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• Dry age-related macular degeneration is an eye disorder that can lead to blindness. It affects millions of Americans.
• A formulation of over-the-counter antioxidant supplements appears to prevent the progression of the disease, even in its advanced stage, known as geographic atrophy.
• There is no cure for AMD, and current pharmaceutical options can be cumbersome and expensive.

A widely available formulation of antioxidant supplements appears to slow the progression of dry age-related macular degeneration (AMD).

Dry AMD is a common eye disorder in individuals aged 55 and over that causes blurred vision, and is a leading cause of legal blindness.

As its name suggests, the condition occurs naturally during aging and is more common in older individuals. It may have little to no effect on vision but may also progress to a more severe, vision-threatening form known as geographic atrophy.

Based on recent estimates, dry AMD is believed to affect nearly 20 million Americans aged 40 and older. However, less than one percent of them have a vision-threatening form of it.

There is no treatment to reverse damage from dry AMD. However, new evidence suggests that a cocktail of over-the-counter antioxidant supplements can slow progression of the disease significantly, even in individuals with geographic atrophy.

55% less disease progression over placebo

In an article published this month in the journal Ophthalmology, researchers from the National Eye Institute found that antioxidant supplementation slowed progression by as much as 55% over three years compared to a placebo.

“These findings are very significant as geographic atrophy affects approximately 5 million people worldwide and, up until recently, we had no treatments to prevent geographic atrophy occurring, slow its expansion, or restore vision to affected areas. The oral supplements have the advantages of a large treatment effect, excellent safety profile, ease of use, and low cost,” Tiarnan D. L. Keenan, BM BCh, PhD, a researcher in the Division of Epidemiology and Clinical Applications at the National Institute of Health’s National Eye Institute, and first author of the study, told Healthline.

Theodore Leng, MD, an Associate Professor of Ophthalmology at Stanford Medicine who wasn’t affiliated with the study, told Healthline, “This study was great because it really confirms some of our suspicions about vitamin supplementation in this specific form of advanced macular degeneration.”

Antioxidant cocktail shows promise

Researchers conducted a post hoc analysis of two major clinical trials that previously investigated the link between antioxidant supplementation and dry AMD progression. Those trials, known as AREDS and AREDS2, honed in on six supplements believed to support eye health and slow disease progression:

• Vitamin C
• Vitamin E
• Copper
• Zinc
• Lutein
• Zeaxanthin

The original studies found that taking this combination of supplements reduced the risk of progression from intermediate to advanced AMD by one-fourth. However, there was nothing to suggest that the supplements would slow progression in individuals whose eyes had already advanced to geographic atrophy, the most extreme form of dry AMD.

Keenan and his team wanted to find out whether the AREDS2 supplement formulation could also help slow disease progression in individuals with the advanced form of the disease.

“Our study shows that the oral supplements have an important role even when geographic atrophy is present,” he told Healthline.

Specifically, they found that over a three year period, the eyes of individuals with geographic atrophy who took antioxidants showed 39.8 microns of disease progression, compared to 73.2 microns in the eyes of those who took a placebo. That’s 55% less progression simply by taking an antioxidant supplement.

Wet vs dry AMD

The vast majority, about 90%, of all cases of AMD are the dry form. However, about 10% of AMD cases may progress to another form, known as wet AMD.

Dry AMD is associated with the presence of large yellow protein deposits under the retina, known as drusen. These deposits damage a small but important area at the back of the eye known as the macula, which allows your eyes to precisely focus on objects in front of you. Dry AMD may progress, but doesn’t always, to geographic atrophy, which can cause permanent loss of vision.

“Imagine you have a camera or a computer screen and you have dead pixels on the screen. That area of dead pixels just expands slowly over time. That’s basically the patient’s experience who has geographic atrophy. They have areas of the retina that are dead or not functional and that area grows in a kind of concentric manner,” said Leng.

Sometimes, wet AMD may develop. Wet AMD or neovascular AMD, is defined by the abnormal presence of blood vessels under the retina that can cause swelling and bleeding. This bleeding and fluid accumulation are where the condition derives its “wet” moniker.

Wet AMD tends to be more severe, progresses more quickly, and always affects the central vision of the macula. It is always considered an advanced stage of AMD.

At this time, AREDS2 antioxidant supplements only appear to be beneficial for dry AMD, not wet.

“Individuals with geographic atrophy should benefit from the AREDS2 formulation supplement. In addition, our previous research has shown that a healthy diet (particularly a Mediterranean-type dietary pattern) and avoiding smoking are strongly associated with slower atrophy growth rates. So a healthy lifestyle is important alongside the supplements,” said Keenan.

The bottom line

A combination of antioxidant supplements known as AREDS2, which includes vitamin A, vitamin C, copper, zinc, lutein, and zeaxanthin, helps slow the progression of dry AMD, even in the advanced stage known as geographic atrophy.

A novel study found that compared to placebo, those taking the antioxidant formulation showed 55% less disease progression.

The supplements are not recommended for wet AMD, a less common but more severe form of AMD.

The sun is shining and most of us will be happy to see the arrival of warmer and drier weather after the wet and cool summer we have had so far. This week’s higher temperatures have triggered a yellow Heat-Health …

• In an eight-week study, a vegan diet showed signs of slowing biological aging compared to an omnivorous diet.
• The Stanford Twin Study recruited identical twins who were subsequently put on opposing diets to study the effects.
• The findings appear consistent with other literature about the anti-aging and protective properties of a vegan diet.

A vegan diet can slow signs of aging at a molecular level in as little as eight weeks, according to new research.

The findings, published July 28 in the journal BMC Medicine, are pulled from the Stanford Twin Study, also the subject of the new Netflix documentary series “You Are What You Eat: A Twin Experiment.” 

Stanford’s experiment asks the question: what happens when pairs of identical twins eat two different, although still healthy, diets?

The eight-week study involved 22 pairs of twins, half of whom (one from each pair) were randomized to a “healthy vegan” diet, while the other half consumed a “healthy omnivorous” diet.

Initial study results, published in November 2023, showed similar results supporting the short-term plant-based diet protocol.

Participants who consumed a vegan diet ate fewer calories, lost more weight, and improved LDL (bad) cholesterol and fasting insulin levels than their omnivorous diet counterparts. 

Does a vegan diet slow down aging?

The research published this week indicates that in addition to these benefits, consuming a vegan diet also improved epigenetic markers associated with aging.

Think of these markers like clocks hidden in your genes: you might be forty years old (your chronological age), but your biological age could be different based on lifestyle factors like diet and exercise influence. 

There is no single unified measure for reading biological age through epigenetics. Instead, the research team employed multiple tests to read these “clocks.”

Scientists can observe patterns in DNA methylation, a natural process that affects gene expression, to estimate biological age using various tests, including GrimAge and DunedinPACE.

“We didn’t really expect much from these clocks, which was the surprising bit because out of all the clocks that we studied, there were about 12 that showed consistent decreases in their epigenetic age,” first study author Varun B. Dwaraka, PhD, head of bioinformatics and principal investigator at TruDiagnostic, told Healthline.

“There was a significant decrease in the vegans, but there was no change in the omnivores,” he said.

Vegan vs. omnivore: Which diet is healthier?

The study was conducted in two phases.

During the first four weeks, participants were provided meals at no cost by the nationwide meal delivery company Trifecta Nutrition (the company was not involved in sponsoring the study). In the second half, participants were responsible for cooking their own meals.

The key for both the vegan and omnivore meal plans is that they both had to be healthy.

“The terms ‘vegan’ and ‘omnivore’ are very broad, and it is quite possible to make poor food choices that would be consistent with these diet patterns,” senior study author Christopher Gardner, PhD, a professor of medicine and a nutrition scientist at Stanford Medicine, told Healthline.

“For example, soda, [some] French fries, and Oreo cookies are all technically vegan,” Gardner noted.

Both groups were instructed to eat diets high in vegetables and fiber while minimizing refined grains and sugars. Researchers utilized the Healthy Eating Index, a validated metric that uses a scoring system to determine the overall quality of an individual’s diet, to gauge the quality of participants’ meals.

By recruiting twins to the study, researchers were able to eliminate one of the largest confounding factors when studying epigenetics: DNA. 

“This was the perfect kind of design because essentially what you’re doing is looking at two genetically identical individuals and then allowing them to have two different diet types and then seeing what the response would be,” Dwaraka said.

“We’ve known in the past that different diets can have different impacts on epigenetic age. But in those interventional trials, it wasn’t really done in a way that controlled for those genetic variances,” he noted.

How do epigenetics affect aging?

The findings go beyond improvements to body composition and cholesterol, demonstrating the role of diet in aging itself.

Epigenetics refers to the way that behavior and environment affect genetics. These changes are not permanent, nor do they directly affect your DNA; instead, like a computer, they affect how the “code” of your DNA is read.

“You can actually read the DNA in a way that formulates different biological processes to occur. So, you can maybe relate this to the idea of having a computer that has the same exact hardware, but based on the software that you’re downloading, you can activate different processes,” Dwaraka explained.

Epigenetic changes can alter gene expression, making you more or less susceptible to various forms of disease. 

So, while you can’t change your DNA itself, you can affect your epigenetics (for better or worse) through day-to-day activities.

“Nutrition and exercise are among the most well‐known environmental epigenetic factors influencing the proper developmental and functional lifestyle, with potential beneficial or detrimental effects on health status,” Myron Szewczuk, PhD, a biomedical and molecular sciences professor at Queen’s University in Ontario, Canada, told Healthline. Szewczuk was not affiliated with the research.

Chronological age changes at the same rate as everyone. Still, your biological age, which refers to the health and functioning of your body on a cellular level, is dynamic and modifiable.

The distinction between chronological and biological age has become an important area of study as the human life span has increased and science has made continual breakthroughs in understanding the human genome.

Long-term effects of a vegan diet on aging are not known

The study, though compelling, may not offer much in the way of practical recommendations for individuals interested in improving their diet.

The study authors say their findings are limited to the eight-week scope and can’t speak to the longer-term effects of either diet, though they do eventually hope to hold a longer trial.

“We cannot say anything beyond just eight weeks because, for example, one of the things that we do know is that a vegan diet without vitamin B12 supplementation can actually have disastrous effects on health,” Dwaraka said.

Despite this caveat, vegan and plant-based diets have been associated with numerous health benefits — but so have omnivorous diets like the Mediterranean diet.

“This is very consistent with the current knowledge that a plant-based diet is associated with benefits for biological aging and other health conditions, such as overall cardiac health,” Alyssa Kwan, a clinical dietitian in cardiology at Stanford Medicine who wasn’t affiliated with the research, told Healthline.

“I think this study, though short term, helps to support evidence for a plant-based diet.”

The takeaway

In an eight-week trial involving identical twins, those who followed a vegan diet showed signs of slowing down the aging process at a molecular level. 

Lifestyle choices including diet and exercise are known epigenetic modifiers, which can make you more or less susceptible to disease.

Although the findings are limited to just eight weeks, other experts say that the study is consistent with other literature on the health benefits of vegan and plant-based diets.

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

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

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

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

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

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

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

How does lenacapavir prevent HIV transmission?

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

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

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

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

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

Does lenacapavir only work in females?

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

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

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

How much do lenacapavir injections cost?

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

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

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

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

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

Takeaway

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

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

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

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

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

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

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

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

What is the 5/20 rule?

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

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

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

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

Valles additionally noted the importance of serving size.

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

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

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

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

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

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

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

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

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

Putting the 5/20 rule into action

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

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

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

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

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

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

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

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

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

Takeaway

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

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

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

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

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

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

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

Potentially, yes, claims a new scientific study.

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

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

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

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

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

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

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

Mapping the potential link between pesticides and cancer

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

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

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

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

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

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

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

Specific pesticide outcomes

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

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

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

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

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

Strengths and weaknesses of the study

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

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

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

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

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

The bottom line

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

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

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

As our world becomes increasingly interconnected and the climate changes, the UK faces challenges that we might associate with more exotic destinations. One such challenge is the potential introduction of invasive mosquito species, particularly the tiger mosquito (Aedes albopictus). This …

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

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

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

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

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

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

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

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

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

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

Where healthcare for women ranks highest and lowest

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Takeaway

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

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

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

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

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

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

While one recent study indicates that plant-based ultra-processed foods might increase the risk of heart disease and early death, a systematic review and meta-analysis, including 12 controlled trials, published in the Canadian Journal of Cardiology suggests that plant-based meat alternatives (PBMAs) might be an exception, actually helping to improve cardiovascular health.

According to the study, while the nutritional profiles of various PBMAs vary widely, overall, they have characteristics that make them heart-healthy.

The researchers also found studies showing that PBMAs could improve certain cardiovascular risk factors, including total cholesterol, LDL, apolipoprotein B-100 (a form of LDL implicated in inherited forms of high cholesterol), and body weight.

They did note, however, that more studies are needed to conclude what the effects on heart health will be long-term.

Why is plant-based meat better for your heart?

Commenting on the study, John Higgins, MD, sports cardiologist at UTHealth Houston, explained that plant-based meat has less saturated fat and more fiber per serving than regular meat.

Saturated fat is significant because it raises low-density lipoprotein cholesterol (LDL), which is often thought of as being the “bad” cholesterol. High levels of LDL can lead to clogged arteries. Polyunsaturated fat, however, has the opposite effect.

Fiber, especially the soluble variety, binds with cholesterol, helping to shuttle it out of the body.

However, he noted that there are other potential factors at work as well. PBMAs can lead to a lowering of trimethylamine N-oxide (TMAO), which is a molecule that may be a risk factor for heart disease.

“Also, cardiovascular harm from traditional meat and egg yolks is not only due to high cholesterol in both and additionally high saturated fats in red meat,” said Higgins, “but also both elevate plasma levels of toxic metabolites of the intestinal microbiome including trimethylamine N-oxide (TMAO).”

Why do recent studies seem to contradict each other?

Michael O. McKinney, MD, a physician, and nutritionist with Health Outlook, told Healthline that the apparent contradiction between this study and another recent study, which found that plant-based ultra-processed foods (a category that can include plant-based meat) reside in “the ingredients as well as the general nutritional profile” of these foods.

“[E]ven though many ultra-processed foods have unhealthy additives like high levels of sodium, sugar and unhealthy fats, plant-based meats developed for health do not contain these components,” he explained.

However, McKinney added that plant-based meats can be divided into two categories: those with whole ingredients and those heavily processed with artificial additives. So, some plant-based meats may be healthier than others.

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

McKinney advises paying close attention to the ingredient list to choose the plant-based meat that is healthiest for your heart.

“Opt for products with whole food ingredients instead of added sugars,” he said.

He also recommends looking for products that have less sodium in order to keep your blood pressure in check.

McKinney further noted that some plant-based meats can actually be high in saturated fat if they are made with coconut or palm oil.

Additionally, he suggests looking at the fiber content since it is also good for heart health.

Finally, McKinney recommends avoiding added sugars. “These are unnecessary and unhealthy, as some processed foods may contain sugars to enhance taste,” he said.

Higgins additionally explained that a diet with regular meat can also be good for your heart if you opt for leaner choices.

“In fact, the Mediterranean diet is also considered heart healthy and includes occasional red meat as well as more frequent lean chicken and fish,” he said.

You can also substitute plant-based foods like fruits, vegetables, whole grains, and nuts in place of meat. These foods can help lower your cholesterol and reduce your risk of heart disease, said Higgins.

Takeaway

A new study has found that plant-based meats can be healthier for your heart than regular meat.

However, another recent study found that ultra-processed plant-based foods — including plant-based meats — can actually increase heart disease risk.

Experts say the seeming contradiction may be explained by the fact that many ultra-processed foods contain high amounts of sodium, sugar, and unhealthy fats.

Plant-based meats designed with health in mind do not contain these ingredients.

When selecting plant-based meats, check the label for their sodium, saturated fat, sugar, and fiber content.

Alternatively, a diet rich in whole plant-based foods with occasional lean meat can also be good for your heart.

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

The weight-loss benefits of GLP-1 medications like Ozempic, Wegovy, and Zepbound are widely known.

However, as more and more people take these medications, there appear to be other benefits, such as reducing one’s risk of heart disease, stroke, kidney disease, and colon cancer.

Recently surfacing are anecdotal accounts of GLP-1 medications also helping people with rheumatoid arthritis (RA) manage their pain and experience a decrease in flare-ups.

“It is well established that autoimmune patients with obesity fare worse than those without. [They] have higher symptoms and less response to traditional therapies,” Dr. Elizabeth Ortiz, rheumatologist and clinical advisor at WellTheory, told Healthline. “I have seen patients lose weight and then require less immunosuppressant therapy for their condition.”

The connection between obesity and rheumatoid arthritis

According to a systematic review and meta-analysis of cohort studies, there is a positive association between levels of body fat and the risk of developing RA. Additionally, higher BMI (in middle age and in early adulthood) and waist circumference were associated with a higher risk of RA.

Obesity has been associated with worse autoimmune and inflammatory symptoms and with less favorable response to standard therapy for RA, added Ortiz.

“In addition to keeping autoimmune patients from feeling their best in the short term, the combination of obesity and autoimmunity can have a major impact on health in the long term,” she said. “Those with rheumatoid arthritis and other autoimmune diseases carry a higher risk of cardiovascular disease than those without these conditions. Our best defense against this is tight control of autoimmune inflammation and all other cardiovascular disease risk factors, such as obesity.”

Because of this, she said managing obesity should be a part of a holistic care plan for anyone with RA or another autoimmune disease.

Emerging “obesity first” approach may help treat rheumatoid arthritis

Dr. Fatima Cody Stanford, associate professor of medicine and pediatrics at Harvard Medical School, said by reducing weight, patients may experience less joint pain and inflammation, improved mobility, and reduced disease activity.

“Moreover, weight loss can improve overall health, reduce comorbidities such as cardiovascular disease and diabetes, and enhance the effectiveness of RA medications,” Stanford told Healthline.

Treating obesity first to help with other conditions has been coined the “obesity first” approach. Stanford said it is an emerging and promising strategy because addressing obesity directly can have a broad range of positive effects on multiple chronic conditions.

“By targeting obesity first, healthcare providers can potentially improve or even resolve associated conditions like type 2 diabetes, hypertension, and dyslipidemia,” she said. “This holistic approach recognizes obesity as a root cause rather than a consequence, aiming to improve overall patient health and simultaneously reduce the burden of multiple chronic diseases.”

However, Ortiz believes it is too early to take an “obesity first” approach for autoimmune disease. While a proportion of patients with autoimmunity may have positive results by solely focusing on obesity, she said this will not be the case for everyone.

“The biologic triggers for any particular individual’s autoimmune disease are complex and personal, and taking an ‘obesity first’ approach without also addressing the underlying autoimmune disease may expose patients to unnecessary risk from poorly controlled inflammation,” she said.

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

As the complex relationships between obesity, metabolic health, and chronic diseases deepen, Stanford said it’s clear that collaboration between obesity medicine physicians, endocrinologists, rheumatologists, cardiologists, and primary care providers is needed to create comprehensive treatment plans that address the root causes of these conditions.

“As new therapies and strategies emerge, they offer hope for improved quality of life and outcomes for patients struggling with obesity and associated chronic diseases,” she said. “Continued research and innovation will be key in advancing these efforts and providing evidence-based care.”

Given the anti-inflammatory properties that GLP-1 drugs provide and their effects on the immune system, Standford said these medications could be promising in the context of autoimmune diseases. She anticipates more research regarding their potential benefits.

“Preliminary research has suggested that GLP-1s may modulate immune responses and reduce inflammation, which could benefit conditions like RA, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD),” said Stanford. “Further research is needed to understand the mechanisms involved and to evaluate their efficacy and safety in these contexts.”

Ortiz agreed. She said those treating autoimmune diseases don’t want to turn to GLP-1 drugs without a better understanding of how and why autoimmune patients may benefit from them.

For instance, key questions that need to be answered include:

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

Understanding the effects of GLP-1 drugs on a person with an autoimmune disease like RA who is not overweight or obese needs further research.

“As we continue to discover [GLP-1s] biologic effects on inflammation and our immune systems and continue to accrue data in people using them for obesity and diabetes, we may find they are a useful tool against autoimmunity, aside from their impact on obesity,” said Ortiz. 

Any positive impact would have to be weighed against potential risks of using these medications, such as the risk of muscle loss, as muscle loss can lead to osteoporosis, a condition often associated with autoimmune diseases, she noted.

Overall, more time is needed to determine whether or not GLP-1 drugs can be used to control autoimmunity and inflammation in those with or without obesity and how best to utilize the medications for these purposes.

“What is likely to be addressed more quickly is how these medications can be utilized as a supplement to standard autoimmune therapy to improve metabolic syndrome and decrease an autoimmune patient’s cardiovascular risk,” said Ortiz.