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Everything in moderation — but with caveats.
As more research confirms the negative health effects of alcohol consumption, even in moderate amounts, long-held beliefs about the purported health benefits of the occasional drink or two are shifting.
A large new study published August 12 in JAMA Network Open found that moderate-level alcohol consumption had no benefit for older adults but raised disease-related mortality risk instead.
The findings are based on health records of more than 135,000 adults ages 60 and older in the United Kingdom with health-related or socioeconomic risk factors.
During initial interviews, participants were asked detailed questions about their alcohol use between 2006 and 2010. Using data from the UK Biobank, researchers found increases in cancer-related and all-cause mortality in low-, moderate-, and high-risk drinkers.
No associations for moderate drinkers without socioeconomic or health-related risk factors were found. However, low risk drinking was still associated with a higher risk of cancer mortality in this group, while moderate drinking continued to show greater chances of death from cancer and other causes.
Meanwhile, a new Gallup poll shows young people in the United States increasingly view alcohol as unhealthy.
“There is a pervasive myth that low or moderate alcohol consumption improves health outcomes,” David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told Healthline. Cutler was not involved in the study.
“Nothing could be farther from the truth. The fact is that population-wide studies demonstrate that any alcohol consumption can have a negative health impact. So, it is difficult to argue with the general conclusion that alcohol consumption may be dangerous to your health,” Cutler said.
This new research highlights what many health experts have long suspected about moderate drinking, despite other studies that may have shown the inverse.
An older study published in 2000 suggests “significant” reductions in cardiovascular mortality risk from drinking red wine. More recently, a 2020 research review highlighted the health benefits of light and moderate alcohol consumption, including reduced cardiovascular disease and type 2 diabetes.
Current guidelines for moderate drinking continue to suggest up to 14 grams or 1 drink per day for females and up to 28 grams or 2 drinks per day for males on days when alcohol is consumed.
In the JAMA study, researchers defined moderate drinking as 20–40 grams of alcohol per day for males and 10–20 grams of alcohol per day for females. This range extends beyond the threshold for current moderate drinking guidelines.
The researchers reported the lowest alcohol-related mortality risks among individuals who consumed no more than 10 grams of alcohol daily (less than 1 standard drink), which became more evident in those with higher socioeconomic status.
“The big picture of the health risks of alcohol should not be ignored,” Cutler said. “Cancer mortality was increased in even the lowest risk drinkers. And if health-related and socioeconomic factors were also present these risks were even greater. So, while some people may find excuses in light alcohol consumption because they lack risk factors for poor outcomes, moderate and heavy drinkers have no such safe haven.”
Daniel Landau, MD, board certified oncologist, medical director of virtual hematology at the Medical University of South Carolina, and contributor for the Mesothelioma Center, told Healthline that alcohol may have been exceptionally harmful to the older adults included in the study because they already had other health issues.
“People who are over the age of 60 often have other comorbidities such as diabetes or heart disease and are already at higher risks of developing cancers,” said Landau, who was not involved in the study. “Adding alcohol on top of these risks seemed to exacerbate these other medical conditions and possibly promote the risk of cancer development.”
Socioeconomic status was also an important factor researchers used to calculate alcohol-related disease risk.
Participants in this study were also mostly white, which means the findings do not account for alcohol’s effects on other racial demographics.
Of those who were classified as having light alcohol consumption, preferred wine, and drank only with meals, no negative health outcomes were reported.
“The theory is that many of these patients were typically of a higher socioeconomic status [and] had more access to care and less comorbidities,” Landau said. “With potentially having a lower rate of diabetes or other medical conditions, the alcohol may not have had the full detrimental effect it did on the rest of the population.”
A new Gallup poll published on August 13 revealed nearly half (45%) of Americans believe that moderate alcohol consumption may be harmful to health.
This is a 6 percentage point increase from last year and a 17 percentage point increase from 2018, marking an all-time high for this survey over the past 20 years.
The shifting opinion about alcohol becomes more pronounced among young people.
Around 65% of adults ages 18 to 34 say alcohol negatively affects health. Indeed, there is a growing “sober curious” movement among Gen Zers.
Still, 37% of respondents ages 35 to 54 and 39% of those 55 and older agree that alcohol may cause harm.
Only 8% of people believe that alcohol may have a positive effect, which Gallup notes is the lowest on record.
“The history of alcohol consumption in our society has always been ambivalent about whether this substance is a tonic or a toxin,” Cutler said. “The evidence shows that alcohol, in any amount, can be harmful. Prudent people should give serious thought to whether any alcohol consumption is in the best interest of their overall health.”
Exposure to ethanol and formaldehyde is harmful to human health. Alcohol beverages contain these components in varying amounts.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), when alcohol is metabolized by the body, most of the ethanol consumed is broken down by the liver and transformed into a toxic compound called acetaldehyde, a known carcinogen that may lead to DNA damage.
While this acetaldehyde reaction is usually short-lived before it’s broken down into acetate, it may still lead to significant damage, particularly in the liver, where the majority of alcohol metabolism occurs.
Other studies have examined the harmful effects of formaldehyde in many alcoholic beverages, Landau noted.
A 2011 study, for instance, detected toxic formaldehyde in 132 of 508 alcohol beverage samples, which included beer, wine, spirits, and other sources of alcohol.
“The conversion of alcohol to formaldehyde is one of the prevailing theories as to why alcohol is detrimental to our organs, especially our liver,” Landau said. “It is very toxic, and excessive amounts of it are incredibly dangerous.”
The shift in public perception about alcohol and mounting evidence showing its potential harm has left many people wondering whether to limit their alcohol intake or avoid it entirely.
In 2023, the World Health Organization (WHO) declared that no amount of alcohol is safe.
The U.S. Dietary Guidelines for Americans, 2020-2025 acknowledges the emerging evidence showing that drinking within the current recommendations may raise the risk of death from all causes, including cancer and heart disease, and advises caution.
However, a silver lining in the JAMA study suggests that having a drink only with meals could help lower the associated mortality risks.
“I remain a believer in ‘everything in moderation,’” Landau said. “However, people have their own theories on what moderation looks like. I generally advise my patients that having a drink with dinner on a weekend is acceptable, but once we start incorporating daily drinking, that starts to become more excessive.”
Public perception about alcohol is shifting as growing evidence shows the potential harm it may cause to human health.
A new study found that even moderate alcohol consumption had negative health outcomes for older adults of lower socioeconomic status.
While that risk was smaller for people of high socioeconomic status or those who only drank during meals, moderate drinking should still be approached with caution.
A new study shows that commercial health insurance paid for the majority of prescriptions in the United States for the anti-diabetes drugs Ozempic and Rybelsus and the anti-obesity drug Wegovy. This trend was especially true for Wegovy.
In contrast, much smaller numbers of prescriptions for these drugs were filled using Medicare Part D or Medicaid, with a tiny fraction of people paying with cash.
“Despite the disproportionate burden of obesity in Medicaid and Medicare Part D populations and recent increases in public spending on weight-loss medications, most Wegovy fills were for the commercially insured,” wrote study author Dima M. Qato, PharmD, MPH, PhD, director for the Program on Medicines and Public Health at the USC School of Pharmacy, and her colleagues.
The study was published August 2 in JAMA Health Forum.
In the study, researchers examined data from IQVIA’s National Prescription Audit PayerTrak. This system covers 92% of prescriptions filled and dispensed at retail pharmacies in the United States.
They looked specifically at prescriptions for semaglutide. This drug is the active ingredient in anti-diabetes medications Ozempic and Rybelsus, and anti-obesity drug Wegovy.
They also examined the type of payment used for the prescriptions — commercial health insurance, Medicaid, Medicare Part D, or cash.
Researchers found that between January 2021 and December 2023, the number of prescriptions filled for semaglutide increased by over 442% (from 471 ,876 to 2, 555 ,308). Of these, over 70% were for Ozempic.
During this period, semaglutide prescriptions increased for all types of payment. However, most of the prescriptions were filled using commercial insurance, particularly for Wegovy.
In 2023, commercial insurance accounted for 61.4% of prescriptions filled for Ozempic, 89.5% of Wegovy prescriptions, and 58.1% of Rybelsus prescriptions.
In contrast, Medicare Part D accounted for only 28.5% of prescriptions filled for Ozempic, 32.9% of Rybelsus prescriptions, and 1.2% of Wegovy prescriptions.
Medicaid accounted for less than 10% of prescriptions filled for all three drug brands in 2023.
A small number of people paid cash for Ozempic and Rybelsus, less than 1% of all prescriptions each.
A larger percentage paid cash for Wegovy — 12.7% of prescriptions in 2021, 2.6% in 2022 and 1.2% in 2023.
This trend may represent increased insurance coverage of this medication over time.
Robert Klitzman, MD, professor of psychiatry and director of the Master of Science in Bioethics program at Columbia University, said that the results of the new study are important, but they don’t give us the whole picture. Specifically, why these prescription trends are happening.
For example, are people with Medicare and Medicaid less comfortable asking their doctor to prescribe one of these drugs for weight loss? And how many people stop taking the drug after a few months, and does it vary by the type of insurance?
“There’s room for more research here to find out why there are differences in the number of people on Medicare, Medicaid, and private insurance taking these medications,” said Klitzman.
However, he pointed out that in 2022, 54.5% of Americans had commercial insurance, 18.8% had Medicaid and 18.7% had Medicare, according to the US Census.
“So the distribution of prescriptions found in the JAMA Health Forum article is not as alarming as one might initially think,” Klitzman, author of Doctor, Will You Pray for Me?: Medicine, Chaplains, and Healing the Whole Person, told Healthline.
Also, he said the fact that patients on Medicare are more likely than others to be on Ozempic or Rybelsus is not surprising “since these people are older and hence more likely to have heart disease or stroke, which would make them eligible for these medications.”
Overall, Klitzman thinks this study only provides a glimpse into how well the United States is handling the obesity epidemic.
More than two in five American adults are living with obesity, according to the Centers for Disease Control and Prevention. Rates are higher among Black adults and adults with lower levels of education.
Newer GLP-1 drugs have been shown to be very effective at helping people lose weight and keep the weight off — as long as they keep taking the medication — but Klitzman thinks this is only part of the solution.
“You certainly want to have a good treatment [such as GLP-1s] available to everyone,” he said, “but I wouldn’t want people to think, ‘all we need is for everyone to take a medication and we’ll all be treated.’”
Eating healthy, staying physically active and learning to deal with stress can also help people lose weight, while offering other benefits.
“Exercise helps you not just lose weight, but it helps with your cognitive thinking and it helps with your heart,” said Klitzman.
However, Lydia C. Alexander, MD, president of the Obesity Medicine Association and chief medical officer of Enara Health, cautions against thinking that people should skip the GLP-1 drugs and only try to lose weight with diet and exercise, something that fuels the stigma surrounding obesity.
People with obesity sometimes get judged for “not taking good care of themselves” or “not trying as hard as they can to maintain a healthy weight,” she told Healthline.
“This thinking is very common, even among primary care physicians,” she added.
While nutrition, physical activity and lifestyle changes are essential to treating obesity, “obesity is a disease,” Alexander said, “and just like any other disease, a medication may also be needed.”
“Because obesity is a metabolic dysfunction, where the body is no longer getting the correct signals to maintain a healthy weight,” she said.
One limitation of the new study is researchers did not have information on why people were prescribed semaglutide, which may have affected prescription rates.
Ozempic was initially approved for the treatment of type 2 diabetes, and later to reduce the risk of serious heart problems in adults with cardiovascular disease who living with overweight or obesity.
This drug is also sometimes prescribed off-label to help people lose weight, something that was especially common before Wegovy was approved in June 2021 by the Food and Drug Administration as an anti-obesity drug.
The extent of coverage for semaglutide and other GLP-1 medications depends upon the type of health insurance — and the condition it is prescribed to treat.
“Medicare Part D will cover GLP-1 medications when they are used to treat type 2 diabetes or people with pre-existing cardiovascular disease who need to lose weight,” said Alexander.
But “there’s an actual clause that prohibits treating obesity [alone] as part of Medicare,” she said. As a result, the Medicare population does not have GLP-1s readily available to them for all uses.
With Medicaid, GLP-1 coverage varies from state to state since these are state-run programs.
“For example, in Arizona, it’s relatively more difficult to have Medicaid cover anti-obesity medications,” said Alexander, “but in California, these drugs are included as part of Medicaid coverage, and many times without prior authorization needed.”
Among commercial insurance plans, coverage also varies.
However, a recent survey found that one-third of employer health plans said they are covering GLP-1 drugs for both diabetes and weight loss. This is an increase from around one-quarter in 2023.
In addition, over half of employer health plans cover GLP-1 drugs only as a treatment for type 2 diabetes, the report from the International Foundation of Employee Benefit Plans found.
However, of employers with GLP-1 coverage only for diabetes, almost one-fifth said they are considering offering the drugs for weight loss.
To find out if your health insurance plan covers GLP-1s for weight loss, check the plan’s formulary and summary of benefits and coverage (SBC). This information should be available on your insurance company’s website.
Ro, a direct-to-patient healthcare company, also recently launched the GLP-1 Insurance Coverage Checker, a free tool to help people find out if their insurance covers treatment with GLP-1 medications.
The company said in a news release that nearly half of its patients have coverage for GLP-1s for weight loss, and most have coverage for more than one medication.
In addition, about two-thirds of patients with coverage paid less than $100 per month, the company said. However, most companies require people to get prior authorization before accessing the drugs.
The list price for Wegovy is almost $1,350 for a month’s supply. This is the amount people without insurance coverage would pay before any discounts or rebates. Drugmaker Novo Nordisk also offers a savings card that allows people to pay cash for a one-month supply for $650.
Researchers found that between 2021 and 2023, the majority of prescriptions in the United States for anti-diabetes drugs Ozempic and Rybelsus, as well as the anti-obesity drug Wegovy, were paid with commercial health insurance. The trend was especially strong for Wegovy.
Smaller numbers of people paid for prescriptions with Medicare or Medicaid, which may reflect fewer Americans having these health plans. However, Medicare does not offer coverage for Wegovy, and Medicaid coverage of GLP-1 drugs varies across states.
The study provides a glimpse into how well the country is tackling the obesity epidemic, but experts say more information is needed. For example, why are there differences in prescription rates across insurance, and how many people are prescribed these drugs solely for weight loss?
A new study from Cleveland Clinic researchers suggests that consuming a 30-gram serving of erythritol, a popular artificial sweetener, could rapidly raise the risk of blood clots.
The findings were published August 8 in Arteriosclerosis, Thrombosis and Vascular Biology.
Erythritol is commonly found in diet, low-calorie, and sugar-free food and drink products, particularly those marketed for keto diets. It is often blended with stevia and monk fruit sweeteners to enhance their bulk.
In the study, researchers examined the effects of erythritol or regular sugar on blood platelets, which play a crucial role in blood clotting. They found that typical amounts of erythritol appear to significantly increase platelet activity, raising potential concerns about an elevated risk of blood clots. Sugar did not have this effect on platelets.
Blood clots form within a blood vessel and may travel to the heart, causing a heart attack, or to the brain, potentially resulting in a stroke. A blood clot can also travel to the lungs, leading to a pulmonary embolism.
The findings from this new study echo the research team’s 2023 findings linking erythritol with a higher risk of heart attack and stroke. This concerning data suggests it may be time to reevaluate erythritol’s safety as a food additive.
Popular sweeteners like Truvia and certain Splenda products contain erythritol as a key ingredient.
Healthline reached out to both companies, but Splenda (Heartland Food Products Group) declined to comment on these new findings.
On behalf of Truvia, the Calorie Control Council (CCC), which represents the low- and reduced-calorie food and beverage industry, told Healthline the findings were “misleading.”
“For more than 30 years, global authorities have repeatedly confirmed the safety and efficacy of erythritol and other low and no-calorie sweeteners,” the CCC representative said.
The new study looked at healthy people with normal kidney function. It involved 20 volunteers, averaging about 30 years old, including both males and females.
After fasting overnight, 10 participants drank water mixed with 30 grams of sugar (glucose), while the other 10 had water with 30 grams of erythritol. Blood samples were taken before they drank and again 30 minutes later.
In those who consumed erythritol, blood levels of erythritol rose dramatically — over 1000 times higher than initial levels. These participants also showed a significant increase in platelet aggregation (clumping) when exposed to certain triggers and an increase in specific markers released from platelets.
There were no changes in platelet reactions after glucose consumption, emphasizing erythritol’s unique effect on platelet function.
Although the study was small and examined the effects of only one dose shortly after consumption, it raises concerns about erythritol’s potential to increase the risk of blood clot formation when consumed in typical daily amounts.
These results follow another recent study by the same researchers, which found that xylitol, another artificial sweetener, may similarly increase blood clotting risk in healthy adults.
This highlights the need for further research into the long-term health effects and cardiovascular safety of sugar alcohols like erythritol and xylitol, especially for those at higher risk of blood clots.
Erythritol is commonly marketed as a natural and healthy alternative to traditional sugar because it is calorie-free and naturally occurs in small amounts in some fruits and vegetables.
However, erythritol is also commercially manufactured through a fermentation process and used in larger amounts as a food additive than would naturally occur in foods.
While many sweetener products contain erythritol as a primary ingredient, it is also found in many other processed foods and drinks, including:
The amount of erythritol used in the present study (30 grams) reflects the typical daily amount that people consume from food and drinks based on data from the 2013 to 2014 National Health and Nutrition Examination Survey and FDA calculations from 2001.
However, given the steady rise in artificial sweetener use, daily intakes of erythritol may have increased since these estimations were made.
Once consumed, erythritol is not digested. It enters the bloodstream through the intestine and is primarily excreted through urine, remaining unchanged.
The body naturally produces small quantities of erythritol, but any extra intake from the diet can build up in the blood, as seen in the current study.
Even though there is growing evidence questioning its safety, the FDA still considers erythritol as “generally recognized as safe (GRAS).” This means that erythritol is deemed safe for the general population to consume in typical daily amounts from food and drink products.
Erythritol has previously been recommended as a sugar alternative for people with chronic conditions like obesity, diabetes, and heart disease.
While erythritol is widely used and remains classified as GRAS, experts are now urging caution and advising against its use.
“The GRAS designation relies on the assumption that a substance is safe based on existing research and historical use, but this approach may not always account for long-term or cumulative risks,” Thomas M. Holland, MD, a physician-scientist and assistant professor at the RUSH Institute for Healthy Aging, RUSH University, College of Health Sciences, not involved in the study, told Healthline.
“While the FDA requires safety parameters to be established and data to be publicly accessible, this does not eliminate the need for consumers to stay informed and cautious,” he warned.
Holland suggested that people should “err on the side of caution” regarding artificial sweeteners like erythritol, especially for individuals at risk of cardiovascular issues or with conditions related to an increased risk of blood clots.
Kiran Campbell, a registered dietitian nutritionist at Dietitian Insights, echoed this sentiment, urging the FDA to reconsider erythritol’s safety.
She told Healthline that consumers should avoid erythritol as a precaution until we know more, especially because nearly half the adult population “has some form of heart disease, including stroke, and may be taking antiplatelet medications.”
Campbell also highlighted the World Health Organization’s (WHO) updated 2023 guidelines, which advise against using non-nutritive (zero-calorie) sweeteners for weight loss or chronic disease prevention.
Holland emphasized the importance of being cautious with food additives and prioritizing natural, whole foods, as these don’t contain harmful additives and instead offer recognized health benefits.
Both Holland and Campbell also advised that, in small amounts, minimally refined natural sugars and sweeteners could be safer alternatives to artificial sweeteners like erythritol. These include:
“While a diet low in added sugars is ideal, occasional consumption of natural sugars is likely safer than relying on artificial alternatives, given the current evidence,” Holland said.
“However, even natural sugars should be consumed sparingly to prevent long-term negative effects, such as metabolic disorders,” he cautioned.
A new Cleveland Clinic study shows that a 30-gram serving of erythritol, a common artificial sweetener, might significantly raise the risk of blood clots.
The research highlights that even substances considered safe by regulatory bodies could pose potential risks, especially for individuals with existing health issues.
As evidence mounts against erythritol and other artificial sweeteners, experts advise consumers to avoid these products as a precaution and consider choosing natural sugar and sweetener alternatives in moderation.
“Star Wars” star Daisy Ridley revealed in the August 6, 2024, issue of Women’s Health that she was diagnosed with Graves’ disease in September of 2023.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Graves’ disease is an autoimmune disorder affecting the thyroid, a small gland in the front of the neck often described as being shaped like a butterfly.
Graves’ disease occurs when the immune system begins to attack the thyroid as if it is an outside invader, causing the gland to become overactive. NIDDK explains that this can cause the body’s functions to speed up.
Ridley told the magazine that she first realized that something was not right when she began to experience hot flashes and fatigue after the completion of her movie Magpie, in which she plays a woman involved in a troubled relationship.
“I thought, Well, I’ve just played a really stressful role; presumably that’s why I feel poorly,” she told Women’s Health.
Upon learning of her symptoms — which also included hand tremors, a racing heart, and weight loss — her primary care doctor referred her to an endocrinologist, who diagnosed her as having the autoimmune condition.
Ridley additionally described to the publication how it felt to finally understand why she had felt so bad: “It was funny, I was like, ‘Oh, I just thought I was annoyed at the world,’ but turns out everything is functioning so quickly, you can’t chill out.”
Ridley has also previously spoken about her diagnoses of endometriosis and polycystic ovarian syndrome (PCOS), which research suggests are linked with a higher risk for Graves’ disease.
Micheal O. McKinney, MD, a physician with Healthy Outlook, said that Graves’ disease results in the excessive production of thyroid hormone, a condition known as “hyperthyroidism.”
When this occurs, it can have various metabolic and systemic complications, he explained.
Some of the symptoms you might experience, per McKinney, include:
“It’s worth mentioning that these symptoms develop gradually over time, so they may resemble other illnesses,” he added, “thus demanding specific testing for accurate diagnosis.”
John Lowe, MD, a physician at Restore Care, explained that the exact causes of Graves’ disease are unknown.
However, certain factors such as genetic predisposition and environmental triggers may contribute to its occurrence, he said.
To minimize your risk, Lowe said, “Relax through practicing yoga, meditation, and physical exercises effectively.”
“Avoid smoking since it increases the risk and severity of Graves’ ophthalmopathy,” he added. Graves’ ophthalmology is a condition in which swelling around the eyes makes them bulge out.
Additionally, you’ll want to be consistent about getting medical checkups of your thyroid health, especially if you have a family history of thyroid conditions, said Lowe.
Lowe described several medical treatments for Graves’ disease. Among these are:
Lowe concluded by noting that Graves’ disease is treatable through both medical intervention and lifestyle changes.
“It is important to diagnose and treat it early enough since any delay may lead to complications as well as affect one’s quality of life significantly,” he said.
“Star Wars” actress Daisy Ridley revealed in a Women’s Health interview that she had been diagnosed with Graves’ disease, an autoimmune thyroid condition that causes an overproduction of thyroid hormone.
It can lead to symptoms of thyroid hormone excess, such as weight loss, rapid heartbeat, and protruding eyes.
The causes of Graves’ disease are unknown, although it may be due to a combination of genetic predisposition and environmental triggers.
However, it can be treated with medications, surgery, and lifestyle adjustments.
A diet low in added sugars is recommended for overall health. The World Health Organization (WHO) recommends that free sugars make up less than 10% of total energy intake because of their links to chronic diseases.
Studies have shown that reducing intake of free sugars helps reduce fat mass. Similarly, carbohydrate restriction, as with the ketogenic diet, is a proven weight loss method that has recently exploded in popularity.
A new study published in the journal Cell Reports Medicine investigates how the low carb, high fat keto diet compared to a diet low in free sugars (sugar added to foods or drinks) and a control diet. The researchers wanted to find out how these eating patterns influenced weight loss and metabolism. The study involved 53 participants and ran for 12 weeks.
According to a news release, the scientists also found that compared with the control diet, the low-free sugar diet and keto diet reduced fat mass by 2.1 and 2.9 kilograms, respectively. They determined this weight loss was unrelated to changes in physical activity — all groups maintained similar activity levels.
However, the scientists found the keto diet increased levels of “bad” cholesterol and other markers associated with cardiovascular disease risk compared to the low-free sugar diet and the control diet. The keto diet was also linked to reduced “good” gut bacteria.
Meanwhile, the diet low in free sugars did not have these negative side effects.
Participants following the keto diet had elevated levels of low-density lipoprotein (LDL) cholesterol, sometimes called “bad” cholesterol.
In particular, they had higher levels of small and medium-sized LDL particles. When it comes to cholesterol, the smaller the particle, the worse it is for health.
In contrast, the low-sugar diet significantly reduced LDL cholesterol.
Participants following the keto diet also had increased levels of a molecule called apolipoprotein B (apoB), a compound found in LDL cholesterol. This protein is linked to atherosclerosis, where the lining of blood vessels develops plaques, increasing the risk of cardiovascular disease.
“This is a meaningful reduction,” study author Javier Gonzalez, PhD, a professor at the University of Bath in the United Kingdom, told Healthline.
“We observed a 0.5 millimoles per liter (mmol/L) reduction. Genetic studies indicate that if the levels of LDL cholesterol were reduced by just 0.35 mmol/L, then over a lifetime, this would equate to a 21% lower relative risk of atherosclerotic cardiovascular disease, including heart disease and stokes,” Gonzales said.
Unlike the reduced-sugar and control diets, the keto diet significantly affected the gut microbiome — the trillions of bacteria that live in the lower intestine.
In particular, they found reduced Bifidobacteria, a “good” gut bacteria. Reduced numbers of these species are linked to increased risks of metabolic, immune, and gut issues.
Bifidobacteria also produce important B vitamins and other compounds that support overall health.
Fiber — a carbohydrate that the digestive system cannot break down — feeds our gut bacteria. Fiber intake is severely reduced on the keto diet, which may explain why this dietary pattern would impact the microbiome.
Carbohydrates are broken down into glucose in the gut. Glucose then enters the bloodstream and travels around the body. This is healthy, but if levels stay too high for too long, blood vessels may become damaged.
In response to rising blood glucose levels, the body releases insulin, which helps the liver and muscles take up the glucose and reduces the levels in the blood.
In this study, those following the keto diet had lower glucose levels in their blood before eating.
However, participants also had reduced glucose tolerance. In other words, glucose was removed from their blood less efficiently after eating, which would cause a longer blood sugar response.
When asked what these keto-related metabolic changes might mean in the long run, Gonzales explained this is a “challenging question to answer.”
Some metabolic changes determined by this study were beneficial (i.e., lower fasting glucose levels), and some were negative (i.e., the increase in apoB).
“This may mean that the long-term effects on health depend on the status of the individual,” Gonzales said. “For example, does someone have a particular problem with controlling their fasting glucose or their blood lipids?”
Gonzalez said he plans to continue this research. “We are keen to explore if there are individual responses to ketogenic diets that may warrant personalized use and whether we can mitigate against some of the unfavorable effects with targeted supplementation strategies,” he said.
“We have just received a large Medical Research Council grant for some of this work and are actively seeking more funding for the rest.”
Sarah Herrington, a nutritionist for Brio-Medical, explained the potential long-term implications of following the keto diet: “Long-term effects of a ketogenic diet may include more significant changes to the gut microbiome, potentially leading to less overall diversity.”
“It may also worsen glucose tolerance — the body will be more sensitive to sugars and carbohydrates when they are reintroduced into the diet,” Herrington continued.
“A ketogenic diet is more likely to alter the way the body uses energy, increasing fat metabolism and making positive short-term improvements in blood sugar regulation, but may have implications in the health of the microbiome long- term.”
Restricting free sugars or following the keto diet can lead to weight loss. But a new study shows the keto diet may have negative health consequences, such as raising bad cholesterol and harming gut health.
However, a diet low in added sugars did not appear to harm health.
“The free sugar restriction achieves this with almost entirely favorable health effects, whereas the ketogenic diet achieves the weight loss with some trade-offs we may need to be cautious about,” Gonzales said.
Another weight loss hack has gone viral on TikTok. This time, it’s Ricezempic, a homemade drink that users claim mimics the effects of GLP-1 weight loss drugs like Ozempic, Wegovy, and Zepbound.
The drink is made by soaking uncooked rice in water for a short period of time, removing and discarding the rice, and then drinking the water.
TikTokers say it’s best consumed first thing in the morning before you eat.
The claim? Proponents say the drink triggers weight loss because it contains resistant starches. They claim that this suppresses your appetite and allows you to feel fuller for longer, similar to Ozempic.
One TikToker even claims that they have lost 27kg (59 lbs) in two months by drinking Ricezempic.
So, can this drink really mimic the effects of GLP-1 drugs and trigger significant weight loss? Health experts aren’t convinced.
Lisa Moskovitz, registered dietitian, CEO of Virtual Nutritionists, and author of The Core 3 Healthy Eating Plan, isn’t surprised to see people turning to Ozempic alternatives like this, but she doesn’t believe Ricezempic is a viable weight loss solution.
“Ozempic hacks are on the rise, and Ricezempic is another example of how many people are searching for magic bullets for weight loss,” she said. “But weight loss is not so simple for the vast majority of people. It’s often due to stressful lifestyles, genetics, and other impeding factors.”
Moskovitz described the trend as “low-hanging fruit, instilling a false sense of hope” in people who are living with obesity or overweight.
Registered dietitian Kim Shapira echoed these thoughts. She said Ricezempic feels like a “reach.”
“There is that great quote that you can’t outrun a bad diet, and I think if we can start talking about the sum total of a person’s diet and lifestyle choices in a positive, empowering way, we won’t see as many fads or have the need for Ozempic at all,” she noted.
One of the reasons so many people are claiming that Ricezempic works as a weight loss aid is because of starch. The rice water is said to contain a naturally occurring resistant starch found in rice.
“Resistant starch can slow down digestion, leading to better blood sugar levels and a longer sense of fullness,” Moskovitz explained. “This can make it easier to eat less and promote a calorie deficit, which is necessary for fat-burning.”
Moskovitz said drugs like Ozempic and Wegovy work through similar mechanisms, although they are much stronger and also target areas in the brain that regulate appetite.
Similarly, Shapira pointed out that Ozempic is a medication that works on the emotional centers of the brain, turning down food noise, too.
“This means when a person experiences discomfort, their mind is now able to differentiate hunger vs emotional needs for food,” she said.
You won’t get the same effects by drinking rice water.
Crucially, rice water isn’t food. “It’s a watery drink full of who knows how much actual resistant starch,” Shapira said.
So, Ricezempic is unlikely to promote significant weight loss, but it may have some other health benefits.
“The main benefit of Ricezempic is consuming more resistant starch,” said Moskovitz. “Resistant starch not only promotes better blood sugar levels, but it can also benefit your gut health and bolster good gut bacteria proliferation.”
This can increase the amount of good bacteria in your digestive tract, which is important for proper digestion, immunity, mental health, and metabolic health.
Shapira said starches have so many benefits, but she says you’re better off getting them from food rather than rice water.
“Eating rice as part of a balanced meal is beneficial,” she says. “So many people fear starches but we need these types of foods to be part of our diet to improve our immune function, heart, gut and brain health.”
Shapira said starches that are resistant are essentially a dietary fiber. “Dietary fiber can improve our gut health in many ways, enhancing digestion and regulating bowels, insulin spikes, and blood sugar.”
That said, Ricezempic is not without potential health risks. In fact, Moskovitz said there are several risks involved with jumping on the Ricezempic bandwagon.
“First, consuming anything uncooked or raw always leaves the possibility of food-borne illnesses, and rice is no exception,” she explained. “Second, rice is one of the leading sources of arsenic, and drinking rice-infused water can increase the concentration and exposure of this toxic heavy metal.”
Moskovitz also said that replacing food with water means you’re reducing the amount of nutritious foods in your diet, which is never ideal.
Additionally, Shapira points out that drinking rice water can increase gas, bloating, and constipation if the rest of your diet isn’t balanced.
The good news is that there are many ways to mimic the effects of Ricezempic in your diet without succumbing to this potentially dangerous trend.
“Eating a higher fiber and antioxidant-rich diet is the best way to boost gut health, promote more stable blood sugar levels, and make it easier to keep calories down and promote healthy, sustainable weight loss,” said Moskovitz.
“You can also supplement with potato starch, which contains a significant amount of resistant starch, even more so than Ricezempic,” she added.
Ricezempic has been touted as an effective alternative to Ozempic, but it’s unlikely to mimic the effects of the drug.
It may slow digestion and improve gut health, but it’s unlikely to lead to significant weight loss, and it’s not the healthiest way to lose weight.
Singer Lance Bass revealed in an Instagram reel that his recent diabetes journey comes with a twist.
“As all of you know, I was diagnosed with type 2 diabetes a few years back,” the singer said in a sponsored post for a continuous glucose monitor. “But when I was first diagnosed, I had a difficult time getting my glucose levels under control, even though I made adjustments to my diet, my medications and my workout routine.”
“I recently discovered I was misdiagnosed,” he said. “I actually have Type 1.5, also known as LADA, or latent autoimmune diabetes in adults.”
Here’s what to know about this condition.
Type 1.5 diabetes, also called latent autoimmune diabetes in adults (LADA), is a form of diabetes that begins during adulthood and slowly worsens over time.
LADA has some similarities to type 2 diabetes — both develop gradually and are diagnosed when someone is an adult.
As a result, LADA is often incorrectly diagnosed as type 2 diabetes. In fact, between 4% and 12% of people with type 2 diabetes may have LADA.
Unlike type 2 diabetes, though, LADA is an autoimmune disease, so it can’t be reversed with changes in diet and lifestyle — although these can help a person manage their disease.
LADA happens when the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, which causes the pancreas to stop making insulin.
“[This] destruction of beta cells occurs very slowly over many years,” said Saleh Adi, MD, a pediatric endocrinologist and vice president of medical affairs at Willow Laboratories, developer of the Nutu app, which helps people prevent or delay the development of type 2 diabetes.
“This results in a gradual loss of insulin secretion and an increase in blood glucose levels,” he told Healthline. “Patients with LADA remain asymptomatic for years until there is significant loss of beta cells, or there is an increase in insulin resistance.”
This kind of damage to pancreatic beta cells also occurs in type 1 diabetes, a form of diabetes that begins in childhood or adolescence. Damage to the beta cells occurs more slowly in LADA than in type 1 diabetes.
LADA is also more genetically similar to type 1 diabetes than to type 2 diabetes. People who have a close family member with LADA, type 1 diabetes, or an autoimmune disease may have a higher risk of developing LADA.
“Many diabetes organizations, including the American Diabetes Association, consider LADA to be simply a sub-type of type 1 diabetes that develops very slowly due to some differences in the autoimmune processes that attack the beta cells,” said Adi.
People usually develop symptoms of LADA after the age of 30. Symptoms may be vague in the beginning. Some people have no symptoms at first.
As with all types of diabetes, the symptoms of LADA are related to high blood glucose, said Adi. They include:
Because damage to the pancreatic beta cells occurs slowly, people with LADA may not require insulin to help control their blood sugar (glucose) level in the first 6 months or more after diagnosis.
Because LADA occurs later in life and often has mild symptoms without much weight loss, many patients are mistakenly diagnosed with type 2 diabetes and treated with oral medications, said Adi.
“However, their symptoms do not improve because what they really need is a replacement of insulin,” he said. “It is therefore critical to distinguish LADA from type 2 diabetes.”
He said certain clinical clues indicate a person may have LADA:
The diagnosis of LADA is then confirmed by the presence of at least one pancreatic auto-antibody, Adi said, which provides evidence of beta cells being destroyed.
Another lab test which suggests that someone may have LADA instead of type 2 diabetes is a low level of C-peptide, he said. This is a surrogate for insulin levels in the blood.
There is currently no way to prevent LADA.
As a result, “the most critical factor in improving the outcomes of patients with LADA is a correct diagnosis and prompt treatment with insulin,” said Adi.
Early treatment can prevent diabetes-related complications such as kidney disease, cardiovascular problems, eye disease, and nerve problems.
In the beginning, LADA may be managed with lifestyle changes such as maintaining a healthy weight, staying physically active, eating a healthy diet, and quitting smoking. These are also recommended for people with type 2 diabetes.
However, as the body slowly loses its ability to produce insulin, most people with LADA will eventually need to use insulin to control their blood sugar. Monitoring their blood glucose with frequent blood sugar testing will also be needed.
“Patients with LADA who finally start taking insulin describe a marked regain in their energy, physical and mental strength, and healthy weight gain,” said Adi.
Earlier treatment can help in other ways.
“Current evidence is that early initiation of insulin therapy can slow down beta cell loss,” said Adi, “making it easier to manage diabetes without a high risk of hypoglycemia.”
Singer Lance Bass announced that he was diagnosed with type 1.5 diabetes, or latent autoimmune diabetes in adults (LADA). This is a form of diabetes that usually develops after the age of 30 and slowly worsens over time.
Unlike type 2 diabetes, LADA is an autoimmune disease in which the immune system mistakenly attacks and destroys the cells in the pancreas that produce insulin. Type 1 diabetes is also an autoimmune form of diabetes, but it begins in childhood or adolescence.
There is currently no way to prevent LADA, but early diagnosis can ensure that people start appropriate treatment. This can prevent diabetes-related complications such as kidney disease and eye problems.
The most common treatment is insulin, which helps control blood sugar levels.
At 95 years old, Sally Froelich has a wealth of life experiences.
In 1950, she began working at Macy’s Department store in New York City and eventually landed a role at Bloomingdale’s, where she was hired to interview people during its morning breakfast offerings. Her interactions with customers led to the creation of “The Sally Froelich Show,” which aired for more than 20 years.
“The guests would talk to me, and the audience would ask questions. It was a lot of fun,” she told Healthline.
She recalls a series for the show called “The Vital Years,” in which she talked with different experts about the aging process.
“I was about 60 years old at the time, and it was really about people my age today — second marriages, exercise, different problems, grandchildren, etc.,” said Froelich.
Remembering the series strikes a chord with her as she is currently one of 600 people participating in the SuperAgers Family Study conducted by the American Federation for Aging Research.
The study aims to recruit 10,000 SuperAgers, who researchers define as people 95 and older who are in good physical and mental health.
The study also enrolls the SuperAgers’ adult children and the children’s spouses who do not have SuperAger parents.
“They are just as important as the SuperAgers because we need to draw comparisons in the frequency of the genes,” Sofiya Milman, MD, MS, national expert on aging and Director of Human Longevity Studies at Albert Einstein College of Medicine, told Healthline.
“The ultimate goal of the study is to help us understand what biology contributes to people living long and healthy lives, and specifically, we’re interested in what genes may play a role in contributing to people’s ability to stay disease-free as they get older.”
By identifying the genes that contribute to people’s longevity, Milman hopes that scientists will be able to develop medications and drugs that can mimic the role of genes that SuperAgers possess so that others who do not inherit those genes can also live longer, healthier lives.
She said older research has implicated genes as likely contributors to longevity, including genes that regulate HDL cholesterol and that control growth hormones.
Moreover, she said genes play a more prominent role than lifestyle in SuperAgers. She determined this by comparing the lifestyles of SuperAgers from previous studies to the lifestyles of people from their generation who did not become SuperAgers.
“We found that they had very similar lifestyles — they didn’t differ in smoking, tobacco or alcohol use, or in their diet, or exercise, so there were really no differences, and yet a small group achieved SuperAger status, and another group did not,” said Milman.
While more Americans are living longer lives today than in past generations, Milman said only about 0.1% live to be 95 or older, most likely due to genetics.
For the other 99.9% of the population, she said lifestyle habits can help stave off age-related diseases like diabetes, heart disease, and cancer.
“The difference is that you can probably delay the onset of age-related diseases with a healthy lifestyle, although it’s unclear whether having a healthy lifestyle will get you to age 95 or 100,” said Milman.
One way to think about it is that 20 to 40% of longevity is due to your genes, which means 60 to 80% is what happens to you when you’re alive, said Rosanne Leipzig, MD, PhD, a geriatrician at Mount Sinai and author of Honest Aging: An Insiders Guide to the Second Half of Life.
Some of that comes down to lucky circumstances, she noted.
“You really don’t have a lot of control over the education you get, prenatal environment, your childhood nutrition, your access to medical care, whether you live in a polluted area — all which can contribute to health and longevity,” Leipzig told Healthline.
She points to the concept of “weathering,” which says that the health of African American women may begin to deteriorate in early adulthood as a physical consequence of cumulative socioeconomic disadvantage.
When given access to healthy lifestyle choices, however, how you choose them can make a difference, Leipzig added.
“We have a lot of control,” she said. “Let’s just say you can certainly make sure you die early.”
In addition to genetics, many lifestyle habits that have been touted for years can help keep you healthy. Froelich practices the following:
Living to be a SuperAger may not be in everyone’s genes, but Milman said as people age, disability and disease are not a given.
“There are many people who remain healthy and independent and have a good quality of life as they get older, so we shouldn’t conflate aging always with disease and disability,” she said.
SuperAgers give her hope for discovering “the secret” to aging well.
“We hope this research will help us all live longer…even if we are not that 0.1 percent of the population who inherit genes,” she said.
Visit the organization’s website to enroll in the SuperAgers Family Study.
Weight loss and diabetes GLP-1 drugs like Mounjaro, Zepbound, Wegovy, and Ozempic have flown off the shelves in recent years, outstripping manufacturing and leading to shortages. This has made it challenging for some people to get access to the drugs they need.
In fact, the diabetes medication Mounjaro has been on the Food and Drug Administration’s shortage list since late 2022, while Zepbound, a drug approved for weight loss, appeared on the list in April 2024.
To meet this growing demand, drugmaker Eli Lilly has bolstered their manufacturing to increase supply and make the drugs readily available again.
On August 1, Lilly CEO David Ricks said in an interview with Bloomberg that the shortage would end “very soon,” Reuters reported.
The next day, the Food and Drug Administration updated the status of Mounjaro and Zepbound in its drug shortage database to indicate they are available once more.
In 2023, Mounjaro drove more than $5 billion in sales, and in the first four months of 2024, doctors issued 63,000 Zepbound prescriptions weekly.
As supplies of these medications dwindled, some pharmacies began producing compounded versions to fill the gaps.
The FDA Food, Drug, and Cosmetic Act allows pharmacists to produce and sell compounded versions, making them a lifeline for those who need the medication. Due to the drug shortage, compounded versions of GLP-1 drugs have become a billion-dollar enterprise.
Britta Reierson, MD, a board certified family physician and obesity medicine specialist, explained that compounded drugs are “custom-made medications prepared by pharmacists to meet the specific needs of a patient.”
“Compounded versions of drugs are not regulated nor approved by the FDA,” Reierson told Healthline.
Mir Ali, MD, a board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, added that “as long as the source is reputable, this is a viable alternative.”
Still, consumers ought to perform their due diligence when considering compounded GLP-1 drugs.
A news release from Eli Lilly in June 2024 outlines some concerns surrounding compounded versions of tirzepatide (the active ingredient in Mounjaro and Zepbound), some of which contained bacteria: “Sterility is a critical safety concern, given that Mounjaro and Zepbound are administered via under-the-skin injection.”
They also write in the release that “in at least one instance, the product was nothing more than sugar alcohol.”
“The national shortage of Zepbound and Mounjaro undoubtedly impacts many people’s health and wellness,” HaVy Ngo-Hamilton, PharmD, a pharmacist and clinical consultant at BuzzRx, told Healthline.
“For a diabetic patient who takes Mounjaro for their blood sugar, not being able to obtain this medication can be detrimental, leading to kidney disease, nervous system issues, and vision problems,” she added.
Ngo-Hamilton explained the issue becomes exacerbated for people who take Mounjaro, as this drug is more frequently used by individuals who cannot tolerate metformin (the most common drug to treat type 2 diabetes) or who do not benefit sufficiently from it.
“Additionally, the uncertainty and stress of not being able to access essential medications has negatively affected their overall well-being and quality of life,” Reierson explained. “The shortage in medications has led to clinicians recommending different medications that may be easier to access, yet may not be as effective for an individual patient.”
Despite the fact that Mounjaro and Zepbound are no longer in short supply, we may not have seen the end of these shortages.
“I think the shortages are likely to continue for the foreseeable future,” Ali told Healthline. “As long as obesity continues to be a big concern, the demand for these medications will remain high.”
Reierson agreed, explaining that “factors like increased demand, supply chain disruptions, and manufacturing challenges” are likely to continue causing supply challenges.
Ngo-Hamilton said she believes “we are better prepared to prevent shortages now that manufacturers have a clearer understanding of the product demand.”
She also noted that FDA-approved alternatives are now entering the market, easing the pressure on Eli Lilly.
These medications have been a game-changer in treating obesity, as they can help people lose significant weight.
However, they are not a magic bullet, and many are worried that their popularity may be causing several issues.
“I have concerns about what I see as widespread and uninformed use of these medications,” Reireson said. “There continue to be mixed messages through social media and endorsements by celebrities that may lead people to seek these medications ‘off-label,’ even if not clinically indicated.”
“The soaring demand has led to shortages and manufacturing delays, resulting in a surge in compounded, counterfeit, and fake medications to hit the market,” Reireson continued. “This keeps me up at night, knowing that some people are at risk for serious complications.”
Ngo-Hamilton had similar thoughts: “My primary concern about the widespread use of these medications is the potential implications for patient safety.”
“With increased marketing, influencer campaigns, patient testimonials, and wall-to-wall media coverage of celebrities experiencing weight loss success using these medications, it can be easy to overlook the potential risks and side effects.”
After months on the FDA’s shortage list, Eli Lilly’s GLP-1 drugs Zepbound and Mounjaro are once more available.
This is good news, as many people who rely on these medications to treat diabetes or help with weight loss have had difficulty filling their prescriptions.
However, while the drugs are currently available, health experts say the growing demand for them could mean more shortages in the future.
