Uncategorized

• Human longevity is affected by a complex number of factors, including lifestyle.
• Through modifiable lifestyle behaviors, including diet, exercise, and limiting sedentary behavior, you can improve longevity and quality of life during aging.
• As with any resolution, sustainability is key, so find ways to integrate healthy habits that will keep you engaged and happy.

The science behind longevity — extending human life span — continues to improve year after year.

Though we have yet to discover a veritable fountain of youth, research indicates that lifestyle choices, particularly diet and exercise, play an outsized role in determining whether or not we live long, healthy lives. That’s good news because it means that you are likely in better control of the factors that influence longevity than you think. 

While we still can’t change our genes, science indicates that genetic makeup is just one part of the complex puzzle of life span. Today, there is also more emphasis on healthy aging rather than just life extension.

“The question we really should be asking and focusing on is what is healthy aging and healthspan, not life span,” Amanda Boyce, PhD., Health Scientist Administrator in the Division of Aging Biology, NIH’s National Institute on Aging, told Healthline.

Healthline spoke with various experts in health and medicine to find the best, most actionable recommendations for living longer and aging gracefully in the new year.

5 science-backed ways to improve longevity in 2025

Give your diet a Mediterranean or Japanese boost

The science is very consistent: when it comes to diets that improve longevity and prevent disease, the Mediterranean diet and the Japanese/Okinawan diet are the best.

While they might seem worlds apart in terms of culture and geography, both emphasize similar dietary patterns. They are heavy on fish as a source of protein, which is rich in brain-boosting and heart-healthy fats. They also include plenty of whole vegetables (fresh or fermented) and limit heavily processed foods and sugar.

“As we approach the new year, know that no one “quick fix diet” will be impactful. When we think about longevity, we must consider dietary patterns and changes that will provide long-lasting impact and, most importantly, are sustainable!” said Alyssa Kwan, MS, RD, Clinical Dietitian in Cardiology, Stanford Medicine.

If you want to start changing your diet to better align with these practices but aren’t sure where to start, here are some simple tips. 

“Focus on one component at a time and make sure it’s something that fits within your personal, religious, and/or cultural preferences. For example, if you enjoy lentils, use them instead of white rice in veggie bowls. But if you dislike fish, then focus on other sources of protein,” said Kristin Kirkpatrick, MS, RD, a nutritionist at the Cleveland Clinic, and co-author of Regenerative Health.

Shed those excess pounds

Obesity is linked to numerous chronic illnesses, including cardiovascular disease and diabetes, and yes, even a shorter lifespan. For many adult Americans, shedding a few excess pounds can be tremendously beneficial to longevity and overall health. 

But rather than just trying to lose weight, learn about the ideal body weight for your age, sex, and height. Losing even 5% of your body weight can significantly impact everything from blood sugar to blood pressure.

“Maintaining a healthy weight across life stages is critical for healthy aging and for improving both lifespan and healthspan,” said Frank B. Hu, MD, PhD, professor and chair of the Department of Nutrition, Harvard T.H. Chan School of Public Health.

“Clinical trials have shown that weight loss achieved through lifestyle changes, medications such as GLP-1 agonists, or weight loss surgeries is associated with a reduced risk of chronic diseases, including diabetes, cardiovascular disease (CVD), and certain cancers, and premature death,” said Hu.

Cut down on sitting

There’s a good chance that you are sitting far more than is good for your health. That’s likely no fault of your own: you sit when you use a computer, watch TV, or meet friends at a coffee shop. But as our lives have become more sedentary, science has homed in on the negative effects that can have on longevity and disease risk. 

“Sedentary behavior, such as prolonged TV watching, has been associated with an increased risk of chronic diseases, including diabetes, cardiovascular disease (CVD), and premature death. This heightened risk is primarily attributed to increased obesity and the displacement of physical activity,” said Hu.

Even if you exercise regularly, sedentary behavior has serious health risks associated with it. So don’t just think about trying to offset lazy days with a hard gym session. Think about ways to increase physical activity throughout the day, even if it just means taking a walk around your house or office, even if you are still exercising regularly.

Exercise — the more, the better

Regular exercise is one of the best things you can do for your health. And it’s not just about your body either. The benefits extend to brain health and cognition, too.

New research published in December 2024 found that among older adults, cardiorespiratory fitness was an excellent indicator of brain health across multiple domains of cognition, including memory.

Finding ways to increase physical activity and cut down on sedentary time in a manner that is enjoyable is key to making the habit sustainable. 

As a starting point, the CDC recommends that adults get a minimum of 150 minutes per week of moderate-intensity physical activity.

“The two things in older adults that we see as a result of aging that lead to decreases in their quality of life are changes in cognition, and functionality, staying up on your feet. Exercise is far and away the thing that impacts both of them,” Katherine T. Ward, MD, clinical section chief of geriatrics at Stanford Medicine, told Healthline.

Boyce adds that establishing habits that can reduce sedentary behaviors and increase activity at the same time is a great place to start.

“You can also build physical activity into your everyday life. For instance, get off the train one stop early and walk or bundle behaviors like only watching TV while you’re exercising,” she said.

Stop smoking

Yes, you’ve heard it before, but the science is as firm as ever: stop smoking, and you will live longer. Period. 

In a study led by Frank Hu and published in 2018, researchers found that “never” smoking was one of five key factors for prolonging life expectancy. The others were:

• maintaining a healthy weight
• regular physical activity
• healthy diet
• only consuming a moderate amount of alcohol

Cigarette smoking is associated with roughly one of every five deaths in the United States each year, amounting to more than 480,000 deaths annually.

Why is smoking so deadly? It is linked to everything from cancer and heart disease to diabetes and COPD. Stopping smoking not only lowers your risk of all these diseases but can add as much as ten years to life expectancy.

Expert recommendations for longevity in 2025

Healthline asked the experts to give their top recommendation for longevity in 2025, and here’s what they said:

“Maintaining a healthy body weight through diet and exercise is something that I have continually strived for,” said Hu.

Ward told Healthline, “Whatever you’re doing for physical activity, add 30 more minutes to it.”

“Move your body. Take a walk after dinner, have a family dance party, or try a new sport. Not only will it improve your health, hopefully, it will bring more joy into your life,” said Boyce.

When it comes to eating healthy, think holistically about other behaviors, including exercise and sleep.

Kirkpatrick emphasized, “Match your dietary pattern (not diet) to your why. If your ‘why’ is ‘I don’t want to get dementia like my mother did,’ for example, then pay attention to relevant supplements, adequate exercise, and a nutrient-specific pattern (along with enhancements in stress management and sleep).”

“Overall, to improve longevity, think about sustainability. Consider other factors such as maximizing sleep, minimizing stress levels, and engaging in an active lifestyle ~150 minutes of physical activity weekly,” added Kwan.

The bottom line

Rather than looking for a quick fix, the science behind longevity suggests that healthy lifestyle habits, including diet and exercise, are most important.

Getting active, losing weight, stopping smoking, eating a Mediterranean diet, and limiting sedentary behavior are keys to not only lengthening your life span but also increasing your quality of life or health span.

Take small, sustainable steps across different aspects of your life to build habits that will last beyond 2025.

Around a million people read our blog in 2024, and we were the most read blog across government in December.

Read this blog post and subscribe for the latest advice and insights.

• Jimmy Carter, the 39th U.S. president, died at age 100 in his hometown in Plains, Georgia.
• The former president left a long legacy working in public health.
• In recent years, Carter has had multiple health issues, including being diagnosed with metastatic melanoma and a fractured pelvis.

Former United States President Jimmy Carter died on December 29 at age 100 in his hometown of Plains, Georgia. Carter was the 39th president and the only former president to reach centenarian status. He leaves a long legacy in global health and infectious disease that has changed the world for the better.

In a statement issued by the White House, President Joe Biden called Carter a “dear friend’ who was “a man of great character and courage, hope and optimism.”

“With his compassion and moral clarity, he worked to eradicate disease, forge peace, advance civil rights and human rights, promote free and fair elections, house the homeless, and always advocate for the least among us.” President Biden said. “He saved, lifted, and changed the lives of people all across the globe.”

Carter has been in in-home hospice since February 2023, following a series of hospitalizations.

Health issues have plagued Carter in the past decade. In 2015, he was diagnosed with metastatic melanoma that had spread to his liver and brain. But he subsequently beat the diagnosis and was declared cancer-free.

In 2019, Carter suffered a series of falls around the time of his birthday in October, with one resulting in a black eye, stitches, and a fractured pelvis. He again went on to make a full recovery.

Carter’s wife of 77 years, Rosalynn Carter, died in November 2023, at age 96. The Carters were the longest-married presidential couple in the U.S. history.

Jimmy Carter’s public health legacy

The former President’s charitable work since his defeat by Reagan in 1980 was legendary. He worked with organizations, including Habitat for Humanity and his namesake, the Carter Center.

Throughout the past decades, Carter has also worked diligently in global health to work toward the eradication of devastating diseases around the world. He has become a patron in the world of neglected tropical diseases, a group of conditions with far-reaching health and economic outcomes. However, because they are found predominantly in impoverished areas, these diseases, which include Chagas, dengue, guinea-worm disease, and river blindness (onchocerciasis), were often not well studied.

Peter J. Hotez, MD, PhD, Co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine, has worked with Carter over the years. In 2006, the two worked on a panel that helped to introduce the term “neglected tropical diseases” into the global health lexicon.

“To have him be out in front, talking about the importance of diseases that previously most people didn’t care about was a tremendous boost to our whole field of neglected tropical diseases,” he told Healthline.

William Schaffner, MD, a professor of infectious diseases at Vanderbilt University Medical School, echoed those sentiments, saying that Carter Center cast a light on “the forgotten problems of forgotten people.”

“These tropical diseases are outside of our daily purview, outside of our daily experience here in the developed world, but they cause untold misery for people around the world,” he told Healthline.

Fight against neglected tropical diseases

Today, the Carter Center continues its fight against neglected tropical diseases with the ultimate goal of eradication in mind. The six at the top of the center’s list are:

• Guinea worm disease
• River blindness (onchocerciasis)
• Trachoma
• Lymphatic filariasis (elephantiasis)
• Schistosomiasis
• Malaria

Neglected tropical diseases are historically hard to treat for many reasons. They most often occur in impoverished regions and countries, often in remote areas. They also tend to be debilitating but not deadly, which can put them lower on the list when it comes to money and resources for treatment, according to Hotez.

“When you’re trying to compete for resources with people who study certain diseases like AIDS or tuberculosis, getting people to care about these chronic and debilitating infections is not always easy,” he said.

River blindness (onchocerciasis) is caused by a parasitic worm that is transmitted to humans through the repeated bites of infected blackflies. The worm larvae migrate within the body to the skin, eyes, and organs, leading to inflammation, lesions, and blindness.

“You can see pictures of a village where there’s a tiny little child, a 5-year-old with a long stick, and the stick is extended behind him, and the other end is held by an adult, and he is leading that adult around the village because the adult cannot see,” said Schaffner.

Schistosomiasis is caused when a parasitic blood fluke infects humans. Freshwater snails serve as an intermediary host for the larvae before releasing them into bodies of water; from there, the larvae are capable of penetrating human skin.

“It is the second most important parasitic disease in the world in terms of its extent and its morbidity,” Ronald Blanton, MD, Chair of Tropical Medicine at Tulane University’s School of Public Health and Tropical Medicine, told Healthline.

Schistosomiasis causes liver and intestinal damage, resulting in bloody urine and stool, among other serious health problems.

Carter’s tireless effort to eradicate Guinea worm disease

Of all the neglected tropical diseases that he has worked to eradicate, the one that Carter’s name is most closely associated with is guinea worm disease. Caused by larvae of the parasite Dracunculus medinensis, most often from drinking from a contaminated water source.

Inside the body, a female larvae will grow, sometimes up to over three feet in length, before emerging through a blister in the skin to expel its own larvae into water.

Carter worked tirelessly to eradicate the disease. In the mid-1980s, the estimated number of guinea worm disease cases stood at 3.5 million. By 1989, that number fell to under one million. According to the most recent reports by the WHO and CDC from 2022, there were only 13 known cases in the world.

In 1995, during the Second Sudanese Civil War, Carter helped to broker the longest humanitarian cease-fire in history to combat the disease. The six-month “guinea worm ceasefire,” as it came to be known, gave health workers the opportunity to distribute some 200,000 water filters capable of filtering out guinea worm larvae and provide treatment and education about the disease.

“I would like to see Guinea worm completely eradicated before I die,” Carter said at a press conference in 2015, “I’d like for the last Guinea worm to die before I do.”

Jimmy Carter’s global health legacy

Carter’s legacy continues to live on.

“The infectious disease world, and particularly those who are interested in global medicine and tropical diseases think of Jimmy Carter in a very, and I mean this seriously, reverential fashion,” said Schaffner.

Hotez told Healthline that Carter’s work and legacy are those of “a life well lived.” 

Hotez prefers, however, to remember Carter as an American who was humble and forever in touch with his roots:

“Before I lived in the South, when we were standing in the breakfast buffet line together, I didn’t know what cheesy grits were, so he gave me a lesson in how to make cheesy grits. I don’t think of President Carter, I think of cheesy grits.”

• Weekend warriors get their exercise in over a couple of days (like the weekend) rather than throughout the week.
• Studies have shown this exercise pattern results in significant health benefits, similar to a more traditional exercise schedule.
• An exercise routine that works is one that works for you and your schedule. Being a weekend warrior can provide flexibility in how and when you get your exercise.

Don’t have time to get enough exercise during the week? Becoming a weekend warrior could help jumpstart your exercise routine.

According to the Centers for Disease Control and Prevention (CDC), adults should get at least 150 minutes of moderate-intensity physical activity weekly. For many people, it makes sense to tackle that throughout the workweek: 30 minutes daily, Monday through Friday, for example. 

For others who may be stretched thin juggling work, family, commuting, school, and countless other obligations, exercising five days per week might not be feasible. Thus, the rise of the weekend warrior: individuals who cram all their physical activity into just a couple of days.

Whether you like to hike, play in amateur sports leagues, or go for an extended gym session, the weekend can be the perfect time to have fun and still get your recommended dose of exercise. 

Health benefits of weekend warrior physical activity

Studies have shown that weekend warriors reap many of the same health benefits as people who exercise regularly throughout the week.

“Getting at least 150 minutes of physical activity per week is broadly associated with improved health and lower risk of disease. So the key question is: Do concentrated activity patterns result in similar benefits as that activity spread out more regularly?” said Shaan Khurshid, MD, MPH, a cardiac electrophysiologist at Massachusetts General Hospital who has published research on weekend warriors.

“We found that consistent with older studies, both weekend warrior activity and regular activity were associated with substantial reductions in risk of cardiovascular disease. Most recently, we found that both weekend warrior and regular activity were associated with lower risk of over 200 diseases and very similar benefits for all of those diseases across the spectrum,” he told Healthline.

The benefits of being a weekend warrior aren’t limited to cardiovascular disease alone. A study published in the British Journal of Sports Medicine in October 2024 found that weekend warriors also experienced benefits to brain health.

In that study, which included more than 75,000 participants, weekend warriors had a significantly lower risk for dementia, Parkinson’s disease, depression, and anxiety compared to those who exercised less than 150 minutes per week. 

The bottom line: get your physical activity in however and whenever you can.

“The data suggests that it’s the overall volume of physical activity rather than the pattern that matters,” said Khurshid.

5 tips to get started with weekend warrior workouts

Being a weekend warrior isn’t about any particular kind of exercise or trend, but rather finding the time in your unique life and schedule to engage in physical activity.

No matter how you get your physical activity in, here are five tips to jumpstart your fitness goals.

1. Create an exercise routine that works for you

Brad Donohue, PhD, a professor of psychology and Creator of The Optimum Performance Program in Sports (TOPPS) at the University of Nevada Las Vegas, told Healthline that being a weekend warrior is “about getting out and exercising to the best of your ability in a manner that is fun and exciting.”

Donohue, who works with UFC fighters, Cirque du Soleil acrobats, and athletes of all levels through his TOPPS program, emphasized that a routine that works is the one that works best for you.

This means if you don’t have time to exercise during the week but enjoy playing sports on the weekend, then lean into that. Don’t get hung up on what works for other people.

“Get out there and just do the best you can for your own situation,” Donohue said.

2. Listen to your body

Being a weekend warrior doesn’t mean you have to be an elite athlete, but it does mean you are putting more strain on your body in a shorter period of time. So, that’s something worth considering based on your own fitness level and medical history.

Khurshid noted he didn’t find any association between weekend warriors and an increased risk of musculoskeletal injury in their research. Nonetheless, some caution is in order.

“It makes sense to listen to your body and follow common sense. I don’t recommend that you necessarily go out and try to exercise 150 minutes on Saturday all at once. I think it makes sense to ramp up your activity gradually and in a manner where you’re listening to your body,” he said.

3. Get friends or family involved

Donohue encourages anyone undertaking a new routine to get friends and family involved as well.

“How do you motivate someone to get out there and do some physical exercise? The key is to bring in family and other people [who] love them to get them to do shared activities and make it fun. We found that the more family members we involved, the greater their engagement, and participation, and also the better the outcomes,” he said.

Bringing together friends or family for group workout classes or weekend sports leagues could be the perfect opportunity to bond, have fun, and, of course, get some exercise.

4. Don’t focus on outcomes

As you start your new routine, focusing on a specific outcome, like a goal weight, could feel natural. But, according to Donohue, that kind of thinking can lead to problematic thinking and, ultimately, burnout.

“With our athletes, anxiety was really associated with outcome thinking, such as focusing on winning, or losing a certain amount of pounds… And if you don’t meet those expectations, then people have a tendency to quit,” he said.

Instead, he suggests, focus on thinking about your physical activity in a positive way: have fun and celebrate your own accomplishments, even the small ones.

“If you can just get out there and walk as much as you can and be happy with that, it’s going to be a lot more fulfilling and sustainable in the long run,” Donohue told Healthline.

5. Limit sedentary activity

Even if you exercise regularly, you should still be mindful of how much time you spend doing sedentary activity.

Too much sitting — whether working at a computer, watching TV, or just relaxing — limits the calories you burn and is associated with many deleterious health outcomes, including early death.

In a November 2024 study that Khurshid co-authored, researchers found that sedentary behavior was still associated with elevated risk of certain cardiovascular diseases, even among those who were physically active.

“Minimizing sedentary time is still important for people, even if they get the recommended levels of physical activity,” he told said.

Takeaway

Weekend warriors are individuals who get their recommended 150 minutes per week of exercise over the course of a few days (such as a weekend), rather spread out through the week.

Numerous studies have concluded that weekend warriors reap many of the same health benefits as those who follow traditional exercise patterns.

Weekend warrior exercise can be a flexible alternative for those with schedules that make it difficult to find time to exercise during the week.

• New research reports that people with chronic kidney disease have an elevated cardiovascular disease risk eight years earlier than people without the disease.
• Researchers add that people with type 2 diabetes have the elevated cardiovascular risk about a decade earlier.
• People with both conditions can have that higher risk as much as 28 years earlier than people without those diseases, researchers say.
• Experts say you can maintain good heart health by eating a healthy diet, exercising regularly, and managing stress levels.

People with type 2 diabetes have an elevated risk of developing cardiovascular disease earlier than someone who doesn’t have the condition. The same goes for those with chronic kidney disease.

For people with both conditions, however, the risk may be much higher, according to new research being presented November 16–18 at the American Heart Association’s Scientific Sessions 2024 in Chicago.

The study has not yet been peer-reviewed or published in a scientific journal, but the researchers said their report provides valuable information.

“Our findings help to interpret the combination of risk factors that will lead to a high predicted [cardiovascular disease] risk and at what age they have an impact on risk,” Vaishnavi Krishnan, lead study author and researcher at Northwestern University in Chicago, and medical student at Boston University School of Medicine, said in a statement.

“For example, if someone has borderline-elevated levels of blood pressure, glucose and/or impaired kidney function, but they don’t yet have hypertension or diabetes or chronic kidney disease, their risk may not be recognized. Understanding how age interacts with risk factor levels is important to optimize [cardiovascular-kidney-metabolic] health,” Krishnan continued.

How age may affect cardiovascular disease risk

In October 2023, the American Heart Association identified a new condition called cardiovascular-kidney-metabolic syndrome.

CKM syndrome makes the connections between cardiovascular disease, kidney disease, obesity, and diabetes. Its risk factors have four stages.

In May 2024, experts reported that 90% of adults in the United States may have CKM syndrome.

In the new research being presented this week, researchers report females with CKM syndrome can expect to reach an elevated risk for cardiovascular disease at age 68. For males with the condition, the age of increased cardiovascular disease risk is 63.

The researchers said that for females with type 2 diabetes, the predicted 10-year cardiovascular disease risk was elevated at age 59. For males, it was 52. That is 9 years earlier for females and 11 years earlier than males compared to those without the condition.

They also reported that for females with stage 3 chronic kidney disease, the predicted cardiovascular risk was elevated at age 60, while for males, it was 55. Both are 8 years earlier than people without the disease.

For people with both type 2 disease and kidney disease, the researchers said the 10-year risk for females was elevated at age 42 while for males it was 35. That’s 26 years earlier for females and 28 years earlier for males compared to people without CKM syndrome.

Experts say the findings are startling.

“Surprising to see such a significant impact on health and quality of life with disease developing nearly three decades sooner (28 years). That is really jaw dropping,” Jayne Morgan, MD, a cardiologist and vice president of medical affairs for Hello Heart, told Healthline.

“Even astute clinicians will likely be surprised by the sobering prediction that the co-existence of these two problems radically increases the risk of early myocardial infarction and stroke,” added Richard Wright, MD, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

New research is a ‘simulated’ study

It should be noted that this research was a simulated study as opposed to using information from medical records of patients.

For this study, the researchers used data from the National and Nutritional Examination Survey 2011-2020.

The researchers utilized this information to create risk profiles to simulate men and women for chronic kidney disease and/or type 2 diabetes at each age from 30 to 79 years.

They then used the American Heart Association Predicting Risk of cardiovascular disease EVENTS (PREVENT) calculator to try to determine at what age someone with each risk profile could be expected to have a higher risk of cardiovascular disease.

Experts said the simulated study does have its merits.

“This interesting and provocative analysis is only a simulation and is not based on actual clinical data, but nevertheless, dramatically points out the potential ‘more-than-additive’ risk these conditions possess in predicting future cardiovascular events,” Wright told Healthline.

“Although not as scientifically sound as an actual prospective population study, the current assessment is based on valid science and should not be ignored,” he added.

“To gauge risk, one can use multiple methods, including retrospective review, a prospective study, or what the authors did — a simulated risk in a simulated population (i.e. not actual patients),” Marilyn Tan, MD, the chief of the Stanford Endocrine Clinic in California, told Healthline. 

“With a simulated risk, the goal is to use various models to identify how different medical factors impact risk,” she noted.

How diabetes and kidney disease affect heart health

Cardiovascular disease (CVD) is an umbrella term that includes heart disease, heart attack, and stroke that may cause serious health issues.

Atherosclerosis is a condition where plaque builds up in the walls of the arteries. This narrows the arteries, making it more difficult for blood to follow and potentially leading to a heart attack or stroke.

Heart failure is also a form of CVD, which occurs when the body isn’t pumping blood as well as it should.

Heart valve problems may also develop with CVD, as well as arrhythmia, which is when the heart beats irregularly. The most common form of arrhythmia is atrial fibrillation (AFib).

The American Heart Association reports that nearly half of all adults in the U.S. are living with some form of cardiovascular disease. Around 1 in 3 has at least three risk factors that contribute to cardiovascular-kidney-metabolic syndrome.

Experts say conditions such as kidney disease and diabetes have a direct effect on heart health.

“Type 2 diabetes leads to high blood sugar levels, which damage the blood vessels in our body. This then results in atherosclerosis which can then lead to conditions such as heart attack and stroke,” explained Cheng-Han Chen, MD, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California.

“Similarly, chronic kidney disease can have effects such as increased blood pressure, atherosclerosis, and inflammation, all of which can then increase the risk of cardiovascular disease,” Chen told Healthline.

“Unhealthy kidneys cannot regulate blood pressure, leading to hypertension,” Morgan added. “Hypertension damages blood vessels and the heart. Sodium retention increases as the kidneys fail, further increasing blood pressure and the workload of the heart, which could lead to heart failure.”

“High blood glucose damages blood vessels and nerves both within the heart and supplying blood to the heart,” she noted. “This leads to early plaque buildup and atherosclerosis, further increasing the risk of heart attacks.”

How to improve your heart health

The American Heart Association has launched a four-year Cardiovascular-Kidney-Metabolic (CKM) Health Initiative.

The initiative will help assess gaps in clinical care as well as identify areas for future research. It will also implement guidelines and screening recommendations.

There are myriad steps you can take to improve your heart health, such as:

• Follow a heart-healthy diet low in sodium and saturated fats with high amounts of fruits and vegetables.
• Stay active and exercise regularly.
• Don’t smoke and avoid second-hand smoke.
• Manage your stress levels.

Experts had praise for the AHA’s new health initiative.

“This is a great initiative to really understand the interplay of these disease processes on the heart, the body, and on healthy aging,” Morgan said.

“It’s great that the AHA is working on guidelines and educating other healthcare providers (including nephrologists and endocrinologists) to promote best practices for reducing cardiovascular risk in the setting of kidney and metabolic disease,” added Tan.

“This is truly a call to action, to both identify those at such risk and to begin more aggressive treatment, earlier than we have traditionally felt necessary,” said Wright. 

“Fortunately, it is known that aggressive lifestyle changes, weight loss, hypertension control, and use of modern pharmacologic therapies can interrupt the vicious CKM spiral and can bend the risk curve in the desired fashion. The American Heart Association should be commended for starting their CKM Initiative and placing a spotlight on this issue. We can only hope that the medical community pays attention,” Wright added.

Takeaway

Researchers say conditions associated with cardiovascular-kidney-metabolic syndrome can elevate a person’s risk of cardiovascular disease at an earlier age.

They report that people with chronic kidney disease can reach that elevated risk eight years earlier than people without the disease.

They add that people with type 2 diabetes can see an elevated risk a decade earlier than those without the condition.

They stress that people with both these diseases, known as cardiovascular-kidney-metabolic syndrome, can see an elevated cardiovascular disease risk as much as 28 years sooner than people without this condition.

• Smoking rates in the U.S. are declining overall, but vaping remains more popular than ever, especially among young people.
• A new study found nearly half of young adults successfully quit vaping at 3 months with a quitline-based intervention.
• Overall, quit rates were higher than expected based on previous studies on smoking cessation among young adults, researchers say. 
• The quitline intervention that included nicotine replacement therapy (NRT) seemed most promising for quitting vaping. This is the first randomized trial testing NRT for vaping cessation.
• Participants also reported satisfaction with coaching calls, which researchers say likely contributed to the higher-than-expected quit rates.

Quitlines are free telephone services for people who smoke and use tobacco that provide support to help them quit. 

In the United States, more than 10 million people have reached out to a quitline to help them quit smoking, a promising intervention for successful smoking cessation, according to the Centers for Disease Control and Prevention (CDC). 

Research on the effectiveness of quitlines has grown in recent decades. 

Now, a new study from the RVO Health Center for Wellbeing Research found that a quitline-based intervention successfully helped young adults quit vaping. E-cigarettes are the most commonly used tobacco product among young people.

The research, funded by the American Heart Association, was published in the American Journal of Preventative Medicine on December 11.

The quitline intervention used in this study provided all participants with some form of treatment. The intervention yielded higher-than-expected quit rates, with nearly half (45%) of participants abstinent after three months. It’s the first large randomized trial examining the impact of a quitline-based intervention with nicotine replacement therapy (NRT).

“These findings suggest that NRT is a promising intervention and needs further examination in future research trials,” said Katrina Vickerman, PhD, director of the Center for Wellbeing Research at RVO Health, a health information and services company that includes platforms like Healthline.

“We were excited to see the success of young adults in this study with overcoming their addiction to the high levels of nicotine that many vaping devices can deliver,” Vickerman said.

Quitline intervention led to successful vaping cessation

While overall smoking rates in the U.S. have declined in recent years, vaping continues to be popular, especially among young people. In 2018, former U.S. Surgeon General Jerome M. Adams, MD, declared a vaping epidemic among youth and young adults. 

The long-term effects of vaping are not fully understood, but emerging evidence cites cardiovascular disease and chronic obstructive pulmonary disease (COPD) as possible health risks. 

Despite the prevalence of vaping and its possible consequences for human health, only a handful of large studies have tested effective vaping cessation strategies. 

“When we initiated this study, there were no published vaping cessation trials to base our estimates on,” Vickerman told Healthline. 

“Smoking cessation interventions for youth and young adults have historically achieved lower quit rates in randomized trials, which may reflect challenges engaging these groups in treatment studies. In this study, we provided everyone with treatment,” she explained. 

“At the time we designed this study, there was very little information about dosing NRT for individuals who vape. We wanted everyone to speak to a quitline coach to allow for an assessment of their nicotine addiction, NRT dosing for those randomized to receive NRT through the study, and education on why and how to use NRT,” she said.

For the study, Vickerman and co-leader Liz Klein, PhD, MPH of The Ohio State University College of Public Health, examined the effects of a two-call coaching protocol, mailed NRT, and a mobile health “mHealth” technology program. The mHealth program was delivered via text message and included links to quit resources like videos, podcasts, and online education content. The control group was a two-call coaching program only.

From July 2021 through September 2022, researchers recruited young adults in the U.S. ages 18–24 who exclusively used e-cigarettes through ads on Facebook, Instagram, and social websites like Reddit.

A total of 981 participants were eligible and randomized into four groups with a 2×2 design. After completing the first coaching call, 508 were fully enrolled. Participants who were enrolled vaped regularly, which researchers defined as 20 or more days in the last month.

The four groups were broken down as follows:

• coaching calls (with no NRT or mHealth)
• coaching calls with mHealth (no NRT)
• coaching calls with NRT (no mHealth)
• coaching calls with mHealth and NRT

The coaching calls were an important part of the study intervention. Vickerman said they follow quitline intervention protocols, which are based on social cognitive theory and current clinical practice guidelines for tobacco cessation. 

The calls begin with a series of questions to understand a person’s tobacco use history, triggers for use, barriers to quitting, and strengths that can help with quitting. Vickerman noted the impact of these calls exceeded the researchers’ expectations.

George Chaux, MD, board certified interventional pulmonologist and medical director of Interventional Pulmonary at Providence Saint John’s Health Center in Santa Monica, told Healthline he found the effectiveness of the coaching calls as the control intervention compelling. Chaux wasn’t involved in the study.

“This study, although limited, suggests that coaching calls are sufficient alone,” Chaux told Healthline, adding that combined forms of NRT may be even more effective for vaping cessation.

Why are quitlines so effective?

Quitlines are confidential services that offer guidance, counseling, and self-help resources, with some providing free medications like NRT.

They are available in every state in the U.S. and have the infrastructure to provide large-scale, effective, and cost-effective interventions for smoking cessation.  

“[Quitlines] are effective in people who are motivated to quit smoking or vaping and simply need support to overcome the cravings of nicotine,” Chaux said.

Vickerman noted that young adults in the study seemed more aware of NRT and more open to using it than anticipated.

“In fact, 28% reported previous use of NRT before the start of the study, and a quarter of participants who were not provided NRT in the study sought out NRT on their own,” she said.

While the 7% improvement in quit rates with mailed NRT was not statistically significant, Vickerman said the findings suggest that NRT is a promising intervention and needs further examination in larger trials. 

“Our study was underpowered to detect a difference of this size; this would be a clinically important difference if it held up in a future, larger study,” she said.

“Given that NRT appeared to be safe (with no unusual side effects) and acceptable for young adults in this study, we would feel comfortable dosing and mailing NRT without coach interaction in future studies. The mHealth intervention had a smaller effect but still warrants further investigation in future trials as mHealth interventions are easily scalable and can reach more individuals in need of help at a lower cost,” she continued.

Vickerman added they would like to better understand which components of the quitline-based intervention are most effective for helping young adults successfully quit.

“It may be that all of the intervention components are not needed, or that one component, like mHealth, is more successful in reaching and engaging participants, but some individuals who vape may need a higher level of support to be successful, like one-on-one coaching,” Vickerman said.

“Understanding the impact of the individual components can inform how best to use public health resources and offer vaping cessation interventions through state quitlines. In future trials, we plan to expand who is eligible to individuals who both vape and use other tobacco products,” she concluded.

Takeaway

Vaping is widespread among young people despite the possible health risks.

A new randomized trial used a quitline-based intervention to help young adults quit smoking and found nearly half of the participants successfully abstained at 3 months.

Researchers were surprised by higher-than-expected quit rates and how well the coaching calls resonated with the young adult participants who often prefer digital engagement.

The quitline intervention that included nicotine replacement therapy (NRT) seemed most promising for vaping cessation.  

Quitlines are free resources available in every state in the U.S., offering support and medications like NRT to help you quit for good. For more information, call 1-800-QUIT-NOW or visit Live Vape Free.

RVO Health provides tobacco cessation services and is a vendor for numerous state quitlines in the U.S.

• A new study found higher levels of inflammation in colorectal cancer tumors, suppressing the body’s ability to fight the disease.
• Researchers note the typical Western diet is a driver of inflammation, while other studies have linked ultra-processed foods to inflammation.
• Experts recommend limiting or avoiding ultra-processed foods to reduce cancer risk, opting for healthier choices including whole grains, fruits, and vegetables.

A new analysis of colorectal cancer tumors shows they have higher levels of inflammation and lack a natural ability to resolve the inflammation.

The study, published December 10 in the journal Gut, examined 162 tumor samples from people with colorectal cancer. The findings indicate the lipid profile of colorectal cancer tumors exhibit a “distinct pro-inflammatory bias.”

The researchers suggest employing “resolution medicine” as a treatment for colorectal cancer to reverse inflammation and restore the body’s healing mechanisms. They also note the typical Western diet has been strongly linked to chronic inflammation and the development and progression of colorectal cancer.

Geoffrey Buckle, MD, a gastrointestinal oncologist at UCSF Health in San Francisco, noted the findings have the potential to expand the knowledge of cancer and inflammation. Buckle wasn’t involved in the study.

“This is a fascinating study that looks at inflammatory changes in colorectal cancer and begins to paint a picture of how inflammation may arise in and around tumors,” Buckle said. 

“Interestingly, it also explores the ways in which inflammation could be a target for future cancer treatment. This work is both interesting and very important. We have long suspected a link between inflammation and cancer, but little is known about the mechanistic underpinnings of this link. This study adds to a growing body of literature suggesting inflammation may play an important role in cancer development,” he told Healthline.

Do ultra-processed foods raise colon cancer risk?

In the United States, ultra-processed foods comprise more than 50% of daily caloric intake by adults. Ultra-processed foods are also a driver of inflammation.

“Many things can increase the risk of inflammation in the body and since inflammation is the basis of many diseases, including cancer, finding anti-inflammatory approaches to offset inflammatory levels (such as limiting ultra-processed foods) and replacing them with foods that reduce inflammation make sense in light of the study’s findings,” Kristin Kirkpatrick, a dietitian at the Cleveland Clinic Department of Wellness & Preventive Medicine in Ohio, told Healthline. Kirkpatrick wasn’t involved in the new study.

Wael Harb, MD, a hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in California, not involved in the study, explained that ultra-processed foods not only lead to chronic inflammation but also immune suppression, “creating an environment conducive to cancer development and progression.”

“The study published in Gut provides compelling evidence linking ultra-processed foods (UPFs) to an increased risk of colorectal cancer (CRC) and a diminished capacity for the body to combat the disease,” Harb told Healthline.

How diet affects cancer risk

For years, health experts have said the traditional Western diet followed by many people in the U.S. can raise a person’s risk of a number of cancers.

They’ve also noted that diet is important for a person before, during, and after treatment for colorectal cancer.

Ultra-processed foods, including sweetened breakfast cereals, candy, white bread, and chips, have been linked to an increased risk of diabetes, heart disease, and cancer. These foods are also linked to an increased risk of obesity as well as cognitive decline.

“Diet is a significant factor and I will add that diet is also a modifiable risk (which differs from age, genetics, etc.),” Kirkpatrick said.

“What we see from the data is that the risk for colorectal cancer related to your dietary pattern is not just what you consume regularly but also about what you limit. For example, high-fiber, high nutrient dense foods can help reduce risk, while processed red meat can increase risk. Regular physical activity, not smoking, and limiting alcohol intake are also modifiable factors,” she explained.

Anton Bilchik, MD, a surgical oncologist as well as chief of medicine and the director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute in California, agrees there are other important elements in addition to diet. Bilchik wasn’t involved in the study.

“There are several risk factors in the development of colorectal cancer. These include diet, obesity, family history and physical inactivity. All are important factors but there are likely many other risk factors that are yet to be defined,” Bilchik told Healthline.

Harb is also in agreement. “While diet is a significant modifiable risk factor for CRC, other factors such as genetic predisposition, family history, age, smoking, alcohol consumption, physical inactivity, and obesity also play crucial roles,” he said. “A comprehensive approach to CRC prevention should address all these elements.”

Harb added it’s also important to follow a healthy diet while undergoing cancer treatment.

“Maintaining a healthy diet during CRC treatment is vital,” he said. “Proper nutrition supports the immune system, enhances tolerance to treatment, and improves overall well-being. Patients should focus on easily digestible foods, such as lean proteins, certain vegetables, and low-fat dairy, while ensuring adequate hydration.”

“It is essential to maintain a healthy balanced diet during treatment because the immune system depends on nutrients to either eliminate cancer cells or prevent them from returning,” Bilchik added.

Buckle listed some cautions when it comes to diet during cancer treatment.

“We certainly encourage patients to try to eat healthy while they are being treated for colorectal cancer, but I also caution patients that adopting dietary changes when undergoing active cancer treatment can be challenging and likely has a small benefit at best,” he said.

“There have been a number of studies looking at specific diets during cancer treatment such as ketogenic diet, Mediterranean diet, intermittent fasting, among others, and while studies have showed promising signals of benefit, further research is needed before ready for primetime or adopting as standard of care. While I do recommend patients try to eat healthy, I also remind patients that its OK to rely on comfort foods during treatment, particularly when dealing with some of the adverse effects of chemotherapy (e.g., loss of appetite, nausea, taste changes),” Buckle noted.

The best foods to lower cancer risk

To reduce cancer risk, Kirkpatrick recommended foods higher in fiber such as whole grains, fruits, and vegetables as well as foods in the allium family such as onions, garlic, and leeks.

Harb suggested getting adequate fiber and antioxidants daily. “To lower CRC risk, I recommend a diet rich in unprocessed foods, including vegetables, fruits, whole grains, legumes, nuts, and lean proteins like fish and poultry,” he said.

“These foods are high in fiber and antioxidants, which promote healthy digestion and support the gut microbiome, potentially offering protective effects against CRC. Limiting the intake of red and processed meats, as well as sugary and ultra-processed foods, is also advisable,” Harb added.

“Fruits, vegetables, foods rich in omega 3 fatty acids such as salmon as well as foods with a high fiber content are all important to reduce the risk of developing colorectal cancer,” Bilchik noted.

“We generally recommend that individuals drink alcohol in moderation, avoid tobacco use, and limit dietary intake of red and processed meat (e.g., sausages, bacon, ham, beef jerky, and other forms of meat that are smoked, salted, fermented, or cured),” Buckle said. 

“We recommend adequate dietary fiber and calcium intake. We also recommend a diet with regular fruit and vegetable intake.”

What to know about colorectal cancer

Colorectal cancer is the second leading cause of cancer-related death in the U.S.

The American Cancer Society (ACS) notes that the diagnosis rate and the death rate for colorectal cancer has been decreasing in the United States since the 1980s.

The ACS attributes the decline to increased screening and adjustments in lifestyle factors. However, they add that most of the decrease has occurred in older adults while the rates among younger adults have been rising.

Earlier this year, it was reported that early onset colorectal cancer in adults under the age of 50 has increased from less than 5 cases per 100,000 people in 1994 to 10 cases per 100,000 people in 2021.

The American College of Physicians now recommends people start getting screened for colorectal cancer at age 50.

Takeaway

Researchers say chronic inflammation raises the risk of colorectal cancer as well as suppresses the body’s ability to fight the disease.

The Western diet, which is laden with ultra-processed foods, is a major cause of chronic inflammation.

Experts recommend limiting ultra-processed foods and consuming natural and healthier foods such as whole grains, vegetables, and fruits.

• In a new study, researchers say what you eat at breakfast is just as important as how much you eat.
• People who consumed between 20% and 30% of their daily energy intake at breakfast and ate higher quality foods showed improvements in waist circumference, triglycerides, and HDL (good) cholesterol.
• Experts recommend healthy breakfast choices such as oatmeal, avocado toast, fruit, and eggs.

Eating a substantial breakfast is important for heart health, but what you eat at that first meal of the day is also important.

That’s the conclusion of a new study published in the Journal of Nutrition, Health and Aging.

Researchers examined the average energy intake of breakfast meals compared to a person’s total daily intake and the quality of the morning meals in terms of proteins, fats, fibers, and other nutrients.

They concluded that a person who consumes an adequate amount of calories at breakfast and does so with high-quality food is at a lower risk of cardiovascular disease.

“Breakfast is the most important meal of the day, but what and how you eat it matters,” said Álvaro Hernáez, a researcher at the Hospital del Mar Research Institute’s CIBER for Cardiovascular Diseases (CIBERCV) in Spain, in a press release.

“Eating controlled amounts — not too much or too little — and ensuring good nutritional composition is crucial. Our data show that quality is associated with better cardiovascular risk factor outcomes. It’s as important to have breakfast as it is to have a quality one,” Hernáez continued.

How a healthy breakfast affects heart health

For their study, researchers examined 383 participants in the PREDIMED-Plus Project, a randomized clinical trial that compared the effects of a Mediterranean diet and regular physical activity with dietary recommendations.

Participants were between the ages of 55 and 75 and were classified as overweight or having obesity. They also had at least three criteria for metabolic syndrome, a group of five risk factors that can increase the likelihood of heart disease, diabetes, and stroke.

The participants were followed for three years with measurements taken at the beginning of the study as well as at 24 months and 36 months.

The researchers divided the subjects into three categories:

• less than 20% of daily energy intake consumed at breakfast
• 20% to 30% of daily energy intake consumed at breakfast
• more than 30% of daily energy intake consumed at breakfast

The researchers reported that people who consumed 20% to 30% of their energy intake at breakfast had 2% to 3% lower body mass index (BMI) measurements than participants who had less than 20% or higher than 30% of daily energy intake at breakfast.

They added that the individuals in the 20% to 30% range also had:

• 2% to 4% smaller waist circumference
• 9% to 18% reduction in triglyceride levels
• 4% to 8% increase in the level of HDL or “good” cholesterol

In addition, the researchers said that participants who had high quality breakfasts had:

• 1.5% smaller waist circumference
• 4% lower triglycerides
• 3% higher HDL cholesterol measurement

“Our body’s daily metabolic rhythms are governed by an internal clock that is affected by when we eat our meals,” explained Cheng-Han Chen, MD, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California.

“Changes in typical mealtimes, such as skipping meals or eating during normal sleep times, can then potentially influence the development of cardiometabolic diseases such as diabetes and obesity,” he told Healthline. Chen wasn’t involved in the study.

Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at the Orange Coast Medical Center in California, told Healthline the new research aligns with other studies showing the health benefits of eating a healthy breakfast.

Ali wasn’t involved in the study but told Healthline the study was interesting but noted a few limitations. “The limitations are a relatively small sample size confined to a narrow ethnic group. Thus, the findings may vary to some extent in different areas, but overall, generally applicable,” he said.

Kate Donelan, MS, RD, a registered dietitian at Stanford Health Care in California, likewise not involved in the study, noted some additional limitations to the research.

“My overall impression of the study is that it reflects what we generally know about health and nutrition. Since it’s just observational, it doesn’t suggest any causality between breakfast and changes in health markers, which is not as helpful as controlled experiments that can determine cause and effect,” Donelan told Healthline.

“Also, the study only included Spanish older adults, which limits the study’s generalizability. Whenever we include only one population in a study, it’s difficult to determine what is due to the factors being studied and what is due to cultural food habits, behavioral patterns, and genetic predisposition,” she added.

Why breakfast is the ‘most important meal of the day’

These new findings are not the first to find that a healthy and substantial breakfast is important for good health.

In 2017, researchers reported that people who make breakfast their biggest meal of the day were more likely to lose weight than those who skipped breakfast or ate lighter meals in the morning.

In 2020, another group of researchers reported that people who eat a big breakfast burn twice the calories daily compared to those who eat a larger dinner.

Other studies have concluded that eating a lot of protein at breakfast can also help people lose weight.

“Breakfast is important because it’s your first chance to fuel your body after an extended period of time without any nutrients,” Donelan said.

“Eating a breakfast with protein, fiber, and fat [regulates] your metabolism [and] improves cognitive function and energy levels. Skipping breakfast can lead to overeating later in the day and create unnecessary blood sugar dips and spikes,” she noted.

“Eating breakfast helps regulate our blood sugar control and helps to limit overeating later in the day. We also think that eating breakfast helps to prevent rises in stress hormones, which could then increase blood pressure,” Chen added.

Kristin Kirkpatrick, a registered dietitian at the Cleveland Clinic Department of Wellness Prevention & Medicine, echoed the benefits of a healthy breakfast.

“We’ve seen other studies, especially in pediatrics that show better attention, performance on tests, etc., when breakfast is consumed,” she told Healthline.

“Breakfast (or, let’s say the first meal of the day) can often set the stage for eating habits the rest of the day. Starting the day in a nutrient-dense manner may help with continuing that form of eating. Additionally, breakfast offers a great opportunity to get in important vitamins and minerals. Finally, depending on the breakdown of macros, having breakfast may play a role in keeping you fuller and satisfied,” Kirkpatrick continued.

Ali added that breakfast “stimulates the metabolism early in the day and if the right types of food are consumed, may help reduce hunger throughout the day. It has also been linked to improved cognitive function, concentration, and mood.”

Diet quality matters for overall health

Experts say diet quality is essential for overall health and well-being.

“Quality of diet is often a good indicator (over quantity) related to health,” Kirkpatrick said.

“The ‘how much’ really boils down to how individuals are assessing their hunger and what aspects relate to those hunger cues (such as social aspects, sleep quality, etc.). However, there is a big difference between having a nutrient-rich breakfast (i.e., oats, eggs, etc.) and an empty calorie breakfast (i.e., breakfast pastry, refined grains, etc.) in terms of health outcomes,” she noted.

Christopher Gardner, PhD, the immediate past president of the American Heart Association’s nutrition committee and a professor of medicine at Stanford University in California, noted it’s important to make healthy choices throughout the day — not just at breakfast. Gardner wasn’t involved in the study.

“Overall dietary pattern is a better indicator of eating in a heart-healthy way versus focusing on one specific meal or food,” he told Healthline.

Ali agreed. “The type of calories a person consumes is just as important as the quantity, not only for breakfast but all meals. Reducing carbohydrate, sugar and highly processed food intake is beneficial for any meal,” he said.

Donelan said that what you eat matters more than how much you eat at any time of the day.

“I think we all know one cup of Oreos is not the same thing as one cup of fruit. Nutrient-dense foods like fruits, vegetables, and whole grains support metabolism and positive health outcomes,” she said.

Nutritious breakfast ideas

In the new study, researchers defined a quality breakfast as one that included healthy amounts of protein, high-value fats, fiber, and minerals such as potassium and iron.

In addition, these breakfasts avoided excessive added sugars and saturated fats.

In general, experts say this is the proper strategy when it comes to choosing breakfast foods. Gardner recommended the following suggestions for breakfast:

• whole grain cereal such as steel cut oats with fruits and nuts
• avocado toast on whole wheat grain toast with toppings such as kimchi or sautéed greens
• veggie scramble with eggs sautéed with vegetables and herbs

Other experts have similar recommendations.

“Nutrient-dense options may include steel-cut oats, eggs, berries, avocado toast (on whole grain bread), yogurt with berries, etc.,” Kirkpatrick said. “However, we can add to these meals (such as adding berries and hemp seeds to our oats, adding vegetables to our eggs like a frittata).”

Chen recommends eating breakfast within one hour of waking up. He suggested foods such as:

• oatmeal
• eggs
• yogurt
• fresh fruit

“A balanced breakfast includes whole grains, protein, healthy fats, and fruit. This could be oatmeal with nuts and berries, Greek yogurt with fruit and granola, or avocado toast with eggs,” Donelan said.

Ali emphasized that people should choose natural foods and avoid highly processed products.

“I recommend to my patients to consume primarily proteins and vegetables and reduce simple carbohydrates and sugars,” he said. “As mentioned in this study, a Mediterranean type of diet is along those lines. This consists of low fat dairy products, whole grains, proteins, and a limited amount of fruit.”

Takeaway

Researchers say people who consume 20% to 30% of their daily energy intake at breakfast have smaller waist circumferences, lower levels of triglycerides, and higher levels of HDL or “good” cholesterol.

They add that people who eat high quality foods during their morning meals experience similar health benefits. Those factors help lower a person’s risk of cardiovascular disease.

Experts recommend people have whole grain cereal, such as oatmeal, or avocado toast or eggs along with fruit at breakfast. 

The sudden passing of Ana Orsini, a vibrant 28-year-old news anchor at…

Content source – www.soundhealthandlastingwealth.com

• Members of the U.S. Preventive Services Task Force say vitamin D supplements do not reduce the risk of falls or bone fractures in healthy older adults.
• They note the vitamin can be helpful for older adults with certain medical conditions like osteoporosis.
• There are some foods that provide a minimal amount of vitamin D, but the most effective way to obtain the nutrient is through sun exposure.

Vitamin D has many health benefits, but it doesn’t reduce the risk of falling and it doesn’t prevent bone fractures in older adults.

That’s the conclusion of a preliminary recommendation that members of the United States Preventive Services Task Force (USPSTF) released this week.

In their draft recommendation, USPSTF members said taking vitamin D supplements with or without calcium does not prevent falls or fractures in women who have gone through menopause or men 60 years and older.

Their recommendation applies to people who live at home. It does not apply to people in assisted living or nursing homes. Nor does it apply to people who take vitamin D or calcium supplements for medical reasons or people who have been diagnosed with osteoporosis.

“Preventing older adults from falling and breaking a bone is important to their ongoing health and independence,” said John Ruiz, Ph.D., a Task Force member and a professor of clinical psychology at the University of Arizona, in a press release.

“Unfortunately, when we reviewed the latest evidence, we found that taking vitamin D with or without calcium does not prevent falls or fractures in older adults, so we recommend against these supplements for people who are not taking them for other medical reasons.”

The Task Force is accepting public comments on the draft report until January 21. The new recommendation is an update from a 2018 report that recommended daily vitamin D supplement for women.

Rethinking vitamin D for fracture risk

Experts not affiliated with the report say there is important information to glean from the Task Force’s new draft recommendation.

“We know that vitamin D deficiency and low calcium diet increases the risk of bone fragility and fractures,” said Edward Hsiao, MD, a professor at the University of California San Francisco as well as the director of the UCSF Metabolic Bone Clinic and the UCSF Endocrine T32 Program.

“We also know that vitamin D supplementation and calcium supplementation, in the setting of bone fragility or vitamin D deficiency, are important for maintaining and improving bone health,” Hsiao told Healthline. “This is even more important if the patient is on treatment for osteoporosis, since these are key substrates for building back bone – and so those medications won’t work well in the absence of these supplements.”

“These guidelines are in line with the recently published guidelines from the Endocrine Society of which I was a part,” added Daniel Bikle, MD, a professor of medicine and dermatology at UCSF.

“Basically, they are for healthy individuals. We are not talking about those with suspected vitamin D deficiency such as those with nutritional deficiencies, osteoporosis, [or] malabsorption,” he told Healthline.

What are the benefits and side effects of vitamin D?

The Task Force members pointed out there are a number of reasons for obtaining a sufficient amount of vitamin D.

Vitamin D is a fat-soluble vitamin that promotes calcium absorption, a process that can help keep bones and muscles strong. It also can play a role in supporting the immune system.

In past studies, researchers have said that low vitamin D levels can contribute to joint pain. Other research has indicated that low vitamin D levels can be a cause of chronic inflammation.

In addition, some research has reported that vitamin D can help reduce the risk of heart disease as well as reduce the risk of severe illnesses such as the flu and COVID-19.

However, excessive amounts of vitamin D can cause stomach discomfort or kidney problems.

“There are a multitude of effects of vitamin D on the body,” said Wendolyn Gozansky, MD, a geriatrician and vice president and chief quality officer at Kaiser Permanente.

“I tell my patients to think about vitamin D as a hormone,” she told Healthline. “It has impacts on muscle, bone, and immune cells and gets metabolized by the liver and kidney. A main function of vitamin D is calcium absorption so, it helps keep your heart, muscles, and bones functioning normally. While taking vitamin D supplements may not prevent falls and fractures, having the right amount of vitamin D in your body supports overall health.”

Despite these benefits, Gozansky offered a word of caution. “Because vitamin D is a fat-soluble vitamin, it can build up in the body over time if you are taking in too much vitamin D,” she explained.

“Toxic levels of vitamin D can result in high blood calcium levels that may result in nausea, vomiting, constipation, muscle weakness, confusion, kidney stones, and more. Always talk to your doctor about any over-the-counter supplements that you are taking. Just because something is available over the counter doesn’t mean it’s automatically safe for you as an individual.”

David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in California, notes that many studies on this topic center on people who have normal vitamin D levels.

“The appropriate conclusion is not that patients do not need any vitamin D but more correctly that patients with adequate amounts of vitamin D will not reduce their fracture risk by additional supplementation,” he told Healthline.

Cutler also noted the Task Force recommendation would mean that insurance companies may not pay for vitamin D supplement treatment.

How to get more vitamin D

It’s recommended that adults get between 600 and 800 international units of vitamin D per day, depending on their age.

It’s estimated that more than 40% of adults in the U.S. have a vitamin D deficiency.

There aren’t a lot of foods that are overloaded with vitamin D.

Nonetheless, there are some foods that can naturally provide your body with some levels of vitamin D. Among them:

• fatty fish (i.e., salmon, halibut, mackerel)
• canned tuna
• cod liver oil
• egg yolks
• mushrooms

Some foods, such as milk and orange juice, are fortified with vitamin D.

However, the main source of vitamin D is sunshine. The vitamin is produced from cholesterol in the skin.

Too much exposure to sunlight, however, can raise the risk of skin cancer. The Centers for Disease Control and Prevention (CDC) recommend that you limit your exposure to the sun, wear a hat, sunglasses, and long-sleeved clothing while in the sun, and apply a broad-spectrum sunscreen to your skin while outdoors.

Cutler noted that all the information about vitamin D can seem confusing.

“Some experts suggested that vitamin D could be obtained safely from sun exposure, a recommendation that was considered controversial because of a potentially increased risk of skin cancer,” he told Healthline.

“Other experts suggested that perhaps being outdoors with sun exposure caused improved health outcomes independent of increased vitamin D. Needless to say, this nuanced balancing of benefits and risks is difficult for experts, let alone the average person, to reconcile.”

“Addressing the issue of vitamin D supplementation with your physician requires looking at all the potential benefits and risks in the context of your personal health situation,” he added.

“This includes addressing diet for adequate calcium intake, exercise for fall prevention, and genetic factors which may affect risk of kidney stones. So, it is only by comprehensively evaluating your entire health status that an appropriate recommendation for vitamin D supplementation can be made,” Cutler explained.

How to avoid falls and fractures

The Centers for Disease Control and Prevention (CDC) reports that more than 1 in 4 older adults in the U.S. falls each year.

The agency notes that falling once doubles the chances of falling again. Yet, less than half of older adults who fall report the incident to their doctor.

The agency adds that one in 10 falls causes an injury to an older adult. Each year, there are 3 million emergency visits as well as 1 million hospitalizations in the U.S. due to falls from older adults. Falls are also a common factor in hip fractures and traumatic brain injuries in older adults.

Injuries from falls can limit an older person’s ability to perform daily activities and live independently.

The CDC recommends regular physical activity for older adults to lessen their chances of falling. These activities include:

• At least 150 minutes of moderate-intensity aerobic activity per week.
• Muscle strengthening activities, including weight lifting and resistance training, at least 2 days per week.
• Activities to improve balance such as standing on one foot.

Experts also recommend older adults get screened for osteoporosis as well as have their vision and hearing tested.

They also urge older adults to stand up slowly after sitting down to avoid a light-headed incident that could cause a fall.

“As a geriatrician, I tell my patients that the best exercise to prevent falls and fractures is the one that you enjoy doing regularly,” said Gozansky. “This can mean weight-bearing exercise like walking or weightlifting as well as balance exercises such as yoga or tai chi.”

Takeaway

Members of the U.S. Preventive Services Task Force have released a preliminary report in which they say vitamin D supplements do not reduce the risk of falls or bone fractures in healthy older adults.

They note that supplementation may still be beneficial for older adults with certain medical conditions such as osteoporosis.

Experts note that sunshine is the best way to obtain vitamin D, although overexposure to the sun can raise a person’s risk of skin cancer.

They say older adults should exercise regularly to strengthen bones and muscle to help reduce their chances of falling or suffering a bone fracture.