018, while in her late 50s, Brown began experiencing tremors in her foot that forced her to stop working at her retail job. Over the next few years, more physical symptoms developed, including slower walking and a hunched posture.

In 2020, she was diagnosed with Parkinson’s disease.

How she found effective treatment for Parkinson’s symptoms

After processing her diagnosis, Brown began taking the medication carbidopa-levodopa, a dopamine promoter that is commonly prescribed to treat motor symptoms of Parkinson’s disease. Developed in the late 1960s, the medication is known as one of the most significant breakthroughs in medicine.

“It worked until it didn’t,” Brown said. “[It] just seemed like all of a sudden, all the symptoms kept coming. They kept coming faster and faster.”

While the medication made her feel better for a few hours at a time for a while, it eventually brought inconsistent relief. This is common, according to Francisco Ponce, MD, neurosurgeon and chief of stereotactic and functional neurosurgery at The Barrow Neurological Institute.

He said over time, the benefit of medication wears off, and complications from medication can develop, leading to uncontrolled symptoms.

“Due to this, patients often find themselves taking more medication with greater frequency. The degree of control of their Parkinson’s symptoms fluctuates throughout the day, and it can feel like they are on a roller coaster ride,” he told Healthline.

Deep brain stimulation provided relief from Parkinson’s symptoms

After three years of pushing through on medication, in 2024, Brown turned to deep brain stimulation (DBS), which involves brain surgery to implant a battery-operated medical device that releases electrical stimulation to specific areas in the brain that control movement. DBS blocks abnormal nerve signals that cause symptoms of Parkinson’s disease.

“Deep brain stimulation therapy gives patients greater and more predictable control of their symptoms, reducing the fluctuations and dyskinesias. In addition, most patients are able to significantly reduce their medication with DBS,” said Ponce.

Brown was referred to Ponce by her Parkinson’s specialist. At the time, she was taking medications seven to nine times a day. While she had a good history of medication responsiveness, she was experiencing dyskinesias (erratic movements) and disabling fluctuations in her symptoms over the course of the day.

“Despite this, we were able to quantify that Veronica’s symptoms did improve by 50% with medication, which is predictive of a good response to DBS,” said Ponce.

In January 2024, he performed two DBS surgeries on Brown. While DBS has been an FDA-approved therapy for Parkinson’s disease for over 20 years, Brown was one of the first patients in the world to be implanted with the latest innovation in Medtronic neurostimulation technology, Percept RC.

“It’s the smallest and thinnest option available to patients today, which was an especially good fit for Veronica due to her petite stature,” said Ponce.

The procedures were performed while Brown was asleep, which helped her overcome some anxiety. The first time they turned on her DBS was January 30.

After surgery, Brown experienced more steady control of her symptoms with fewer fluctuations, as well as a reduction in her medication requirements and dyskinesias.

“I was very fortunate, and it worked on me. I woke up one morning and came downstairs and said, ‘I’m going to bake some cookies,’” she said. “Everybody just kind of looked at me like, what is she doing?”

It had been years since her family had seen her show such excitement and energy.

Only 4% of Parkinson’s patients who are eligible for DBS receive it

Although DBS is FDA approved and studies show its efficacy for Parkinson’s disease, because it’s a brain surgery, people are hesitant to embrace it.

“Our goal is, through outreach and education, to help increase the awareness that this is a data-proven therapy that significantly improves quality of life in patients with Parkinson’s disease,” said Ponce.

He hopes that more people will consider it because DBS surgeries are now more comfortable and less stressful than in previous years.

“It’s hard to imagine undergoing major surgery while awake, but this is often the norm for patients who need brain surgery,” Ponce said. “Today, we know it’s safe and effective to perform DBS procedures while patients are awake or asleep under general anesthesia, which can help ease the apprehension that many have about the surgery.”

Di Rocco added that other reasons that contribute to only 4% of eligible patients having the procedure done include age, having other medical conditions that put them at high risk for surgery, and cognitive changes.

“Oftentimes, you want to use this procedure on people to resettle their motor function, but they often have also developed cognitive or intellectual problems, which makes this non-indicated,” said Di Rocco.

Additionally, not all neurosurgeons are trained or have the support to perform DBS surgery.

Brown is grateful she qualified for and had access to DBS surgery.

“I’ve only got one tiny little scar; it’s maybe an inch long,” she said.

The advocacy of her husband and support from others living with Parkinson’s disease helped her through the process and continues to help her today.

“[If] you can find a good support group of people who’ve been through it, it’s very helpful…everybody has something different to contribute,” said Brown. “And it could be just one lady who already had Parkinson’s [sharing] how she dealt with it.”

In fact, it was a woman Brown met in a support group who told her about her personal experience with DBS.

“She told me about, you know, what to expect,” she said. “All the different people that I’ve met through Parkinson’s, everybody has something different to contribute.”

To find a support group near you, visit the Parkinson’s Foundation or the Michael J. Fox Foundation.

• TikTok’s Winter Arc Challenge urges people to work on their health during the winter.
• The 90-day challenge asks people to choose 10 healthy activities to do every day.
• These activities address both physical and mental health.
• Experts say the challenge can help people form healthy habits.
• However, people should be careful that they are following sound health advice.

Have you ever made a New Year’s resolution for yourself, perhaps vowing to finally lose those extra pounds or get into the best shape of your life? About 3 out of 10 people made a New Year’s resolution in 2023, according to Drive Research, so it wouldn’t be surprising if you have made one in the past.

Now, however, TikTok users are putting a new spin on things by getting an early start on transforming their lives with the Winter Arc Challenge.

Proponents of the Winter Arc Challenge suggest taking 90 days in the late fall and winter to prioritize your physical and mental health rather than waiting for the new year to get a start.

“These are the months where a lot of people tend to slow down … this is the time where people tend to let their foot off the gas,” explains TikTok influencer @carlyupgraded, adding that the Winter Arc Challenge is about “dialing … in and getting super laser focused on your goals.”

@carlyupgraded

WINTER (ARC) IS COMING ⚔️❄️ you tapping in?? #winterarc #mindset #reinventyourself #realityshifting

♬ original sound – CARLY

According to Fortune Well, the Winter Arc Challenge features a hardcore mindset reminiscent of another viral TikTok trend called the 75 Hard Challenge.

They additionally write that it does not have a set plan. Instead, people generally come up with a list of 10 self-improvement activities that they’d like to add to their daily routine, such as walking 10,000 steps, drinking more water, or journaling every day.

The activities chosen are meant to boost both physical and mental wellness.

However, experts point out that there could be both pros and cons to following this challenge. We contacted two of them to get their opinions about the Winter Arc Challenge’s potential benefits and risks.

The pros of TikTok’s Winter Arc challenge

Jonathan Kaplan, M.D. — who is a board-certified plastic surgeon, tech innovator, TikTok influencer, GLP-1 expert, and entrepreneur as well as the founder and CEO of BuildMyHealth — said he sees “a lot of potential” in this viral TikTok trend.

“From my point of view, there are some real benefits to the 90-day personal development framework,” he said.

Kaplan noted firstly that it makes use of a “key psychological window” between November and January when people are already thinking about bettering themselves.

“Creating a community-driven, structured challenge is more likely to keep people accountable and moving,” he stated.

Another pro of the Winter Arc Challenge is that it leverages what research has shown about how long it takes to form a new habit. Kaplan pointed to a 2009 study published in the European Journal of Social Psychology which found that, on average, it took people about 66 days to turn a regular practice into a habit.

“[S]o psychologically, a 90-day commitment gives us enough time to form a real habit,” he said.

Additionally, since the challenge focuses simultaneously on physical and mental health, Kaplan said it addresses the interdependence of wellness, a focus that he uses in his own medical practice.

“The social media piece — which will probably involve TikTok documentation and community support — provides an additional layer of motivation by way of shared experience and, perhaps, social reinforcement,” he concluded.

The cons of the TikTok’s Winter Arc challenge

However, Joseph Trunzo, Ph.D. — who is a licensed, practicing clinical psychologist with expertise in the psychological management of chronic medical illnesses and the treatment of mood and anxiety disorders as well as the Associate Director of the School of Health & Behavioral Sciences and a professor of psychology at Bryant University — urged caution with challenges such as the Winter Arc Challenge.

“Broad-based health advice delivered through social media channels (or any media for that matter) that are not tailored to the individual’s physiological and psychological needs can be ineffective or, at worst, directly harmful,” he said.

Trunzo further discussed the risks associated with misinterpreting advice, taking that advice to an extreme, or doing something inadvertently harmful.

“While the advice itself may be generally helpful, the application of the advice by the individual – which will encompass all of their psychological, social, and behavioral influences – may not be so beneficial,” he noted.

Trunzo added that the best idea is to work with professionals — such as your doctor, therapist, or trainer — to ensure that you are working toward your goals in a healthy, effective way.

If you don’t have access to professionals, he advises looking for information from reputable sources and organizations.

“Working on your goals with others can add a positive social aspect as well,” he suggested.

Finally, Trunzo explained that, while getting healthy can be hard, it should never feel bad.

“[E]xcessively negative thinking, feelings of guilt, isolation, consistently negative comparisons of self to others, or anything else that feels burdensome are all signs that the plan should be re-evaluated,” he said.

Takeaway

TikTok’s Winter Arc Challenge encourages people to get a headstart on improving their physical and mental health during the late fall and winter rather than waiting to make a New Year’s resolution.

The 90-day challenge generally involves making a list of 10 health and wellness-promoting activities to be done every day.

Experts say this challenge can be beneficial in helping people form better habits.

However, they should be cautious and make sure that they are seeking out sound advice from professionals.

• U.S. Surgeon General Dr. Vivek Murthy issued a new advisory highlighting health disparities in tobacco use despite the fact that cigarette smoking has declined in recent decades.
• The report found unequal progress in smoking cessation among racial and ethnic groups and across various sociodemographics.
• Quitting smoking can have short- and long-term benefits on human health.
• There are many resources available to help with smoking cessation, such as the American Cancer Society’s Great American Smokeout and 1-800-QUIT-NOW.

Cigarette smoking is the leading cause of preventable disease, disability, and death in the United States.

Cigarette smoking and secondhand smoke exposure are responsible for about 1 in 5 deaths, according to the Centers for Disease Control and Prevention.

While cigarette smoking has declined more than 70% in the U.S. since 1965, a new advisory from U.S. Surgeon General Dr. Vivek Murthy highlights ongoing health disparities in tobacco use.

The November 19 report cites unequal progress in smoking cessation, showing disparities among racial and ethnic groups, income, education, gender identity and sexual orientation, occupation, geography, and health status, among other factors.

Despite the concerning data, Dr. Murthy appears optimistic, envisioning a tobacco-free future with reduced death and disease burden in these population groups. The report outlines various factors affecting tobacco-related disparities and proposes actions to promote smoking cessation and improve health equity in the U.S. 

“Tobacco use imposes a heavy toll on families across generations. Now is the time to accelerate our efforts to create a world in which zero lives are harmed by or lost to tobacco,” Dr. Murthy said in the advisory. “This report offers a vision for a tobacco-free future, focused on those who bear the greatest burden, and serves as a call to action for all people to play a role in realizing that vision.”

Quitting smoking can have immediate, short- and long-term benefits on human health. The American Cancer Society’s annual Great American Smokeout on November 21 is one of many resources available to begin a smoke-free journey.

Factors affecting disparities in tobacco use

The Surgeon General’s advisory sheds light on multiple health disparities related to tobacco use, such as:

• Poverty, racism, discrimination, and other social determinants of health.
• Marketing tactics by the tobacco industry targeting Black and Hispanic people and those with low-income status.
• Gaps in prevention protections and barriers to treatments to help with smoking cessation.
• Social and environmental influences.

Poverty is a major driving force in tobacco-related health disparities, the report found. Cigarette smoking is twice as common among people who live in poverty compared to those who do not.

The report also shows that disparities in secondhand smoke exposure, particularly among children, Black people, and those living in low socioeconomic status, have increased since 2000.

Additionally, people who live in rural areas or reside in the Midwest or South are more likely to use tobacco, as are those who identify as gay, lesbian, or bisexual, and those who live with a mental health condition or substance use disorder.

“Progress, in the form of improvements in tobacco-related policies, regulations, programs, research, clinical care, and other areas, has not resulted in the same outcomes for everyone,” said Adm. Rachel L. Levine, HHS Assistant Secretary for Health, in the advisory. “We have not made progress unless we have all made progress.”

Quitting smoking reaps immediate health benefits

Smoking is associated with many negative health outcomes, such as lung cancer, chronic obstructive pulmonary disease (COPD), and heart disease.

When you quit smoking, you immediately reap health benefits, such as a reduced risk of a cardiovascular event. While some benefits can be seen from cutting back, health experts recommend quitting smoking entirely. 

“Cutting down on smoking can potentially be useful if it puts someone on the path to eventually quit,” Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California, told Healthline in a recent interview. 

“Quitting smoking is essential to minimize the risk of a future cardiovascular event and can potentially be lifesaving,” Chen said.

There is value in calling coaching quitlines like 1-800-QUIT-NOW. The CDC notes these resources are often key to success in quitting smoking. Other resources include websites such as: 

• Smokefree.gov 
• We Are Truth
• Become an Ex

Additionally, the Great American Smokeout from the ACS is an email-based program offering support for quitting smoking.

To quit smoking, experts recommend starting your smoke-free journey by making a concrete plan.

“Set a target quit date, preferably within 2 weeks, and support your quit attempt with medication and counseling. This combination of support — rather than relying on one or neither — is key and leads to higher success rates,” Hilary Tindle, MD, PhD, the founding director of ViTAL, the Vanderbilt Center for Tobacco, Addiction, and Lifestyle at Vanderbilt University Medical Center, told Healthline in a recent interview. 

“If someone does not succeed on the first quit attempt, keep trying,” Tindle said. “ In the U.S., more than 50% of all people who ever smoked have now quit.”

Takeaway

U.S. Surgeon General Dr. Vivek Murthy issued a new advisory highlighting health disparities in tobacco use despite a decline in cigarette smoking in recent decades.

Cutting back on smoking can be beneficial, but experts recommend quitting altogether. Doing so can immediately improve your health and reduce your risk of death.

There are many resources available to help you quit smoking. Try the American Cancer Society’s Great American Smokeout and 1-800-QUIT-NOW to learn more.

• Organic carrots have been linked to a multistate E. coli outbreak, resulting in 15 hospitalizations and one death.
• The CDC is warning consumers to check their refrigerators for the contaminated produce and discard it immediately.
• E. coli is a common foodborne infection that can result in both mild symptoms and severe complications requiring hospitalization.

A multi-state E. coli outbreak linked to organic carrots has resulted in 15 hospitalizations and one death so far, according to the CDC.

In a food safety alert issued this week, the CDC warned that E. coli infections have been reported from 18 states, with nearly 40 sickened. The outbreak has been traced to organic carrots sold by Grimmway Farms, which are available in a wide variety of grocery stores under brand names including Cal-Organic, Trader Joe’s, Wegmans, and 365.

The outbreak is still considered active by the CDC, although the products are no longer on store shelves. Consumers are urged to check their homes and refrigerators for any affected carrots and discard them immediately.

Escherichia coli, or E. coli, is a bacterium that can live in human intestines and is one of the most common causes of foodborne illness in the United States. There are multiple species of E. coli, some of which are harmless. Others can result in mild symptoms, including nausea, fatigue, and diarrhea, and even more serious, potentially life threatening symptoms. 

“This is definitely a recall that consumers should take very seriously to protect themselves and their loved ones,” Joseph Lambson, PharmD, Director of the New Mexico Poison and Drug Information Center, and an Assistant Professor at the University of New Mexico College of Pharmacy, told Healthline.

Which states and products are affected by the outbreak?

The E. coli outbreak has been linked to infections in 18 states across the US, from California to New York. Affected states include Texas, South Carolina, Pennsylvania, Michigan, Colorado, and many more.

Currentl,y Washington, Minnesota, and New York are reporting the highest number of cases, followed by California and Oregon.

Grimmway Farms organic carrots and baby carrots are sold under many different brand names, including:

• 365
• Bunny Luv
• Cal-Organic
• Raley’s
• Sprouts
• Trader Joe’s
• Wegmans
• President’s Choice

A full list of states and products affected by the recall can be found here. 

The contaminated products can be identified through their best-if-used-by dates.

Baby organic carrots with best-if-used-by dates are approximately between 9/11/2024 and 11/12/2024, and whole organic carrots between 8/14/2024 and 10/23/24. However, not all brands will carry a best-if-used-by date on their packaging.

Consumers should check their households for affected products and discard them immediately. Any surfaces that the carrots have come into contact with should be cleaned immediately with hot soapy water. 

Signs and symptoms of E. coli infection

“E. coli is not a new toxin. It’s something that we’ve known about for a long time in medicine. And the good news is that we know what symptoms to look for. We’re pretty good at detecting and treating the infection. Most people recover, although some of the more severe cases are very tragic,” said Rais Vohra, MD, a professor of Clinical Emergency medicine at UCSF Medical and director of the California Poison Control System Fresno-Madera Division.

The symptoms of E. coli generally manifest within 3 to 4 days after infection. Mild symptoms are nonspecific and can feel like general “food poisoning”:

• Nausea
• Diarrhea
• Fever
• Loss of appetite
• Vomiting, in rare cases

In some cases, the symptoms are more severe, particularly when the variety of E. coli produces shiga toxin. Shiga toxin producing E. coli (STEC) can result in severe, bloody diarrhea (dysentery), and other serious complications like hemolytic uremic syndrome, which can lead to kidney failure and death.

“STEC actually gets into the lining of the gut, and the whole gut starts to kind of just peel off, which is where you get bloody diarrhea; it’s a much more invasive disease. Then the bacteria can actually get into your bloodstream, and then you can even get blood poisoning, also known as sepsis,” said Vohra.

Healthy adults will likely survive an E. coli infection with supportive care, but some groups are at increased risk of severe illness. 

“If you happen to be immunocompromised, if you happen to have some condition that makes you more vulnerable to dehydration, such as diabetes, you could be at increased risk,” said Vohra.

Elderly individuals and young children are also at increased risk of dehydration and severe symptoms from E. coli infection.

What to do if you think you are experiencing symptoms of E. coli infection

The best medicine for foodborne illness is prevention. That means basic hygiene and food safety practices like hand washing and disinfecting surfaces. However, if you think you’ve consumed a contaminated product or already have symptoms, the best course of action is supportive care at home: make sure to rest and hydrate. 

Replenishing fluids and electrolytes that are lost through vomiting and diarrhea is the most important facet of care at this stage. 

However, in some instances, supportive care may be insufficient.

“If the symptoms are more severe, such as having a fever that’s above 102 degrees Fahrenheit, or having diarrhea that’s occurring for longer than three days, or bloody diarrhea, any of the symptoms that the CDC on their website lists as more severe, in that situation, it would be recommended to then reach out to a healthcare profession,” said Lambson.

Vohra also recommends that everyone pay special attention to hygiene and food safety heading into the holiday season.

“Everyone’s getting ready to cook their best dishes and share them with families. Please, please be hygienic when you do that. If you’re going to be cooking meat, know how to prepare it. Clean your vegetables. Double check your list of groceries to make sure that they’re not being recalled at the national or at the state level, wherever you happen to be,” he told Healthline.

The bottom line

A multistate E. coli outbreak linked to organic carrots has resulted in nearly 40 reported illnesses, including 15 hospitalizations and one death.

Grimmway Farms sold the contaminated carrots under various brand names, including Trader Joe’s, Cal-Organic, and Bunny Luv.

The affected products are no longer on store shelves but may be in your refrigerator. Consumers are urged to check for contaminated products and discard them immediately.

E. coli infection is a common foodborne illness that may result in mild symptoms (diarrhea, nausea, and vomiting) or more severe complications, including dysentery (bloody diarrhea) and hemolytic uremic syndrome.

Patients in British hospitals with serious, antibiotic-resistant gut infections have little in common with snakebite victims overseas. But when scientists made an unlikely connection in 2018, it led to trials for a potential new treatment for antibiotic-resistant infections. In this …

• A new study says that regular walking could help you live longer.
• Those who were most active moved the equivalent of 160 minutes of walking per day.
• People who are not very active could gain as much as 11 years of life by walking more.
• Walking increases life span by improving cardiometabolic health.
• It’s important to start slow and build up to your walking goal.

According to a study published online on November 14, 2024, in the British Journal of Sports Medicine, getting less physical activity is linked with premature death.

However, the researchers found that increasing physical activity — for example, taking daily walks — could extend how long people live.

If people were as active as the top one-quarter of Americans, they could live around 5 years longer.

Additionally, if people who are among the least active brought their activity up to this level, they might add an additional 11 years to their lives.

The authors further speculated that infrastructure changes like walkable neighborhoods and green spaces, which help promote activities like biking and walking, could lead to greater longevity within the general population.

Greater physical activity linked to living longer

To conduct their study, the researchers gathered data from people older than age 40, which was collected via activity trackers for the 2003-2006 National Health and Nutrition Examination Survey (NHANES).

They also used 2019 U.S. Census data as well as 2017 death data gleaned from the National Center for Health Statistics.

The team then created a mathematical model to predict how different levels of physical activity could influence how long people lived.

They found that the 25% of individuals who were most active engaged in activity levels equivalent to walking 160 minutes every day at a pace of 3 mph.

Based on this, they estimated that if all people boosted their activity to this level, they could increase their life expectancy from 78.6 to 84 years — an increase of over 5 years.

However, being in the lowest 25% of activity was associated with a decrease in life expectancy of around 6 years.

If these less active individuals logged an additional 111 minutes of walking each day, though, they could conceivably experience even greater benefits, living nearly 11 years longer.

How walking might increase longevity

John Lowe, MD, a physician at Restore Care specializing in preventive health and lifestyle medicine, who was not involved in the study, explained that regular walking has several beneficial effects that contribute to a longer life.

It can help you decrease your resting heart rate, manage cholesterol, and reduce your chances of heart attack or stroke.

“Walking … can be useful for glucose metabolism,” he added, “because [it is] known to enhance insulin actions, which would enable better blood sugar management and reduce the chances of type 2 diabetes. A walk after meals is particularly effective for blood glucose control.”

Regular walking can also protect the body from systemic inflammation, according to Lowe. Systemic inflammation has been associated with several chronic diseases in epidemiological studies.

“Maintaining a walking routine helps downregulate inflammatory markers, including C-reactive protein (CRP), which helps improve immune system responsiveness and maintain cellular health,” he concluded.

How to get started walking more daily steps

Dr. Sean Ormond, a pain management doctor with Atlas Pain Specialists, who was also not a part of the study, said that walking doesn’t have to take a large commitment to make a difference for you.

“Start with small, doable changes that fit into your daily life,” he said. “For example, instead of finding the closest parking spot, park farther away and enjoy the walk. Swap the elevator for the stairs when you can. Take five- or ten-minute walking breaks during your workday — maybe a quick lap around your house, office, or even your yard.”

Ormond added that taking a gentle walk after meals can be beneficial because it helps you digest your food and doesn’t feel like exercise.

“If you have kids or pets, make walking a family affair,” he suggested. “[I]t’s a great way to bond while staying active.”

If you’d like to take a more structured approach, Ormond said step-counting apps and fitness trackers can make walking more fun. “Set small, realistic goals, like an extra 500 steps a day, and build from there,” he said.

Also, he said that people shouldn’t become discouraged if the 160 minutes of activity mentioned in the study seems like a daunting goal.

“Every step you take is a step toward better health,” said Ormond. “What matters most is consistency.”

“So, lace up your shoes and see where a walk can take you — physically, mentally, and emotionally. It’s one of the easiest ways to nurture your body and mind for years to come,” he said.

Takeaway

A new study has found that greater amounts of physical activity are associated with living longer.

Setting a goal to walk 160 minutes per day could increase people’s lifespan by around 5 years.

Also, those people who are least active could increase their longevity by as much as 11 years.

Walking helps you live longer because it has beneficial effects on your cardiometabolic health.

To get started with walking, make small, realistic changes, keep things fun, and build up slowly.

• Eating certain foods can exacerbate GI discomfort and other common side effects associated with GLP-1 weight loss drugs like Ozempic and Wegovy.
• Navigating holiday meals can be challenging as they often include many of these foods, such as high fat, greasy, and sugary items.
• Health experts say it’s essential to understand what foods might worsen the side effects of the medication so that you can approach the holiday with strategies to minimize severe discomfort.

Thanksgiving is a time for family, (parade) floats, and, let’s be honest, food.

“Thanksgiving is all about food, eating, and over-indulgence: Turkey, stuffing, sweet potatoes, and pumpkin pie,” says Chris McGowan, MD, a gastroenterologist, obesity medicine specialist, and the founder of True You Weight Loss. “For many, eating to the point of discomfort is the highlight of the holiday and a way of showing appreciation to the host and chef.”

But McGowan says that, for the hundreds of thousands of people taking GLP-1 weight loss medications like Ozempic, Wegovy, Mounjaro, or Zepbound, the eat-until-you’re-full-and-then-get-seconds approach may present physically painful challenges.

These medications are associated with common side effects like nausea and vomiting, which can intensify when a person consumes certain foods, including high fat, high-sugar items that are often front and center on Thanksgiving tables.

“As we approach the food-centric holiday season, it’s essential to understand which foods might worsen the side effects of anti-obesity medications,” McGowan says.

Healthline spoke with McGowan and other obesity medicine specialists, who shared their tips for which Thanksgiving foods are the least likely to trigger side effects and which ones are best to limit or avoid for people taking weight loss drugs.

How GLP-1 drugs can affect appetite and tolerance for certain foods

GLP-1 medications are a class of antiobesity and antidiabetic drugs, semaglutide (Ozempic and Wegovy) and tirzepatide (Zepbound and Mounjaro). They can help people lose significant weight, but they can also change how a person tolerates certain foods.

“GLP-1 medications mimic the GLP-1 hormone, which is produced in the small intestine. This hormone regulates blood sugar levels, appetite, and digestion,” says Michael L. Glickman, MD, a triple board certified family and obesity medicine physician who founded Revolution Medicine. “The medication helps with weight loss by slowing digestion and increasing satiety. This helps reduce food portions.” 

Portions are generally large on Thanksgiving, but that’s not the only potential pitfall for people taking drugs like Ozempic.

“Thanksgiving favorites, which tend to be high in sugar, carbohydrates, and unhealthy fats, can be more likely to cause gastrointestinal issues when they stay in the stomach longer,” Glickman says.

GI issues, like nausea and vomiting, are common side effects associated with GLP-1 drugs, so consuming these foods can either trigger or worsen them, explains Mir Ali, MD, a board certified general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center.

Thanksgiving foods to avoid on Ozempic, Wegovy, and similar drugs

First, it’s important to note that there is no specific “Ozempic diet,” and you can still enjoy all your favorite Thanksgiving dishes in moderation.

“It’s perfectly fine to enjoy all of Thanksgiving’s tastes and flavors, but be mindful of portions and keep the heavier foods to a minimum,” McGowan says.

Ali says greasy, fried, sugary, high carb, calorie-dense foods take a while to digest. Because of this, they may be more likely to trigger uncomfortable side effects.

According to McGowan, some Thanksgiving staples that fit this bill include:

• Stuffing
• Candied yams (often doused in butter, sugar, and marshmallows)
• Green bean casserole (often heavy in cream and fried onions)
• Mashed potatoes with gravy
• Pecan pie
• Canned cranberry sauce (often high in sugar)
• Macaroni and cheese

Ali also advises people to be mindful of alcohol consumption.

“Alcohol contains a large amount of carbohydrate calories and can cause more nausea and reflux,” Ali says.

Ali also adds that foods affect people differently, so it’s critical to tune into your body.

Thanksgiving foods least likely to cause side effects on Ozempic, Wegovy

The holidays can feel emotionally nourishing — and they can be physically, too. 

 “For many, the holidays represent an important time for family and social gatherings and celebrations,” McGowan says. “It’s important to continue enjoying the season’s positive aspects without triggering troublesome or potentially dangerous medication side effects.”

Glickman suggests prioritizing foods like lean proteins, fiber, and non-starchy vegetables.

Glickman and McGowan said the meal’s star, the turkey, fits that bill if it’s roasted.

McGowan says some other foods include quintessential Thanksgiving menu items like: 

• Roast vegetables like oven-roasted carrots, parsnips, and Brussels sprouts
• Homemade cranberry sauce using a recipe that minimizes sugar
• Sauteed or steamed green beans

Tips for managing Thanksgiving while taking GLP-1 drugs like Ozempic

 McGowan recommends taking time before Thanksgiving to reflect on details like the menu, guest list, location, and potential challenges. 

“Anticipating these scenarios can help you stay in control and enjoy the day,” McGowan says.

The following simple tips can help you manage potential challenges during holiday meals.

Don’t skip meals

Glickman and McGowan say “saving” calories by ditching or severely limiting food intake ahead of a Thanksgiving meal is a common mistake for people trying to lose weight or maintain weight loss. It can backfire. 

“Skipping meals will only lead to excessive hunger and overeating,” McGowan says.

Glickman suggests prioritizing breakfast on Thanksgiving morning.

“Start your day with a healthy high protein and fiber breakfast and lunch,” Glickman says. “This will prevent you from starting Thanksgiving dinner with 10/10 hunger and limit overeating.”

Bring a food you’re excited to eat

Food is more than fuel for the body — it’s about taste, socialization, and memories. Hearing about the foods you “can’t eat” or “can’t have much of” ahead of a food-centered holiday like Thanksgiving can feel like a downer, especially if you aren’t the host or handling the cooking.

McGowan says you can avoid this pain point by adding some favorite dishes to the Thanksgiving meal that you know you’ll enjoy from a taste and lack of side effect perspective. 

Strategize the meal

Glickman recommends starting the meal by filling your plate with whole foods like veggies, whole grains, and lean proteins before adding smaller portions that can worsen GLP-1 side effects. Then, eat the nourishing foods that are less likely to cause discomfort first, like protein-rich roasted turkey and fiber-packed veggies.

“This will also help with satiety,” Glickman says.

Savor the meal

“Eating slower allows time for the sensation of fullness to become more apparent and helps avoid overeating,” Ali says.

McGowan says it also helps you enjoy the whole experience of the meal, including family, friends, and flavors.

Go for a post-meal walk

Glickman says heading out for a walk following a meal is useful.

“Going for a walk within 30 minutes of your Thanksgiving meal helps with motility, improves digestion, and limits insulin spikes,” Glickman says. “Walking after large meals can be a useful tip to help stay on track with your weight loss journey.”

Avoid leftovers

“Once-a-year” foods can become more than that because of leftovers.

“Keep Thanksgiving to one meal,” McGowan says. “If you are hosting, send your leftovers with guests. If you’re a guest, either decline the leftovers or take them home and toss them.”

Takeaway

If you’re taking a GLP-1 medication like Ozempic, Wegovy, Mounjaro, or Zepbound, eating certain foods can trigger common side effects such as nausea, bloating, and diarrhea.

Navigating holiday meals can be challenging as they often include many of these foods.

Health experts say it’s essential to understand what foods might worsen the side effects of the medication so that you can approach the holiday with strategies to minimize severe discomfort.

Experts say eating foods like lean proteins (including roasted turkey) and fiber-rich foods like roasted vegetables may be best to prioritize, while it’s a good idea to limit foods that are high in fat, carbs, and sugar.

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• In 2025, an annual $2,000 out-of-pocket cap will keep costs low for Medicare enrollees on drugs covered by Part D plans.
• A payment plan will allow Medicare enrollees to pay for their drugs in capped monthly installments rather than paying the full cost upfront at the pharmacy.
• A drop in the number of stand-alone Part D drug plans will mean fewer choices for enrollees, which may simplify the process of choosing a Medicare plan.

Several changes are coming to Medicare’s Part D prescription drug plans in 2025 that could potentially impact enrollees’ benefits and costs, including changes in premiums, a new out-of-pocket cap, and a drop in the number of drug plans being offered.

“All in all, these 2025 changes offer a good balance between managing costs and adding protections for Medicare beneficiaries,” said Brandy Burch, CEO at BenefitBay.

“For most people, these updates will provide more stability and predictability in their healthcare expenses,” Burch told Healthline, “which can make a big difference when it comes to planning for the year ahead.”

Here’s a rundown of the top five changes coming to Medicare Part D prescription drug plans.

Increase in Plan D prescription drug base premium

The Medicare Part D base beneficiary premium will increase in 2025 over the previous year. However, this doesn’t mean Medicare enrollees will pay more out of pocket each month for their Part D drug benefits.

Here’s why.

The base beneficiary premium will be $36.78 in 2025, a 6% increase from 2024, reports nonprofit KFF. This increase is capped at 6% due to a provision in the Inflation Reduction Act.

The Inflation Reduction Act also provides a premium stabilization mechanism. This limits the actual premium increases for Part D plans to about $2 per month on average.

The base premium is not what Part D enrollees pay each month. It is the base amount allowed for premiums.

The Centers for Medicare & Medicaid Services (CMS) projects that, thanks to the government’s premium stabilization efforts, the average monthly premium for stand-alone Part D plans will decrease by 4% to $40.00 in 2025.

Actual monthly premiums will range from $0 to $100 or more, reports KFF. In addition, enrollees with higher annual incomes ($103,000 or greater for individuals; $206,000 or greater for couples) will pay an income-related premium surcharge on top of the regular premium.

CMS projects that the average monthly premium for people with a Medicare Advantage plan that includes prescription drug coverage will fall by 13% to $13.50 in 2025.

However, a recent analysis by ValuePenguin found that overall Medicare Advantage premiums will increase by 4% for 2025 over the previous year — going from $24 to $25 per month. This rate change varies by state.

These are average changes, so your plan’s premiums may change by a different amount — up or down. It’s important to shop around during the Medicare Open Enrollment period, which runs from October 15 to December 7, to find the best plan for your budget and needs.

In addition, over 14 million people with Medicare will have a $0 premium for Part D plans, thanks to the government’s Low Income Subsidy (LIS) program.

$2,000 out-of-pocket max and end of coverage ‘donut hole’

You may have heard about the “donut hole” — or gap in prescription drug coverage — about Medicare Part D. 

You enter this gap once your Medicare Part D plan has paid a certain amount for your prescription drugs during a single coverage year. At this point, you’ll pay more out of pocket for your prescription drugs until you reach your yearly limit.

Depending on your plan, when you hit your yearly limit, the plan may help pay for the cost of your prescription drugs again.

If this sounds confusing, don’t worry. The donut hole will disappear after 2024 and be replaced by a new $2,000 out-of-pocket cap in 2025. This change, due to the Inflation Reduction Act, affects all Medicare plans.

Once you have paid $2,000 out of pocket for covered drugs during a calendar year, you will automatically get “catastrophic coverage.” As a result, you won’t have to pay out of pocket for drugs covered by Part D for the rest of the year.

An estimated 1.4 million Medicare Part D enrollees without low-income subsidies are expected to benefit from the $2,000 out-of-pocket cap, reports KFF. These people had annual out-of-pocket spending above this limit.

Burch said the $2,000 out-of-pocket cap will have a big impact for Medicare enrollees.

“For people who rely on costly medications, having this cap means they can finally plan their healthcare budget without worrying about unexpected high costs,” she said. “It’s a big step in providing peace of mind and knowing that once they hit that $2,000 threshold, they’re covered for the rest of the year.”

This change will not only lower out-of-pocket drug costs for enrollees — especially for those taking multiple or high-priced medications — but it is also likely to help them take their drugs as prescribed, which can improve their health outcomes.

Payment plan to spread out drug costs

Also coming in 2025 is the option for Part D enrollees to pay their prescription drug costs in capped monthly installments instead of all at once at the pharmacy.

The Medicare Prescription Payment Plan is available for all plans at no cost, including Medicare drug plans and Medicare Advantage plans with drug coverage. However, participation is voluntary.

If you choose this option, instead of paying for your drugs at the pharmacy, you will get a monthly bill from your Medicare drug plan or Medicare Advantage plan.

”This [payment plan] makes the cost [of drugs] feel more manageable by breaking it down over time,” said Burch. “It’s like having a bit of breathing room, rather than facing a large payment all at once. And that flexibility can be a relief for those on a tight budget.”

Jenn Kerfoot, chief strategy and growth officer at DUOS pointed out that people on the Medicare Prescription Payment Plan can’t be sent to a credit collector for not paying their bills. However, the plan can kick them off the payment plan if they don’t pay their bills, she told Healthline.

Fewer stand-alone Part D plans

KFF reports that in 2025, there will be 26% fewer standalone Part D plans than in the previous year and 5% fewer Part D plans for Low-Income Subsidy (LIS) beneficiaries.

These drops are due to changes stemming from the Inflation Reduction Act, which takes effect in 2025, including the $2,000 out-of-pocket cap. Part D plans and drug manufacturers will also have to pay a larger share of drug costs above the cap, and Medicare will pick up less for drug costs.

However, KFF said enrollees in each state will still be able to choose from at least a dozen standalone plans and many Medicare Advantage drug plans.

While some people may end up losing their current plan, having fewer plans overall could help simplify things for people during Medicare Open Enrollment.

“Fewer choices mean people don’t have to spend as much time evaluating and comparing endless options, which can be overwhelming,” said Burch. “For a lot of older adults, a streamlined set of options can make the process easier and help them focus on finding the best fit, without all the guesswork.”

New Manufacturer Discount Program

At the start of 2025, the Medicare Coverage Gap Discount Program will end. This program helps cover the cost of prescription drugs for Part D beneficiaries who reach the donut hole. 

Since the donut hole is going away due to the new $2,000 out-of-pocket cap, the Coverage Gap Discount Program is no longer needed.

It will be replaced starting in 2025 by the Manufacturer Discount Program. Under this program, the manufacturer will typically pay a 10% discount for brand-name drugs and biologics during the initial Part D coverage phase, said CMS. 

When a beneficiary reaches the catastrophic phase—after the $2,000 out-of-pocket cap—the manufacturer will typically offer a 20% discount on these drugs and biologics.

“This change may alter how drug discounts are applied, particularly for brand-name medications,” said Burch. “but the good news is that financial relief [for enrollees] for prescriptions should still be there.”

However, “it’s important for enrollees to double-check how this update might affect their specific medications during open enrollment,” she added. “That way, they can avoid any surprises when it comes to costs.”

Kerfoot recommends that people consider several things when shopping for a Medicare drug plan this year, including whether their plan from 2024 is still offered, whether their existing plan cut their benefits, whether the medications they are taking are still covered by the plan, and whether the premium changed.

Burch also suggests that people keep in mind the five major changes happening next year.

“With the adjustments to out-of-pocket limits, payment options and plan choices, it’s important to pick a plan that best aligns with their specific healthcare and financial needs,” said Burch. “Taking a little extra time now to understand the new landscape can help save a lot of worry, and potentially a lot of money, throughout 2025.”

Takeaway

Several changes are coming to Medicare Part D prescription drug plans in 2025 that could impact drug costs and plan coverage. One change is an annual $2,000 out-of-pocket cap. Once enrollees hit this limit, they won’t have to pay out of pocket for their drugs for the rest of the year.

A new payment plan is also starting up in 2025 that will allow enrollees to pay for their drugs in the form of capped monthly installments rather than all at once at the pharmacy. This free option is available for all Part D plans, including Medicare Advantage plans with drug coverage. Participation is voluntary.

In 2025, there will be 26% fewer stand-alone Part D plans than in 2024 and slightly fewer Part D plans for low-income older adults. However, at least a dozen stand-alone plans are available in each state, so enrollees will still have options.