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• An Alzheimer’s disease drug may soon have a new dosing schedule.
• The medication, Leqembi, is currently administered via an infusion every two weeks. 
• Under the proposed changes, the medication would be administered once a month.
• Leqembi is a medication that clears highly-toxic protofibrils, a type of protein, from the body. 

A medication designed to slow early Alzheimer’s disease (AD) may soon have a new dosing schedule. 

The medication, Leqembi, is currently administered via an infusion every two weeks. 

Once it’s in the body, it helps clear amyloid plaques from the brain to delay cognitive decline. 

The Food and Drug Administration (FDA) recently accepted an application from the drug manufacturer, Eisai, for a monthly intravenous dosing option, according to a press release.

The new dosing schedule would help reduce the burden for people with Alzheimer’s and their caregivers, but it’s unclear if the shift impacts the efficacy and safety profile of the drug. 

The agency stated it will make a decision by January 25, 2025. 

“If approved, the new dosing schedule for Leqembi would provide a more convenient treatment option for Alzheimer’s patients and their caregivers, potentially improving adherence and outcomes,” Jonathan J. Rasouli, MD, a spinal neurosurgeon at Staten Island University Hospital, told Healthline. 

Here’s how the drug works

Leqembi is a medication that clears highly-toxic protofibrils—a protein that contributes to neuronal injury—from the body. 

Protofibrils are thought to be one of the most damaging forms of amyloid beta (Aβ) proteins, or the type of plaques found in the brain of people with AD.

Research has shown that reducing protofibrils may help prevent the progression of AD.

“By binding to these plaques, Leqembi helps clear them from the brain, which could potentially slow progression of the disease,” explains Rasouli.

Leqembi is currently approved to be administered every two weeks through an hour-long infusion session.

“Its effectiveness has been demonstrated in clinical trials, where it has shown the ability to reduce amyloid plaques and slow cognitive decline in patients with early Alzheimer’s disease,” says Rasouli. 

That said, the medication is new so its effectiveness and long-term benefits are still being evaluated, he added.

How the dosing shift would impact patients

According to the press release, the once-a-month regimen will continuously clear the protofibrils throughout the month.

But the change in dosing will need to be evaluated in clinical trials. 

“It’s possible that a different dosing schedule could alter the drug’s pharmacodynamics, which in turn could affect its overall safety and efficacy profile,” Rasouli said. 

The FDA will be reviewing several factors, including the safety, efficacy, side effects, and benefit-to-risk ratio associated with the new dosing schedule. 

The new dosing regimen would also be less burdensome for people with Alzheimer’s, the press release states. 

Fewer treatments mean fewer visits to healthcare facilities, which can lower the burden for patients and their caregivers, according to Rasouli.

“The dosing frequency would make it easier for patients to obtain as they are given by infusion centers which remains a barrier to patients receiving this class of medications,” said Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA.

This might improve how well people adhere to their treatment, ultimately improving outcomes.

Doctors would benefit from the shift as well: The once-a-month dosing change could “streamline the treatment process, reduce logistical challenges, and potentially lower overall healthcare costs,” Rasouli said.

Some doctors are skeptical of this new class of medications 

According to Segil, Leqembi has not yet been embraced by neurologists.

“As these anti-brain amyloid medications are being used more clinically, clinical neurologists like me are observing no noticeable difference in the patients being given these anti-amyloid medications,” he said. 

Segil is concerned about the side effects as multiple patients in the clinical trials developed brain bleeds, cerebral edema, and some died. 

The medication has been linked to various side effects, including angioedema (swelling) and anaphylaxis (a life-threatening allergic reaction). 

In rare instances, the drug can cause amyloid-related imaging abnormalities (ARIA) to show up on brain scans, including microhemorrhages and superficial siderosis.

Segil would like to see more details regarding these events. 

To him, the risks outweigh the benefits. 

Most neurologists have continued to use the last generation of Alzheimer’s medications such as donepezil and memantine because the side effects appear to be less severe, says Segil.

“I remain extremely concerned these medications will cause patient deaths and await post-marketing surveillance to keep tabs on the adverse effects from this family of medications,” he said.

The bottom line:

A medication designed to slow early Alzheimer’s disease (AD) may soon have a new once-a-month dosing schedule. The medication, Leqembi, clears amyloid plaques from the brain to help delay cognitive decline. Administering it once a month, instead of every two weeks, may help reduce the burden people with Alzheimer’s and their caregivers face. More data is needed to better understand the effectiveness and safety profile of the new dosing schedule—and some neurologists remain concerned about the side effects. 

• Céline Dion is speaking out about stiff person syndrome (SPS), a diagnosis she first revealed nearly two years ago.
• SPS is a rare autoimmune neurological disease that affects muscles and coordination, resulting in muscle stiffening, painful spasms, and an increased risk of falling.
• There is no cure for SPS, but individuals can improve their quality of life through treatments including immunotherapy, benzodiazepines, and physical therapy.

Almost two years ago, Canadian music icon Céline Dion revealed a rare diagnosis known as stiff person syndrome and largely disappeared from public life; now she’s now discussing her diagnosis with NBC News.

She’s one of the top-selling musicians of all time, with more than 200 million albums sold, but Céline Dion, 56, rarely performs these days. Instead, she’s been fighting back against a rare autoimmune neurological disorder known as stiff person syndrome (SPS), which affects her ability to move and, yes, sing.

Speaking to NBC’s Hota Kotb on Tuesday, Dion revealed the uncomfortable truth about living with SPS.

“It’s like somebody is strangling you. It’s like somebody is pushing your larynx/pharynx,” she said in the interview.

As the name implies, Dion also deals with muscle stiffness that has impacted her quality of life and ability to do things that she loves.

“If I cook — because I love to cook — my fingers, my hands, will get in position. … It’s cramping, but it’s like in a position where you cannot unlock them,” she said.

She regularly deals with muscle spasms in her throat and abdominal area as well. One particular incident was so strong that Dion broke one of her ribs.

“Unfortunately, these spasms affect every aspect of my daily life…sometimes causing difficulties when I walk and not allowing me to use my vocal cords to sing the way I’m used to,” she told Kotb.

“All I know is singing,” she said. “It’s what I’ve done all my life. And it’s what I love to do the most.”

What is stiff person syndrome?

“SPS is an autoimmune neurological condition where the cause is not known at this time. What ends up happening is that the nervous system becomes hyper-excitable, which ultimately leads to the symptoms and signs that we see,” Scott Newsom, MD, a Professor of Neurology and Director of the Stiff Person Syndrome Center at Johns Hopkins Medicine, told Healthline.

Autoimmune diseases are conditions in which the immune system mistakenly damages healthy cells. Type 1 diabetes, lupus, and rheumatoid arthritis are among the cluster conditions considered autoimmune diseases.

In the case of SPS, the condition is also neurological, meaning that it affects parts of the nervous system.

SPS is believed to affect only one or two people out of one million. However, due to its rarity and the range of symptoms associated with it, experts believe it’s more common than current statistics indicate.

Diagnosis is also tricky, usually requiring a referral to a neurologist and blood tests for specific antibodies.

“It’s a tricky diagnosis because it does require evaluation by a neurologist. If there’s a suspicion, getting a patient to a neurologist quickly, first and foremost, is the most important part of the diagnosis,” Shailee Shah, MD, an Assistant Professor in Neuroimmunology at the Vanderbilt University Medical Center, told Healthline.

It most commonly develops during mid-life, between the ages of 30 and 50. Like other autoimmune diseases, SPS affects more women than men. Individuals with other autoimmune diseases are at increased risk of getting SPS.

SPS is progressive, and individuals may experience a wide range of symptoms. The most common of which are muscle stiffness or rigidity and painful spasms in the abdomen, back, and limbs. Mobility may also be affected, resulting in an irregular gait, stiff movement, and an increased risk of falling. Over time, spasms may also result in changes to posture, including lordosis and kyphosis.

Other resulting symptoms include increased emotional distress, anxiety, and depression. 

“SPS is considered a spectrum disorder. From symptom onset to diagnosis can take several years, so people are not aware of the condition, and then we see this expanding spectrum of symptoms,” said Newsom.

As a progressive disease, SPS manifests as a spectrum, meaning there is a diverse range of symptoms and severity.

Variations of SPS include:

• Classic stiff person syndrome: symptoms include muscle stiffness, rigidity, and spasms
• Focal stiff person syndrome: similar to the classic syndrome but may be isolated to an arm or leg. Eventually the trunk of the body may become affected as well.
• SPS with cerebellar ataxia: an even rarer form of SPS that overlaps with cerebellar ataxia, resulting in more muscle control, double vision, and dizziness.

The biological mechanism of SPS

Although the true cause of SPS is still unknown, scientists have identified a link with an antibody known as GAD65, which can indicate the presence of an autoimmune disorder.

“There are certain proteins that are usually expressed in inhibitory neurons that are being targeted by this immune response. And there are auto-antibodies that we think are markers of disease. The one that’s most important is called GAD65, which is the antibody targeting glutamic acid decarboxylase. We think this is one of the most common causes of this disease,” said Shah. 

Glutamate decarboxylase is an enzyme found in the brain that is an essential part of chemical signaling involving GABA. GABA is a neurotransmitter that helps to slow down your brain and plays a role in feelings like anxiety, stress, and fear associated with a hyperactive nervous system.

In SPS, the immune system attacks this critical pathway.

“Those GABA pathways become dysfunctional, and these pathways are there to keep the nervous system calm. So, when it’s not calm, anything that feeds into that hyper-excitable nervous system will trigger the symptoms or make them worse,” said Newsome.

Due to this “hyper-exciteable” state of the nervous system, emotional stress, abrupt loud noises, and other shocks can trigger muscle spasms.

Can you treat SPS?

There is no known cure for SPS, but a combination of therapies can improve symptoms and quality of life.

“What has been classically done for this disease is based on treatment of other autoimmune diseases systemically and neurologically, as well as symptom management,” said Shah.

Treatment is a multi-pronged approach that includes immunotherapies, such as intravenous immunoglobulin, that work directly on the immune system. Depending on the severity of symptoms, doctors may also prescribe benzodiazepines to help calm the central nervous system, muscle relaxers, and drugs that act on the GABA pathway, such as gabapentin.

Other interventions, specifically those working on the body, movement, and muscles, can also be helpful to alleviate pain and improve mobility, such as:

• Stretching
• Massage
• Yoga
• Acupuncture
• Physical therapy
• Qigong

“When you put all of this together, I’ve seen better outcomes over time. There’s no cure, so those outcomes could be just helping the person’s day-to-day quality of life. And with the immune therapies, we have seen that for the individual, it could help prevent progression and worsening over time,” said Newsom.

The bottom line

Céline Dion is speaking publicly with her diagnosis of stiff person syndrome (SPS), a rare autoimmune neurological disease.

SPS affects the body’s muscles, causing muscle stiffness, painful spasms, and worsening mobility.

There is no cure for SPS, but a multi-pronged treatment, including benzodiazepines, immunotherapies, and physical therapy, can improve quality of life and improve mobility.

• Social media influencers are encouraging a dangerous movement to avoid sunscreen.
• The new anti-sunscreen movement makes several false claims about the association between sun exposure, sunscreen use, and cancer.
• Both Mineral-based and chemical-based sunscreens are safe, and neither are toxic.

Summertime means more sunshine, which can put your skin at increased exposure to the dangers of the sun.

While protecting your skin when outside is important, social media influencers are pushing a misinformed anti-sunscreen movement that encourages skipping sunscreen altogether.

Some of these misleading posts have received millions of views and may have people wondering about the topic.

According to the company Glam, which analyzed search increase data using Google Trends, traffic significantly increased in late May for several questions regarding the associations between cancer, sun exposure, and sunscreen use, including:

• Does the sun cause skin cancer: up 170%
• What causes cancer in sunscreen: up 160%
• Does sunscreen cause skin cancer: up to 110%
• Does sunscreen cause cancer: up to 70%

Experts spoke with Healthline to set the record straight and debunk four of the most popular anti-sunscreen myths circulating online.

Myth: There is no proof that the sun causes cancer

The link between sun exposure and skin cancer is well-established through decades of epidemiological studies, said Dr. Dino Prato, CEO and founder of Envita Medical Centers. Research consistently shows higher rates of skin cancer in people with greater sun exposure.

Prato explained that ultraviolet (UV) radiation from the sun damages the DNA in skin cells, leading to mutations that can result in skin cancer.

“UV exposure wreaks havoc on the skin by generating free radicals that produce inflammation and damage cell function and your skin’s DNA. This DNA damage can cause changes in your genes called mutations that lead to skin cancer,” he told Healthline.

When exposed to too much sun, skin cells are damaged beyond what your body can naturally repair, causing those cells to die, said Dr. Susan Massick, a dermatologist at The Ohio State University Wexner Medical Center.

“This kicks off an inflammatory reaction, where the blood vessels dilate, and inflammatory cells come in to help. This generally takes 4 to 6 hours for an inflammatory reaction to start, which is how you can get sunburned and not realize it,” she told Healthline.

Once the inflammatory reaction kicks in, swelling and pain are felt, and the skin turns red. Blood vessel dilation causes the skin to feel warm.

Cells damaged beyond repair die off and slough off, which is why your skin peels several days after a sunburn. Those skin cells that are damaged but survive are no longer able to protect from the elements, said Massick.

“It’s these mutated cells that survive but can then turn precancerous and eventually cancerous in some cases with additional sun exposure. So, to decrease your risk of skin cancer, you should avoid blistering sunburns but also to avoid ongoing and accumulated, i.e., chronic, sun exposure,” Massick said.

According to the Skin Cancer Foundation, about 90 percent of nonmelanoma skin cancers and 86 percent of melanomas are associated with solar UV. Additionally, more than 419,000 cases of skin cancer in the U.S. each year are linked to indoor tanning, which uses UV radiation.

Myth: People who wear sunscreen are always getting skin cancer

This is like saying that wearing a seatbelt increases the risk of car accidents, said Dr. Gary Goldenberg, medical and cosmetic dermatologist and assistant clinical professor at Mount Sinai Hospital.

“People often feel a false sense of security and don’t practice safe sun after putting on SPF. But, in fact, studies have shown that using sunscreen in combination with other safe sun practices like wearing a hat and sun protective clothing, and seeking the shade, decrease the risk of sunburn and UV skin damage,” he told Healthline.

Furthermore, several studies have shown that just wearing sunscreen decreases the number of precancerous skin lesions, Goldenberg added. This is because it acts as a barrier that blocks or absorbs harmful UV radiation.

Myth: In the late 1970s, skin cancer increased because people started wearing sunscreen

While there has been a steady increase in skin cancer diagnoses over the years, Goldenberg said the increase is not because of sunscreen but rather due to an aging population, increased recreational sun exposure, and increased awareness and diagnosis.

“Climate change has definitely contributed, with the increase in temperature,” he said.

The American Academy of Dermatology Association states that the following are some risk factors for developing skin cancer.

• Experiencing five or more blistering sunburns between ages 15 and 20 increases a person’s melanoma risk by 80% and nonmelanoma skin cancer risk by 68%.
• Using tanning beds increases the risk of melanoma, including early-onset melanoma.
• People who have skin that burns easily, have blonde or red hair, have a history of excessive sun exposure, including sunburns, use tanning beds, have a weakened immune system, or have a history of skin cancer are at risk for all types of skin cancer.
• People with more than 50 moles, atypical moles, or large moles are at risk.

Myth: Mineral-based sunscreen is safer than chemical-based sunscreen

Both Mineral-based and chemical-based sunscreens are safe, and neither are toxic. Mineral-based sunscreens consist of naturally occurring mineral ingredients of titanium dioxide or zinc oxide, while chemical sunscreens are chemical-based, but this does not equal toxicity, said Massick.

“Mineral sunscreens are physical blockers and reflect UV rays off the skin, whereas chemical sunscreens tend to absorb and scatter the ultraviolet rays, so they protect along different pathways,” she said. “Mineral sunscreens are not necessarily safer, but they are less likely to cause rash or skin irritation in the way some sunscreens can for people with sensitive skin.”

Because of this, she suggested people choose mineral sunscreens over chemical sunscreens, “but not because of any concerns regarding toxicity or overall safety, but more because people tend to get more skin rash and irritation to some of the chemical ingredients in chemical-based sunscreens.”

She recommended people avoid sunscreens with fragrance, scents, and perfumes that tend to cause skin irritation.

Prato added that oxybenzone and octinoxate should be avoided due to their toxic effects on marine ecosystems. Additionally, since 2019, PABA (para-aminobenzoic acid) is no longer deemed safe and effective for use in sunscreen by the Food and Drug Administration (FDA).

Stay on top of recalls of aerosol sunscreens that contain benzene, which can be absorbed through the skin or inhaled, Prato warned.

“Short-term exposure to high levels of benzene can cause headaches, dizziness, and may even be fatal,” he said.

Tips for buying sunscreen

As you look over the varied sunscreen options, consider the following tips from Massick:

• The higher percentage of zinc oxide and titanium dioxide means the more effective they are at physically blocking the UV rays
• Broad spectrum UVA and UVB protection are both needed for full protection
• Choose a sunscreen that is water-resistant for at least 80 minutes
• Aim for SPF 50+
• A higher price doesn’t mean better protection
• Look at the expiration date

“It is also beneficial to choose products that suit your skin type, such as oil-free options for oily skin or hydrating formulations for dry skin,” said Prato.

For an annual guide on the safety and efficacy of sunscreen products, visit the Environmental Working Group (EWG).

Other ways to protect yourself from the sun

In addition to sunscreen, other measures that can help protect you from the sun include:

• Blocking out the sun with shade or parasols and umbrellas.
• Wearing protective UPF clothing, such as shirts, bathing suits, pants, and skirts
• Putting on a wide-brimmed hat that covers your ears, neck, and scalp
• Wearing high quality sunglasses that offer 100 percent UV protection from all UV light
• Avoiding activities outside during peak sun hours from 10 am to 3 pm

Petro said to consider other factors like self-screening, getting annual skin checks with a dermatologist, and increasing antioxidants, such as vitamins C, E, and A, zinc, selenium, beta carotene, omega-3 fatty acids, lycopene, and polyphenols in your diet.

“Avoid foods that cause inflammation and toxicity to your immune system and remember that gradual sun exposure is good as vitamin D is also essential for us,” he said.

• Poppi brand soda is being sued for claims of consumer fraud and false and misleading advertising. 
• A class action lawsuit alleges that the drinks’ prebiotic fiber content is insufficient to provide meaningful gut health benefits.
• Experts say the amount of prebiotic fiber included in each can is likely insufficient, but Poppi is still a healthier choice than most other sodas
• You can get more prebiotics into your diet by eating certain plant and fermented foods. 

Prebiotic soda brand Poppi, beloved by celebrities, is being sued on claims of consumer fraud and “false and misleading claims.”

The class action lawsuit alleges that the brand’s claims that the drink is good for health are untrue. 

They say the drink, billed as a “better for you” soda, does not provide meaningful prebiotic effects. 

Poppi’s marketing has centered on the soda’s inclusion of prebiotic fibers, which are beneficial for gut health. 

However, the lawsuit claims, “Poppi soda only contains two grams of prebiotic fiber, an amount too low to cause meaningful gut health benefits for the consumer from just one can.”

Are Poppi’s claims about gut health benefits exaggerated?

Rebecca Russell, a functional medicine registered dietitian specializing in gut health, says this looks like another case of brands overpromising on the health benefits of their products. 

“All too often I see products that claim to be a ‘magical’ fix for a specific problem, when in reality our bodies are complex, and no one thing will be the fix,” she points out. 

Russell believes the prebiotic fiber in Poppi sodas is far too low to meaningfully improve gut health. 

“It is thought that closer to 3-10 grams of prebiotic fibers a day is considered effective in altering the gut microbiome,” she says, pointing to a study published in 2019. 

Another thing to note is that a variety of prebiotic fibers is key to gut health.

“Products like Poppi are just one type of prebiotic fiber, so it lacks that diversity that our guts need,” Russell explains. 

Like Russell, board certified registered dietitian Tiffany Ma says two grams of prebiotic fiber per can is likely insufficient to create meaningful changes in gut microbiota or overall gut health when consumed as a stand-alone source.

“Prebiotics are non-digestible food components that selectively stimulate the growth and activity of beneficial gut bacteria,” she explains. “They can improve gut health by enhancing digestion, boosting the immune system, and increasing the production of short-chain fatty acids (SCFAs) like butyrate, which have anti-inflammatory properties and support the integrity of the gut lining.” 

Does she believe a drink like Poppi could have a negative impact on the gut? 

Ma says the gut is unique and complex and differs so much from individual to individual that it’s difficult to tell.

However, she does point out that the inclusion of “added prebiotics” (insulin) in Poppi can actually cause gastrointestinal distress, such as bloating and cramping.

“Since Poppi is a liquid very little digestion is taking place, and that can heighten these negative effects,” she explains. 

Russell shares similar concerns. She says Poppi is unlikely to have a positive effect on your gut microbiome, largely because no single food or drink item can serve as a comprehensive solution for gut health. 

“This beverage may actually lead to unwanted gut symptoms such as gas, bloating, and loose stools as too much inulin, which is the prebiotic fiber included here, can potentially cause symptoms,” she explains. 

Sugar and “natural flavors” in sodas may negatively affect your gut

Another area of concern is sugar content. At 4 grams of sugar per 12 fluid oz can, Poppi is significantly lower in sugar than most sodas. 

Still, Russell says it would be better to get prebiotic fiber from other food sources that do not have added sugars. 

She says that excess sugar can harm gut bacteria, disrupting their delicate balance. 

“One ingredient that can be called into question is ‘natural flavors’ since this term is broad and encompasses a wide range of substances that may not be health-promoting,” Russell notes. “Despite being derived from natural sources, these flavorings undergo significant processing and may end up being chemically similar to artificial flavorings.” 

In spite of that, unless you’re drinking a lot of Poppi every day, it’s unlikely to have any serious negative health effects. 

“Unless one consumes a 12-pack of Poppi per day, there truly wouldn’t be any major health concerns to make note of,” says Ma. 

She believes Poppi can still prove to be a healthier alternative to full-calorie sodas for heavy soda drinkers or those who are looking to manage their weight.

Healthier alternatives to Poppi soda

If you are looking for a healthier alternative to Poppi, there are plenty to choose from. Eating more whole foods is the best way to get more prebiotic fiber in your diet. 

“For meaningful prebiotic effects, consider foods naturally high in prebiotics, such as garlic, onions, leeks, asparagus, bananas, and whole grains like oats and barley,” advises Ma. 

She says eating a diverse range of plant foods is key.

“Aiming for at least 30 different plant foods per week (which includes fruits, vegetables, nuts, seeds, legumes, and whole grains) has been shown in the literature to result in a more diverse gut microbiome,” she explains. 

Fermented foods are beneficial, too.

“Foods like yogurt, sauerkraut, kimchi, kefir, and miso contain probiotics that can help balance the gut microbiome,” Ma notes. 

Russell agrees. She says “eating the rainbow” by filling your plate up with colorful whole foods is a great way to get a variety of prebiotics into your diet. 

Limiting your sugar intake is also a good idea to optimize your gut health. 

“Excess added sugars can promote the growth of harmful bacteria in the gut and lead to a decrease in beneficial bacteria, so aim for less than 10% of total calories to come from added sugars,” Ma advises. 

Takeaway 

Poppi sodas likely don’t have enough prebiotic fiber to provide any meaningful benefit to your gut health.

However, that doesn’t mean they can’t be enjoyed in moderation.

They appear to be a healthier alternative to most other sodas, which typically have a much higher sugar content.

• A pair of immunotherapy drugs have shown impressive results in treating a subset of colorectal cancer known as mismatch repair-deficient (dMMR) colorectal cancer.
• DMMR colorectal cancer is characterized by genetic mutations which make it easier for the immune system to identify.
• The drugs resulted in a “major pathological response,” reducing tumor size to less than 10% in the vast majority of patients. 

Colorectal cancer is notoriously resistant to immunotherapy options. But, for a subset of patients, a novel treatment shows promise,

Mismatch repair-deficient (dMMR) colorectal cancer is present in between 10-15% of all colorectal cancer patients and is characterized by a high number of mutations in genes responsible for repairing mistakes that can occur during DNA replication. While it can show up in other forms of cancer, including breast and prostate, it is most commonly found in colorectal cancer.

Treatment options for DMMR colorectal cancer can be tricky. On one hand, it tends to be more resistant to chemotherapy, but researchers have now been making inroads with immunotherapy.

Major response in 98% of patients

Surgery is the primary treatment for colorectal cancer, but in research published this week in the New England Journal of Medicine scientists found that a pair of immunotherapy drugs administered before surgery significantly diminished tumor size without serious safety concerns. 

Researchers set out to study the safety profile of the drugs by observing whether patients who took them would still be able to undergo surgery within an allotted time frame or if they would have to delay their surgery. About 98% of patients underwent timely surgery, meaning they had less than a two-week delay when taking the combination of drugs.

Researchers observed immune-related side effects in 73 patients, with severe (grade 3 or 4) events occurring in 5 patients. None of the patients discontinued treatment due to these adverse events.

The effects of the drugs on the tumors themselves were also surprising. The study found 95% of patients experienced a major pathological response, shrinking the tumor to less than 10% of its size. Meanwhile, Two-thirds of patients had a complete pathological response, meaning there was no residual evidence of the tumor after treatment.

More than two years after surgery, no patients experienced a recurrence of the cancer. The patients are being followed for longer to evaluate the durability of their response.

“I don’t think anybody expected these results or the extent of these results,” Kristen Ciombor, MD, an Associate Professor of Medicine at Vanderbilt University Medical Center who wasn’t affiliated with the study told Healthline.

“Two-thirds of patients didn’t have any tumor left, which is really incredible. It’s something that we don’t see at that rate and extent with pretty much any other therapy,” she said.

Advances in immunotherapy

The study, conducted by researchers in the Netherlands, involved 115 patients with non-metastatic, locally advanced, previously untreated dMMR colon cancer. That’s a technical way of saying colorectal cancer which has developed beyond the earliest stages (patients in the study had either stage II or II cancer) but has still not spread (metastasized) to other organs in the body.

Doctors administered the patients two different immunotherapy drugs prior to surgery. The drugs, nivolumab and ipilimumab, belong to the same class of immunotherapy treatment, known as immune checkpoint inhibitors, but utilize unique biological mechanisms from one another.

“The greatest advance we’ve had in decades of cancer research has been in the field of immunotherapy. Developing immune treatments to help the immune system attack cancer is something that we’ve dreamed about since the 1950s,” George Fisher, MD, PhD, a Professor of Medical Oncology at Stanford Medicine, told Healthline.

The results of this latest trial demonstrate how far the field has come. 

The concept of immunotherapy is simple to describe, but extremely complex to implement. When the body mounts an immune response it must identify friendly cells and foreign invaders. In order to do this, T cells, which are your body’s defenders in the immune response, perform a sort of “handshake,” known as an immune checkpoint, with healthy cells that marks them as safe. Without this, the T cells will attack.

Some forms of cancer can abuse this mechanism to hide from the immune system. Those cancers can then continue to grow without fear of an immune response.

Immune checkpoint inhibitors work by preventing cancer cells from faking this “handshake” and allowing the immune system to identify and kill them.

An additional complication is that colorectal cancer in particular tends to remain well hidden from immune system detection. But dMMR versions are different; the genetic mutations characteristic of dMMR make it easier for the immune system to pick out, and also more susceptible to immunotherapies.

“If you have more mutations, then you make more abnormal proteins. And if the immune system is capable of recognizing abnormal proteins, then those cells that have the most mutations are the ones most likely to have proteins that might be recognized as foreign,” said Fisher.

“The genetic mutations in these tumors makes it what we call ‘immunologically hot.’ So the immunotherapy can work better against the tumor itself,” said Ciombor.

Implications of the study

Experts interviewed by Healthline said that there is still much more work to do before we can know if the immunotherapy treatments in the study will be safe and effective among a larger group of patients, but the results are exciting nonetheless.

“There’s no doubt that this study is very impressive and the fact that we can see such tremendous changes in such a short interval of time with treatment with both drugs really suggests that there is likely to be a subset of patients who will not need to go to surgery,” said Fisher.

Should trials continue to show safety and efficacy, certain groups of patients could have new options available to them. For example, older patients or those with certain comorbidities that make them an unsuitable candidate for surgery might be able to opt for immunotherapy.

Patients with low-grade cancer could also potentially elect not to have surgery, although the long-term outcomes of immunotherapy without surgery have not yet been established. 

As with any treatment, there will be a question of risk versus benefit. An immunotherapy treatment prior to surgery might preclude the necessity for chemotherapy but at the risk of a severe complication called immunotherapy toxicity.

“It at least raises the possibility that there may be other options to treat this type of cancer,” said Ciombor.

“If you can avoid chemotherapy, that would be a win. Ultimately if you can avoid surgery too, then that’s really amazing. But we can’t draw that conclusion from this study yet. It’s going a little too far to say,” she said.

The bottom line

In a study involving over 100 patients, a dual-drug immunotherapy treatment shows impressive results in treating a specific form of colorectal cancer.

Mismatch repair-deficient (dMMR) colorectal cancer is found in 10-15% of all colorectal cancer cases and is characterized by a high number of genetic mutations.

These genetic mutations allow it to be more easily recognized by the immune system and make immunotherapy more likely to be effective.

• A new report, published on June 6, suggests xylitol might impair the body’s clotting abilities. 
• Artificial sweeteners like xylitol are often marketed as a healthier alternative to natural sugar, but growing evidence suggests they may harm multiple body systems.
• Xylitol is found in items like chewing gum, peanut butter and some baked goods.

Xylitol, the zero-calorie sugar substitute used in processed foods like peanut butter, gum, baked goods, and candies, has been linked to a greater risk of heart attack and stroke, a new study has found. 

The report, published in the European Heart Journal on Thursday, suggests the sweetener might impair the body’s clotting abilities. 

Xylitol has received a stamp of approval — the Generally Recognized as Safe (GRAS) status — from the Food and Drug Administration, which indicates a substance is thought to be harmless.  

Artificial sweeteners like xylitol are often marketed as a healthier alternative to natural sugar, but growing evidence suggests they may harm multiple body systems.

“I hope this serves as a calling for new regulatory guidelines to improve labeling mandates and remove sugar substitutes like xylitol from GRAS status,” senior study author Stanley Hazen, MD, PhD, Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute and Co-Section Head of Preventive Cardiology in the Heart, Vascular & Thoracic Institute, told Healthline. 

Sugar substitutes may impair clotting activity 

The researchers analyzed blood samples of over 3,000 people who were being assessed for heart disease. 

They found that, over a 3-year period, people with the highest levels of xylitol in their blood had double the risk of heart attack, stroke, and death compared to those with the lowest levels. 

The investigators also conducted in vivo, interventional, and rodent experiments to understand how xylitol impacts cardiovascular function and found that the sweetener appears to impact platelet function. 

Hazel says that while the current evidence identified an association between xylitol and cardiovascular events, there may be a causal relationship at play.

He suspects there may be a receptor on our platelets that responds and interacts with sugar alcohols like xylitol.

Platelets, a type of blood cell, play an important role in clotting, explains Cheng-Han Chen, MD, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA. 

They clump “together to form plugs that seal wounds and prevent excessive bleeding,” he said. 

Per the new findings, xylitol might increase the stickiness of platelets in the bloodstream and increase the risk of clotting in the brain and heart, and trigger cardiovascular events like a heart attack or stroke. 

The growing body of literature shows artificial sweeteners, including another sugar alcohol sweetener called erythritol, are linked to worse cardiovascular outcomes. 

“Xylitol was not previously proven to have this association, but this new study suggests that it may have similar effects on the body,” Rigved Tadwalkar, MD, a board-certified consultative cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, said.

More studies are needed to better understand the impact xylitol consumption, especially at varying doses, has on cardiovascular function.

“It is important to remember that this is an observational study, so it does not definitively prove xylitol directly causes cardiovascular problems,” Tadwalker said.

Doctors recommend limiting the use of sugar substitutes 

Hazen says the findings highlight a potentially significant public health concern. 

“The very same people most likely to be targeted for taking sugar substitutes — those with obesity, diabetes, metabolic syndrome — are the most vulnerable,” he said. 

By reaching for what appears to be a healthier option, he says, people wind up increasing their cardiovascular risks. 

Chen’s advice: Limit how much xylitol you use. 

“People should consider avoiding consuming large amounts of xylitol until more is understood about its adverse effects,” Chen said. 

Tadwalker hopes the findings motivate clinicians to have comprehensive conversations with their patients about the potential risks of xylitol. 

“This knowledge can be used to tailor dietary recommendations for individual patients,” he said. 

The bottom line:

Consuming a lot of xylitol, the zero-calorie sugar substitute used in processed foods like peanut butter, gum, baked goods, and candies, may boost your risk of heart attack and stroke, a new study has found. The new study suggests the sweetener may impair platelet activity and increase the risk of clotting, which could trigger a cardiovascular event.

• Mounjaro and Zepbound can help qualified individuals lose and maintain weight and blood glucose levels.
• These medicines are not recommended for short-term use.
• Stopping them can prompt weight regain, blood sugar spikes, and increased appetite, among other side effects.

Like Ozempic and Wegovy, Mounjaro and Zepbound can help people control blood sugar levels and reduce or maintain weight.

While these GLP-1 drugs are not recommended for short-term use, people stop taking them for a variety of reasons, including reaching their weight loss goals, severity of side effects, and cost.

In fact, a recent study found that most people quit taking GLP-1 drugs within the first three months, which isn’t long enough to see their effects.

However, many people may not be aware of the changes they’ll likely experience in the days and weeks after they stop taking these medications, especially for those who quit cold turkey.

“When coming off any medication, it is essential to talk to your healthcare provider to understand the changes that may occur within your body,” says HaVy Ngo-Hamilton, PharmD, a pharmacist and clinical consultant at BuzzRx. “Many medications are safe to quit cold turkey, while certain medications require careful tapering to avoid unpleasant withdrawal effects or even harmful outcomes.”

These are the most common biological and psychological changes people experience after they stop taking Mounjaro or Zepbound.

Weight regain

While some effects of stopping Mounjaro and Zepbound are currently more anecdotal, weight regain (sometimes referred to as “Ozempic rebound“) has some data behind it.

In a 2023 randomized clinical trial, 783 participants took tirzepatide (the generic name for Mounjaro and Zepbound) for 36 weeks. Those who stayed on the drug until week 52 lost an additional 5% of body weight, while those who stopped and took the placebo regained 14% of the weight lost.

These results are consistent with those in a 2022 trial extension on semaglutide (the generic name for Ozempic and Wegovy), which suggested that people who stopped taking 2.4 mg weekly doses regained two-thirds of the weight they lost within one year of cessation.

To grasp why patients regain weight after stopping the drugs, it might help to understand how they work.

“Tirzepatide is a glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist,” Ngo-Hamilton says. “Tirzepatide stimulates GLP-1 and GIP receptors, making it the first medication in its class to target both GIP and GLP-1 receptors.”

The body naturally produces GIP and GLP-1, which Ngo-Hamilton says are responsible for:

• Communicating with the pancreas to secrete more insulin after eating
• Boosting insulin sensitivity
• Controlling blood sugar production
• Slowing stomach emptying so you feel fuller sooner and longer

Zepbound and Mounjaro help the body in these efforts but don’t make permanent changes.

“After discontinuing an anti-obesity medication, our body’s weight-promoting mechanisms fire back up,” explains Dr. Christopher McGowan, MD, ABOM, a gastroenterologist, obesity medicine specialist, and founder of True You Weight Loss. “The underlying biology has not been altered.”

Appetite can increase

Decreasing appetite and quieting food noise and cravings are among the key reasons experts say Zepbound and Mounjaro help people lose weight. As a result, a person will likely experience an increase in appetite for the same reason they experience an uptick in weight.

“When stopping tirzepatide, it is highly likely your appetite will return to what you considered normal before using the drug,” Ngo-Hamilton reiterates. “By mimicking the actions of certain natural body hormones, this medication both literally and figuratively keeps your stomach full for longer periods of time by slowing emptying after eating, increasing insulin production, and triggering feelings of satiety.”

Since a person feels hungrier sooner, they may be more likely to consume more food.

“As you increase the frequency and portion needed to satisfy your hunger, your stomach will stretch over time, requiring larger portions to feel satiated,” Ngo-Hamilton says. 

This is a change that you’ll likely notice shortly after you’ve stopped taking the drug, as the half-life of tirzepatide is about one week.

“This means that within four weeks, most of the drug has exited the body,” says McGowan. “However, within one to two weeks after stopping the medication, patients may experience rebound hunger and appetite.”

Sense of taste may change

This one is less straightforward, but it’s possible that people may experience a change in food taste after stopping tirzepatide.

“Studies haven’t supported any meaningful correlation between changes in taste or food aversions as a result of taking tirzepatide or semaglutide, though there have been anecdotal accounts of this from people who use the medications,” Ngo-Hamilton says.

Again, food isn’t just about tastebuds and the stomach. The brain is involved.

“Taste involves a complex neurological process that starts with cells in taste buds and ends in key centers of the brain,” explains Dr. Michael Glickman, MD, the founder and CEO of Revolution Medicine. “GLP-1 receptors have been found along multiple parts of this pathway.”

• Taste sensitivity. “One aspect of the disease of obesity is that there is a dulling of receptor response to taste and therefore the desire for overly sweet and salty foods is strong,” Glickman says. “With GLP-1 action causing increased taste sensitivity, the need for overly sweet and salty foods is diminished.”
• Perception of types of taste. “Reward centers of the brain encourage increased consumption of certain flavors, especially sweetness, as this signals a quick source of energy for the body,” Glickman says. “GLP-1 action reduces the effect of these reward pathways, thereby reducing cravings for sweet foods.”
• Genetic coding and expression of cells responsible for taste. “GLP-1 directly influences the types of cells that are expressed and, in so doing, can change the profile of taste cells such as those found in the tongue,” Glickman says.

Mood changes

The link between GLP-1 drugs and mental health is still being studied, and it can go either way. 

“For example, it’s thought that mood changes may occur due to how the drugs interact with brain chemicals such as dopamine and serotonin,” Ngo-Hamilton says. “What we do know is that studies have shown that people who take Zepbound and Mounjaro for weight loss can experience mood changes – whether positive or negative.”

For instance, Eli Lilly, which makes Zepbound, cautions people to note thoughts of suicide and depression and discuss them with a doctor. Additionally, low blood sugar might cause mood changes.

The FDA is continuing to monitor for suicidal thoughts and actions in these medicines but indicated that early data does not suggest a causal link. 

And data published in 2024 on drugs, including semaglutide and tirzepatide, indicated that people with diabetes who took the drugs were less likely to experience anxiety and depression than those who didn’t.

So, what might this mean for stopping? 

Ngo-Hamilton says some people may experience poorer mental health.

Dr. Katherine H. Saunders, MD, DABOM, the founder and executive vice president at Intellihealth, agrees, pointing out that “weight regain, as well as an increase in hunger, cravings, [and] food noise, may cause some patients to feel anxious or depressed.”

However, others may report the opposite.

“In some cases, people have reported increased feelings of depression or thoughts of suicide while using these drugs, which may decrease or cease completely once they stop,” Ngo-Hamilton says.

Insulin spikes

While weight loss may make headlines, it’s not the only benefit of taking tirzepatide. One of the key benefits of tirzepatide — and why Monjaro got the FDA’s green light for diabetes treatment — is its ability to help with insulin levels.

“Because tirzepatide triggers insulin production and is commonly used to manage high blood sugar/type 2 diabetes, people who stop using it may experience spikes in their blood glucose levels if their bodies are unable to produce sufficient insulin without other antidiabetic medications being onboard,” Ngo-Hamilton says.

GI side effects

GI discomforts, like nausea and diarrhea, are common. Though they can taper with time, for some, they may prompt people to cease use. 

“If you experienced gastrointestinal side effects while your body was adjusting to the medication, you may experience some or all of these side effects while your body adjusts to the absence of the medication,” Ngo-Hamilton says. “Generally, after stopping the drug, it may take around 25 to 30 days for it to leave the body completely.” 

If side effects persist beyond this timeframe,  Ngo-Hamilton recommends speaking with a healthcare professional.

Takeaway

Zepbound and Monjaro are intended for long-term use. Cessation can prompt a person to regain weight and appetite, as the drugs do not change a person’s biology permanently.

Some people anecdotally report feeling better mentally after stopping, while others say the opposite — potentially because the return of food noise and weight can be emotional.

Gastrointestinal discomfort experienced while taking these drugs should taper within a month of stopping. Patients are encouraged to speak with their healthcare provider if the symptoms persist longer. 

“It is very important to have a detailed discussion with your provider prior to discontinuing the medication,” Glickman says. 

• New research suggests that intermittent fasting combined with protein pacing may be more beneficial for weight loss and gut health than calorie restriction.
• Participants who followed intermittent fasting with protein pacing lost more body weight and abdominal and visceral fat mass and had a higher fat-free mass percentage. 
• Experts say this may be due to the thermogenic effect of protein and metabolic flexibility.
• If you’re interested in protein pacing, you should consider spacing meals by 3 to 5 hours and aim to spread your protein intake evenly across each meal.

New research has found that intermittent fasting with protein pacing is more effective than calorie restriction for gut health and weight loss.

The study published in the journal Nature Communications compared the effects of intermittent fasting and protein pacing with heart-healthy calorie restriction on gut microbiota remodeling and metabolomic profiles.

Intermittent fasting with protein pacing involves limiting meals to certain times and evenly spacing protein intake throughout the eating window. 

For eight weeks, participants were divided into two groups. One group followed intermittent fasting with protein pacing, while the others simply restricted their calories.  

The calorie intake and expenditure of both groups were matched. 

The intermittent fasting and protein pacing group ate four meals containing 25-50 g of protein per day. Their total macronutrient composition was 35% carbohydrate, 30% fat, and 35% protein intake. 

Intermittent fasting with protein pacing was found to enhance weight loss significantly. Study participants who followed intermittent fasting with protein pacing lost more body weight and abdominal and visceral fat mass. They also had an increase in fat-free mass percentage. 

Intermittent fasting with protein pacing also showed a more profound impact on gut microbiota. 

What is protein pacing, and how can it aid with weight loss?

“Protein pacing involves eating four high protein meals, containing 25-50 grams of protein each, at regular intervals throughout the day, typically every three to four hours,” Marilia Chamon, a registered nutritional therapist and gut health expert, explains.

She said there’s a growing body of evidence supporting the use of protein pacing as an effective strategy for weight loss and metabolic health.

“Protein pacing – distributing protein intake evenly throughout the day – can help maintain muscle mass and promote satiety,” she says. 

This can be a good approach to weight loss as it typically makes you feel fuller for longer, reduces cravings, and, in the long term, can contribute to the development of muscle mass. 

Why intermittent fasting and protein pacing together may be more effective for weight loss

There are several reasons why intermittent fasting and protein pacing may be a more effective weight loss tool than simply following a calorie deficit. 

“Intermittent fasting promotes periods of low insulin levels, which can enhance fat burning,” Chamon notes. 

It may also, as the study suggests, positively impact gut microbial diversity. 

“A diverse gut microbiome is associated with better digestive health, reduced inflammation, and improved metabolic function, all of which can contribute to more effective weight loss,” Chamon explains. 

There are also metabolic improvements to consider. The study found that intermittent fasting with protein pacing influenced circulating metabolites (small molecules involved in metabolism) to a greater extent than calorie restriction. 

Chamon says better metabolic health can enhance the body’s ability to manage weight, process nutrients, and reduce fat storage.

Kelsey Costa, a registered dietitian and science communications officer at Examine, describes the combo of intermittent fasting and protein pacing as having a “synergistic” effect on weight loss.

“Participants in the intermittent fasting with protein pacing group consumed significantly more protein daily per kilogram of body weight than the control group,” she points out. 

“This potentially led to a greater energy deficit due to protein’s thermogenic properties and its role in preserving lean muscle mass, which burns more energy than fat.” 

Costa says the significant difference in average protein intake overall may have been more influential on the study’s results than the spaced timing of protein intake.

She adds that intermittent fasting, specifically, may improve metabolic flexibility, allowing the body to more efficiently switch between using carbohydrates and fats for energy. 

“This may lead to greater fat loss during fasting periods and potentially contribute to weight loss,” she explains. 

In contrast, Costa says calorie restriction alone may result in loss of fat, but also a greater loss in lean muscle mass, leading to a slower metabolism and higher potential weight regain once regular eating habits are resumed. 

How to incorporate protein pacing into your diet 

If protein pacing seems like the right weight loss tactic for you, you might be wondering how to get started. 

“To effectively implement protein pacing for weight loss, consider spacing meals by 3 to 5 hours and aim to spread your protein intake evenly across each meal,” advises Costa. 

She says specific protein goals are individual depending on factors such as body weight, health conditions, and physical activity levels. You might like to look at how much protein you’re already consuming and aim to increase it. 

Foods to eat include:

• lean meats
• fish
• eggs
• dairy products
• legumes
• tofu
• tempeh

Chamon says it’s important to ensure your overall diet is balanced while protein pacing. 

“While focusing on protein, ensure you are also consuming a balanced diet with plenty of vegetables, fruits, whole grains, and healthy fats to meet your overall nutritional needs,” she advises. 

Costa agrees. She says you should focus on consuming whole, minimally processed foods.

“Whole foods are typically richer in nutrients and free from added sugars, unhealthy fats, and artificial additives, thereby promoting overall health and well-being,” she explains. 

Finally, if you’re protein pacing, Chamon says to make sure you’re drinking plenty of water. She says staying hydrated is essential to overall health and can help control hunger. 

Takeaway 

Intermittent fasting used together with protein pacing may be more beneficial for weight loss and gut health than calorie restriction alone, according to new research.

Participants who followed intermittent fasting with protein pacing lost more body weight and abdominal and visceral fat mass. They also had a higher fat-free mass percentage. 

Experts say this may be due to the thermogenic effect of protein and metabolic flexibility.

• Sticking to the Mediterranean diet was associated with a decreased risk of mortality, according to a new study.
• The Mediterranean diet helps lower cardiometabolic risk factors, such as insulin resistance, BMI and blood pressure.
• The diet includes high amounts of vegetables, fruits, whole grains, and heart-healthy fats.

A new study showed higher adherence to the Mediterranean diet was linked with a reduced risk of all-cause mortality.

The findings were published in JAMA Network Open on May 31.

Researchers looked at health information from 25,315 women, which included blood samples, biomarker measurements, and dietary data between 1993 and 1996. These women were followed up for 25 years.

Results showed a 23% decrease in all-cause mortality risk, which may be partially explained by cardiometabolic risk factors. These include biomarkers of inflammation, insulin resistance, metabolism, and body mass index (BMI).

Health benefits of the Mediterranean diet

“When it comes to cardiovascular disease there are various risk factors which are modifiable – meaning we have control over them,” said Nicole Roach, a registered dietitian at Northwell Lenox Hill Hospital. “Diet is a major modifiable risk favor.”

To address cardiovascular disease, often times the Mediterranean diet will be recommended. There are several benefits to following a Mediterranean diet. 

• Lowering “bad cholesterol.” The Mediterranean diet avoids food rich in saturated fat, this can help lower our LDL Cholesterol, often known as “Bad Cholesterol.”
• A Mediterranean diet can also help raise our “Good Cholesterol,” otherwise known as HDL.
• This diet may promote weight loss by encouraging healthier, more nutritious food choices. However, it can also help maintain a healthy weight if you are not looking to lose weight.
• This diet may help lower blood pressure by avoiding processed foods, which often contain high sodium levels due to added salt.
• Following a Mediterranean diet can also help increase fiber intake as this diet is rich in whole fruits and vegetables. Fiber supports bowel movements and gut health, helps maintain blood sugars within targeted goals, and helps promote satiety, which can aid in weight loss or maintenance.
• Choosing foods known to have anti-inflammatory properties may help decrease overall inflammation within the body. Decreased inflammation is beneficial to the heart and reduces the risk for various types of cancer.
• May be helpful for mood, cognitive function, and healthy brain aging.

“All of the above benefits of a Mediterranean diet can result in improved heart health as well as improved over all health,” Roach stated. 

This study suggested that the diet helped reduce: inflammation, triglyceride-rich lipoproteins, insulin resistance, and body mass index. These factors likely contributed to why people with higher adherence to this diet had lower mortality risk.

Mediterranean diet and decreased risk of all-cause mortality

The blood metabolites measured explained some of the effects of the Mediterranean diet on mortality.

“This included having lower molecules that are involved in inflammation and lipids that cause deposits in arteries that can lead to heart disease,” Dr. Marie-Pierre St-Onge, associate professor of nutritional medicine at Columbia University Vagelos College of Physicians and Surgeons, stated. “Lower blood pressure and better glucose control also contribute to the reduced risk of mortality.”

John Higgins, MD, a sports cardiologist at UTHealth Houston, agreed.

“Improved cardiovascular risk factors (blood pressure, cholesterol, blood glucose) as well as improved vascular function, improved coagulation profile, and less chance of an angry plaque (lower inflammatory markers) would result in lower rates of cardiovascular events (heart attack, stroke, peripheral arterial disease),” Higgins said.

In the current study, researchers found that improvements in measures of blood pressure, HDL and LDL cholesterol, and blood glucose control, such as hemoglobin A1C, were not as strongly associated with reduced mortality risk from adherence to the Mediterranean diet as some other biomarkers. However, they did acknowledge that previous studies have reported such associations.

More specifically, the researchers found biomarkers of metabolism and inflammation, triglyceride-rich lipoproteins, insulin resistance, and body mass index may contribute the most to the reduced mortality risk associated with the Mediterranean diet.

“The Mediterranean diet is rich in many nutrients and dietary components like polyphenols, that have anti-inflammatory properties,” said St-Onge. “It is high in fiber and low in sugar, which contribute to better glucose control, and is low in saturated [fat] while being higher in monounsaturated fat, which are known to produce [a] better lipid profile with lower LDL cholesterol and triglycerides and higher HDL cholesterol.”

The foundations of the Mediterranean diet include fatty fish, nuts, extra virgin olive oil, legumes, vegetables and fruit.  

Julia Zumpano a registered dietitian with the Cleveland Clinic Center for Human Nutrition, said foods high in omega 3 fatty acids such as certain fish, walnuts, flax seeds and chia seeds when combined with foods that reduce inflammation, such as legumes, fruits and vegetables, “have been shown to reduce blood sugars, reduce insulin, improve gut health and regularity.”

Zumpano recommends eating grains that are whole grains, in addition to minimally processed foods.  Zumpano recommends avoiding commercial baked goods, sugar-sweetened beverages or processed meats, which have been shown to increase inflammation, blood sugars, triglycerides, weight and risk of chronic diseases.

Takeaway

A new study found that sticking to the Mediterranean diet was linked with a decreased risk of all-cause mortality in women.

The Mediterranean diet may help reduce cardiometabolic risk factors, such as insulin resistance, BMI, and inflammation.

There are other factors that need to be taken into consideration which are family history, exercise habits and lifestyle.

• New findings suggest that the longer you have excess weight, the higher your risk of sustaining a stroke or heart attack.
• People who have had excess weight for at least a decade had up to a 60% increased risk of cardiac issues.
• Researchers say the study findings may help physicians treat people before they develop full-blown heart disease.

New research has found that for many people, the longer you have excess weight, the higher your risk of sustaining a stroke or heart attack.

These findings were identified via a research team that included members from Harvard and pharmaceutical company Eli Lilly, who sponsored it. The research was presented at the recent Endocrine Society’s Annual Meeting this month.

The researchers looked at people with a BMI of over 25, which would classify them as a person having overweight. The data used for the study came from two long-standing research gathering efforts, the Nurses’ Health Study and the Health Professionals Follow-Up Study. Of the 109,259 women and 27, 239 men whose data was analyzed, 8.8% of participants had sustained a cardiac event between 2000 and 2020.

The researchers found that for men under 65 and for women under 50, having excess weight for over a decade was linked to a 25-60% increase in cardiovascular events such as stroke or heart attack.

However, those findings did not hold for women over 50 and men over 65. No data was available for men under 35. This study has yet to be published in a peer-reviewed journal.

Earlier treatment could help decrease risk of stroke, heart attack

Matthew I. Tomey, MD, a cardiologist at the Mount Sinai Fuster Heart Hospital, says that findings will help physicians treat patients earlier.

“For far too long we have started far too late in addressing modifiable risk factors for cardiovascular disease,” Tomey said. ” A growing body of evidence is teaching us as cardiologists that subclinical cardiovascular disease [before it is diagnosable] is brewing beneath the surface in our 20s and 30s.  Earlier identification of subclinical disease and earlier proactive efforts to control controllable risk factors are huge opportunities to decrease the world’s burden of cardiovascular disease on a large scale.”

Alexander Turchin, MD, MS, an associate professor in Harvard’s medical school and director of quality in diabetes at Bringham and Women’s Hospital, said the study’s findings could help people improve their health.

“I think what I want them to take away is that if you have excess weight at any point in time, it doesn’t seal your fate. You can still make a difference in your health if you reduce this excess weight over time and decrease your excess weight exposure,” said Turchin, who presented the study.

Key takeaways for better heart health

Philip Nimoityn, MD, a clinical assistant professor of medicine at Thomas Jefferson University and cardiologist with Cardiology Consultants of Philadelphia, says that these findings are in line with updated guidance for heart health.

“A number of years ago, the focus was on decreasing lipid levels, saying that lower is better. The new mantra is lower for longer because, in reanalysis of long-term lipid-lowering and cardiovascular risk studies over many years, it’s now been shown that if you intercede and interrupt risk at a young age, you have much more chance of decreasing future disease and events.”

Nimoityn points to newer options for medications that can reduce cardiovascular inflammation—a precursor to cardiac events— like the FDA’s 2023 approval of Lodoco as one area where advancements are being made.

Tomey also highlights the American Heart Association’s public guidelines, which focus on lifestyle changes including diet and exercise to stay heart healthy.

“The more disciplined a person is over time in maintaining a healthy diet, regular physical activity, abstinence from tobacco, restorative sleep patterns, a healthy body weight, and ideal levels of blood cholesterol, blood pressure and blood glucose, the more likely they are to avoid development and progression of preventable cardiovascular disease,” Tomey said.

Why do we still rely on BMI as a major health factor?

Experts who spoke to Healthline stressed that looking at an indicator like body mass index, which was the marker used in the study, is an important part of the picture, but not the whole picture. 

“It’s not a perfect measurement, and we know that,” Turchin said. “But measurements that are better are not routinely available, not routinely done in everyday care, they’re harder to do, potentially harder to get right…Keeping excess weight for a long time is not great for somebody’s health and puts them at increased risk of heart attack and stroke.”

Michelle Routhenstein, MS, RD, owner of Entirely Nourished, says people need to be aware of their cardiac health through more lenses than just their weight. 

“I can’t tell you how many people get dismissed from their doctor because they don’t look like they have heart disease. And so because they’re an athlete because they’re thin and they’re not cardio metabolically healthy, a lot of their doctors will be like, No, you’re fine. You eat healthy, you exercise, don’t worry. And then they have a coronary artery event,” Routhenstein said.

Takeaway

New research finds people who have had excess weight for over a decade are at higher risk for cardiac events.