• Both high blood pressure and chronic kidney disease are common complications of diabetes.
• If blood pressure is well controlled, this can help slow the progression of diabetic kidney disease.
• Several medications are used to control blood pressure, among them dihydropyridine calcium-channel-blockers (DCCBs).
• However, a new study suggests that this blood pressure treatment could speed up the progression of diabetic kidney disease in people with type 2 diabetes.

People with type 2 diabetes often also have hypertension (high blood pressure), which increases their risk of developing chronic kidney disease and kidney failure.

However, controlling blood pressure is effective in slowing the progression of kidney disease, as well as reducing the risk of cardiovascular events.

Dihydropyridine calcium-channel-blockers (DCCBs) are widely used as an extra therapy to treat hypertension in people with type 2 diabetes, alongside renin–angiotensin system inhibitors(RASi) and sodium–glucose cotransporter-2 inhibitors (SGLT2i).

Now, a study presented at the 63rd European Renal Association Congress in Glasgow, United Kingdom, suggests that DCCBs could be associated with poorer kidney outcomes in people with type 2 diabetes.

The research found that DCCB use was associated with a 33% higher risk of major adverse kidney events, when compared with other hypertension treatments used with people with type 2 diabetes.

These findings are yet to appear in a peer-reviewed journal.

The Association of British Clinical Diabetologists (ABCD) told Medical News Today: 

“Treatment of hypertension is crucial in the management of diabetic kidney disease (DKD). Whilst treatment of hypertension with drugs that block the renin-angiotensin system (RAS) is of proven benefit in reducing progression of DKD, many patients require additional antihypertensive agents to achieve blood pressure targets. Dihydropyridine Calcium Channel Blockers (DCCB) are often used second or third line in many patients with DKD.” 

“This data suggests that DCCBs may be associated [with] a more rapid progression of kidney disease in such patients. This is, of course, important and concerning. There may, however, be many confounders, and the findings need to be replicated in larger cohorts, ideally prospectively, before guidelines should be significantly changed,” they added.

High blood pressure and diabetic kidney disease

Diabetic kidney disease develops when persistently high blood glucose, which results from poorly controlled type 2 diabetes, damages small blood vessels in the kidneys, meaning that they cannot filter waste products from the blood effectively.

If people also have high blood pressure, this accelerates the condition, damaging the kidneys further.

People with type 2 diabetes are commonly treated with 2 medications to control blood pressure and help the functioning of the kidneys.

RASi are the first-line treatment for hypertension, and SGLT2i lower blood glucose and protect both the cardiovascular system and kidneys.

However, these two treatments are often not enough to control blood pressure, so clinicians prescribe additional blood pressure treatments, such as the widely used DCCBs. 

Although DCCBs are highly effective in controlling blood pressure, this new study suggests that they may actually increase risk of diabetic kidney disease progression.

Benaya Rozen-Zvi, MD, principal investigator of this research and Director of the Nephrology Department at Rabin Medical Center, Petah Tikva, and Clinical Associate Professor, Tel Aviv University, Israel, told us that:

“These results are of significant clinical importance, given that more than 80% of patients with chronic kidney disease (CKD) also suffer from hypertension. Selecting the appropriate antihypertensive treatment is critical, as it can directly influence the rate of kidney disease progression.”

Possible increase in kidney disease risk

In this study, researchers analysed data from 31,041 adults with type 2 diabetes between 2016 and 2021. All patients were being treated with RASi and SGLT2i to control their blood pressure and blood glucose levels, plus another medication for blood pressure control.

Of the group, 11,841 (38.1%) were also receiving DCCB, and 19,200 (61.9%) a non-DCCB anti-hypertensive therapy. During a median follow up of 3.5 years, 482 patients experienced a major adverse kidney event, and 2,066 patients died.

Rozen-Zvi explained that most of these deaths were not due to kidney disease: “Because mortality in this population is primarily driven by cardiovascular disease or infections, the number of deaths directly attributed to kidney disease itself is low. However, it is important to note that the risk of cardiovascular mortality is increased several-fold in diabetic patients who have concurrent kidney disease.”

A 2022 study comparing almost 10,000 patients with type 2 diabetes who took DCCBs to almost 10,000 non-DCCB users suggested that DCCBs could decrease the risk of advanced chronic kidney disease, or end stage renal disease.

However, this latest study found that those on DCCBs had a higher risk of their kidney disease progressing to a major adverse kidney event than those taking other blood pressure medications.

Timna Agur, lead author of the study, Nephrology Department at Rabin Medical Center, Petah Tikva, and Gray Faculty of Medical and Health Sciences, Tel Aviv University noted in a press release that the “findings raise important questions about whether these medications are always the best option for patients already receiving modern kidney-protective therapies.”

Further research needed to verify findings

ABCD cautioned that several unknowns still remain, and the findings of the study require rigorous replication and verification. Speaking to MNT, they said that “residual confounding cannot be controlled for, and indication bias may [still] be present.”

Rozen-Zvi also told us that, as this was an observational study, the authors could not make definitive clinical recommendations about whether DCCBs should be used for patients with type 2 diabetes.

He advised that “patients on these combined therapies should consult their treating physicians to determine the most optimal blood pressure management strategy for their specific case.”

The team is currently planning further studies to evaluate this research question within a non-diabetic population.

How can people with type 2 diabetes lower their blood pressure?

Type 2 diabetes and hypertension, which is twice as common in those with type 2 diabetes as in people without the condition, are risk factors for coronary artery disease, cerebrovascular disease, renal failure and congestive heart failure, so both need to be treated effectively to reduce the risks of these complications.

The first step in lowering blood pressure is lifestyle changes — weight loss, a high potassium and low sodium diet, such as the DASH diet, moderating alcohol intake and increasing physical activity. 

However, if lifestyle changes are insufficient to attain healthy blood pressure, clinicians have a range of treatments at their disposal.

Rozen-Zvi said that thiazide diuretics were an alternative to DCCB that could be used alongside RASi and SGLT2i, telling MNT they are “safe and effective options that can be used in combination with these therapies. However, they sometimes require careful monitoring of the glomerular filtration rate (GFR) and serum electrolytes following the initiation of treatment.”

As with all medications, he stressed that patients should only change their treatment following advice from their physician.

• Research suggests that phytic acid, a natural compound present in plant-based foods such as beans, lentils, nuts, seeds, and whole grains, plays a critical role in maintaining the integrity of the intestinal barrier.
• The preclinical mouse study suggests that phytic acid activates a protein that helps regulate genes involved in protecting the gut lining and prevents ‘leaky gut.’
• When this protein activity is impaired, the intestinal barrier becomes more susceptible to damage and inflammation, suggesting this pathway is essential for gut health.
• The findings identify a potential therapeutic target for conditions affecting the intestinal barrier, such as inflammatory bowel disease. However, further research is still necessary.

The intestinal lining acts as a barrier between the gut contents and the rest of the body. Typically, this barrier selectively allows nutrients to pass into the bloodstream while preventing potentially harmful substances, such as bacteria and toxins, from escaping the intestine.

When this barrier becomes compromised, harmful molecules can enter the bloodstream, potentially triggering immune responses and inflammation.

This process, often described informally as leaky gut syndrome, is associated with various digestive disorders, such as Celiac disease, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS).

Although the importance of maintaining intestinal barrier integrity has long been recognized, the exact mechanisms involved have remained incompletely understood.

Now, research suggests that a naturally occurring compound found in many plant-based foods could play an important role in maintaining the gut’s protective barrier.

The research, published in Nature Communications, reports that phytic acid, commonly found in whole grains, beans, lentils, nuts, and seeds, appears to help preserve intestinal barrier function through a key cellular pathway. The findings could eventually lead to new approaches for treating conditions associated with intestinal permeability.

Phytic acid activates a key protective pathway

In the study, investigators examined the role of histone deacetylase 3 (HDAC3). This protein helps regulate genes involved in maintaining the structure and function of the intestinal lining.

The researchers found that phytic acid, also known as InsP6 or phytate, directly activates HDAC3.

“HDAC3 has long been linked to health and disease, but this work is among the first to show in detail how it preserves intestinal barrier function,” study author Prasun Guha, PhD, Assistant Professor at the University of Nevada, Las Vegas (UNLV), told Medical News Today.

According to the study authors, phytic acid appears to be necessary for optimal HDAC3 function, helping preserve the gut’s protective defenses. When HDAC3 functions correctly, it helps suppress genes that can contribute to intestinal barrier breakdown and inflammation.

“In our study, we found that InsP6 (phytic acid), a very small molecule of about 10 angstroms in size, binds to the large HDAC3 and corepressor complex and is essential for turning on its deacetylase activity,” Guha explained. “This activity allows HDAC3 to repress genes that would otherwise be continuously expressed and disrupt cell-cell junctions, leading to leaky gut.”

“By acting as a metabolic cofactor InsP6 directly links cell metabolism to epigenetic control of gut barrier genes. Because InsP6 is water-soluble and orally deliverable, our animal data suggest a realistic path toward restoring lost HDAC3-mediated protection without genetic manipulation, and given HDAC3’s roles in other tissues, this InsP6-dependent regulation may have broader relevance that future studies will need to explore,” he detailed.

Potential implications for inflammatory bowel disease

Impaired intestinal barrier function, or “leaky gut,” likely relates to a variety of gastrointestinal, metabolic, and autoimmune conditions. Thus, these study findings may have important clinical implications.

The researchers in UNLV’s Guha Lab suggest the result may not only identify a mechanism that contributes to gut barrier breakdown, but also indicates that the process may be reversible.

If confirmed in future human studies, therapies aiming to enhance HDAC3 activity, or deliver phytic acid-derived treatments could offer a new strategy for restoring intestinal health.

“Our animal study suggests that targeting this pathway could help conditions like IBD by not only reducing intestinal permeability but also limiting colitis-associated inflammation,” Guha told MNT.

“That said, these findings are still preclinical, so the next step is to determine the minimum effective dose in animal models and then assess safety and efficacy in clinical trials before considering patient use,” he added.

Diet alone may not be enough

The research highlights a potentially broader connection between nutrition and disease prevention. However, while phytic acid is already present in many commonly consumed foods, the researchers caution that simply increasing dietary intake may not necessarily produce therapeutic effects.

For example, various factors such as absorption, metabolism, disease severity, and individual differences could influence how effectively phytic acid works in the body. As a result, future treatments may require targeted supplements or specially formulated medications rather than dietary changes alone.

“Phytic acid has long been called an anti-nutrient because it can bind minerals like iron, zinc, and calcium and may reduce their absorption. But that is only part of the story,” Guha emphasized.

“Our findings show that InsP6 can also act as a helpful signaling molecule. In our study, very small amounts of InsP6 were sufficient to restore HDAC3 activity, suppress harmful gene expression, and protect the gut barrier,” he noted.

“At the same time, concerns about mineral binding should not be ignored. Larger oral amounts of InsP6 may behave differently, and much of it may be broken down in the gut, including by bacteria, before reaching tissues. So what matters is dose, context, and physiology. More in vivo work is needed to understand how oral InsP6 affects mineral availability at the tissue and cell levels,” Guha said.

“Overall, our work suggests that phytic acid should not be viewed only as harmful. It is better understood as a context-dependent molecule with important biological benefits. In our animal studies, purified research grade oral InsP6 protected against intestinal permeability, but we did not test dietary forms, so these findings should not be taken as dietary or clinical advice,” he told us.

While promising, the study was conducted in preclinical animal models. Therefore, further research is needed to determine whether phytic acid-based therapies can safely improve intestinal barrier function in individuals with conditions associated with increased gut permeability before the findings can be translated into clinical treatments.

“Our findings support a more balanced view of phytic acid–rich foods, such as legumes, whole grains, seeds, and nuts. These foods may provide compounds that support gut barrier biology,” said the researcher.

“However, our study does not yet prove that ordinary dietary intake alone is sufficient to treat or prevent disease in humans. That will require carefully controlled clinical studies. At this stage, the safest conclusion is that phytic acid should not be viewed only negatively; it may be one contributor to the gut-health benefits associated with plant-rich diets,” Guha concluded.

• A review of 22 studies found no clear evidence that naturally occurring trans fats in dairy products increase the risk of heart disease, stroke, cardiovascular death, or type 2 diabetes.
• Unlike industrially produced trans fats, naturally occurring trans fats found in foods such as milk, cheese, butter, and yogurt may affect the body differently and did not significantly worsen cholesterol or other cardiovascular risk markers.
• The findings suggest that current concerns around trans fats may not apply equally to naturally occurring dairy trans fats, highlighting the importance of distinguishing between industrial and natural sources.

Trans fats are a type of unsaturated fat that can occur naturally in foods from ruminant animals such as cows, sheep, and goats, or can be created artificially during food manufacturing and are often present in some processed and fried foods

Artificial trans fats, often produced through partial hydrogenation of vegetable oils, have long been associated with an increased risk of cardiovascular disease and type 2 diabetes.

Due to these risks, many countries, including the United States, have introduced restrictions or bans on artificial trans fats in processed foods.

Naturally occurring trans fats, however, are found in smaller amounts in dairy products and some meats, and researchers have debated whether they have the same harmful effects as industrial trans fats or may even have neutral or beneficial metabolic effects.

Now, a new analysis adds to growing evidence suggesting that naturally occurring trans fats may not carry the same cardiovascular risks

The findings, published in Nutrition Research, found no clear link between dairy-derived trans fats and an increased risk of heart disease, stroke, cardiovascular death, or type 2 diabetes.

How do natural trans fats affect cholesterol, blood lipids, heart health?

The research team reviewed evidence from 22 studies involving participants from Europe, Canada, and the United States.

First, they reviewed 10 controlled dietary trials in which participants consumed dairy products with naturally elevated trans fat levels, then measured the effect on blood lipid biomarkers, which can help determine heart disease risk.

Across the trials, participants consumed between 1.3 and 13.2 grams (g) of dairy trans fats daily. The analysis found no meaningful differences in cholesterol or other blood lipid markers when compared with regular dairy consumption.

The team also reviewed 12 long-term observational studies that followed thousands of participants for years, in some cases more than 20 years. These studies measured levels of dairy-derived trans fats in the bloodstream and tracked health outcomes over time.

Again, the studies found no association between higher levels of dairy trans fats and increased risk of heart disease, stroke, cardiovascular death, or type 2 diabetes.

Michelle Routhenstein, MS, RD, CDCES, CDN, a cardiology dietitian and owner of Entirely Nourished, who was not involved in the study, was not surprised by the study findings.

“I was not surprised by these findings because previous research has shown that handmade trans fat behaves differently in the body than trans fats that naturally occur in dairy foods. We also have previous research suggesting that dairy foods have a pretty neutral effect on cardiovascular health,” Routhenstein told us.

“What is important to differentiate in this study is that it looked specifically at blood markers of dairy trans fats and still found no meaningful association with cardiovascular disease risk.”

– Michelle Routhenstein, MS, RD, CDCES, CDN

Why the findings matter

Although awareness around trans fats has increased significantly over the past two decades, particularly following global campaigns from the World Health Organization (WHO), confusion remains over the difference between industrial and naturally occurring forms.

Ian Givens, PhD, DFdSci(h.c.), one of the study’s lead authors and Professor of Nutrition at the University of Reading, told Medical News Today that many people still have misconceptions about dairy-derived trans fats, not knowing that, broadly speaking, there are two types.

Givens hopes the findings help clarify the differences between natural and artificial trans fats, which differ slightly in structure.

“I think that not all trans fatty acids are the same health-wise. Broadly, there are those industrially produced and those naturally produced by the microbes in an animal’s digestive system,” he explained.

“Trans fatty acids are defined as unsaturated fatty acids that contain a double bond in the so-called trans conformation. If the hydrogen atoms bonded to each of the carbons in this double bond are on the same side, this is called cis (generally natural),” the researcher detailed.

“If the two hydrogens are on opposite sides, this is called trans (industrial and natural), but natural trans differ from industrial mainly by the position of the double bond in the fatty acid chain,” continued Givens.

The researchers also add that the findings could also influence future food labeling policies, which often do not distinguish between industrial and naturally occurring trans fats.

“Put simply, the limits imposed on dietary trans-fat intake should be only based on the amounts of industrial trans not the total trans. There are now quick ways of identifying which are which,” Givens emphasized.

Experts caution against overinterpreting results

Although the findings may ease concerns around trans fats present in dairy products, it is still advisable to focus on overall dietary patterns rather than single nutrients.

Dietary guidance continues to encourage limiting industrial trans fats while consuming dairy in moderation as part of a balanced diet. The current Dietary Guidelines for Americans advises 3 servings of dairy per day as part of a 2,000-calorie dietary pattern, adjusting as necessary depending on individual caloric requirements.

Additionally, the researchers note that dairy products contain a complex mix of nutrients, including calcium, protein, and saturated fats, meaning their health effects cannot be explained by trans fat content alone.

While this review highlights the differences between natural and artificial trans fats, further research is still necessary to fully understand how naturally occurring trans fats interact with metabolism and cardiovascular health.

• Glycemic load considers how amounts of particular foods affect blood sugar. 
• Diets with lower glycemic loads may offer certain health benefits like lower cancer risk and diabetes prevention. 
• A recent secondary analysis suggests that consuming an avocado daily may help lower dietary glycemic load. 

Avocados are packed with nutrients and have many potential health benefits, including for heart, bone, and digestive health.

A recent study published in Current Developments in Nutrition evaluated how eating a daily avocado affected glycemic load.

Glycemic load has to do with how specific amounts of specific foods influence blood sugar. As noted in the current study, diets with lower glycemic load may help with diabetes prevention, as well as decrease risk for certain cancers and all-cause mortality.

The study confirmed that eating a daily avocado helped to lower dietary glycemic load, pointing to another potential health benefit of avocados. 

Benefits of a daily avocado: Lower glycemic load

This particular study was a secondary analysis of another trial called the Habitual Diet and Avocado Trial. This trial divided participants into two groups, with one group consuming a large avocado each day and the other group following their normal diet.

However, the control group was also instructed to have two or fewer avocados each month. This intervention lasted 6 months.

Participants all had an elevated waist circumference and were 25 years old or older. Aside from the avocado intervention, with avocados provided, researchers instructed participants to continue their normal lifestyle and diet.

The avocado group did have a higher level of certain nutrients in their diets, like fiber and total fat, but also consumed lower amounts of animal protein. Carbohydrates also made up less of their energy intake. 

Throughout the intervention, researchers conducted dietary recalls. Based on data from three 24-hour dietary recalls, researchers averaged participants’ daily glycemic index and glycemic load.

Glycemic index considers how blood sugar increases after eating a food in comparison to a reference food like sugar.

The final analysis included a total of 961 participants, which excluded participants with missing data. Researchers adjusted for various factors in their analysis, including body mass index, education level, and ethnicity. 

The findings showed a distinct benefit for the avocado intervention group. This group had lower dietary glycemic load compared to the control group, even though glycemic index measurements were about the same.

When looking at how certain food groups contributed to glycemic load, the major difference between the two groups was the avocados. 

Emily Lantz, PhD, a nutritionist at UTMB, who was not involved in this research, noted that: “In this study, consuming a single avocado once a day lowered the overall glycemic load. It highlights that making simple choices to regularly include healthy foods may make a difference on health.”

The study authors note that avocados contain a high amount of fiber, and the boost in fiber consumption could be part of the reason that participants experienced a lower dietary glycemic load. Another reason for the lower glycemic load could also be the fat present in avocados.

Why might avocados help with blood sugar?

The funding for this study came from the Hass Avocado Board, although this group was not involved in collecting the data or writing the study. 

Since this is a secondary analysis, any limitations from the original trial are worth considering. For example, the principal investigator of the original trial could exclude participants based on their judgment, which could introduce possible bias.

Furthermore, researchers evaluated diet based on participant recall, which could be inaccurate, and certain covariate data was also based on participant reporting. 

Another consideration is the sample group. For example, 73% of the group was female, over half were white, and the group also included only overweight or obese individuals. More research in other groups may be helpful and there should be caution in generalizing the results. 

Researchers note that glycemic index and glycemic load also have limitations, including certain variations that can happen. 

It is possible that researchers did not account for additional factors that could have contributed to the results. It’s also worth considering that the benefits don’t necessarily come from consuming avocados, but rather thanks to a conjunction of factors, which the authors do discuss.

The study authors do note that, while it didn’t reach a level of statistical significance, the avocado group saw a decrease in the amount that dairy, sweets, and desserts contributed to glycemic load. 

This suggests a change in the source of participants’ carbohydrate consumption. The authors suggest that the lower dietary glycemic load could partly be explained by a lower intake of carbohydrates in the intervention group and how avocados may limit the total number of carbohydrates available in participants’ diets.  

Registered dietitian, Karen Z. Berg, MS, CDN, who was not involved in the research, also noted the following to Medical News Today: 

“Avocados are a nutrient-dense food and have many health benefits. They are high in calories, monounsaturated fats, and fiber. Avocados are very filling, so when people eat more avocados, they are likely eating less of other foods that are possibly less healthy. This could be why this study had such positive outcomes.”

Should you add more avocados to your diet?

Overall, the research suggests another potential benefit that avocados may have to offer. The study authors suggest that eating avocados could help with people’s dietary patterns.

Researchers also note that the intervention was simple, making it something that could be realistically maintained.

This doesn’t necessarily mean that there will be major changes to dietary recommendations. Lantz noted that: 

“The researchers calculated glycemic load (GL) and glycemic index (GI), which are estimates of how blood sugar goes up after a meal based on the amount and quality of carbohydrate in a meal. Lower glycemic load and glycemic index have been associated with better weight loss outcomes and blood sugar control in diabetics. However, the overall evidence is not strong enough for low GI/GL foods to be part of national recommendations for lifestyle modifications.” 

Overall, people who want to incorporate avocados more into their daily diets can work with professionals like nutrition experts to get appropriate guidance.

They can discuss possible benefits and how avocados can be part of a healthy diet that incorporates other essential components as well. 

• Being physically active has been linked to a longer, healthier life.
• However, questions remain about what types of exercise are best and how many minutes a week to spend on it for the best results. 
• A new study found that a combination of both high aerobic activity and between 60 and 119 minutes per week of strength training may be best for lowering a person’s mortality risk from any cause.
• Scientists also found that between 90 and 120 minutes a week of resistance training may also possibly lower a person’s risk of dying from cardiovascular or neurological diseases. 

Being physically active has been linked to a longer, healthier life, but what type of exercise is best? Should you focus on aerobic exercises, like walking or running? Or strength training with weights or bodyweight exercises like pilates? And how many minutes of each should you get during the week?

A new study recently published in the British Journal of Sports Medicine helps to provide some guidance and answers to these questions.

Researchers found that a combination of both high aerobic activity and between 60 to 119 minutes a week of strength training may be best for lowering a person’s mortality risk from any cause. 

Scientists also found that between 90 to 120 minutes a week of resistance training may also possibly lower a person’s risk of dying from cardiovascular or neurological diseases. 

Why study both aerobic and strength training exercises? 

For this study, researchers analyzed about 30 years of data from more than 147,000 participants with an average age of 54 of three large previously-conducted studies — Health Professionals Follow-up Study, 1992–2022; the Nurses’ Health Study, 2002–2021; and the Nurses’ Health Study II, 2003–2021. 

Study participants were asked questions about their weekly aerobic exercise and strength training regimen every two years, for up to 30 years total. 

“The benefits of aerobic activity for longevity are already well established,” Edward Giovannucci, MD, ScD, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health, and corresponding author of this study, told Medical News Today. “What has been less clear is how resistance training relates to long-term mortality risk, especially at different volumes and in combination with aerobic activity.”

“Physical activity is not one single behavior,” added Yiwen Zhang, PhD, postdoctoral research fellow at the Harvard T.H. Chan School of Public Health, and the first author of this study. “Aerobic activity and resistance training may benefit health through different pathways, so it is important to study them separately and together.” 

Strength training 90-120 min/week lowers mortality risk by 13%

At the study’s conclusion, researchers found that participating in 90 to 120 minutes a week of strength training was correlated with a 13% lower risk of dying from any cause. And, scientists note, no further benefit was observed above 120 minutes a week. 

Additionally, that amount of weekly strength training was also associated with a 19% lower risk of dying from a cardiovascular disease, and a 27% lower risk of dying from a neurological disease.

“For cardiovascular disease mortality, this finding is generally consistent with previous studies showing that resistance training is associated with lower cardiovascular disease risk, particularly for myocardial infarction,” Giovannucci explained. “For neurological disease mortality, there has been growing evidence suggesting that strength training may help preserve cognitive function.”

“However, this finding should be interpreted cautiously,” he added. “Neurodegenerative diseases such as Alzheimer’s can begin many years before diagnosis, and early symptoms may reduce a person’s ability or motivation to exercise. Also, neurological causes of death, especially dementia, can be difficult to classify accurately. More research is needed before drawing firm conclusions.”

Lowest death risk with aerobic activity, strength training combo

Researchers also found that the lowest mortality risks were found among study participants who combined both high aerobic activity and between 60 to 119 minutes a week of resistance training every week. 

“Aerobic exercise is generally linked to improved hemodynamics, lipid profiles, and cardio-respiratory fitness, whereas resistance training may improve glucose metabolism, body composition, and muscular strength,” Zhang explained to MNT.

“Some randomized trials in patients with coronary artery disease also found that, compared with aerobic activity alone, combining aerobic and resistance training yields greater improvements in cardiorespiratory fitness and body composition,” she said.

Giovannucci said for the next steps in this research, they will be looking for opportunities to examine resistance training in a more diverse population and in relation to outcomes beyond mortality, such as physical function, independence, and quality of life. 

“It will also be important to study resistance training more precisely, including exercise type, intensity, load, and using more objective measures if possible,” he added. 

Cardio, resistance training, or both?

MNT spoke with Swapnil Patel, MD, MHCM, FACP, vice chair of the Department of Medicine at Hackensack Meridian Jersey Shore University Medical Center, and assistant professor at Hackensack Meridian School of Medicine in New Jersey, who was not involved in this study, about these research findings. 

Patel commented that these findings reinforce something we have been emphasizing in preventive medicine for years: exercise should not be viewed as an “either-or” choice between cardio and strength training.

“Many patients focus heavily on walking, running, cycling, or other aerobic activities because they are often associated with heart health and weight loss. This study provides compelling long-term evidence that resistance training offers independent benefits and appears to further reduce mortality risk when combined with aerobic exercise.”
— Swapnil Patel, MD, MHCM, FACP

“Different forms of exercise affect the body through different biological pathways,” Patel continued. “Aerobic exercise improves cardiovascular fitness, blood pressure, insulin sensitivity, and metabolic health, while resistance training helps preserve muscle mass, improve functional strength, enhance glucose metabolism, and reduce frailty,” he explained.

“Understanding how these exercise modalities influence specific disease outcomes allows clinicians to provide more targeted recommendations to patients,” he said.

“This study is especially important because it highlights a potential association between resistance training and reduced neurological disease mortality, an area that has received far less attention than cardiovascular disease,” Patel added.

“As our population ages and conditions such as dementia and neurodegenerative diseases become increasingly prevalent, identifying lifestyle interventions that may help preserve neurological health is a major public health priority. The findings suggest that strength training may play a meaningful role in healthy aging beyond simply maintaining muscle mass and mobility.”
— Swapnil Patel, MD, MHCM, FACP

Seek out professional guidance when starting strength training

MNT also spoke with David Cutler, MD, a board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, who was also not involved in this study, who said that for patients who only focus on aerobic exercise, it’s an eye opening study for them. 

“This is something that’s been known for a long time of the benefits of strength training, but this certainly brought it home how profound that benefit can be,” Cutler continued.

“A lot of people just focus on one form of exercise, whether it be strength training exercise as in this study, or on aerobic exercise. A lot of people focus on core exercise because they’re bothered by back pain — they know that core exercises can be helpful for that. And a lot of people focus a lot on stretching exercise, which can also be very helpful in terms of maintaining mobility. And this program, nor others, have focused on how important a comprehensive exercise program is, which incorporates strength training, aerobics, core, and stretching.”
— David Cutler, MD

For readers who may want to start strength training but aren’t sure where to start, Cutler advised getting guidance from a physical fitness trainer. 

“There are some dangers in strength training exercise regarding injury, and I think getting some guidance from a trainer is actually a very good idea and money that’s very well spent to avoid injury and avoid incurring extra costs,” he said. 

• As of 2021, about 17.9 million people around the world were living with rheumatoid arthritis. 
• Past studies show that rheumatoid arthritis can negatively impact a person’s health by increasing their risk for several health complications, including depression. 
• Recent evidence suggests that some of these health issues may not only be complications of this condition, but may also help maintain the disease especially in people with difficult-to-treat rheumatoid arthritis. 
• Researchers have developed a new model based on their findings to help improve the treatment of difficult-to-treat rheumatoid arthritis cases. 

As of 2021, about 17.9 million people globally were living with rheumatoid arthritis — an autoimmune type of arthritis that causes inflammation in the joints. 

Past studies show that rheumatoid arthritis can negatively impact a person’s health by increasing their risk for irreversible joint damage, osteoporosis, heart disease, eye issues, sleeping problems, obesity, and mental health conditions like anxiety and depression. 

Now, two new papers — a perspective paper published in the journal Nature Reviews Rheumatology, and a commentary in The Lancet Rheumatology — have concluded that some of these health issues, such as depression, may not only be complications of rheumatoid arthritis, but may also help maintain the disease especially in people with difficult-to-treat rheumatoid arthritis. 

How lifestyle factors impact rheumatoid arthritis

In these two papers, the authors reflect on how certain health problems, such depression, smoking, obesity, and sleep disorders, may impact rheumatoid arthritis and its symptoms. 

“Historically, treating [rheumatoid arthritis] meant focusing almost exclusively on physical joint inflammation,” György Nagy, MD, PhD, head/director of the Department of Rheumatology and Immunology at Semmelweis University in Hungary, senior and corresponding author for the Nature Reviews Rheumatology perspective peace, and co-lead author of The Lancet Rheumatology commentary, told Medical News Today.

“Yet, in daily clinical practice, we frequently see patients whose blood work looks completely normal, but who are still experiencing pain, fatigue, and whose everyday functioning is limited,” Nagy added.

“Lifestyle factors like smoking and obesity, and coexisting health conditions like depression and fibromyalgia disproportionately skew the patient-reported metrics used to calculate [rheumatoid arthritis] severity scores. If a patient’s pain is amplified by depression or a sleep disorder rather than active joint swelling, traditional arthritis drugs simply won’t touch it. A recent meta-analysis by Xie et al. [on which the paper in The Lancet provides commentary] systematically identifies different lifestyle factors as major drivers of treatment failure.”

– György Nagy, MD, PhD

Health issues may trap those with rheumatoid arthritis in ‘vicious circle’

Nagy said that the most crucial finding is that these health issues do not just casually exist alongside rheumatoid arthritis; they feed into it bidirectionally, trapping the patient in a grueling “vicious circle.”

“For example, a patient with severe [rheumatoid arthritis] pain may become physically inactive, leading to obesity,” he detailed.

“Obesity generates low-grade systemic inflammation, which further worsens the [rheumatoid arthritis] trajectory. Similarly, failing multiple medications lowers mood and motivation, triggering depression; that depression then amplifies pain perception in the brain and lowers the patient’s ability to rigidly adhere to their treatment plan,” Nagy explained.

“Recognizing that these factors actively maintain the disease state is revolutionary because it means we can break the cycle by targeting the modifiable lifestyle factors directly, sometimes without even needing a new drug,” the researcher added. 

New treatment model incorporates ‘smart triage’ component

Nagy and his team developed a model that could potentially improve the treatment options for people with difficult-to-treat rheumatoid arthritis. 

“Currently, [rheumatoid arthritis] care is treated as a linear, ‘one-size-fits-all’ escalator,” he explained. “If a drug fails, the clinician automatically steps up to the next, stronger drug. Our model introduces a smart triage layer.“

“Instead of universally escalating medication when standard care under-performs, the clinician halts to perform a ‘structured multi-domain reassessment.’ We treat the patient’s unique condition like a puzzle, evaluating four specific zones: disease biology, clinical conditions (comorbidities), behavioral habits (adherence), and contextual realities (such as sleep or social support),” Nagy told us.

“Instead of just changing the prescription, our model might pivot a patient toward a multidisciplinary roadmap: engaging pain specialists, psychologists for mental well-being, or personalized nutrition and lifestyle coaching to address weight or smoking,” he continued. “It shifts medicine from rigidly treating a generic disease to flexibly treating an individual human being.”

Nagy said that finding new avenues for “difficult-to-treat” rheumatoid arthritis patients is vital because blindly escalating powerful immunomodulatory medications doesn’t work for everyone. 

“Unnecessary drug escalation can expose patients to unwanted side effects and rising healthcare costs without actually relieving their symptoms,” he added. “We must understand the deeper, non-inflammatory drivers to alleviate this impactful clinical and socioeconomic burden.”

Further evidence of the mind-body connection

MNT spoke with Erica Frenkel, NBC-HWC, FMCHC, functional medicine-certified and a nationally board-certified health and wellness coach, and owner of Erica Frenkel Health Coaching, about these findings. 

“We’ve long known about the mind-body connection,” Frenkel, who was not an author on either of the papers, commented. “Generally it is discussed as a one way relationship — illness, pain, or other physical ailments can lead to depression and other mental health issues. What’s less frequently discussed is that the mind-body connection is actually a two-way relationship.”

“So I’m glad to see research that illustrates the reality that our physical health and wellbeing can be impacted when we are not mentally well,” she added. “My hope is that it leads to more integrative care where we don’t silo mental health and physical health but rather care for the whole person.”

MNT also spoke with Neha Patil Kumar, a licensed marriage and family therapist (LMFT) and owner of Prose & Psyche Counseling, about the findings regarding depression and difficult-to-treat rheumatoid arthritis.

“I’m not at all surprised that depression can sustain persistent rheumatic symptoms,” Patil Kumar, who was likewise not involved in authoring the recent papers, told us.

“We know that depression can negatively impact an individual’s ability to perceive and process pain, which can result in poor treatment adherence and worse outcomes overall. The links between mental health conditions and chronic conditions need to be studied to ensure that clinicians are aware of every possible factor contributing to a patient’s pain in order to provide the most effective, comprehensive treatment possible,” she noted.

Patil Kumar further said that it would be encouraging to see future research evaluate multidisciplinary treatment models that incorporate mental health care into the management of rheumatoid arthritis. 

“If depression contributes to persistent symptoms, addressing psychological well-being alongside medical treatment may improve patients’ quality of life and overall health outcomes,” she added. 

• Chronic fatigue is thought to affect more than 3 million people in the United States alone.
• Experts are unsure what causes it, but it may occur after a viral infection or major physical stressor.
• Now, a study has found that deficiencies in vitamin B12 and folate (vitamin B9) are linked to physical and mental fatigue, so may be a factor in chronic fatigue.
• The researchers suggest that, while their study cannot prove causation, maintaining adequate levels of these B vitamins could help to reduce fatigue-related outcomes.

Fatigue is something that everyone experiences from time to time, but for some people, it is not a transient symptom, but a chronic condition that affects their daily functioning.

Chronic fatigue, the Centers for Disease Control and Prevention (CDC) report, may affect around 3.3 million Americans, interfering with work, school and social life, as well as day-to-day tasks. 

Experts believe that chronic fatigue may sometimes follow a viral infection, or could occur after extreme physical stress, such as major surgery. It is 2–4 times more likely to occur in women than men.

A new study from Japan suggests that diet may influence energy levels and motivation. The research, published in Nutrients, found that people who had raised levels of a biomarker, homocysteine, indicating deficiency in vitamins B9 (folate) and B12, were more likely to experience fatigue or lack of motivation than those who had adequate levels.

Although the cross-sectional analysis cannot prove causation, researchers suggest that further studies into links between diet and fatigue should be carried out to verify their findings.

Eamon Laird, PhD, Lecturer in Nutrition ATU Sligo and Adjunct Professor TCD Dublin, Ireland, who was not involved in this research, told Medical News Today that the study raised an interesting hypothesis, and that there seemed to be an association between these B-vitamins and measures of fatigue, but emphasized that the findings should be interpreted with caution. 

And Thomas M. Holland, MD, MS, Physician-Scientist and Assistant Professor, Division of Digestive Diseases and Nutrition, Rush Institute for Healthy Aging, Chicago, likewise not involved in the study, commented that:

“One of the most important takeaways from this paper is that homocysteine may serve as a broader biomarker reflecting metabolic stress, vascular health, inflammation, or micronutrient status rather than simply indicating isolated B12 or folate deficiency alone.”

“The findings fit within a larger body of research linking elevated homocysteine with cardiovascular and cognitive outcomes, suggesting that these metabolic pathways may influence multiple aspects of health simultaneously,” Holland added.

Homocysteine levels indicate B-vitamin deficiency

The researchers carried out functional measurements, blood sampling and questionnaires on 2,618 adults who visited the Center for Health Science Innovation at Osaka University between April 2018 and March 2020. 

Of these, 602 were included in the final analysis, after those with missing data or samples (particularly of homocysteine), or who used supplements, were excluded.

Laird expressed some concern about the number of exclusions, telling MNT it “raises questions regarding selection bias and representativeness”.

Homocysteine is an amino acid formed during the breakdown of methionine, an amino acid found in foods such as nuts, beef, lamb, cheese, turkey, pork, fish, shellfish, soy, eggs, dairy, and beans.

Folate and B12 are essential for the breakdown of homocysteine, so the researchers used blood concentration of homocysteine to indicate levels of the vitamins.

“The authors are very explicit that these findings should be interpreted cautiously and viewed primarily as hypothesis-generating rather than definitive evidence of causality. Because the study is cross-sectional, it can identify associations, but it cannot determine whether elevated homocysteine causes fatigue or reduced motivation, or whether other physiological or lifestyle factors contribute to both simultaneously.”

– Thomas M. Holland, MD, MS

The researchers found that in both men and women, higher homocysteine levels were associated with lower serum folate and B12 levels. 

Lower vitamin levels linked to fatigue and lack of motivation

The researchers assessed fatigue and motivation using the 14-point Chalder Fatigue Scale, which is commonly used to assess chronic fatigue, and a visual analog scale.

In men, high homocysteine was associated with higher physical fatigue scores and, in women, with lower motivation scores.

Holland explained possible reasons for the connections: 

“Vitamin B12 and folate are heavily involved in cellular energy production, DNA synthesis, red blood cell formation, and neurological function. When levels are inadequate, homocysteine levels can rise because the body cannot efficiently convert it into other important compounds involved in normal metabolism. Elevated homocysteine has been linked with oxidative stress, impaired blood vessel function, inflammation, and altered neurotransmitter pathways, all of which may influence both physical energy and mental motivation.”

“In simpler terms, if cells are not efficiently producing energy or the brain is not optimally regulating signaling chemicals involved in mood and drive, people may experience symptoms such as exhaustion, mental fog, reduced stamina, or decreased motivation,” he continued.

“However,” he added, “it is important to emphasize that this study did not show that low folate or B12 directly caused fatigue; rather, homocysteine appeared to serve as a broader marker connected to these metabolic processes.”

Both Holland and Laird cautioned that the sex differences, while interesting, should be interpreted with caution, with Laird telling us that “the formal sex-by-homocysteine interaction analyses were not statistically significant, suggesting there is no clear evidence that the associations truly differ between men and women.“

“If genuine, the findings may be [due to] biological differences in homocysteine metabolism, hormonal influences (particularly oestrogen), or sex-specific effects on fatigue and motivation pathways,” Laird hypothesized.

How can you boost your B12 and folate levels?

Holland advised that “maintaining a dietary pattern rich in fruits, vegetables, legumes, whole grains, lean proteins, omega-3-rich fish, olive oil, and minimally processed foods likely supports healthier homocysteine metabolism and overall physiological resilience.”

Laird added that sufficient of both B12 and folate can be obtained through either diet or supplements:

“Vitamin B12 is mainly found in animal-based foods such as meat, fish, eggs, and dairy products, while folate is abundant in green leafy vegetables, legumes and fortified cereals. For individuals with low dietary intake or increased requirements, supplements containing vitamin B12, folic acid, or both may help improve status and support normal metabolic function.”

“Fortified food products are ideal,” he emphasized, “as they often contain both vitamins and in smaller amounts which can be eaten little and often as vitamin B12 absorption is inversely related to dose with the higher the dose consumed at one time, the lower the percentage being absorbed.”

• The latest breast cancer screening guidance document released by the American College of Physicians has drawn mixed reactions.
• The updated guidelines include changed advice on routine supplemental MRIs or ultrasounds, AI-based mammograms, and screening age.
• The 2026 iteration contradicts previous U.S. Preventive Services Task Force (USPSTF) guidelines, which has left many people confused about when to start screening.
• Medical News Today spoke to 2 experts to learn more about when to start breast cancer screening and what methods may be best.

The American College of Physicians (ACP) released a new guidance statement in the Annals of Internal Medicine in April 2026, reigniting debate over breast cancer screening age and frequency.

A comprehensive review by researchers from Trinity College Dublin and St James’s Hospital, published in the Cochrane Database of Systematic Reviews, also found that current statistical tools used to estimate breast cancer risk may fall short in pinpointing individual risk in women with a family history of the disease.

Currently, there is no international consensus on routine screening mammography, and many major medical and health organizations offer different guidance.

The main point of contention between such practices boils down to a debate of pros versus cons. On one hand, the life-saving benefits of early cancer detection are apparent; however, there is also some concern around overdiagnosis, false positives, patient anxiety, and unnecessary biopsies.

It is important to note that most of the current advice is geared toward women at average risk of breast cancer, namely those without a personal history of breast cancer, high familial risk, or those carrying high-risk genetic mutations.

Medical News Today spoke to the following two experts to get clarity on the best screening age and methods for breast cancer prevention and detection:

• Syed Ahmad Raza, MBBS, FCPS, MRCP (UK), SCE Medical oncology (UK), consultant internal medicine and a medical oncologist.
• And Loren Rourke, MD, MHCM, FACS, board certified breast surgical oncologist.

What the U.S. Preventive Services Task Force (USPSTF) recommends

The USPSTF updated its formal guidance in 2024, underscoring the importance of earlier screening:

• When to start screening: Age 40 years, marking a shift from earlier recommendations to wait until age 50.
• How often to get screened: Every other year (biannually).
• When to stop screening: Through age 74, citing lack of evidence of benefits versus harms in women ages 75 and older.

What the American Cancer Society (ACS) recommends

The ACS guidelines highlight individual decision making power as a key factor in screening:

• When to start screening:
  – At ages 40 to 44, women should have the option to start yearly screening if they wish to do so.
• How often to get screened:
  – At ages 45 to 54, women should get annual mammograms.
  – At ages 55 and older, women can switch to getting mammograms every 2 years but should have the option to do so every year if they choose.
• When to stop screening: Women should continue screening as long as they are in good health and have a life expectancy of 10 years or more.

What the ACR and ASBrS recommend

The American College of Radiology (ACR) & American Society of Breast Surgeons (ASBrS) combine the advice of the USPSTF and ACS, and advocate for a more aggressive preventive screening schedule:

• When to start screening: Age 40 years.
• How often to get screened: Every year (annually).
• When to stop screening: Until life expectancy drops below 10 years.

• Some current research has been focusing on how to identify the earliest signs of Alzheimer’s disease. 
• One tool that doctors are beginning to use to help predict a person’s Alzheimer’s disease risk in its earliest stages is through biomarker blood tests.
• A new study has found that these biomarker blood tests may also help doctors find very early signs of cognitive decline in midlife adults without a dementia diagnosis.  
• Researchers believe that using biomarker blood tests in this way may lend greater credence to initiating healthy lifestyle modifications known to help lower dementia risk. 

As scientists continue to learn more about the potential causes behind Alzheimer’s disease, some recent research has been focusing on looking for the earliest possible warning signs for this type of dementia. 

One tool that doctors are beginning to use to help predict a person’s Alzheimer’s disease risk in its earliest stages is through blood tests that search for specific biomarkers in the blood. 

Now, a new study published in The Lancet, primarily funded by the National Institutes of Health (NIH), has found that these biomarker blood tests may also help doctors detect very early signs of cognitive decline in midlife adults without a dementia diagnosis. 

Researchers believe using Alzheimer’s disease biomarker blood tests in this way may give more credence to initiating healthy lifestyle modifications known to help potentially lower dementia risk. 

Positive biomarker test linked to worse cognition later in life

For the study, researchers analyzed data from participants of the U.S. Coronary Artery Risk Development in Young Adults (CARDIA) Study. Researchers selected about 1,300 of these study participants with an average age of 61. 

Of this pool, 6% showed a high level of the proteins beta-amyloid and tau in their blood, which are considered hallmarks of Alzheimer’s disease. 

Scientists found that the participants in this 6% had lower processing speeds and executive function. And when tested five years later, those with high beta-amyloid and tau biomarkers had about 2.5 to 4 times the risk of rapid decline in verbal memory, and around 3 to 4 times the risk of rapid decline in processing speed. 

“What we found is that having these (biomarker blood) tests be positive were not common, but if they were, they were associated with worse cognition and greater decline compared to those not positive,” Kristine Yaffe, MD, distinguished professor and vice chair of the Departments of of Psychiatry, Neurology, and Epidemiology at the University of California – San Francisco (UCSF) and senior author of this study, told Medical News Today.

“More and more people will ask for these tests, and companies are doing direct-to-consumer advertising. So we don’t want to alarm people, but if positive, provide them with guidance (on) how to improve/lower risk for cognitive decline, and maybe in the future consider new medications for Alzheimer’s disease.”
— Kristine Yaffe, MD

More precise early Alzheimer’s diagnosis tools needed

MNT spoke with Megan Glenn, PsyD, clinical neuropsychologist in the Center for Memory and Healthy Aging at the Hackensack Meridian Neuroscience Institute at Jersey Shore University Medical Center in New Jersey — who was not involved in this study — about this research.

Glenn said she felt highly encouraged by the study’s findings, as it feels as though multiple lines of research are finally converging. 

“We have known for a long time that subtle cognitive changes and biological markers, particularly amyloid accumulation, begin developing decades before a patient meets the criteria for a formal dementia diagnosis,” she explained. “We have been searching for accessible ways to detect these earliest signs during this ‘preclinical’ phase so we can intervene sooner, and this study represents a major step toward making early detection scalable and accessible to the general public.” 

When it comes to diagnosing a person’s Alzheimer’s disease risk as soon as possible, Glenn said we need more precision because having Alzheimer’s biomarkers doesn’t guarantee someone will develop clinical symptoms. 

“Amyloid accumulation in the brain is like the kindling, but not the fire — it sets the stage, but doesn’t guarantee progression unless other factors, like tau tangles, are also present,” she detailed. “We need to figure out exactly who among those with early biomarker changes will actually go on to develop dementia.”

“Developing early detection is critical because by the time memory loss and other symptoms are obvious, the brain has already suffered significant, likely irreversible damage,” Glenn continued.

Prevention is better than cure

“Historically, many Alzheimer’s treatments — even recently approved medications that successfully clear amyloid — have shown modest clinical effects, potentially because they are given too late in the disease process. If we can accurately identify risk during the preclinical stage, we can potentially intervene with lifestyle changes and/or disease-modifying therapies before permanent damage occurs. It is always better to prevent the damage in the first place than to try to mitigate it after the fact.”
— Megan Glenn, PsyD

Blood test could help make risk conversation more concrete

Additionally, researchers believe that by detecting early signs of Alzheimer’s disease, people can better target modifiable risk factors. 

“The proteins that cause Alzheimer’s disease take decades to accumulate in the brain,” Yaffe explained. “ The blood tests can detect these proteins — tau and amyloid-beta. So it might be good to detect early so people can lower their risk by lifestyle interventions and possibly drugs. They can also be monitored closely by their clinician.” 

MNT spoke with Dung Trinh, MD, an internist for the MemorialCare Medical Group and chief medical officer of the Healthy Brain Clinic in Irvine, CA — who was not involved in this study — and he commented that a blood test like this could make the risk conversation more concrete.

“Many patients hear ‘exercise more,’ ‘control blood pressure,’ ‘sleep better,’ or ‘manage diabetes,’ but those recommendations can feel general or abstract,” Trinh explained. “If a patient has evidence of Alzheimer’s-related biomarker changes, that can create a more personalized and urgent conversation about brain health.”

Why a positive test doesn’t necessarily mean dementia

“I would explain it carefully: a positive biomarker result does not mean someone has dementia, and it does not predict the future with certainty. But it may suggest that Alzheimer’s-related biology is present, which makes it even more important to aggressively address the factors we can modify.”
— Dung Trinh, MD

In practical terms, Trinh said, that means focusing on blood pressure, cholesterol, diabetes, physical activity, smoking, sleep apnea, depression, hearing loss, social isolation, nutrition, and medication review. 

“The (press release) also highlights Dr. Kristine Yaffe’s point that modifiable risk factors — including physical and cognitive inactivity, depression, smoking, and heart health — play an important role in dementia risk,” he added. “The goal is not to scare patients. The goal is to give them agency. A biomarker result should open the door to prevention-oriented care, not fatalism.” 

• There are several healthy lifestyle choices people can make to help protect their brain health as they age, such as eating a brain-healthy diet. 
• Past studies show that certain foods, such as diets with high-fat and high-sodium foods, may also impact future brain health. 
• A new study found that while switching to a healthier diet may benefit your brain function, it may not fully reverse cognitive issues caused by eating a high-sugar diet, via analysis of data from animal models.  

As we age, it is common for brain health to slightly decline. For instance, it may be harder to remember things and multitasking may become more difficult. 

Previous research shows there are several healthy choices people can make throughout their lives to potentially slow brain aging.

These include being physically active, prioritizing sleep, managing stress, not smoking, staying mentally stimulated, and following a brain-healthy diet, such as the MIND diet.

When it comes to diet, past studies further show that certain foods may also impact future brain health. For example, studies have reported that consuming a high-fat diet may negatively impact memory formation, and consuming too much salt may lead to cognitive impairment.

“Brain health is at the core of wellbeing,” Michael D. Kendig, PhD, senior lecturer in the School of Life Sciences at the University of Technology Sydney in Australia, told Medical News Today. “We now know that diet has a major influence on brain health over the lifespan, with the ability to protect against, or increase the risk of cognitive decline.”

Kendig is the senior author of a new study review in the journal Nutritional Neuroscience, which found that, while switching to a healthier diet may benefit brain function, it may not fully reverse cognitive issues caused by eating a high-sugar diet, via analysis of data from animal models.  

What can animal studies reveal about human brain health?

For this review, researchers analyzed findings from 27 previous studies using rodent models. The animals were all fed high-fat, high-sugar diets for at least 2 weeks. Some rodents were then placed back on their normal healthy food or continued on the high-fat, high sugar diet. 

Researchers waited at least 24 hours before scientists assessed the animals’ cognition status. 

“Much of the world now eats a dietary pattern characterized by higher than ideal intake of sugar, sodium, and saturated fat,” Kendig said.

“We know that these diets can impair cognitive function — even after a few days or weeks — but not as much is known about what happens to cognition when a bad diet stops, even though this is happening all the time in day-to-day life when people decide to improve eating habits,” he added. 

“This led us to review all the studies on this question in preclinical models [in rats and mice],” Kendig explained.

“Animal models are especially valuable here because in people, multiple aspects of lifestyle are likely to change when someone’s diet improves — perhaps [they] may start exercising more, cut alcohol, and/or generally feel more confident about their ability to look after themselves (self-efficacy). All of these might contribute to improvements in cognition, making it more difficult to isolate the effects of nutrition specifically. The controlled conditions of animal experiments allow us to do this very precisely.” 

– Michael D. Kendig, PhD

High-sugar diets may later impair memory

At this study’s conclusion, researchers did find that rodents that were switched back to a healthy diet performed better on memory tasks than those that continued on the unhealthy diet. 

However, scientists determined that memory recovery depended on the composition of the unhealthy diet. Memory recovery was seen in rodents who were fed a high-fat diet, but not in those fed a diet only high in sugar or a combined high-fat, high-sugar diet. 

“This was an unexpected result that requires more research,” Kendig explained. “We interpreted this to suggest that recovery of memory was prevented when the unhealthy diets contained sugar — either sugar alone, or combined high fat/sugar.“

“A tentative conclusion is that high-sugar diets may promote forms of cognitive impairment that are more persistent after diet quality improves,” he told us.

“I think this result points to the fact that high-fat diets impact the brain in different ways than high-sugar or combined high-fat, high-sugar diets,” the scientist added.

“For example, several studies have shown that high-sugar diets may produce a stronger neuroinflammatory response in the brain than high-fat diets. This could explain why unhealthy diets containing sugar promote more lasting cognitive impairments,” he hypothesized. 

Might these findings in rodents also apply to humans?

As these findings all come from animal studies, MNT asked Zack Ramilevich, MD, a neurologist with the Marcus Neuroscience Institute, part of Baptist Health South Florida, whether or not these findings may extend to humans. 

“Absolutely, and I believe there is a strong translational basis for it,” Ramilevich, who was not involved in the review, commented.

“We already have robust clinical evidence linking high-sugar high-fat diets to structural changes in the human brain. Specifically, an accelerated volume loss in the hippocampus, our primary memory-forming center. Because the fundamental neuroanatomy and metabolic pathways governing memory are conserved between rodents and humans, it stands to reason that our brains share a similar capacity for recovery. There is no clear biological reason to believe human brains are uniquely excluded from the benefits of removing a metabolic insult.”

– Zack Ramilevich, MD

Ramilevich said thatthe ideal next step in this research would be transitioning from animal models to trials in humans. 

“Furthermore, the next phase of this research needs greater stratification into different types of fats and sugars, rather than just lumping them together as ‘unhealthy food’,“ he continued.

“Since the current data hints that high-fat diets might actually offer better memory recovery than high-sugar diets, future studies must isolate the specific cognitive impacts of fructose versus glucose, and explicitly separate inflammatory saturated fats from possibly beneficial omega-3 fatty acids to see exactly how they interact with our memory centers,” said Ramilevich.

Encouraging, yet cautionary findings

MNT also spoke with Dung Trinh, MD, internist for the MemorialCare Medical Group and chief medical officer of the Healthy Brain Clinic in Irvine, CA, who said while the findings of this study are encouraging, they’re also cautionary. 

“It is encouraging because switching to a healthier diet appeared to improve memory performance in animal models,” Trinh, who was likewise not involved in the review, detailed.

“But it is cautionary because the improvement was incomplete, especially after diets high in sugar or combined high-fat/high-sugar diets,“ he emphasized.

According to Trinh: “The key message is not that brain health is fixed or that damage is irreversible, but that prevention may be more powerful than rescue. Diet quality matters, and prolonged exposure to unhealthy diets may have lasting effects on memory-related brain systems.” 

He said it’s important for researchers to continue to find new ways in which people may be able to retain their brain health as they age through their diet because brain aging and dementia risk are among the greatest public health challenges we face, and diet is one of the few risk factors that can be modified across the lifespan. 

“We do not yet have a cure for Alzheimer’s disease or most causes of cognitive decline, so prevention and risk reduction are essential,” added Trinh.

“If certain dietary patterns can protect memory systems, reduce inflammation, improve metabolic health, and support vascular function, that gives patients and physicians practical tools long before symptoms begin. The most valuable research is not just about adding years to life, but preserving independence, memory, mobility, and quality of life,” he concluded.

A new review now argues that sleep is not just a time for the brain and body to rest and recover, but that during sleep the brain’s housekeeping services kick into action to clear waste products that, over time, can lead to cognitive decline and dementia.

In a review published in Science, neuroscientist Maiken Nedergaard, MD, DMSc, from the University of Rochester Medical Center, NY, suggests that, sleep-related mechanisms play a complex role in the maintenance of brain health.

 Steven Allder, MD, consultant neurologist at Re:Cognition Health, not involved in the review, told Medical News Today that:

“What makes this review compelling is the link between sleep and this clearance process. During deep, slow-wave sleep, glymphatic activity increases significantly, allowing more efficient removal of waste. This provides a biological mechanism that helps explain why chronic sleep disruption is associated with increased risk of cognitive decline and dementia. It is important to emphasize that this is not a simple cause-and-effect relationship, but rather a key pathway in a broader network of brain health factors, including vascular function, inflammation and aging.”

How sleep can impact brain health

During the daytime, neuromodulators such as norepinephrine, acetylcholine, serotonin, and dopamine work independently to support behavior and cognition.

However, during sleep, they act in a coordinated rhythm to support glymphatic clearance of metabolic waste.

Nedergaard told MNT that:

“There is now converging evidence from multiple lines of research suggesting that impaired glymphatic clearance during sleep plays a central role in the pathogenesis of neurodegenerative diseases. Emerging evidence further indicates that these slow brain-body rhythms are major drivers of glymphatic clearance. Together, these observations suggest that understanding how sleep rhythms regulate brain clearance may be fundamentally important for understanding aging and dementia.”

Studies have shown that during non-REM sleep — the phases described by fitness/sleep trackers as core and deep sleep — neuromodulators are synchronised and their oscillations correspond to microarousals.

These short bursts of EEG activity that do not wake the person happen approximately every 50 seconds during non-REM sleep and last from a few hundred milliseconds to a several seconds.

The neuromodulators drive the glymphatic system by making tiny blood vessels contract and expand, moving cerebrospinal fluid (CSF) that clears away neurotoxic proteins, such as beta-amyloid and tau, which are closely associated with development of Alzheimer’s disease.

If sleep is disturbed, the rhythms are interrupted, which leads to less effective clearance of waste products, so may increase risk of cognitive decline and dementia.

“The relationship between sleep and dementia risk is increasingly understood as bidirectional and system-wide, with the glymphatic system at the centre of this model,” Allder told us.

“On one hand, impaired sleep, particularly reduced slow-wave sleep, can limit glymphatic clearance of neurotoxic waste such as amyloid-beta and tau, allowing accumulation over time. This may contribute to neuroinflammation, synaptic dysfunction and neurodegeneration,” he explained.

“On the other hand,” he added, “early neurodegenerative changes can themselves disrupt sleep architecture, meaning sleep disturbance may also be one of the earliest clinical markers of disease. This creates a feedback loop where impaired sleep and impaired clearance reinforce each other.”

Heart-rate variability and brain cleaning: What’s the link?

In her review, Nedergaard highlighted that heart-rate variability be a biomarker of sleep-related brain health. These subtle changes in timing between heartbeats during sleep appear to be closely tied to the neuromodulator rhythms occurring in the brain. 

“Heart-rate variability appears to be regulated by the same slow physiological rhythms that coordinate glymphatic clearance during sleep. We therefore speculate that high heart-rate variability during sleep may reflect effective glymphatic function and restorative sleep,” she told MNT.

“If heart-rate variability is validated experimentally and proves to be a reliable biomarker of glymphatic clearance, it could become a simple and inexpensive tool for identifying individuals at increased risk of dementia and for monitoring treatment responses in clinical trials targeting sleep and brain clearance mechanisms,” she advised.

Allder agreed that using heart-rate variability as a biomarker was “an interesting and potentially very practical idea.”

“Heart rate variability and nocturnal cardiovascular rhythms are already recognised indicators of autonomic nervous system activity, which is closely linked to sleep architecture and deep sleep quality,” he told us.

“Because glymphatic activity is strongly coupled with slow-wave sleep, it is biologically plausible that cardiovascular patterns during sleep could indirectly reflect how effectively this clearance system is functioning,” he noted.

“However,” he cautioned, “this remains an indirect proxy. Heart rate fluctuations are influenced by many confounders, including stress, medication, fitness level and underlying cardiovascular disease. While this could eventually contribute to a non-invasive screening tool, it would need to be validated alongside more direct imaging or biomarker-based measures of glymphatic activity before being used clinically to identify dementia risk.”

How to improve your brain rhythms during sleep

To improve the brain rhythms during sleep, and therefore help ensure that brain clearance is as efficient as possible, Nedergaard advised that people follow the advice for maintaining healthy sleep overall.

“Regular sleep schedules, sufficient sleep duration, physical activity, minimizing stress, and avoiding stimulants or bright light exposure late in the evening,“ she recommended.

“Improving sleep quality is likely beneficial because glymphatic clearance is most active during deep sleep,” said the scientist.

• Researchers found that Aedes aegypti, or yellow fever mosquitoes, can learn to associate the smell of DEET with a food reward through repeated exposure during feeding.
• In laboratory experiments, more than 60% of trained mosquitoes attempted to feed when exposed only to the smell of DEET, suggesting the insects had formed a positive association with the repellent.
• Trained mosquitoes were attracted to DEET-treated human skin, while untrained mosquitoes avoided it, indicating that mosquito behavior toward repellents may be shaped by experience.
• The findings suggest DEET remains highly effective, but maintaining consistent repellent levels through regular reapplication may be important to prevent mosquitoes from adapting to fading concentrations.

Mosquitoes are common across the United States, with more than 200 types of mosquitoes living in the continental United States and U.S. territories.

Most mosquitoes in the U.S. are nuisance mosquitoes that do not spread disease, but some bites can transmit mosquito-borne diseases, such as West Nile virus, Dengue fever, Chikungunya, and Zika virus.

Although present in America, the burden of these diseases is highest in tropical and subtropical areas.

Prevention is often the most effective defense against mosquitoes, with public health officials recommending insect repellents containing DEET.

Typically available as liquids, lotions, or sprays, the chemical likely deters mosquitoes by interfering with their sensory receptors, making humans harder to detect and unappealing. Health experts emphasize the DEET-based repellents are safe and effective when used as directed.

Now, a new study suggests mosquitoes may be more adaptable than previously thought, and the yellow fever mosquito can learn to associate the smell of DEET with a food reward, potentially changing how the insects respond to the chemical over time.

The findings, published in the Journal of Experimental Biology, raise new questions about mosquito behavior and how to effectively use repellents in real-world settings.

Mosquitoes may learn from experience

DEET has long been considered the global gold standard in insect repellents. Previously, it was thought that DEET worked because mosquitoes disliked its taste and smell, and because it made humans harder to detect.

However, these findings suggest that the mosquito brain may play a larger role than previously understood.

In the study, researchers used a form of Pavlovian conditioning, the same learning process made famous by Russian physiologist Ivan Pavlov, to train mosquitoes to connect the smell of DEET with feeding opportunities.

The study focused on Aedes aegypti, a mosquito species known for spreading serious viral illnesses including Yellow fever, Dengue fever, Zika, and Chikungunya.

Mosquitoes were placed behind mesh fabric while a warm blood source was positioned nearby. Once the insects began feeding, researchers introduced the smell of DEET.

After repeating the process four times, more than 60% of the mosquitoes later attempted to feed when exposed only to the odor of DEET.

The researchers then tested whether the learned behavior affected mosquito preferences. Mosquitoes were offered a choice between two human hands, one untreated and one coated with DEET at standard concentrations.

Untrained mosquitoes avoided the DEET-treated hand, while the trained mosquitoes were attracted to it.

The team also found mosquitoes could form the same learned association when sugar rather than blood was used as the reward.

Could reapplication be more important?

Importantly, the findings do not suggest that people should stop using DEET. The study authors emphasize that DEET remains one of the most effective repellents available, particularly in tropical and subtropical regions where mosquito-borne diseases are common.

Instead, the results indicate that how and when repellents are applied could influence their effectiveness.

If DEET concentrations weaken over time and mosquitoes can still feed, insects may begin associating the scent with a successful meal. This could be especially relevant for products such as treated clothing, where DEET levels may gradually decline after prolonged use.

Maintaining a consistent level of repellent protection may help reduce the likelihood that mosquitoes form these learned associations.

Rather than applying a large amount of DEET once, more frequent reapplication could potentially provide better protection by keeping the repellent active.

“Our results highlight the importance of taking the time to read the manufacturer’s recommendations on dosage and application frequency to ensure the product is effective,” lead author Clément Vinauger, PhD, an assistant professor in the Department of Biochemistry in the College of Agriculture and Life Sciences at Virginia Tech, told Medical News Today.

“Our work represents a very particular experimental scenario designed to test whether the DEET molecule itself is aversive — because of its toxicity to the mosquito or how it is detected by the mosquito — or whether mosquitoes interpret the molecule, and this interpretation can be changed by prior experiences.” 

“DEET is still considered the gold standard of repellents, and it is highly repellent to mosquitoes. A possible real-world situation our work mimics is a mosquito biting someone who applied DEET long ago.”

“If the amount of DEET remaining on that person’s skin is too low, it is possible for a mosquito to bite and learn the association between the presence of DEET and the possibility of obtaining a blood meal. But we think this situation is likely rare, and people should keep using DEET and reapply it according to the manufacturer’s recommendations to prevent this from happening.” 

– Clément Vinauger, PhD

Understanding how mosquitoes adapt

The study builds on years of research into mosquito learning and sensory behavior. Vinauger’s laboratory at Virginia Tech investigates how mosquitoes use smell, vision, and memory to locate hosts and adapt to changing environments.

Previous work from the group has suggested mosquitoes can remember and avoid hosts that swat at them, combine visual and odor cues to track humans, and respond differently to certain body soaps.

“We were not that surprised by the speed at which they could learn to associate DEET and a reward because our prior work had shown that the same species can learn to associate other body odors — lactic acid, octenol, for example — with a blood reward in only three trials, and that was enough for them to form long-term memories of that association,” Vinauger said to MNT.

“What is remarkable in the present study is the extent to which mosquitoes learned to ‘like’ DEET and even preferred the arm of a volunteer sprayed with DEET over the untreated arm of the same volunteer, meaning that the presence of DEET increased the attractiveness of this human host,” he added. 

“Again, our experimental design is closest to a scenario in which someone has trace amounts of DEET on their skin, a mosquito bites, and learns that DEET isn’t so bad after all. But we didn’t simulate this exactly: In our assays, mosquitoes were exposed to high concentrations of DEET only after they began feeding.” 

– – Clément Vinauger, PhD

As mosquito populations expand and potential resistance to insecticides grows, it is becoming increasingly important to understand these behaviors and develop effective strategies to protect against them,

“This work highlights the importance of a better understanding of the sensory biology, behavior, and cognitive abilities of mosquitoes for designing novel repellents, rather than the more costly and time-consuming approach consisting of testing hundreds of substances for their potential effectiveness,” Vinauger told us.

“Diversifying our arsenal against mosquitoes would help lower the risk of seeing mosquitoes becoming resistant, indifferent, or outsmarting our control strategies,” he concluded.

• A new study involving more than 100,000 participants concludes that certain food preservatives could harm cardiovascular health.
• The researchers identify eight preservatives that are linked to hypertension (high blood pressure).
• They also concluded that one additive was specifically associated with cardiovascular disease.
• While worrying, the study design means that the results cannot conclusively prove causation.

The results of a recent study published in the European Heart Journal suggest that certain common preservatives in food may increase hypertension and cardiovascular risk.  

Because this observational study cannot prove causation — other factors may explain the link — the authors call for further research. 

They also call for a re-evaluation of the risks by the relevant bodies, including the Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA).

The rise of preservatives in food

With ultra-processed foods (UPFs) making headlines on a weekly basis, the scientific community and public at large are more focused on the potential health effects of food additives than ever before.

Preservatives, as the name suggests, prevent food from spoiling and pathogen invasion. They both improve food safety while increasing profits by extending shelf life. In 2019, roughly one-third of products purchased in the United States contained at least one preservative.

To be used in a product in the U.S., the United Kingdom, Europe, and many other regions, these additives are tested for safety. However, some believe that this testing is not thorough enough.

Interestingly, certain preservatives naturally occur in foods, such as ascorbic acid (vitamin C) and alpha-tocopherol (vitamin E). Consumption of these compounds within whole foods is associated with better cardiovascular health.

However, some early research suggests that their impact may be harmful when consumed outside of whole foods, at least for some populations.

According to the authors of the new study, little research has been conducted on the cardiovascular effects of preservatives, so this study provides fresh insights.

Some preservatives linked to type 2 diabetes, cancer

The current study uses data from the largest nutrition study of its kind, called NutriNet-Santé. 

The project began in France in 2009 and now involves more than 100,000 participants who regularly submit dietary data. The researchers also have access to blood samples and stool samples to assess participants’ gut microbiome.

In recent years, the group has focused on the impact of ultra-processed foods and additives on health. Earlier this year, for instance, they published research looking at the links between preservatives, type 2 diabetes, and cancer.

They concluded that preservative intake was associated with an increased incidence of type 2 diabetes and some cancers. Now, they are focusing on the association between these additives, hypertension, and cardiovascular disease.

Quick note: In this study, the statistical term “incidence” measures the number of new cases of hypertension or cardiovascular disease that occurred during the study’s follow-up.

Which preservatives are most common in food?

In total, the analysis included data from 112,395 people, more than two-thirds of whom were female, with an average age of 42.8. These individuals were followed for an average of 7.9 years.

The scientists identified 58 different preservatives that were consumed by participants. Of these, 17 were consumed by at least 10% of participants, so the researchers focused on these compounds and their associations with cardiovascular disease and hypertension.

The most common 10 preservatives were:

1. Citric acid: Consumed by 91.3% consumers (largely from processed fruit and vegetables). 
2. Lecithins: 86.4%.
3. Total sulphites: 83.5% (mostly from alcoholic drinks).
4. Ascorbic acid: 83.0% (largely from processed fruit and vegetables).
5. Sodium nitrite: 73.3% (largely from processed meat products).
6. Potassium sorbate: 65.3%.
7. Sodium erythorbate: 52.5% (largely from processed meat products).
8. Sodium ascorbate: 49.7%.
9. Potassium metabisulfite: 44.2%.
10. Potassium nitrate: 32.3% (largely from processed meat products).

Unearthing new links between preservatives and heart health

As part of their analysis, the scientists accounted for a range of variables, including age, sex, height, body mass index (BMI), physical activity, smoking status, educational level, and family history of cardiometabolic disorder and hypertension. 

Their analysis also controlled for macronutrient consumption, how much fruit and vegetables they ate, and their intake of alcohol, salt, meat products, and dairy.

Even after adjusting for these factors, they found that higher intakes of total non-antioxidant preservatives were associated with a higher incidence of cardiovascular disease and coronary heart disease.

Similarly, higher intakes of these preservative types were associated with a higher incidence of hypertension:

• total preservatives: 24% higher 
• total non-antioxidant preservatives: 29% higher
• total antioxidant preservatives: 22% higher

Antioxidant preservatives prevent chemical spoiling, whereas non-antioxidant preservatives work by killing microbes. 

When the scientists drilled down into specific compounds, greater intakes of these preservatives were associated with a higher incidence of hypertension:

• total sorbates: 39% higher
• potassium sorbate: 39% higher
• citric acid: 25% higher
• potassium metabisulfite: 16% higher
• total nitrites: 16% higher
• sodium nitrite: 16% higher
• ascorbic acid: 14% higher
• sodium erythorbate: 14% higher
• total ascorbates: 13% higher
• total erythorbates: 13% higher
• sodium ascorbate: 12% higher
• total sulphites: 11% higher
• extracts of rosemary: 10% higher

When assessing which individual preservatives were associated with a higher incidence of cardiovascular disease, only one remained significant:

• ascorbic acid: 15% higher 

Importantly, the researchers found no statistical interaction between diet quality or intake of UPFs. This means the effect is not solely because people who consumed more preservatives had an overall poorer diet. 

Limitations and the future

The current study has limitations. Because it is an observational study, it cannot prove causation. It is still possible that some other factor is responsible for the relationship between preservatives and heart health.

However, the authors end their paper with a call to arms: “This study provides new insights for revisiting the evaluation of the safety of these food additives, which should consider the benefit/risk balance between food preservation with these additives and their potential impact on cardiovascular health.”

• New research suggests that adults who completed 560 to 610 minutes of moderate-to-vigorous exercise per week had a more than 30% lower risk of cardiovascular disease than inactive individuals.
• Current guidelines of 150 minutes of weekly exercise were linked to a more modest 8 to 9% reduction in cardiovascular risk.
• The findings suggest that those with lower cardiorespiratory fitness appeared to need more weekly exercise than fitter individuals to achieve the same heart health benefits.
• Researchers suggest future exercise recommendations may need to become more personalized, with separate targets for minimum health benefits versus optimal cardiovascular protection.

Regular exercise plays a vital role in improving heart health by strengthening the heart muscle, helping it work more efficiently, and reducing the risk of heart conditions.

Cardiorespiratory fitness describes the ability of the heart, lungs, and blood vessels to supply oxygen to the muscles during exercise. It can serve as a powerful, independent biomarker for heart health. It is improved through aerobic activities, such as walking, running, cycling, and swimming, which can help improve blood circulation and lower blood pressure and cholesterol levels.

Current guidelines from the World Health Organization (WHO) recommend that adults complete at least 150 minutes of moderate-intensity exercise each week, or 75 minutes of vigorous exercise. Strength exercises are also recommended at least twice a week.

However, this one-size-fits-all approach to exercise may not provide sufficient activity levels for all people, with a new study suggesting that some may need roughly four times higher weekly exercise than the current guidelines to achieve significant protection against heart attacks and stroke.

The findings, published in the British Journal of Sports Medicine, also propose personalized targets, suggesting that a person’s fitness level may influence how much exercise they need to gain cardiovascular benefits.

Current exercise guidelines may only offer a ‘minimum’

The researchers analyzed health and activity data from more than 17,000 adults participating in the UK Biobank study. The average age of participants was 57 years, 56% were female, and 96% were white.

Individuals wore wrist-based activity trackers continuously for 7 days and completed exercise testing designed to estimate their VO2 max. This is a measure of cardiorespiratory fitness that reflects the maximum volume of oxygen the body can use during intense exercise.

The analysis also included data on smoking status, alcohol intake, self-rated health and diet, body mass index, resting heart rate, and blood pressure.

During nearly 8 years of follow-up, the researchers recorded more than 1,200 cardiovascular events, including atrial fibrillation, heart attacks, heart failure, and strokes.

Adults who met the current 150-minute recommendation saw an 8 to 9% reduction in cardiovascular risk, regardless of fitness level. However, researchers reported that substantially larger benefits appeared only at much higher exercise volumes.

Notably, adults who completed between 560 and 610 minutes of moderate-to-vigorous physical activity each week achieved substantial protection in cardiovascular risk, classed as a greater than 30% risk reduction.

However, the researchers add that only 12% of people in the study achieved this level of exercise.

Study author Ziheng Ning, PhD, Professor of Faculty of Health Sciences and Sports at Macao Polytechnic University emphasized to Medical News Today that these findings should not deter people from exercising.

“I think it is important that people interpret this finding carefully and not conclude that 150 minutes is ‘insufficient’ or ‘meaningless.’ The current WHO guideline remains extremely important because it is achievable, evidence-based, and clearly beneficial.”
— Ziheng Ning, PhD, study author

“What our study suggests is that 150 minutes per week may function more as a minimum effective threshold rather than the amount associated with maximal cardiovascular protection,” he said.

“To some extent, we were surprised that the estimated risk reduction at 150 minutes was relatively modest compared with the larger reductions observed at higher activity levels. However, modern lifestyles are also extremely sedentary. Many individuals spend most of the day sitting, so relatively short periods of exercise may not fully counterbalance prolonged inactivity physiology,” Ning explained.

“At the same time, cardiovascular adaptations are likely cumulative and nonlinear. Improvements in vascular function, autonomic regulation, metabolic health, and cardiorespiratory efficiency may continue developing with larger accumulated activity exposure over time,” he added.

Fitness levels appear to matter for heart health

The study also found that people with lower cardiorespiratory fitness may require roughly 30 to 50 additional minutes of weekly exercise to achieve the same level of protection as fitter individuals.

For example, participants with lower fitness required approximately 370 minutes of moderate-to-vigorous activity per week to lower cardiovascular risk by 20%, compared with around 340 minutes among those with higher fitness levels.

The researchers note that this may reflect a steeper challenge that people who are less physically conditioned may experience. This aligns with previous knowledge, as cardiorespiratory fitness is already known to be strongly linked with heart health, and lower fitness levels have consistently been associated with a higher risk of heart problems.

Researchers call for more personalized exercise advice

Based on their findings, the researchers suggest that exercise guidance may need to shift away from a one-size-fits-all approach. Instead, future recommendations could distinguish between the minimum amount of exercise necessary for basic cardiovascular protection and the higher levels required for optimal risk reduction.

However, the team highlights that the study was observational, meaning it cannot prove cause and effect. Additionally, the participant group was predominantly white and may have been healthier than the broader population, potentially limiting the generalizability of the findings.

Also, the study did not fully account for certain factors, such as sedentary behavior or lower-intensity physical activity.

“I believe that [personalized exercise recommendations based on fitness levels] may gradually become an important future direction,” Ning told MNT. “Traditional public health guidelines are designed to be simple, achievable, and broadly applicable across populations. That remains extremely valuable.”

“However, our findings suggest that individuals with different cardiorespiratory fitness levels may require different amounts of physical activity to achieve comparable cardiovascular protection. This raises the possibility that future exercise medicine could become more individualized, incorporating fitness status, baseline cardiovascular risk, age, metabolic health, and lifestyle factors,” he continued.

“One important message from our study is that exercise should probably not be viewed as a simple pass/fail threshold. Cardiovascular protection appears to exist along a continuum. Some movement is better than none, more movement may provide additional benefit, and fitness itself plays an important independent role.”
— Ziheng Ning, PhD, study author

“Our findings ultimately support a broader shift toward more personalized and precision-based approaches to exercise and preventive medicine. In other words, we may gradually move from one-size-fits-all recommendations toward fitness-informed personalized exercise prescriptions,” Ning added.

What this means for everyday health

While the suggestion of requiring 4 times the amount of recommended exercise may sound daunting, it should not discourage people who do not regularly meet current exercise goals.

Even modest increases in physical activity remain beneficial for heart health, and current guidelines are still considered an important baseline for reducing disease risk.

Instead, the study findings suggest that people seeking greater cardiovascular protection may benefit from gradually increasing activity levels over time. In particular, people can incorporate enjoyable activities that improve overall fitness, such as brisk walking, jogging, swimming, or cycling.

The findings also support future preventive heart care strategies implementing personalized exercise targets based on an individuals fitness levels rather than universal guidelines.

• In 2024, about 1.4 billion adults globally were living with high blood pressure. 
• Hypertension is currently treated through a combination of medications and healthy lifestyle factors.
• A new study has found that taking peppermint oil each day may also help with lowering high blood pressure. 

According to the World Health Organization (WHO), about 1.4 billion adults around the world were living with high blood pressure in 2024. 

Medically known as hypertension, this condition occurs when the heart has to use more force than normal to move blood through the arteries. Left untreated, high blood pressure can lead to several health issues, such as heart attack, stroke, heart failure, chronic kidney disease, vision loss, and dementia. 

High blood pressure is currently treated through a combination of medications and healthy lifestyle factors, such as eating a low sodium diet, being physically active, and maintaining a healthy weight.

Now, a study recently published in PLOS One Journal has found that taking peppermint oil each day may also help with lowering high blood pressure. 

Why peppermint oil?

For this study, researchers recruited 40 adults who had either elevated blood pressure, also sometimes referred to as “pre-hypertension,” and stage 1 hypertension.

According to the American Heart Association (AHA), elevated blood pressure occurs when a person’s systolic blood pressure is between 120–129 millimeters of mercury (mmHg) and diastolic blood pressure under 80 mmHg, while stage 1 is defined by a systolic blood pressure between 130-139 mmHg and diastolic pressure between 80-89 mmHg.

Study participants were randomly selected to receive either 100 microliters (μL) per day of either peppermint oil or a peppermint-flavored placebo.

“We were interested in peppermint oil because peppermint contains biologically active compounds, particularly menthol and flavonoids, that have plausible relevance to blood pressure regulation,” Jonathan Sinclair, DSc, PhD, course leader MSc sport and exercise sciences at the University of Lancashire in the United Kingdom, and lead author of this study, told Medical News Today.

“Previous research has suggested that peppermint may have antioxidant, anti-inflammatory, smooth muscle relaxant, and vasodilatory properties, all of which are potentially relevant to hypertension,” Sinclair added.

“Our group had also previously conducted a placebo-controlled trial in healthy individuals, where peppermint oil supplementation was associated with reductions in systolic blood pressure,” he continued.

“That provided a strong rationale to examine whether similar effects could be observed in a population where blood pressure reduction is more clinically relevant: individuals with pre-[hypertension, also commonly referred to as ‘elevated blood pressure’] and stage 1 hypertension,” Sinclair detailed.

Peppermint oil lowers systolic blood pressure, resting heart rate

After 20 days, researchers found the study participants taking peppermint oil lowered their systolic blood pressure by an average of 8.5 mmHg. 

“The reduction in systolic blood pressure was important because systolic blood pressure is a major predictor of cardiovascular risk, and even relatively modest reductions can be meaningful at a population level,” Sinclair explained.

“In our trial, after adjusting for baseline values, systolic blood pressure at 20 days was approximately 8.5 mmHg lower in the peppermint group compared with placebo, which is a sizable short-term effect. This finding suggests that peppermint oil supplementation may have the potential to support blood pressure reduction in people with pre- and stage one hypertension.”

– Jonathan Sinclair, DSc, PhD

Additionally, scientists discovered that study participants taking peppermint oil also experienced significantly lower resting heart rates after 20 days. 

“Resting heart rate is an important cardiovascular marker because a higher resting heart rate has been associated in epidemiological research with increased cardiovascular and all-cause mortality risk,” Sinclair said.

“In our study, resting heart rate was significantly lower in the peppermint group compared with placebo after the 20-day intervention, which suggests that peppermint oil may have influenced not only vascular tone but also cardiovascular regulation more broadly,” he noted.

How might peppermint oil lower blood pressure? 

If peppermint oil is able to help lower a person’s blood pressure, how does it work? 

Sinclair said the most plausible explanation relates to menthol, one of the main bioactive constituents of peppermint oil. 

“Menthol can activate TRPM8 channels, which are found in vascular and sensory tissues, and this activation may contribute to vasodilation through calcium-dependent endothelial signalling, nitric oxide-related pathways, and relaxation of vascular smooth muscle,” he explained. “In simple terms, peppermint oil may help blood vessels relax, which could reduce the pressure against which the heart has to pump.”

“However, our trial was not designed to directly measure these mechanisms, so while the biological rationale is strong, future studies should include measures such as endothelial function, nitric oxide metabolites, vascular stiffness, and autonomic markers to establish how peppermint oil may be exerting these effects,” Sinclair added.  

Best initial treatments for high blood pressure should be not be drugs

MNT had the opportunity to speak with Craig Basman, MD, FACC, FSCAI, associate director of the Structural and Congenital Heart Program at Hackensack University Medical Center in New Jersey, about this study, who commented his initial reaction was one of cautious optimism. 

“The findings that a simple, inexpensive, and widely available substance like peppermint oil could potentially lower blood pressure are certainly intriguing,” Basman, who was not involved in this research, said.

According to him: “It’s promising to see a study that is a randomized controlled trial, which is the gold standard for clinical research. However, it is a small study of only 40 patients, so while the results are encouraging, they are not definitive.” 

“The best initial treatment for high blood pressure should be non-pharmacological approaches. Medications are mostly safe and effective, but they come with cost, compliance issues, and side effects. Oftentimes we can avoid medications with lifestyle modifications such as diet and exercise, which are the cornerstones of blood pressure management. These nonmedicinal options can empower patients to take a more active role in their own health and can be more accessible and affordable for many people.” 

– Craig Basman, MD, FACC, FSCAI

For future research, Basman said the most important next step is to see this research replicated in a larger, more diverse population. 

“A study with more participants would provide more robust data and help to confirm these initial findings,” he detailed. “It would also be beneficial to see longer-term studies to understand if the effects of peppermint oil on blood pressure are sustained over time and to identify any potential long-term side effects.”

“Additionally, research into the mechanism of action — how exactly peppermint oil is working to lower blood pressure — would be valuable,” Basman added. “This could lead to a better understanding of its effects and potentially to the development of more targeted therapies in the future.”

• In a clinical trial, adults who switched from high-dose injectable obesity drugs to oral GLP-1 pill Foundayo were able to maintain most of their previous weight loss over 1 year, with relatively limited weight regain.
• In another trial, patients who reduced their Zepbound dose to a lower 5 mg maintenance dose also preserved much of their earlier weight reduction compared with those who stopped treatment entirely.
• Both trials suggest maintenance strategies, such as lower-dose injections or oral therapies, could offer patients more flexible, potentially more convenient options for sustaining weight loss after intensive treatment.

Incretins are gut hormones that help regulate appetite, blood sugar, and digestion. Medications that mimic these hormones include GLP-1–based treatments, such as Zepbound, Wegovy, and Foundayo, which can lead to significant weight loss.

However, weight regain after stopping these medications is common, with research showing that many people regain at least some weight after stopping therapy, especially without ongoing lifestyle support.

Long-term weight maintenance represents one of the biggest challenges in obesity treatment. Many people may require ongoing treatment to maintain results. Instead of stopping medication suddenly, some people may transition gradually to lower doses. Alternatively, others may consider switching to oral formulations to improve adherence and maintain weight loss.

Now, two new late-phase clinical trials, sponsored by Eli Lilly and Company, suggest that transitioning from high dose injectable weight loss medications to either a daily pill or a lower maintenance dose can help people living with obesity to keep off most of the weight they have already lost

The results of the ATTAIN-MAINTAIN and SURMOUNT-MAINTAIN trials were presented at the European Congress on Obesity and published in Nature Medicine and The Lancet, respectively, and highlighted in a Lilly press announcement.

ATTAIN-MAINTAIN trial with GLP-1 pill Foundayo

Previous research suggests that 1 year after stopping weight loss medication, people may regain, on average, 60% of their lost weight. This raises questions as to whether obesity medications may need to be used long term.

The trials explored possible maintenance strategies of either switching from injections to an oral pill or reducing the dosage of injectable medication to help preserve earlier weight reduction.

One placebo-controlled trial, called ATTAIN-MAINTAIN, followed adults who had previously completed the SURMOUNT-5 obesity trial, a randomized controlled study evaluating whether tirzepatide, the active ingredient in Zepbound, led to greater body weight reduction versus semaglutide in adults with obesity.

The trial involved participants who had previously reached a body weight plateau. Individuals either switched from high dose Wegovy or high dose Zepbound to daily oral Foundayo or a placebo.

Participants who had been taking high dose Wegovy and switched to daily oral Foundayo regained an average of 0.9 kilograms (kg), or about 2 pounds (lbs) over 1 year. Those who transitioned from high dose Zepbound to Foundayo regained about 5 kg (11 lbs) on average over the same period.

The researchers note that people previously treated with tirzepatide generally lost more total weight initially, which may partly explain the larger rebound.

“These findings are not surprising,” Mir Ali, MD, a bariatric surgeon, bariatric medicine specialist and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Medical News Today.

“We’ve already seen similar patterns with other GLP-1 medications, including oral semaglutide. One consistent theme across studies is that when patients stop these medications, weight regain is common. So it follows that continuing treatment helps preserve weight loss over time.” 
— Mir Ali, MD

SURMOUNT-MAINTAIN trial with lower dose Zepbound

In the other placebo-controlled trial, SURMOUNT-MAINTAIN, the researchers investigated the efficacy and safety of maximum tolerated dose (MTD) tirzepatide and a lower 5 milligram (mg) dose for maintaining body weight reduction in adults with obesity.

After an initial 60 weeks on Zepbound at the MTD, participants either continued on the MTD, reduced the dose to 5 mg, or received a placebo.

Participants continuing treatment with Zepbound MTD preserved all of their prior weight loss over the 1-year period, while those on the dose reduction maintained all but 5.6 kg on average.

“These results align closely with what many clinicians are already seeing in practice,” Ali said. “Patients can often maintain their weight loss with a lower dose after initial success, which can help balance effectiveness with tolerability.” 

According to Lilly, both trials met their primary and all key secondary endpoints. The pharmaceutical company highlights that both primary endpoints were to demonstrate that oral Foundayo or Zepbound continuation at either the reduced dose or MTD was superior to placebo in maintaining body weight reduction.

How this may affect long-term obesity management

The findings add to growing evidence that obesity behaves like a chronic disease rather than a short-term condition that can be permanently reversed after temporary treatment.

Adherence to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is important for their effectiveness. However, roughly half of the people using these drugs discontinue them within 1 year. Research indicates that stopping or interrupting obesity treatments, particularly weight-loss medications like GLP-1 drugs, frequently results in a rapid regain of lost weight.

The trial findings suggest that individuals may have greater flexibility in how they continue treatment after achieving substantial weight loss. Switching to an oral pill may appeal to those who dislike injections or want a simpler dosing routine, while a lower injectable dose may offer a cheaper option that may also result in less adverse events.

“This supports the idea that obesity should be treated as a chronic condition,” Ali explained to MNT. “Just like high blood pressure or diabetes, it often requires ongoing management. For many patients, transitioning to a maintenance dose after achieving weight loss may be a practical and sustainable long-term strategy.” 

Weight loss surgery vs. GLP-1 drugs

“Bariatric surgery remains the most effective option for long-term weight loss in appropriately selected patients. However, for those who choose medication-based treatment, it’s important to understand that these therapies are not short-term fixes—they typically require ongoing use to sustain results.”
— Mir Ali, MD

How long will weight loss results last?

Although the results appear promising, the studies primarily evaluated people who had already responded well to treatment and tolerated the medications.

For example, participants in the trials reported side effects that were generally consistent with previous studies, such as gastrointestinal symptoms, which are one of the main reasons that can lead to discontinuation of the drugs.

Additionally, longer-term data will also be necessary to determine how durable maintenance effects remain over multiple years. It will also be important to establish whether lower doses continue to protect against weight regain, and which patients benefit most from switching to oral therapies.

“Data like this could play an important role in shifting how obesity treatment is viewed—both clinically and by insurers,” Ali noted to MNT. “If long-term therapy is shown to be necessary to maintain health benefits, it may strengthen the case for broader insurance coverage and more consistent access to these medications.” 

“Overall, these studies reinforce the growing recognition of obesity as a long-term medical condition. Continued research showing the benefits of maintenance therapy may help reduce barriers to care, particularly when it comes to insurance coverage and long-term treatment planning.”
— Mir Ali, MD

• Research is ongoing regarding how migraine affects the risk for other health conditions. 
• One area of interest is how migraine affects the risk for ischemic stroke in middle-aged and older adults.
• One study found that in middle-aged and older adults, experiencing migraine with aura was linked to a higher risk for ischemic stroke. 

Experiencing migraine headaches can be challenging and painful. A subgroup of people who have migraine attacks experience migraine with aura, which involves experiencing distinct symptoms before or while the headache is occurring. 

One recent study published in Neurology Open Access, an official American Academy of Neurology journal, evaluated how migraine was linked to risk for ischemic stroke in older and middle-aged adults. Ischemic strokes happen when there’s an obstruction of blood supply to the brain, and most strokes are of this kind.

The researchers found that experiencing migraine aura was linked to a higher risk of ischemic stroke.

When considering age and sex, researchers found there was also a higher risk for ischemic stroke for men under 72 who experienced migraine episodes with or without aura.   

Migraine with aura and ischemic stroke risk

Previous research has suggested that migraine with aura may increase risk for ischemic stroke, but there has been less focus on middle-aged and older adults. 

This research included 11,381 participants who were part of the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a group that included adults who were at least 45 years old. Participants provided answers via a phone interview regarding migraine headaches and experiencing migraine with aura. 

The average age of participants was just over 72 years old, and just under 10% of participants experienced migraine attacks. The average follow-up time with participants was 6.4 years. 

Among participants with migraine, 3.9% experienced an ischemic stroke. This included 4.7% of migraine participants who experienced migraine with aura, and 3.3% of migraine participants who did not experience an aura. Among participants without migraine, 3.4% experienced an ischemic stroke. 

Overall, researchers did not find that migraine in general was significantly associated with risk for ischemic stroke. Breaking this down by subtype, migraine without aura was not associated with a higher risk for ischemic stroke. However, migraine with aura was associated with a higher risk of ischemic stroke. 

Exploratory analyses further found that men younger than 72 who had migraine episodes had the greatest risk for ischemic stroke. In contrast, women and older men did not appear to be at an increased risk for ischemic stroke. 

Finally, while it didn’t reach statistical significance, participants with migraine were more likely to experience an ischemic stroke that was because of small vessel disease. 

Overall, researchers suggest their findings indicate that middle-aged and older adults who experience migraine with aura have a 1.5 to 1.9 times higher risk for ischemic stroke. 

The study provides key insight into how migraine relates to stroke risk in older and middle-aged adults.

Walavan Sivakumar, MD, board-certified neurosurgeon, director of neurosurgery, and chief of staff at Providence Little Company of Mary in Torrance, CA, who was not involved in this research, offered Medical News Today his perspective on the study findings.

Sivakumar noted that:

“The REGARDS cohort is a robust, biracial national sample with rigorous stroke adjudication, lending credibility to the findings. The headline result — that migraine with aura confers a 73% increased hazard of ischemic stroke even after adjusting for traditional cardiovascular risk factors — is clinically meaningful. What I found most striking, however, was the unexpected subgroup finding: Men under 72 with migraine, regardless of aura status, had more than a 3.5-fold increased stroke risk, which was counterintuitive given prior literature emphasizing risk in younger women. That finding alone warrants serious follow-up.” 

Should everyone with migraine worry about stroke risk?

While these study results are insightful, they also have limitations. For example, there may be a risk for bias related to the exclusion of younger women with migraine who had already experienced a stroke.

Researchers encourage caution when it comes to the stroke subtype information in this study since they had limited data on this front. 

Some data, like migraine status, sex, and race, were based on participant reporting. Additionally, clinical care access may not have been equal for participants, and it’s possible that there was some migraine misclassification that occurred. Misclassification could have led to lower associations regarding migraine and ischemic stroke. 

Migraine with aura was also self-reported, based on participants reporting vision changes prior to migraine headaches.

Since blurry vision can also occur with migraine headaches, it’s possible that there was overclassification when it came to migraine with aura status. Based on how aura was evaluated, non-visual auras were also not evaluated. 

Researchers didn’t have data on when participants were diagnosed with migraine, which also could have impacted findings. Residual confounding is also possible because of unaccounted-for factors. 

Since the study population only included white and Black individuals, it’s unclear if the results would be similar in other groups. The research may also be limited by other components of the REGARDS study.

For example, researchers note that this study “oversampled Black adults and individuals living in the southeastern Stroke Belt area of the United States.” Finally, funding of the study and the related guidance could have influenced results. 

Reza Bavarsad Shahripour, MD, RPNI, FASN, FAHA, Assistant Professor in the UCSD Stroke Center, and Director of the Neurovascular Lab in Department of Neuroscience at UCSD, who was likewise not involved in this research, highlighted the following limitations of the data: 

“Migraine diagnosis and aura status were based on self-report rather than formal International Headache Society diagnostic criteria, and the study lacked detailed information regarding migraine onset, attack frequency, severity, and treatment history. Additionally, although the relative risk increase was significant, the absolute event rates remained relatively modest, with ischemic stroke occurring in 4.7% of participants with migraine with aura compared with 3.4% of those without migraine.”

‘Findings may encourage clinicians to incorporate migraine history’ in stroke prevention

This research suggests that it may be important to consider migraine with aura when it comes to risk factors for ischemic stroke, although there’s likely a need for more research. 

Shahripour noted that, “from a clinical standpoint, these findings may encourage clinicians to incorporate migraine history, especially aura symptoms, into broader vascular risk assessment and stroke prevention counseling.“

“Migraine with aura may represent more than simply a headache disorder and could potentially serve as an independent cerebrovascular risk marker,” he added.

Sivakumar also noted similar clinical implications, saying that: “This study reinforces that migraine with aura should not be treated as merely a headache disorder — it is a cerebrovascular risk marker that deserves a place in our clinical risk stratification conversations.“

“Neurologists and primary care physicians should be asking about aura status in patients who report migraines and documenting it,“ he added.

“If the male-under-72 subgroup finding is replicated, it could have real implications for how we counsel this demographic about stroke prevention, including aggressive management of modifiable risk factors like hypertension, dyslipidemia, and smoking. It may also prompt consideration of whether migraine history should be formally incorporated into cardiovascular risk scoring tools,” Sivakumar suggested.

• A new study suggests that quitting smoking may be associated with a lower risk of dementia and slower cognitive decline over time.
• The researchers found that the participants who quit smoking had a 16% lower risk of dementia compared with people who continued smoking.
• The cognitive benefits of quitting smoking were strongest among people who gained little or no weight after quitting.

Quitting smoking cigarettes can reduce the risk of many health conditions, including cancer, heart disease, and stroke. A new study suggests that smoking cessation may also support long-term brain health. 

The study followed more than 32,000 adults in the United States for up to 25 years to examine the connection between smoking habits, post-cessation weight changes, and cognitive health. 

The researchers found an association between smoking cessation and a lower risk of developing dementia. They also found that these people experienced slower rates of cognitive decline compared with people who continued smoking.

The study is published in Neurology.

Smoking and cognitive health: Data from a large study

Smoking rates in the U.S. have steadily declined over the past several decades as more research on the health issues it can contribute to, such as heart disease and lung cancer, has come out. According to the American Lung Association, smoking rates dropped below 10% in 2024.

Researchers are interested in how smoking can affect brain health. For example, a recent study suggests that smoking may contribute to cognitive decline through oxidative stress. 

A new long-term study adds to this by looking at the potential cognitive impacts of smoking cessation.

The researchers analyzed data from the Health and Retirement Study, a large-scale study of U.S. adults aged 50 and above. The analysis included 32,802 adults who did not have dementia at the beginning of the study.

The study followed the participants between 1995 and 2020, with a median follow-up period of nearly 10 years. During that time, they completed interviews every 2 years about their smoking habits, body weight, lifestyle behaviors, and medical history.

The researchers grouped participants into three categories: 

1. current smokers
2. former smokers
3. never-smokers. 

They considered participants who reported smoking during one interview but not the next to have quit smoking during the study period.

The scientists also tracked weight changes after quitting smoking, ranging from no weight gain to a gain exceeding about 22 pounds.

To measure cognitive health, the researchers used assessments that evaluated skills such as word recall, counting backward, and serial subtraction. 

Smoking cessation: Excessive weight gain negates benefits

By the end of the study, nearly 6,000 participants had developed dementia.

Compared with people who kept smoking, participants who quit smoking during the study had a 16% lower risk of dementia. 

People who quit smoking before the study began also had lower dementia risk, as did people who had never smoked.

The researchers found that the benefits of quitting appeared to increase over time. Dementia risk gradually declined the longer people remained smoke-free, approaching the level seen in never-smokers after about 7 years of smoking cessation.

“In our study, the benefits appeared stronger with longer time since quitting,” lead study author Hui Chen, PhD, Zhejiang University School of Medicine, told Medical News Today. “The practical message is: quit smoking, stay physically active, eat well, and manage cardiovascular and metabolic health.”

The study also examined how weight gain after quitting smoking affected these outcomes.

Participants who gained little or no weight after quitting appeared to experience the greatest cognitive benefits. 

People who gained up to about 11 pounds still showed a significantly lower dementia risk and slower cognitive decline compared with people who continued smoking.

The participants who gained more than 22 pounds after quitting smoking, however, did not appear to have any cognitive benefits. 

“Our study suggests that people who quit, overall, had lower dementia risk and slower cognitive decline than those who continued smoking, so quitting smoking should remain the priority,” Chen said. 

“Some weight gain after quitting is common and should not discourage cessation,” he continued. “However, preventing excessive weight gain may help preserve the long-term brain-health benefits of quitting.”

Chen noted that smoking likely affects the brain through multiple pathways, including vascular damage, inflammation, and oxidative stress. 

Smoking cessation must come with healthy habits

Dung Trinh, MD, an internist at MemorialCare Medical Group and chief medical officer of the Healthy Brain Clinic, told MNT that the findings reinforce the importance of smoking cessation for long-term brain health.

“What stands out most is that smoking cessation was associated with a reduction in dementia risk, but the benefit was not uniform,” Trinh, who was not involved in the current study, said. 

He noted that people who quit smoking and gained little or no weight appeared to preserve the cognitive benefit, while those with substantial weight gain did not show the same reduction in dementia risk.

“The practical takeaway is clear: quit smoking, stay quit, and pair cessation with healthy weight and metabolic management,” Trinh suggested.

Anoop Singh, MD, a board-certified psychiatrist from Mindpath Health, said the study offers a hopeful message about the potential brain-health benefits of quitting smoking.

“What stands out most is the hopeful message that quitting smoking may benefit not only the heart and lungs, but also long-term brain health,” Singh, who was likewise not involved in this research, told us. 

He noted that the study found lower dementia risk among people who quit smoking, especially with only modest weight gain after quitting.

Singh emphasized that concerns about weight gain should not discourage people from quitting smoking.

“Some weight gain can happen and should not be seen as failure,” he said. “The goal is to combine smoking cessation with steady habits: regular movement, good sleep, stress management, balanced meals, and appropriate medical or behavioral support.”

– Anoop Singh, MD

• Vitamin D is an important nutrient in the body, supporting bone, muscle, and immune system health. 
• Past studies also show that vitamin D may help protect the body from certain diseases, like cognitive impairment and dementia. 
• A new study has found that taking a high dose of vitamin D3 during pregnancy may help set up offspring for better cognitive health by age 10. 

Vitamin D is an important nutrient in the body as it plays a large role in bone and muscle health, as well as immune system support. 

Past studies also show that vitamin D may help alleviate symptoms of depression, and could help lower the risk of certain chronic conditions, such as type 2 diabetes, multiple sclerosis, rheumatoid arthritis, cardiovascular disease, cognitive impairment, and dementia. 

Now, a new study published in the journal JAMA Network Open has found that taking a high dose of vitamin D3 during pregnancy may help set the offspring up for better cognitive health by age 10. 

High vitamin D supplementation improves visual, verbal memory

There are two types of vitamin D — vitamin D3 and vitamin D2. For this study, researchers focused on vitamin D3, which is either synthesized in the human body through sunlight exposure, or absorbed from certain foods like fatty fish, cod liver oil, egg yolks, and foods fortified with vitamin D. 

Researchers conducted a second analysis of findings from the Copenhagen Prospective Studies on Asthma in Childhood 2010 randomized clinical trial, which took place 2009-2010, and included 700 mother-child pairs from Denmark.

During pregnancy, mother participants had taken either a high-dose of 2,800 International Units per day (IU/d) or standard-dose (400 IU/d) vitamin D3 supplement from week 24 to their first week postpartum. 

Scientists assessed the cognitive function of almost 500 children from the original study when they reached age 10 using part of the Copenhagen Prospective Study on Neuro-Psychiatric Development (COPSYCH), which tests 11 different cognitive functions, such as spatial working memory, motor speed, sustained attention, and reaction time.

At the study’s conclusion, researchers found a positive association between high-dose vitamin D3 supplementation during pregnancy to a child’s visual memory, verbal memory, and flexibility by age 10.

More evidence of the ‘superpowers’ of vitamin D

Medical News Today had the opportunity to speak with Sheryl Ross, MD, a board-certified ob-gyn and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, about this study.

Ross, who was not involved in the research, commented that seeing this new study makes her even more excited about the superpowers of vitamin D, which has always behaved more than just a typical vitamin.  

“Vitamin D has always gone above and beyond bone, muscle, and immune support as a vitamin,” Ross detailed. “Its collateral health benefits of potentially preventing chronic diseases, cognitive decline, dementia, and depression for people is exciting, especially if some of the cognitive benefits are being passed onto the baby.“

“More research on how vitamin D can help the cognitive health of the baby is needed,“ she cautioned, “but this initial study is an exciting beginning.” 

Ross explained that:

“Vitamin D receptors are all over the body including the memory center, called the hippocampus, in the brain. It also has a role in developing neurons, dopamine and serotonin production, anti-inflammatory protection, and defending against oxidative stress that can negatively affect brain function. Having adequate Vitamin D levels helps support memory, learning, and cognitive functioning. It makes sense that in the developing brain of a baby, having adequate vitamin D levels support overall cognitive functioning.” 

“This study was the perfect segway to make the connection between adequate maternal vitamin D levels and improved long-term cognitive functioning for developing babies,” she noted.

“More research could be done introducing a diversified patient cohort, longer-term follow-up beyond 10 years, monitoring vitamin D levels prior to pregnancy and using advanced brain imaging (MRI) on the developing baby to identify areas of the brain most responsive to vitamin D,” suggested the ob-gyn.

How best to increase vitamin D intake during: Expert advice

Monique Richard, MS, RDN, LDN, a registered dietitian nutritionist and owner of Nutrition-In-Sight, offered some expert tips on how best to increase vitamin D3 intake during pregnancy.

“Vitamin D continues to be one of the most common nutrient insufficiencies I see as an RDN,” Richard said.

“Food-first recommendations remain an important priority, but it can be difficult to obtain adequate vitamin D from food alone depending on the dietary pattern, access and body’s ability to absorb, convert and use,” she noted.

She listed out some of the best food sources for vitamin D, which include: 

• fatty fish like salmon, trout, tuna, and sardines
• egg yolks
• UV-irradiated mushrooms
• fortified foods such as dairy products, plant milks, cereals, and some orange juices.

“Many of these foods are also rich in fatty acids, vitamin C, choline, potassium, magnesium, and B vitamins that further support maternal and child health by supporting brain function, cell reproduction and development, immune system support, and more,” Richard explained.

“From a practical nutrition standpoint, consistency matters most — along with individualized testing and recommendations from a healthcare professional,“ she added.

“If supplements are suggested, the brand, source, quality of the product, form and delivery method as well as dose, frequency, duration and timing — […] when these are taken, with what and when during the day — are equally important to address and be done in collaboration with the RDN and healthcare team,” Richard advised.

“A balanced approach includes sensible sun exposure when appropriate, vitamin D-rich foods, fortified foods, and supplements, if, and as needed — with reassessment and big picture evaluation being followed — particularly for higher-risk groups or those with documented insufficiency,” she emphasized.

Casting some final reflections on the study findings, Meridan Zerner, MS, RDN, CSSD, LD, CHWC, founder of Meridan Zerner Nutrition in Dallas, TX, who was not involved in this research, told MNT that while these results seem encouraging, the data is nuanced, and the current guidance would likely not change based on one secondary analysis.

“There are several unmeasured contributors and the demographic base is not reflective of a wide population,” Zerner continued.

“The dose of [vitamin] D is higher than the American College of Obstetricians and Gynecologists (ACOG) recommendations of 600 IUs for prenatal care, and 400 IUs are often found in a prenatal vitamin assuming, some [vitamin] D will come from the diet as well,” she pointed out.

“Other guidelines would need to be carefully assessed [on a] person by person [basis] before recommending a much higher dose,” Zerner concluded.

• A new study suggests that females are more likely than males to experience several modifiable dementia risk factors, including depression, physical inactivity, and sleep problems.
• Additionally, certain risk factors, particularly hypertension, higher BMI, diabetes, and hearing loss, were linked to stronger negative effects on cognitive performance in females compared to males.
• The study suggests that dementia prevention strategies may be more effective when tailored by sex, focusing not only on how common a risk factor is, but also on how strongly it impacts cognition.
• The findings support targeted interventions, with approaches such as improving cardiovascular health, increasing physical activity, and treating depression potentially offering greater benefits for females.

Dementia is more prevalent in females than in males. In the United States, women account for nearly two-thirds of Alzheimer’s disease, the most common form of dementia. Previously, researchers suggested this discrepancy may be due to women living longer, with increasing age being the strongest known risk factor for dementia.

However, growing evidence suggests that sex differences may influence both the development and progression of dementia. Notably, hormonal changes, genetics, healthcare disparities, and social determinants of health could all contribute to the unequal burden of dementia among women. Additionally, women may respond differently to certain risk factors across their life span.

Now, a new study from researchers at the University of California, San Diego School of Medicine suggests that women may experience stronger cognitive effects from several modifiable dementia risk factors than men, even when those risks are less common overall.

Published in Biology of Sex Differences, the findings support tailored dementia prevention strategies that target the specific modifiable risk factors most applicable to each individual.

Some dementia risk factors may affect women more severely

In the study, the researchers analyzed health and cognitive data from more than 17,000 middle-aged and older adults in the U.S.

They examined 13 established modifiable dementia risk factors using data from the nationally representative Health and Retirement Study. These included depression, obesity, physical inactivity, smoking, hearing loss, diabetes, hypertension, sleep problems, alcohol use, cholesterol levels, poor vision, social isolation, and education level.

The analysis found notable differences in both the prevalence and impact of these factors between sexes.

Namely, females were more likely to report depression, physical inactivity, sleep problems, elevated cholesterol, smoking, poor vision, and lower educational attainment. Meanwhile, males were more likely to experience hearing loss, diabetes, and heavy alcohol use.

However, the most significant finding was that several risk factors appeared to be more strongly associated with poorer cognitive performance in females.

Conditions relating to cardiovascular and metabolic health, such as hypertension and higher body mass index (BMI), had stronger negative cognitive associations in women than in men. Additionally, although hearing loss and diabetes were more common in males, they were linked to worse cognitive outcomes in females.

These findings suggest that the higher dementia risk in females may reflect both greater exposure and stronger negative effects of these risk factors.

Which factors affect females more strongly?

Judy Pa, PhD, professor of neurosciences at UC San Diego School of Medicine and corresponding author of the study, spoke to Medical News Today about the possible sex-based differences that may cause these factors to affect female cognition more strongly:

“There are a few areas of research that link women and heightened Alzheimer’s disease risk. In addition to the additional stressors from caregiving (and sandwich generation of young children plus aging parents), strong evidence shows that the major genetic risk factor for late-onset Alzheimer’s disease is the APOE4 risk allele.”

“This is found in about 25% of the general population and elevates the risk of developing Alzheimer’s disease dementia in women more than in men. This may be due to the role of the APOE gene in lipid metabolism (heart health),” she continued.

“Another factor to consider for women is the major life event of menopause, which is largely a neurological [transition]. There are major biological shifts that occur with menopause, like changes in blood pressure, glucose metabolism, and inflammation. But we don’t understand how these systemic changes influence brain health.”
— Judy Pa, PhD

Pa also mentions they are part of a national scientific leadership team that is studying how menopause influences brain health through the Longitudinal Menopause Project (LMP). She adds that this study will serve as one of the flagship scientific programs examining the perimenopause period in women 35 to 59 years of age.

What the findings could mean for dementia prevention

The researchers suggest the results support a more personalized approach to dementia prevention, often referred to as precision medicine.

Rather than applying the same prevention priorities to everyone, future strategies could move beyond identifying the most widespread risks and instead focus on the risk factors that appear most harmful within specific groups.

“We are pursuing different approaches to personalized dementia prevention, including a current large NIH clinical trial grant under review,” Pa told MNT.

“The key is personalized, precision prevention. What is the best treatment and for whom? This includes both sex/gender and genetic risk as there is emerging evidence that dementia prevention approaches could differ depending on APOE4 status,” she said.

“While this newly published study is not causal in nature as it comes from longitudinal observation data in the U.S., we are examining each of the factors individually based on one’s risk profile to better understand causality in a randomized clinical trial, and one factor of many is sex/gender.”
— Judy Pa, PhD

Based on these findings, for females this may include a greater emphasis on treating depression, increasing physical activity, managing blood pressure, improving cardiovascular health, and addressing obesity and metabolic conditions.

As these risk factors are modifiable, they offer practical opportunities to reduce dementia risk before cognitive symptoms appear.

However, the study authors add that additional long-term research is still necessary to better understand why these sex-based differences emerge and how they evolve over time.

Identifying 14 risk factors to help prevent dementia

“We are deeply committed to tailored, personalized, precision prevention approaches for dementia,” Pa emphasized to MNT.

“We believe a one size fits all approach will not work for everyone. And that we are likely to have greater benefit and impact if approaches are tailored to a specific risk factor profile, including sex/gender, APOE4, and current risks like untreated high blood pressure, inactive lifestyle, poor sleep, and early cognitive complaints, among others.”
— Judy Pa, PhD

“With successful NIH funding, we will launch a precision prevention approach in a large, randomized controlled trial of approximately 1,000 older adults in the U.S., to move the needle closer and closer to tailored prevention strategies for our communities,” Pa announced.

Although more research is required to develop more targeted interventions for disproportionately affected groups, such as females, previous research has highlighted various risk factors for the general public.

Namely, evidence suggests that nearly half of all dementia cases worldwide can be prevented or delayed by addressing 14 modifiable risk factors across a person’s lifespan. These include:

• less education
• hearing loss
• high LDL cholesterol levels
• depression
• traumatic brain injury
• physical inactivity
• diabetes
• smoking
• hypertension
• obesity
• excessive alcohol
• social isolation
• air pollution
• visual loss

As such, while the magnitude of certain risk factors will vary among individuals, it is generally advisable to address preexisting health issues, adopt a healthier dietary plan, increase physical activity, and maintain cognitive stimulation to help prevent dementia.

• Cardiovascular disease is a major risk factor for cognitive decline and dementia.
• Research has linked heart attacks with an increased risk of cognitive decline.
• Now, a study suggests that even undiagnosed heart attacks, or silent myocardial infarctions, can speed cognitive decline.
• The researchers recommend that routine electrocardiograms to detect silent MIs, together with self-reported history, might help identify individuals at higher risk of long-term cognitive impairment. 

Cardiovascular disease is a group of disorders of the heart and blood vessels, thought to affect around 650 million people worldwide. A common result of cardiovascular disease is myocardial infarction, better known as a heart attack.

In the United States, the Centers for Disease Control and Prevention (CDC) report that about 805,000 people have a heart attack each year, of which one in five are “silent,” or undiagnosed at the time.

Now, a study has suggested that any type of heart attack, even a silent one, increases a person’s risk of cognitive decline over time.

Speaking to Medical News Today, 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, explained that:

“It is not entirely understood why a history of myocardial infarction is associated with faster cognitive decline. It may be that people who have heart attacks are also more likely to develop blockages in blood vessels in the brain, leading to brain ischemia and even brain infarcts that accelerate brain deficits.”

The research, which is published in Stroke, suggests that electrocardiograms (ECG), and self-reported history, could be a low-cost way to identify people at higher risk of cognitive decline.

Cardiovascular disease linked to cognitive decline

Research has suggested that there is a link between cardiovascular disease and cognitive decline, and that the link is two-way.

Coronary heart disease, heart failure, higher blood pressure variability, sudden blood pressure drops, and atrial fibrillation are all thought to increase the likelihood of cognitive impairment. But cognitive impairment also increases the risk of cardiovascular events, such as strokes and heart attacks.

This new research looked at data from more than 20,000 Black and white Americans aged 45 and over enrolled in the REGARDS (REasons for Geographic And Racial Differences in Stroke) study, a longitudinal cohort study investigating elevated stroke mortality in the south eastern United States. 

This region, known as the Stroke Belt, has had a higher stroke mortality rate than the rest of the U.S. since the 1940s, for reasons which may include a larger proportion of Black people and residents with higher prevalence of traditional stroke risk factors, higher prevalence of inflammation and infection, and lower socioeconomic status.

For their analysis, researchers included participants who had baseline interview data about their medical history, had undergone height, weight, blood pressure, ECG, medication inventory, fasting blood sample, and urine collection at baseline and follow up and had interpretable ECG data.

At their interview, participants were asked whether they had ever had a heart attack diagnosed by a physician. They then underwent ECG screening, which detects signs of a previous heart attack.

The researchers recorded silent heart attacks for those people who had ECG evidence of a previous heart attack, but had never been diagnosed with one. Those who had no ECG evidence of heart attack, but had been diagnosed with one were recorded as “self-reported myocardial infarction.”

In total, 2,183 (10.4%) of participants had any heart attack, of which 1,098 were self-reported (5.2%), 281 clinical (1.3%), and 804 silent heart attacks (3.8%).

During the follow-up period of between 10 and 14 years, the researchers also carried out annual cognitive assessments with all participants, to assess whether they had any cognitive impairment over time.

Any heart attack linked to faster cognitive decline

The researchers found that any heart attack, whether silent, self-diagnosed, or with evidence from ECG and diagnosis, was linked to higher likelihood of cognitive impairment, with an even stronger link to severe cognitive impairment over time.

White, Black and male participants all showed similar declines in cognitive scores for all MI types. For females, only self-reported and silent heart attacks were associated with faster cognitive decline, but the researchers noted that silent MI was more common in females. They suggest that this may be due to under diagnosis of MI in females.

The researchers noted that individuals with silent heart attacks have more small vessel disease, and less large vessel atherosclerosis that those with recognised heart attacks, as well as greater risk of ischemic stroke.

They suggest that subclinical cerebral infarcts — small strokes that cause no symptoms and often precede symptomatic strokes — in these people could contribute to cognitive deterioration. 

Could routine ECG help detect those at most risk?

ECG, which Chen — who was not involved in the recent research — confirmed was “a useful screening tool for patients we think are at higher risk of heart disease”, detects undiagnosed heart attacks by recording irregular heart patterns.

In people who have had a heart attack, the Q-wave — the small wave before the main contraction of the ventricles that results in a large R-wave on the ECG readout — is deeper or wider than on an ECG from someone who has not had a previous heart attack.

The researchers conclude that: “evidence of a prior [myocardial infarction] was associated with an accelerated rate of cognitive decline in a large national, biracial population,” and  “[u]sing ECG and self-reported history may provide a pragmatic, low-cost strategy to identify individuals at elevated risk for cognitive decline.”

Keep heart and blood vessels healthy to reduce cognitive decline risk

Studies show that common cardiovascular diseases interact with cognition, particularly in the elderly, and that they may increase the risk of dementia. Keeping your heart and blood vessels healthy could, therefore, help reduce your likelihood of cognitive decline.

Chen advised:

“To keep the blood vessels in the heart and brain healthy, we recommend that people get regular physical activity, eat a diet low in saturated fat and sodium, avoid tobacco and alcohol, keep their blood pressure, blood sugar, and cholesterol numbers under control, maintain a healthy weight, and get enough quality sleep.”

• A new study highlights that people with a biological age older than their chronological age have a higher risk of developing dementia and may develop the disease earlier in life.
• The findings suggest that individuals with both accelerated biological aging and genetic risk factors could be up to 10 times more likely to develop dementia.
• Using a blood-based ‘metabolomic aging clock’ could help identify those at risk before symptoms appear, and support earlier prevention strategies and improved recruitment for dementia clinical trials.

Biological age is a measure of how fast a person’s cells are aging, independent of their actual calendar, or chronological age. It estimates a person’s age by measuring biomarkers and can represent an individual’s overall health state.

While chronological age can only move forward, biological age can be younger or older than calendar age, depending on health and lifestyle factors.

Growing research suggests that a higher biological age, known as biological age acceleration, could serve as a reliable predictor of disease onset.

Now, new research led by scientists at King’s College London, in the United Kingdom, suggests a blood-based measure of biological age could help identify people at greater risk of developing dementia before clinical symptoms emerge.

The study, funded by the National Institute for Health and Care Research Maudsley Biomedical Research Centre, was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

Notably, the findings suggest that people whose biological age exceeded their chronological age were significantly more likely to develop dementia, particularly vascular dementia, and tended to develop the condition at a younger age.

Biological aging clock and dementia risk

Biological aging clocks describe tools that analyze molecular data to estimate a person’s biological age. In this study, researchers used a metabolomic aging clock to analyze metabolites, or small molecules produced during metabolism, which are detectable in blood plasma.

Changes in these metabolites have previously been linked to age-related illnesses and premature mortality.

Using blood samples from more than 220,000 participants in the UK Biobank database, the research team calculated each individual’s biological age and compared it with their chronological age.

The resulting difference, called “MileAge delta,” indicated whether a person was aging faster or slower than expected.

Over the course of the study, nearly 4,000 participants developed dementia. The analysis suggests that those with a biological age exceeding their chronological age by more than one standard deviation, which accounted for roughly 16% of participants, had a 20% greater risk of developing dementia over time compared with people whose biological age was younger.

Notably, the risk was even more pronounced for vascular dementia, where accelerated biological aging was associated with a 60% higher likelihood of developing the disease.

Lead author Julian Mutz, PhD, King’s Prize Research Fellow at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, told Medical News Today he was not surprised by the strong link to vascular dementia.

“This partly reflects the type of data used to develop the metabolomic MileAge clock. The metabolites measured by the Nightingale Health metabolomics platform are predominantly lipids and lipoproteins, which are molecules closely linked to cardiovascular and metabolic health,” said Mutz.

“It is therefore not surprising that the clock is especially sensitive to vascular risk and by extension to vascular dementia,” he added.

Biological aging and genetic risk

While aging is the strongest known risk factor for dementia, certain genetic variants can also increase risk. Namely, research highlights that individuals carrying two copies of the APOE4 variant are at the highest genetic risk for developing dementia.

The researchers discovered that combining biological aging data with genetic risk factors substantially improved dementia risk predictions.

Namely, individuals with advanced biological aging, who also carry two APOE4 gene variants, were up to 10 times more likely to develop dementia than the average participant in the study.

“The tenfold figure is striking but it is worth unpacking what is driving it,” Mutz explained to MNT. “APOE4 substantially raises risk and indeed is the strongest genetic risk factor for dementia. What our metabolomic clock adds is an additional non-genetic risk factor.”

“So while a tenfold increase is a very large, it reflects the combination of a powerful genetic risk factor with an indicator of biological aging. The important point is that these two sources of risk are complementary. And unlike genetic risk, metabolomic aging is potentially modifiable through lifestyle or clinical intervention.”

– Julian Mutz, PhD

The team also note that these two factors appear to act independently, suggesting distinct genetic and biological aging pathways linked to dementia.

Dementia risk may not be inevitable

While advancing age and genetic variants are known risk factor for dementia, the researchers emphasize that it is not an unavoidable condition.

Previous estimates suggest that approximately 45% of global dementia cases could be delayed or prevented through addressing modifiable risk factors, such as cardiovascular health, smoking, diet, exercise, and social isolation.

The researchers note that their findings could contribute to earlier diagnosis and intervention. Combining genetic and biological aging information could enable preventative strategies to help delay or even stop dementia in its tracks.

Potential future role in screening

Based on their findings, the research team believe that blood plasma-based aging clocks could eventually become a practical tool for identifying higher-risk individuals in midlife, due to being minimally invasive and relatively scalable.

Additionally, the technology could also help to improve recruitment for clinical trials focused on dementia prevention or disease-modifying therapies.

“There are two ways this could help,” Mutz told MNT. “First, biological aging markers like MileAge could serve as outcome measures in trials.”

“Dementia takes many years to develop, which makes it difficult and expensive to use dementia incidence as a trial endpoint. A blood-based aging marker that can be measured at any time point could offer a practical way to assess whether an intervention likely impacts aging and, by extension, disease risk,” he added.

“Second,” Mutz detailed, “these markers could help identify and recruit individuals with older than expected biological age into trials, enriching the study population with people more likely to benefit from intervention.”

However, while the results are promising, the researchers caution that more research is still necessary before metabolomic aging clocks are introduced into routine clinical care. While the study highlighted an association between biological aging and dementia risk, it does not prove that accelerated biological aging directly causes dementia.

• A meta-analysis of 32 phase 3 clinical trials, involving more than 43,000 adults with overweight or obesity, found that newer anti-obesity medications were associated with significant reductions in blood pressure.
• Participants taking the medications lost an average of 10.9% of their body weight and experienced an average 5.2 mmHg reduction in systolic blood pressure compared with placebo.
• Results suggest that every 1% reduction in body weight was linked to a 0.34 mmHg drop in systolic blood pressure, with weight loss explaining roughly 77% of the blood pressure-lowering effect.
• The findings suggest that modern obesity drugs, such as GLP-1 drugs, may provide cardiovascular benefits beyond weight loss alone, although further studies are necessary.

Obesity is a chronic condition that affects more than two in five adults in the United States. The main treatment for obesity is sustained weight loss, which typically involves lifestyle modifications, and may also include certain medications.

Anti-obesity medications are drugs that can aid in weight loss, primarily by curbing appetite, increasing feelings of fullness, or altering fat absorption.

There is a growing demand for weight-loss drugs, and guidelines highlight the role of certain medications, such as glucagon-like peptide-1 (GLP-1) receptor agonists, in treating obesity.

Modern obesity medications may offer an additional cardiovascular benefits beyond weight loss, such as helping to manage high blood pressure, or hypertension.

Obesity and hypertension frequently occur together and significantly increase the risk of cardiovascular disease, stroke, kidney disease, and premature death. Current medical guidelines already recommend weight management as a key strategy for controlling hypertension.

Now, a study presented at the European Congress on Obesity 2026 by researchers from Leiden University Medical Center and University Health Network, in The Netherlands, suggests modern obesity medications may have a larger role in cardiovascular risk reduction than previously appreciated.

Findings from the large meta-analysis — which are yet to appear in a peer-reviewed journal — indicate that greater weight loss achieved with newer anti-obesity medications was closely associated with reductions in systolic blood pressure.

How much did blood pressure change?

Researchers analyzed data from 32 phase 3 clinical trials involving 43,618 adults with overweight or obesity. Participants had an average age of 54 years, and average body mass index (BMI) of 35.5, with nearly 60% living with hypertension and almost 10% living with type 2 diabetes.

There was an even split of male and female participants, the median treatment duration was 66 weeks, and the baseline systolic blood pressure was 128 millimeters of mercury (mm Hg).

Systolic blood pressure refers to the top number in a blood pressure reading and measures the pressure against the artery walls when the heart is pumping blood around the body.

The American Heart Association (AHA) recommends a target systolic blood pressure below 120 mm Hg, with most guidelines defining hypertension as consistent systolic readings of 130 mm Hg or higher.

Across all studies, participants taking obesity medications lost an average of 10.9% of their body weight compared with placebo. This was accompanied by an average reduction of 5.2 mmHg in systolic blood pressure.

Notably, the analysis found that every 1% reduction in body weight was associated with a 0.34 mmHg decrease in systolic blood pressure.

Mir Ali, MD, bariatric surgeon, bariatric medicine specialist and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, told Medical News Today he was not surprised by the association.

“These results are not surprising to me; as a bariatric surgeon, I have seen the improvement in hypertension (as well as diabetes and many other conditions) in our post-surgical weight loss patients,” said Ali. 

“Any improvement in blood pressure can help reduce morbidity associated with hypertension; furthermore, many patients can have their blood pressure medications reduced with even modest improvements in blood pressure,” he noted.

“These findings again reinforce how obesity contributes to many health conditions including hypertension. Reducing obesity can have a significant impact on improving hypertension as well as many other health conditions.”

– Mir Ali, MD

Blood pressure reductions and weight loss

This relationship between weight loss and blood pressure remained consistent after adjusting for study duration, baseline BMI, sex distribution, and diabetes status.

Additionally, the researchers suggest that around 77% of the variation in blood pressure lowering could be explained by the amount of weight lost.

“Our findings suggest that the blood pressure reductions observed with modern obesity pharmacotherapies are closely linked to the magnitude of weight loss achieved,” lead study author, Marcel Muskiet, MD, told MNT.

“Across more than 43,000 participants from phase 3 clinical trials, greater weight reduction was consistently associated with larger decreases in systolic blood pressure. Clinically, this reinforces the concept that treating obesity is not only about weight reduction itself, but also about improving cardiovascular risk factors such as hypertension,” Muskiet noted.

“Importantly, in several of the included trials, background antihypertensive medications were reduced or discontinued more frequently in participants receiving active treatment,” he added.

“This likely attenuated the observed between-group differences in blood pressure, meaning that the true intrinsic blood pressure-lowering potential of these therapies may actually be underestimated in current clinical trial data,” the study author pointed out.

“The magnitude of blood pressure lowering observed with some of these therapies approached that seen with standard antihypertensive medications, highlighting the growing role of weight-centric therapies within cardiovascular risk management for people living with overweight or obesity.”

– Marcel Muskiet, MD

However, the analysis also found that some blood pressure benefits may occur independently of weight loss.

Some evidence suggests these drugs could also directly affect blood vessels, kidney function, and stress signaling pathways in the body, potentially contributing to lower blood pressure independently of weight reduction.

“Although most of the blood pressure reduction appeared attributable to weight loss, our analyses also suggest that additional weight-independent mechanisms may contribute,” Muskiet said.

“GLP-1 receptor agonists and related multi-hormone therapies may influence blood pressure through several biological pathways, including promoting natriuresis (sodium excretion by the kidney), improving endothelial and vascular function, reducing arterial stiffness, and modulating sympathetic nervous system activity,” he explained.

“In addition, some emerging multi-hormone receptor modulators may interact with hormonal systems involved in blood pressure regulation, including the renin-angiotensin-aldosterone system,” Muskiet detailed.

“However,” he noted, “the precise contribution of these mechanisms remains uncertain and will require dedicated mechanistic and individual patient-level studies.”

Which drugs were studied?

The analysis focused on anti-obesity drugs, a growing class of medications designed to improve weight loss and metabolic health by influencing hormones involved in appetite regulation, blood sugar control, and energy balance.

This included glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as Ozempic and Wegovy, and newer multi-hormone receptor modulators (MHRMs). This describes drugs that target multiple metabolic pathways, including GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), such as Zepbound and Mounjaro.

“Overall, therapies associated with the greatest weight loss generally produced the largest blood pressure reductions,” Muskiet highlighted.

“In our analysis, tirzepatide showed among the largest reductions in systolic blood pressure, alongside substantial weight loss. Some of the newer multi-hormone receptor modulators also demonstrated pronounced effects, although data remain more limited for several emerging agents,” he added.

“That said, importantly, we would caution against overinterpreting differences between individual agents, as the included trials differed in populations, background therapies, and study design. The overarching pattern was that greater weight loss tended to translate into greater blood pressure reduction across pharmacological classes,” said the study author.

More studies underway

The study authors add that several ongoing trials are investigating whether anti-obesity medications may directly improve cardiovascular and kidney function beyond their effects on body weight.

These include large hypertension-focused clinical trials, as well as studies examining how the drugs affect blood vessels, heart function, and kidney physiology.

They also caution that their study had limitations. The analysis relied on trial-level data rather than individual patient records. This makes it difficult to determine cause and effect. Additionally, blood pressure was not the primary outcome in many of the included studies, so differences in study design may have influenced results.

Still, the consistency of the findings across multiple trials strengthens the overall conclusion that substantial weight loss achieved with newer obesity drugs is linked to clinically meaningful improvements in blood pressure.

• Cardiovascular disease is the leading cause of death for women globally.
• A woman’s heart disease risk increases after menopause.
• A new study found that, during perimenopause, women are twice as likely to have a low cardiovascular health score, especially when it comes to diet. 
• Researchers believe this offers women a ‘window of opportunity’ during perimenopause to make lifestyle changes that may help lower their heart disease risk in the future.

According to the World Heart Federation, cardiovascular disease is the leading cause of death for women around the globe, accounting for about 30% of all deaths. 

While a woman can develop heart disease at any age, past studies show that a woman’s risk for cardiovascular issues increases after menopause, which is generally around the age of 52. 

“Heart disease is still the leading killer of women, and yet for decades, the research, the clinical trials, the risk calculators were built almost entirely on men,” Garima Arora, MD, Professor of Medicine in the Division of Cardiovascular Disease at the University of Alabama at Birmingham, told Medical News Today.

“We’ve definitely made progress, but we’re still playing catch-up. Women’s cardiovascular risk doesn’t follow the same trajectory as men’s. It’s tied up with reproductive hormones, with pregnancy history, with life stages that men simply don’t go through,” Arora added.

She is the senior author of a new study published in the Journal of the American Heart Association, which found that during perimenopause — the time when a woman’s body starts the menopause transition — women are twice as likely to have a low cardiovascular health score based on the American Heart Association’s (AHA) Life’s Essential 8, especially when it comes to diet. 

Researchers believe this gives women a “window of opportunity” during perimenopause to make lifestyle changes that may help lower their heart disease risk in the future.

Focusing on menopause stages and heart disease risk

For this study, researchers analyzed health data from more than 9,200 women between the ages of 18 and 80 years, who had participated in the National Health and Nutrition Examination Survey between 2007 and 2020.

Based on question responses, study participants were categorized as either premenopausal with an average age of 34, perimenopausal with an average age of 50.5, or postmenopausal with an average age of 60.

Arora said that she and her team decided to examine how different menopause stages might impact a woman’s heart disease risk partly because she kept seeing the disconnect between what the literature keeps telling us and what women are actually experiencing. 

“Patients come in during perimenopause feeling like their bodies have shifted: being unable to lose weight, feeling like their energy is gone, not being able to sleep well, and cardiovascular risk isn’t really part of the conversation yet,” she explained.

“The consensus has always been to just revisit this in a few years,“ she told us. “But what if those few years are exactly when it matters most? That question drove a lot of this work.”

Perimenopausal women twice as likely to have low heart health scores

During the study, researchers examined how well study participants continued to adhere to the AHA’s Life’s Essential 8 — eight key measures to help improve and preserve cardiovascular health, such as eating a healthy diet, quitting smoking, maintaining a healthy weight, and being physically active.

Scientists discovered that perimenopausal women were twice as likely to have an overall low Life’s Essential 8 score when compared to premenopausal women, especially when it came to diet. 

“To me, the significance [of this finding] is really about timing,” Arora said. “If we’ve been directing our attention and our resources only toward postmenopausal women when it comes to cardiovascular prevention, and it turns out the highest relative risk is earlier, during perimenopause, then we’ve been showing up late.“

According to her, “having twice the odds of poor cardiovascular health compared to premenopausal women after accounting for age is a clinically meaningful signal that tells us we should be starting these conversations sooner.” 

“Perimenopause is not a waiting room for postmenopause: It’s a high-stakes window for cardiovascular health in its own right, and we need to start treating it that way. The time to pay attention to a woman’s heart health is during the transition, not after it.”

– Garima Arora, MD

Perimenopause is ‘critical window’ for heart risk modifications

MNT had the opportunity to speak with Jennifer Wong, MD, a board-certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, about this study and why perimenopausal women may be twice as likely to have a low cardiovascular health score compared to women with regular menstrual cycles.

“During perimenopause, women commonly experience adverse metabolic changes, including worsening lipid profiles, increased insulin resistance, and greater accumulation of visceral adiposity,” Wong, who was not involved in this research, detailed.

“These physiologic shifts contribute to an elevated cardiovascular risk profile and may partially explain the higher prevalence of low cardiovascular health scores in this population,” she told us..

“Estrogen plays a significant role in cardiovascular physiology,” Wong further explained. “During the early menopausal transition, estrogen is associated with more favorable lipid profiles, improved insulin sensitivity, and enhanced endothelial function, contributing to vascular flexibility. Declining estrogen levels during menopause may therefore contribute to increased cardiovascular risk.” 

Middle age, particularly during the perimenopausal transition, Wong said, represents a critical window for cardiovascular risk modification.

“Perimenopause should be recognized as a pivotal period for cardiovascular risk assessment and preventive care,” she noted. “Adoption of heart-healthy behaviors during this stage can significantly improve long-term cardiovascular outcomes and overall health.”

“Suboptimal cardiovascular health during midlife is associated with progressive atherosclerotic plaque development, which increases the risk of myocardial infarction [heart attacks], cerebrovascular events [like stroke], chronic kidney disease, and cognitive decline,” Wong added. “Early intervention is essential to mitigate these long-term adverse outcomes.”

How can perimenopausal women improve their diet for heart health?

As diet consistently received the lowest Life’s Essential 8 scores among perimenopausal women, and continued to decline through further menopause stages, Monique Richard, MS, RDN, LDN, a registered dietitian nutritionist and owner of Nutrition-In-Sight, shared her top tips on how to improve diet scores when transitioning to perimenopause, menopause, and postmenopause. 

“The fluctuations and decrease in estrogen, bone density, muscle composition, thyroid function, as well as changes in insulin sensitivity can affect multiple systems at once and so we want to support the whole-body and address specific needs identified,” Richard said.

“One of the most important things I tell women is that it is not the time to ‘eat less,’ but to eat more strategically. As with all stages of life, if we want to flourish, we must nourish,” she emphasized.

Richard encouraged women to think about building a plate that nourishes hormones, muscles, bones, brain, and the microbiome all at once, and made the following recommendations for prioritizing nutritional needs during perimenopause and menopause:

• adequate hydration and electrolytes
• calcium– and vitamin D-rich foods for bone health
• colorful fruits and vegetables rich in polyphenols and antioxidants
• fermented foods with probiotics such as yogurt, kefir, kimchi, or miso
• flaxseed for lignans and cardiovascular support
• omega-3-rich foods like salmon, walnuts, chia, and flax
• prebiotic fibers obtained from foods such as beans, oats, onions, garlic, asparagus
• protein at consistent intervals to support muscle mass and metabolic health
• soy foods for naturally occurring protecting isoflavones.

“We’re really working to lift the ‘taboo’ related to perimenopause and menopause, and redirect understanding and care,” Richard said.

“It is not simply an ‘estrogen issue,’ or ‘woman’s problem,’ to deal with alone. It’s a whole-body transition that benefits from a whole-person approach, in addition to empathy, humanity, and updated tools that offer support and care. The right nutritional plan will help be foundational to any additional complementary interventions necessary. Midlife is not the beginning of decline but a ‘rebirth’ and ‘refresh’ for a vibrant next several decades of health.”

– Monique Richard, MS, RDN, LDN

• When snacking, the quality and quantity of foods consumed may impact health.
• A recent study has found that the timing of snacking, particularly when late at night, can affect digestive health and the gut microbiome.
• This research, presented at Digestive Disease Week, also uncovers the relationship between late-night eating and chronic stress.

Is it the late hour, or the lifestyle and stress that push us toward it that makes snacking at night so unhealthy? Turns out, it may be a combination of both, which can affect not only our weight but also our gut health, including our microbiome.

Research presented at Digestive Disease Week (DDW) 2026 suggested that snacking takes a “double” toll on the digestive system, driven by the combination of chronic stress and late-night eating. This demonstrated how the body’s internal clock and stress levels work together to affect gut health.

Led by Harika Dadigiri, MD, resident physician at New York Medical College at Saint Mary’s and Saint Clare’s Hospital, New Jersey, the study suggests that when people eat may be just as important as what they eat.

The findings are yet to be published in a peer-reviewed journal.

What the study found

Using two major datasets, the National Health and Nutrition Examination Survey (NHANES) and the American Gut Project, the research team led by Dadigiri identified a “chrononutrition-stress axis” that measures how stress levels affect our eating patterns and timing.

In the NHANES cohort, people who had levels of high stress and were late-night eaters were 39.3% more likely to experience abnormal bowel habits such as constipation or diarrhea, compared to 23.2% in people with low stress levels and ate at typical eating times.

Individuals with high levels of stress who were late-night snackers, which the researchers defined as having consumed more than 25% of their daily calorie intake after 9 p.m., were also 1.7 to 2.5 times more likely to experience bowel issues.

Having high levels of physiological stress (called allostatic load) independently increased the risk of abnormal bowel habits. Coupled with late-night eating, this created an even larger negative effect.

These results indicate that meal timing can change how stress affects the communication between the brain and the gut.

What if I’m having healthy snacks at night?

The results of the study suggest that even when people aren’t necessarily consuming “junk” or processed food, eating late at night can disrupt digestive processes and the body’s natural internal clock, or its 24-hour circadian rhythm.

Past research has shown that a disrupted circadian rhythm is linked to chronic conditions such as dementia, cardiovascular disease, and cancer.

“This is an observational study, so it discounts anything to change the guidelines, but it [strengthens] the ongoing research about the chrononutrition axis and time-restricted eating,” Dadigiri said.

The disruptive effects of stress on gut bacteria

According to the study, late-night snackers who had high levels of stress also showed disrupted gut microbial diversity, which was significantly reduced. Measuring microbial diversity using the Shannon Index, the researchers said this indicated that this group of people were in a state of gut dysbiosis.

This provides evidence that lifestyle habits can disrupt the gut-brain axis.

Michelle Routhenstein, MS, RD, CDCES, CDN, preventive cardiology dietitian at EntirelyNourished.com, said that while the results were not surprising, she found it intriguing “how the combination of high stress and late-night eating amplified the effects on gut health.”

“High stress alone raised the odds of abnormal bowel habits by about 32%, but when it was paired with late-night eating, the risk jumped to a 1.7 to 2.5 fold increase, reinforcing the importance of aligning to one’s circadian alignment and acknowledging the gut-brain axis,” she said.

Why the results may be controversial

It is important to note that, as the study is observational, it has only identified associations between late-night eating and gut issues. The findings do not prove that they cause it. Experiencing high stress or poor gut health may also prompt people to eat later.

The study also defines late eating as any time after 9 p.m., which does not account for shift workers or differences in cultures and their eating habits.

Routhenstein underscored that meal timing recommendations need to be personalized to the individual, taking into account their schedules, biology, and lifestyles.

“For shift workers, the meaningful measure is eating relative to their sleep-wake cycle, not clock time, for it to be tailored to their circadian rhythm. This can look like consolidating meals within a 12-hour window aligned with waking hours,” she said. 

“My approach is never a rigid ‘no eating after 9 pm’ rule. It’s about compressing the overall eating window and reducing physiological stress load, both of which are actionable regardless of cultural background,” she added.

Does this mean I shouldn’t snack at night, ever?

“I was surprised by the results as this was a curious question from my own late-night eating,” Dadigiri said. She said one big takeaway from this study is that “late night eating alone won’t cause change[s] in bowel habits.”

“An occasional [light] snack won’t hurt you, but be mindful about when you are eating when you are already stressed out,” she told MNT.

Routhenstein, meanwhile, drew attention to the importance of aligning with, not fighting against, our biology.

“Circadian rhythm alignment is foundational to your health, and this research reinforces that. We need to stop looking at these factors in isolation. It wasn’t late eating alone or stress alone that increased the risk; it was the combination that drove the risk the most.”

The researchers recommend maintaining a structured meal routine during high-stress periods and, preferably, consuming more calories earlier in the day to support optimal digestive function.

• Insufficient sleep can have adverse health effects, but a new study suggests that too much sleep could also do harm.
• The study, which analyzed the biological clocks of half a million people, suggests that both too little and too much sleep are associated with faster aging of almost every organ in the body.
• The researchers suggest that too few hours of sleep—and too many—may speed aging in the brain, heart, lungs, and immune system, and are associated with a wide range of diseases.

According to the National Institutes of Health, quality sleep is as essential for our survival as food and water. But how much sleep is optimum?

New research suggests that getting either too much sleep or too little sleep, particularly in mid- and later life, is associated with faster aging of almost all organ systems in the body.

The study, published in Nature, suggests that between 6.4 and 7.8 hours of sleep a night is associated with healthy aging, lower disease risk, and enhanced longevity. Any more or any less was associated with an increased risk of disease and mortality.

“The finding that around 6.4–7.8 hours of sleep appeared to be associated with healthier biological aging reinforces the idea that sleep is one of the most important modifiable lifestyle factors for long-term health. We often focus on supplements and advanced biohacking technologies, but sleep remains foundational for recovery, mitochondrial function and cellular repair.”

— Tunc Tiryaki, Founder of London Regenerative Institute Clinics, who was not involved in the study.

Using biological aging clocks

Using data from the UK Biobank on around half a million people, the researchers combined self-reported sleep duration with biological aging clocks—measures of physiological rather than chronological age—for 23 organ systems.

From these, they identified organ-specific biological age gaps (BAGs), which can show differences between the biological and chronological age of these organs. BAGs have shown great predictive value for disease morbidity, cognition, and risk of mortality.

Previous research has shown a U-shaped relationship among sleep, brain aging, and mortality, and the researchers wanted to test, using BAGs, whether a similar relationship exists across multiple organ systems.

They also assessed whether long and short sleep duration were associated with increased all-cause mortality and systemic disease (not just in the brain) and late-life depression. And they examined whether sleep disturbances were modifiable risk factors for disease (or genetic predisposition), a result of disease, or a bidirectional relationship.

“What makes this study particularly interesting for longevity medicine is its systems-based approach. Instead of relying solely on chronological age, the researchers assessed biological aging using imaging, proteomics and metabolomics, providing a more comprehensive picture of aging across multiple organ systems.”
— Tunc Tiryaki

Short and long sleep linked to health issues

The researchers found that both short and long sleep were associated with brain and body health issues.

They found a significant association between short sleep, depressive episodes, and anxiety, as well as with obesity, type 2 diabetes, hypertension, ischemic heart disease, and heart arrhythmias (irregular heartbeat). 

Both short and long sleep were linked to chronic obstructive pulmonary disease, asthma, gastritis, and gastroesophageal reflux.

The authors suggest that while short sleep appears to exert direct effects on multiple organ systems, long sleep appears to have greater neuropsychiatric effects and may reflect underlying latent disease. 

Emer MacSweeney, MD, MBBS, MRCP, FRCR, CEO and Medical Director at Re:Cognition Health, who was also not involved in the study, explained some of the processes involved: 

“Too little sleep increases stress hormones, inflammation, and oxidative stress, all of which can accelerate aging in the brain and body. Sleep is also when the brain clears waste products through the glymphatic system, including proteins associated with neurodegenerative disease.”
— Emer MacSweeney

“On the other hand, excessively long sleep may reflect underlying health problems such as depression, inflammation, metabolic dysfunction, or early neurodegeneration. The brain appears to function best within a relatively stable sleep range rather than at either extreme,” MacSweeney told Medical News Today.

“Sleep optimization is one of the most effective forms of preventive health support,” Tiryaki said.

Sleep patterns can change depending on environment

Although they found some genetic associations for short and long sleep duration, the researchers concluded that there were relatively few in their large sample, so they hypothesize that sleep duration is largely determined by environmental factors and is therefore modifiable.

So how can you help yourself get a good night’s sleep? 

“Optimum sleep involves proper management of medical conditions, psychiatric conditions, and environmental stressors,” Sarathi Bhattacharyya, MD, pulmonologist, sleep medicine specialist, and medical director of MemorialCare Sleep Disorders Center at Long Beach Medical Center in Long Beach, CA, who was also not involved in the study, told MNT.

“Generally speaking, ensuring a consistent wake time to consistently align your circadian rhythm and practicing good ‘sleep hygiene’ in the evenings and a wind-down period before bed are key steps. Light exposure, late food or drink consumption, overly intensive exercise, and suboptimal treatment of medical/psychiatric conditions can all contribute to short sleep duration, either by delaying onset of sleep or by disrupting normal sleep progression,” he added.

However, he cautioned that it is important to avoid the urge to sleep in to compensate for a few nights of poor quality sleep “as these longer periods of sleep can actually disrupt your circadian rhythm and worsen the cycle of suboptimal sleep.”

“Sleep need is still individual. While this study identified an optimal range at a population level, genetics, age and health status all influence how much sleep a person needs. Sleep quality is also just as important as sleep duration.”
— Emer MacSweeney

Could sleep disturbance be a sign of undiagnosed illness?

The researchers used Mendelian randomization to minimize the possibility of reverse causality — that underlying illness was causing short and longer sleep duration, rather than sleep disturbance causing health problems.

However, Tiryaki cautioned:

“Although Mendelian randomization strengthens the argument against reverse causality, I suspect the relationship is at least partly bidirectional. Poor sleep may accelerate biological aging, while aging-related changes in metabolism, inflammation, and neurodegeneration can also impair sleep quality and duration. This is commonly observed in individuals with metabolic dysfunction or chronic inflammatory states.”

“Improving sleep quality and supporting circadian regularity may therefore contribute to greater resilience, recovery, and long-term healthspan,” he advised.

MacSweeney agreed: 

“The authors themselves acknowledge they cannot completely exclude reverse causality. In neuroscience, we increasingly view sleep disruption as both a driver and an early marker of aging-related disease processes.”

• A new study examined how dietary adjustments may affect biological aging in older adults. 
• The researchers found that diets lower in fat and higher in plant-based foods or complex carbohydrates were linked to lower biological age estimates.
• The findings add to growing evidence linking plant-forward diets to improved metabolic and cardiovascular health.

A new study from researchers at the University of Sydney in Australia examined how different combinations of fat, carbohydrates, and plant-based protein affected biological age in adults ages 65 to 75.

During the 4-week study, participants who followed lower-fat or more plant-focused diets experienced greater reductions in biological age estimates compared to those eating a more typical high-fat omnivorous diet.

The study is published in Aging Cell.

Biological age: How is it different from chronological age?

Diet plays an important role in healthy aging and may influence inflammation, metabolism, and the risk of chronic diseases in older adults.

Scientists are interested in whether certain eating patterns could affect biological age markers tied to overall health. 

While chronological age reflects someone’s actual age based on their birth, biological age reflects how well the body is functioning physiologically. Ideally, someone would have a matched or lower biological age (or age gap). 

The researchers in the new study analyzed data from 104 older adults participating in the Nutrition for Healthy Living study. The participants were between 65 and 75 years old and were generally healthy. 

None of the participants smoked or had major chronic conditions, such as cancer or type 2 diabetes.

The scientists randomly assigned the participants to one of the following four diet groups: 

1. omnivorous/high-fat
2. omnivorous/high-carbohydrate
3. semi-vegetarian/high-fat
4. semi-vegetarian/high-carbohydrate.

The semi-vegetarian diets emphasized plant-based proteins, while omnivorous diets included more animal-based foods. 

All groups consumed 14% of their calories from protein, but the diets otherwise varied in fat and carbohydrate content, with some diets higher in fat and lower in carbohydrates, while others were lower in fat and higher in carbohydrates. 

The researchers noted that the carbohydrates in the study primarily came from minimally processed foods rather than refined sugars or ultra-processed carbohydrates.

Prior to the participants beginning their diet plans, the researchers measured their baseline biomarkers, including biomarkers tied to inflammation (such as C-reactive protein) and cardiovascular health, to determine their biological age scores. 

Once the participants started their eating plans, they continued for 4 weeks, and then the researchers checked their biomarkers again.

Switching diets can rapidly affect aging processes

After comparing biomarker data before and after the dietary intervention, the researchers found that the omnivorous/high-fat group showed little change in biological age markers after the 4-week period.

The study authors noted that the diets for this group were “most like participants’ baseline diets.” However, the other three groups experienced reductions in biological age estimates overall. 

The omnivorous/high-carbohydrate group, which focused on reducing dietary fat while emphasizing complex carbohydrates, had the most significant improvement in biomarker data.

Both of the semi-vegetarian groups (semi-vegetarian/high-fat and semi-vegetarian/high-carbohydrate) showed improvements in multiple biological age markers, but they were not as statistically significant compared to the omnivorous/high-carbohydrate group. 

While the study findings indicate that these dietary changes may contribute to a rapid change in biological aging, it is not clear whether this would hold up in the long term since the study only lasted for 4 weeks.  

The researchers said the biological age changes observed in the study may reflect temporary physiological responses to dietary changes rather than lasting changes to the aging process itself.

“It is difficult to distinguish whether the observed changes reflect the immediate impact of nutritional inputs on integrated physiological systems or a systematic improvement in ageing-related health,” the study authors wrote. 

‘Promising’ findings but longer study needed

Dung Trinh, MD, internist of MemorialCare Medical Group and Chief Medical Officer of Healthy Brain Clinic, spoke with Medical News Today about the findings. 

Trinh said the findings suggest that the body’s metabolic and inflammatory systems may respond quickly to dietary changes, but cautioned against interpreting the results as proof that diet can reverse aging. 

“Short-term improvements in biological age markers are encouraging, but not definitive,” Trinh said, adding that the biomarkers are better viewed as “a physiologic snapshot” more so than evidence of long-term benefits.

When asked whether the study findings support older adults eating a higher-carb diet, Trinh emphasized that the study should not be interpreted as support for eating more processed carbohydrates but for focusing on macronutrients and higher-quality food.

“Diet quality and macronutrient context matter,” explained Trinh. “Carbohydrates from vegetables, legumes, fruits, intact grains, and fiber-rich foods are very different from carbohydrates from sugary beverages, pastries, and refined snacks.”

Trinh hopes to see a longer trial, of at least 6 to 12 months, to determine whether the health benefits found in the study hold up over a longer period of time. 

Claire Burum, RD, a Doctify-verified dietitian based in Australia, also spoke with MNT about the study.

Burum called the findings “promising,” but cautioned that short-term improvements in biological age markers should not be confused with proof of slower aging or longer lifespan.

“Biological age markers estimate health and aging risk rather than directly measuring outcomes like mortality,” Burum said, adding that the study still reinforces the idea that “biological aging is responsive to dietary intervention.”

Burum also emphasized that the study does not suggest people should simply eat more carbohydrates. 

“The practical takeaway is not ‘eat more carbs,’ but to prioritize high-quality, minimally processed carbohydrates within an overall balanced diet.”

– Claire Burum, RD

She added that the strongest evidence for healthy aging still supports diets rich in fruits, vegetables, legumes, whole grains, nuts, and minimally processed foods.

• Research links combined aerobic and resistance exercise, as well as high intensity interval training (HIIT), with significant reductions in 24-hour blood pressure in adults with hypertension.
• The analysis suggests that aerobic exercise was the most consistently effective form of exercise for lowering blood pressure, with reductions observed during both daytime and nighttime periods.
• Evidence suggests that aerobic and combined exercise should remain the primary recommendations for lowering blood pressure, with further research needed for other activities.

High blood pressure, or hypertension, is a major risk factor for many cardiovascular diseases, such as stroke, heart attack, and heart failure. Research suggests that nearly half of U.S. adults have hypertension, with many unaware they have high blood pressure.

Although exercise has long been recommended as part of hypertension treatment, most studies have focused on aerobic exercise, highlighting it as the most consistent method for reducing 24-hour ambulatory blood pressure.

Ambulatory blood pressure monitoring (ABPM) describes a 24-hour, continuous, automated recording of a person’s blood pressure during daily activities and sleep.

Unlike blood pressure readings taken during a doctor’s appointment, ABPM measures fluctuations throughout daily life and during sleep. As such, many healthcare professionals consider it the ‘gold standard‘ for diagnosing hypertension.

Now, a pooled analysis, published in the British Journal of Sports Medicine, investigating other forms of exercise suggests that combining aerobic and resistance exercise, as well as participating in high intensity interval training (HIIT), may significantly reduce blood pressure across a 24-hour period in adults with high blood pressure.

Analyzing 31 randomized controlled trials

To better understand how different forms of exercise affect blood pressure, the researchers reviewed comparative clinical trials published between November 2024 and August 2025.

The pooled analysis included structured exercise interventions lasting at least 4 weeks and covered several exercise types. This included:

• aerobic exercise such as brisk walking, running, and cycling
• resistance training using the body or weights
• isometric exercise, such as planks and wall sits
• HIIT
• yoga and pilates
• recreational sports, including soccer, beach tennis, and handball

In total, the researchers analyzed data from 31 randomized controlled trials involving more than 1,345 participants and 67 different exercise interventions.

Notably, the researchers found that aerobic exercise remained the most consistently effective approach for lowering blood pressure throughout the day and night. Combined exercise and HIIT also reduced blood pressure over 24 hours.

Combined exercise shows significant blood pressure benefits

In particular, the meta-analysis found that combined exercise training and HIIT were linked to meaningful reductions in systolic blood pressure over a 24-hour period. This refers to the top number in a blood pressure reading, which measures the pressure against the artery walls when the heart is pumping blood around the body.

The American Heart Association (AHA) recommends a target systolic blood pressure below 120 millimeters of mercury (mm Hg).

When compared with no exercise, combined exercise training reduced systolic blood pressure by an average of 6.18 millimeters of mercury (mm Hg). Additionally, HIIT reduced systolic blood pressure by 5.71 mm Hg, and aerobic exercise reduced it by 4.73 mm Hg.

Study author Rodrigo Ferrari, PhD, a professor at the Federal University of Rio Grande do Sul, Brazil, explained to Medical News Today why combined training may be effective for hypertension.

“Combined training is particularly beneficial because it integrates the physiological mechanisms of both aerobic and resistance exercise, offering a more comprehensive health profile,” he said.

“While it produced the largest point estimate for reducing 24-hour systolic blood pressure, this modality is also crucial for addressing age-related declines in functionally. By leveraging complementary pathways, combined training enhances both cardiovascular and neuromuscular functions simultaneously,” he explained.

HIIT also shows beneficial results

Diastolic blood pressure, the lower number in a reading, describes the pressure in the arteries when the heart relaxes between beats. The AHA advises a target diastolic blood pressure below 80 mm Hg.

For diastolic blood pressure, the researchers observed average reductions of 4.64 mm Hg with HIIT, 4.18 mm Hg with pilates, 3.94 mm Hg with combined exercise, and 2.76 mm Hg with aerobic exercise.

“HIIT serves as a realistic and effective alternative because it significantly reduces both 24-hour systolic and diastolic blood pressure while requiring less time than traditional continuous exercise,” Ferrari told MNT.

“This efficiency directly addresses time constraints, which are one of the most significant global barriers to exercise adherence. Although larger trials are still needed to broaden current recommendations, HIIT is a promising strategy for maintaining cardiorespiratory fitness and managing hypertension in time-pressed individuals,” he said.

Why aerobic exercise may work best for blood pressure

Previous research has suggested that isometric exercise may be the most effective approach for lowering blood pressure.

However, the study authors suggest that aerobic exercise may offer unique cardiovascular benefits. They note that aerobic exercise may improve endothelial function, or how well blood vessels work, while also reducing vascular resistance through sustained vasodilation.

“Aerobic exercises works primarily by reducing systemic vascular resistance and improving endothelial function through sustained vasodilation,” Ferrari said.

“Furthermore, it remains the most evidence-based option due to the large volume of clinical trials and participants, which provides the highest level of statistical precision for its blood pressure-lowering effects,” he concluded.

Conversely, they add that resistance training may temporarily increase arterial stiffness due to the high-pressure demands placed on the cardiovascular system during lifting exercises. As such, they suggest that resistance exercise should be viewed as complementary for lowering blood pressure rather than a first-line strategy.

The researchers propose that these physiological differences may explain why their findings differed from previous reports.

Is exercise alone enough to lower blood pressure?

While other forms of exercise, such as yoga, pilates, and recreational sports, appeared to offer some benefit, the evidence was less conclusive. The researchers caution that further research is needed before recommending these exercise approaches as primary treatments for hypertension.

The research team also highlights that their analysis had several limitations. Many of the trials involved relatively small numbers of participants, side effects were often poorly reported, and information about whether participants followed their exercise programs consistently was frequently missing.

Still, the authors conclude that aerobic exercise, either continuous or interval-based, and combined exercise training should remain as the primary evidence-based recommendations for lowering 24-hour ambulatory blood pressure in adults with high blood pressure.

• Maintaining weight loss can sometimes be just as hard as losing the weight in the first place. 
• More than 50% of people who lose weight regain it within two years, and up to 80% regain it within five years. 
• A new study found that walking about 8,500 steps a day may help a person maintain their weight loss after dieting. 

While everyone knows that losing weight can be hard, it can sometimes be just as tricky to keep it off once you hit a healthy goal weight. 

Past research shows that more than 50% of people who lose weight regain it within two years, and up to 80% regain it within five years. 

Maintaining weight loss is currently a hot topic of discussion, thanks to the recent increase in glucagon-like peptide-1 (GLP-1) receptor agonists such as Wegovy and Zepbound. Recent studies show that some people who stop taking a GLP-1 regain as much as 60% of their lost weight within one year. 

“A major part of people with obesity who initially lose weight tend to put some or all of it back on again,” Marwan El Ghoch, MD, associate professor of food science in the Department of Biomedical, Metabolic, and Neural Sciences at the University of Modena and Reggio Emilia in Italy, told Medical News Today.

“This usually happens three to five years after weight loss, regardless [of] the treatment they underwent. Therefore, I think that the most important and greatest challenge when treating obesity is preventing weight regain in the long term,” he said. 

El Ghoch is the co-lead author of a new study published in the International Journal of Environmental Research and Public Health that found walking about 8,500 steps a day may help a person maintain their weight loss after dieting. 

Comparing daily step amounts for maintaining weight loss

For this study, researchers analyzed data from 18 previously conducted trials involving participants who were overweight or obese and who were either dieting on their own or participating in a lifestyle modification program that included dietary recommendations and exercise advice, such as walking more and reaching a certain number of steps per day. 

El Ghoch said he and his colleagues decided to examine a potential link between daily steps and their impact on maintaining weight loss to help test two hypotheses.

“Usually, after the weight loss phase, a phenomenon called metabolic adaptation, which is simply the body’s physiological response to weight loss where the metabolism slows down significantly, as the body perceives the calorie deficit and weight loss as a threat to survival and accordingly try to contrast this to prevent further weight loss.”
— Marwan El Ghoch, MD, co-lead author of the study

“I thought that increasing physical activity in terms of daily steps can be of help in maintaining the weight loss during the later phase of the weight management programs,” he said.

“Moreover, many patients after [the] weight loss phase return to the previous unhealthy habits and behaviors that they used to have before such overeating and sedentarism,” El Ghoch continued.

Increasing daily steps helps lose weight and keep it off

At the study’s conclusion, scientists found that participants who followed a lifestyle modification program and increased their daily steps to about 8,454 by the end of the weight loss journey lost an average of 4.39% of their starting weight. 

Those same participants, when continuing to get in about 8,241 steps a day, were able to keep off an average of 3.28% of the weight they had lost. 

Researchers found that those dieting on their own didn’t increase their daily steps or lose any weight. 

El Ghoch said that these findings imply that patients with obesity who are willing to start a lifestyle modification program for weight management, should always be encouraged to progressively increase their daily step from baseline through the weight loss phase — reaching around 8,500 steps/day — and maintain this level of steps during the weight maintenance phase, since this behavioral strategy is associated with maintaining significant weight loss in the long term and prevent weight regain. 

“As [such], these programs should be always considered a valid option, especially as a first-line intervention, since they can lead to clinically meaningful weight loss (≈4–5%) and weight loss maintenance (≈3.5%). These findings need to be openly and clearly discussed with patients before starting any lifestyle modification program due to its important impact on the treatment outcome.” 
— Marwan El Ghoch, MD, co-lead author of the study

A simple, actionable strategy for maintaining weight loss

MNT spoke with Swapnil Patel, MD, MHCM, FACP, vice chair of the Department of Medicine at Hackensack Meridian Jersey Shore University Medical Center, and assistant professor at the Hackensack Meridian School of Medicine in New Jersey, who commented that his initial reaction to this study’s findings is that this suggests a simple, actionable strategy for patients to maintain weight loss. 

“The finding that approximately 8,500 steps per day is associated with preventing regaining weight is a target that I can share with my patients. This research reinforces the importance of a comprehensive lifestyle approach, combining both healthy diet and physical activity, for long-term success.” 
— Swapnil Patel, MD, MHCM, FACP

Patel said it’s important for researchers to continue to find new ways in which people can help keep weight off after dieting, especially in a world where many people are using GLP-1s to lose weight and may experience issues maintaining weight loss if they stop using the medication.

“While GLP-1s are effective for weight loss, many patients regain weight after stopping them,” he explained. “This study highlights a non-pharmacological approach, and a tenet of good health — physical activity, that is valuable for long-term weight management, either as a stand-alone strategy or in conjunction with weight loss medication.”

Regular exercise can help preserve muscle during weight loss

MNT also spoke with Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this research, which he said shows the importance of regular exercise. 

“It’s what we emphasize to our patients that can enhance and maintain weight loss, but we still emphasize that the majority of weight loss comes from the diet,” Ali explained.

“Being consistent with some sort of exercise not only can help maintain weight loss and enhance weight loss, but also helps to preserve muscle and reduce muscle loss. So that’s also important [for] any kind of weight loss journey is to minimize muscle loss. [W]e see it in our surgical patients as well, so anything that can help to minimize that and also enhance maintenance of weight loss is going to be helpful,” he said.

For readers who may worry about hitting an 8,500-step goal every day in a seated office environment, Ali advised breaking it up — walking before and after work.

“The main thing, if you can’t hit the 8,500, is just being consistent. Try to get a minimum of 30 minutes or more of exercise a day, and again, you can break it up into smaller portions.”
— Mir Ali, MD

“It’s tough to figure out a regimen for everybody because everybody’s schedule and their activity level and their health is different, so it’s just trying to find something that you can be consistent with, and walking is great exercise,” Ali added. “It’s just finding the time to do it adequately.” 

• A study suggests that middle-aged and older adults with stronger, more regular daily patterns of activity and rest showed signs of slower biological aging.
• Participants with clearer differences between daytime activity and nighttime rest, and less fragmented routines, had more ‘youthful’ physiological age scores.
• The associations remained significant even after researchers accounted for factors including chronological age, sex, education, and certain health conditions.
• The findings suggest that rest-activity rhythms could become targets for interventions, potentially using wearable devices or lifestyle changes, aimed at slowing the aging process.

Biological aging refers to how well the body functions as it ages, which may not always be the same as a person’s chronological age.

Some people may age more slowly and stay healthier for longer, while others may experience faster aging due to various factors, such as lifestyle habits.

It is possible to partly measure aging through epigenetic changes. This describes changes to genes without altering the DNA itself.

Using these patterns, an epigenetic clock can estimate a person’s biological age. If a person’s epigenetic age is older than their chronological age, it may suggest faster aging and a greater risk of age-related diseases.

Lifestyle habits can strongly influence epigenetic aging, with research highlighting regular exercise and healthy sleep habits as powerful tools to support healthy aging.

Notably, growing research is showing an association between aging and changes in circadian rest-activity rhythms. This refers to the natural, roughly 24-hour cycles in a person’s pattern of being awake and active versus resting and sleeping.

Now, a study published in JAMA Network Open adds to this evidence, suggesting that adults who maintain stronger and more consistent patterns of daily activity and rest may experience slower biological aging.

What did the study find?

The study included 207 middle-aged and older adults participating in the long-running Baltimore Epidemiologic Catchment Area (ECA) cohort study. Participants had an average chronological age of around 68 years.

To measure daily activity patterns, the research team, led by the Johns Hopkins Bloomberg School of Public Health, used wrist-worn actigraphy devices for approximately 7 consecutive days.

These devices tracked periods of activity, rest, sleep, and sedentary behavior. Participants also kept sleep and nap logs.

The investigators compared these activity patterns with 4 established epigenetic clocks that estimate biological age using epigenetic markers. The clocks used in the study were:

• Horvath clock
• Hannum clock
• PhenoAge
• GrimAge.

The findings suggest that individuals with stronger and less fragmented rest-activity rhythms had significantly lower biological age scores on the GrimAge and PhenoAge measures, indicating slower physiological aging.

The associations remained even after accounting for factors such as chronological age, sex, education level, and certain health conditions.

Co-senior author Brion Maher, PhD, MS, a professor in the Bloomberg School’s Department of Mental Health was not surprised by the strength of the associations.

He told Medical News Today “it is not entirely surprising since GrimAge and PhenoAge are newer-generation epigenetic clocks that were designed to capture aging-related health risks, including mortality risk, disease burden, and physiological decline.”

“Because rest-activity rhythms are closely related to overall health, it makes sense that their associations would be more apparent in epigenetic clocks that are associated with health and mortality than with clocks that are primarily designed to estimate chronological age.”

– Brion Maher, PhD, MS

Similar trends also appeared with the Horvath and Hannum clocks. However, those findings did not reach statistical significance.

Why do rest-activity rhythms matter?

Rest-activity rhythms reflect the body’s broader circadian system. This describes the internal biological processes that regulate sleep, activity, hormone release, metabolism, and other functions over a roughly 24-hour cycle.

As people age, these rhythms often weaken and become more irregular. Another recent study by the research team linked weaker and more fragmented rest-activity rhythms to shrinking of the brain in older adults.

Previous studies have also linked disrupted circadian rhythms with a range of health problems, including cognitive decline, psychiatric disorders, and some cancers.

Therefore, the researchers suggest that rest-activity rhythms could become a useful marker of aging, and may provide a more meaningful measure of health than chronological age alone. If supported by further research, they may also emerge as possible targets for interventions to slow the aging process.

The study’s lead author was Chunyu Liu, a PhD student supervised by Maher and the other co-senior author, Adam Spira, PhD, MA, also a professor in the Bloomberg School’s Department of Mental Health.

“I think rest-activity rhythms may be an observable window into circadian regulation, and circadian regulation is not just related to aging—it may be part of the aging process itself,” Liu told MNT.

“In addition, circadian regulation is closely connected with many biological processes involved in aging. Stronger circadian rhythmicity may help coordinate these processes, which could be reflected in lower epigenetic age acceleration.”
– Chunyu Liu

Spira explained to MNT how measuring wrist movement in the study may reflect fragmented rhythms.

“In this study, we did not directly measure circadian rhythms — we measured movement at the wrist over 24-hour periods, which is an indirect measure of circadian function. The resulting data also reflect an array of environmental influences, such as bright light exposure at certain times of day,” he detailed.

“Fragmented rhythms represent more frequent, rapid transitions between rest and activity within a day. Fragmented sleep could manifest as fragmented motor activity at night in these rest-activity rhythm metrics,” Spira added.

“In general, more continuous, consolidated sleep is thought to be one of the many consequences or manifestations of stronger, less fragmented circadian rhythms,” he told us.

Researchers caution study was exploratory

While the study highlights a clear distinction between daytime activity and nighttime rest and “younger” biological aging, the authors emphasize that the study was cross-sectional, meaning it examined activity rhythms and biological aging at roughly the same point in time.

As a result, the research cannot determine whether disrupted rhythms contribute to faster aging, or whether aging itself weakens circadian patterns. The researchers note that longer-term studies will be necessary to clarify the direction of the relationship.

They also add that the study population may have underestimated the true effect, as the participants were older adults healthy enough to take part, whereas those who experience more rapid aging may have been too unwell to participate.

Managing circadian rhythms

The researchers suggest that wearable technology could eventually help monitor physiological aging and other health risks in real time.

“I think this is feasible in the long term,” Liu said to MNT. “Wearable devices are very good at continuously capturing patterns of rest and activity over multiple days or weeks. Those data likely provide a more reliable picture of daily rhythms than the information a healthcare provider obtains from a patient during a short clinical visit.”

“However, physiological aging is complex and likely cannot currently be measured directly in real time by wearables alone,” she added.

“The more realistic near-term use is that wearable-derived rhythm measures could help identify people with disrupted daily patterns who may be at higher risk for adverse aging-related outcomes, and could guide earlier lifestyle or clinical interventions,” Liu pointed out.

The study authors add that they hope to conduct future clinical trials investigating whether strengthening daily rest-activity rhythms could help slow biological aging.

• A global expert panel has recently announced that the condition hitherto known as polycystic ovary syndrome (PCOS) will officially undergo a name change to polyendocrine metabolic ovarian syndrome (PMOS).
• The name change acknowledges the fact that this gynecological condition is not just characterized by the formation of cysts on the ovaries but actually impacts metabolic health more broadly, as well as other aspects of health.
• The experts hope that the name change will lead to more accurate diagnoses and timely treatment of the condition.

On Monday, May 12, 2026, an international panel of experts dubbed the Global Name Change Consortium announced — via a health policy paper published in The Lancet — the official name change of polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS).

Previously, doctors would diagnose the condition formerly known as PCOS based on the presence of fluid-filled cysts on a person’s ovaries.

This condition is also characterized by irregular periods and unusual hair growth due to hormonal imbalances.

By shifting the name of the condition to focus on its metabolic implications, rather than the presence of ovarian cysts, and through the health policy changes outlined in the Lancet paper, the global expert panel is now aiming to emphasize the true systemic impact of this condition.

Not just ovarian cysts but a complex endocrine condition

Getting from PCOS to PMOS took no less than 14 years involving multidisciplinary expert consultations as well as surveys conducted with a total of 14,360 participants who had received a diagnosis.

The new name will be adopted globally over a 3-year transition period, with experts expecting that this process will be completed in 2028.

Through this name change, experts acknowledge that this reproductive system condition does not always present as expected — that is, it does not always involve the formation of ovarian cysts — and it affects more than just the reproductive organs, as it can impact hormone production, weight, a person’s skin, their metabolic health, as well as mental health.

“What we now know is that there is actually no increase in abnormal cysts on the ovary, and the diverse features of the condition were often unappreciated,” said one of the lead experts involved in the name-change process, Helena Teede, FRCOG, FRANZCOG, MBBS, PhD, Director of the Monash Centre for Health Research & Implementation at Monash University in Australia, in a press release.

Speaking to Medical News Today, Sameena Rahman, MD, board-certified ob-gyn, sex-med gynecologist, and menopause specialist, who was not part of the name-change panel, said she was thrilled about this change.

“This name change has been a long time in the making,” Rahman told us. She explained that “the previous name, PCOS, was both misleading and incomplete because it focused narrowly on ovarian cysts, which are not present in every patient and are not the root cause of the condition.”

“The updated terminology better reflects the true scope of the syndrome as a whole-body condition driven by insulin resistance, hormonal imbalance, and inflammation. It also helps destigmatize the diagnosis and shifts the conversation beyond reproductive health alone, recognizing that this is a complex metabolic and endocrine condition that affects multiple systems throughout the body.”

– Sameena Rahman, MD

A step towards better care and faster diagnosis

The experts in charge of the name change are also hoping that by shifting the focus in such a way as to emphasize that PMOS is a complex health condition, there will be fewer delayed diagnoses in the future, as well as care that is fully personalized.

Historical data suggests that many have not received a diagnosis for their condition until they sought fertility treatment, as the complexity of symptoms has often led to misdiagnoses, or contradictory diagnoses from different healthcare professionals.

“It was heart-breaking to see the delayed diagnosis, limited awareness and inadequate care afforded those affected by this neglected condition,” Teede noted in the press release.

“The agreed principles of the new name included patient benefit, scientific accuracy, ease of communication, avoidance of stigma, cultural appropriateness and accompanying implementation. This change was driven with and for those affected by the condition and we are proud to have arrived at a new name that finally accurately reflects the complexity of the condition. Make no mistake, this is a landmark moment that will lead to desperately needed worldwide advancements in clinical practice and research.”

– Helena Teede, FRCOG, FRANZCOG, MBBS, PhD

Rahman shared this hope, and emphasized that, “importantly, the updated terminology encourages clinicians and patients to view this as a lifelong metabolic and inflammatory condition — not simply a gynecologic issue.”

“That broader understanding can lead to earlier intervention and a stronger focus on preventing long-term cardiometabolic complications [associated with this condition] such as heart disease, diabetes, and other chronic health conditions,” she told us.

• New research from the United Kingdom shows that people who engage in artistic pursuits of various kinds experience a slower pace of aging.
• The study even suggests that the positive effect of having an active cultural life is akin to that of regular exercise.
• While this study does not prove a causal relationship, the researchers believe that artistic and creative pursuits can have beneficial effects on many aspects of health, including lowering inflammation and protecting brain health.

Participating in creative pursuits and engaging with arts and culture is good for the soul but could it also help the body stay in shape? That seems to be what a new study from University College London (UCL) in the United Kingdom is suggesting.

The study — whose findings appear in the journal Innovation in Aging — has found an association between engagement with arts and culture and a slower pace of biological aging.

Other studies have connected creativity with better cognitive health. For instance, research published in Nature Communications in October 2025 found that activities such as dancing and engaging with the visual arts could help the brain stay younger for longer.

It may be, however, that creative and artistic interests and activities may help the entire body maintain its youthfulness in some respect.

Speaking to Medical News Today, one of the study authors, Feifei Bu, PhD, principal research fellow in statistics/epidemiology within the Social Biobehavioural Research Group in the Department of Behavioural Science and Health at UCL, said that the research team was keenly interested in exploring just how artistic interest can actually shape our health throughout our lives.

“Arts and cultural engagement is increasingly seen as a health behaviour,” Bu suggested. “Many studies have linked it to health outcomes such as better cognition, lower depressive symptoms, and improved physical health.”

“However, very little research has examined whether its benefits are biologically embedded — so that’s what we wanted to explore in this study,” she told MNT.

More frequent artistic engagement linked to slower aging

In their study, the UCL researchers assessed survey responses regarding their engagement in arts and culture, as well as blood test results provided by 3,556 participants with a mean age of about 52 years. A little more than half of the participants were female, and the rest male.

The data came came from the UK Household Longitudinal Study.

In brief, the researchers wanted to see how engagement in the arts and culture would correlate with epigenetic aging — changes to DNA that influence the rate of biological aging.

They used no fewer than 7 epigenetic clocks in their research, which are tools for assessing age-related DNA changes.

Two of the younger-generation epigenetic clocks used, in particular — called DunedinPoAm and DunedinPACE — help provide an estimate of the pace at which a person is aging. The faster the pace of aging, the more likely it is that a person also has a higher risk of developing age-related conditions.

Another epigenetic clock, called PhenoAge, helped the researchers estimate individuals’ biological ages.

Overall, tests conducted using the three next-gen epigenetic clocks suggested that the more people engaged in artistic and cultural activities, and the wider the breadth of their cultural-artistic interests, the slower their pace of aging, and the younger their estimated biological age.

According to DunedinPACE data, engaging in artistic pursuits at least 3 times a year was linked to a 2% slower aging pace, and engaging in creative pursuits on a monthly basis was linked to a 3% slower aging pace compared to engaging with arts less than 3 times a year.

Those who pursued cultural activities on a weekly had a 4% slower aging rate compared to those who pursued such activities less than 3 times a year.

Cultural engagement as beneficial as regular exercise

Notably, these positive associations appeared to be on a par with the beneficial effects of exercise on aging, as the researchers also found that individuals who exercised on a weekly basis had a similarly slower aging pace.

These associations persisted with regard to biological age: according to PhenoAge tests, participants who engaged in artistic pursuits on a weekly basis or more frequently were 1 year younger on average compared to those who rarely pursued creative or cultural activities.

The researchers noted a similar association between weekly or more frequent exercise and biological age.

These associations were strongest for participants 40 years of age or older, and persisted even after the researchers accounted for confounding factors including body mass index (BMI), smoking status, education, and income level.

The older epigenetic clocks did not reveal any associations between more frequent cultural engagement and slower aging pace, or between exercise and and aging pace. The study authors believe this may be because the older generation of epigenetic clocks are less sensitive predictors of age-related changes.

Commenting on this study, Şebnem Ünlüişler, Chief Longevity Officer and genetic engineer at the London Regenerative Institute, in the United Kingdom, who was not involved in the research, said she was heartened by the findings:

“The findings are really encouraging — it is particularly interesting that arts and cultural engagement showed a measurable association with slower biological ageing, highlighting the importance of emotional wellbeing, creativity and social connection in long-term health. While the study does not establish causation, it adds to the growing body of evidence suggesting that meaningful lifestyle experiences may positively influence ageing pathways.”

Likewise, Opel Baker, MBChB, DipOccMed, MRCGP, general practitioner at the Mayfield Clinic Brighton and Hove, U.K., who was also not involved in the research, noted that he found the paper “really interesting.”

“Studies like this are incredibly important because they remind us that health is not shaped by medicine alone, but by how we live, connect and engage with the world around us,” Baker told us.

He noted that in his own experience as a family doctor he has witnessed “the profound impact that artistic and creative pursuits can have on both mental and physical wellbeing.”

Does it matter what cultural activities you engage in?

According to Bu, it does not matter what artistic, creative, or cultural activities a person chooses, as long as they engage in plenty of such pursuits — the more diverse the better.

“The arts cover a wide range of activities, each offering a distinct set of ‘active ingredients’ — [such as] esthetics, sensory or physical stimulation, social interaction, and emotional evocation — that benefit health,” the researcher told us.

“Our research shows that both frequency and diversity matter. The ‘most useful’ way would depend on the individual — their interests, what’s available to them, and what they enjoy doing consistently.”
– Feifei Bu, PhD

“Whether it is painting, music, dance, theatre or simply engaging with culture more regularly, these activities provide emotional release, cognitive stimulation, stress reduction and often valuable social connection, all of which are strongly linked to healthier aging,” Baker also said.

In Ünlüişler’s opinion, “activities that combine multiple benefits simultaneously may be particularly impactful.” She offered dance as an example, noting that it “incorporates movement, coordination, music, and social interaction, supporting both physical and cognitive health.”

Another example she cited was “group singing [which] may also offer unique benefits through breath control, emotional expression, and social bonding.”

“However,” Ünlüişler emphasized, “the study suggests that regular and meaningful engagement may matter more than any single activity itself.”

How exactly might creative activities help slow aging processes?

Bu stressed that the current study is “an observational study, [and thus] shows an association, not causation.”

“Although these findings are promising, more research is needed to cross-validate these findings and to strengthen the evidence for causality,” she cautioned.

Still, the study author had some working hypotheses as to the potential biological mechanisms that might underlie the association between engagement in artistic and cultural pursuits and a slower rate of aging.

According to her, “a likely explanation is that arts engagement helps reduce stress, inflammation and cardiovascular risks, all of which have been shown to be linked to epigenetic aging.”

Ünlüişler hypothesized that one key mechanism mediating the association between regular cultural engagement and a slower pace of aging is stress reduction.

“Chronic stress can accelerate aging through increased cortisol levels, inflammation and nervous system dysregulation, whereas activities such as music, painting, or dance may promote relaxation and emotional regulation,” she explained.

“Arts engagement may also support brain health through cognitive stimulation and neuroplasticity,” which refers to the brain’s ability to build fresh connections between neurons, Ünlüişler continued.

“In addition, social and creative activities are associated with improved mood, reduced inflammation, and a stronger sense of purpose, all factors linked to healthier aging,” she pointed out.

Baker agreed, making similar points to Bu and Ünlüişler, emphasizing the importance of lowering stress levels and building a sense of community through artistic pursuits:

“Chronic stress and isolation are two of the biggest contributors to poor long-term health, inflammation and accelerated ageing. Artistic pursuits can counteract this by promoting relaxation, improving mood, supporting brain function and creating a sense of purpose and fulfilment. What is particularly encouraging about this research is that it reframes creativity not as a luxury, but as something that may genuinely support longevity and overall health outcomes.”

How else might cultural engagement benefit health?

The UCL research team is not stopping at this study. Going forward, they are planning to validate the current findings on different populations, and to expand the research to look at other possible health benefits of cultural engagement.

“We plan to cross-validate these findings across different countries and populations. We also want to look beyond epigenetic clocks and explore other biological outcomes related to arts and cultural engagement.”

– Feifei Bu, PhD

Baker and Ünlüişler both also wanted to see further research validating the findings of the current study.

“Epigenetic aging clocks are still a relatively young area of research, and while they are promising, they currently show correlation rather than direct causation. This means we cannot yet say definitively that arts engagement slows biological ageing, only that there appears to be an association that warrants further investigation,” Baker pointed out.

Ünlüişler “would like to see long-term interventional studies exploring whether arts engagement can actively slow biological aging over time and which mechanisms are most responsible, such as stress reduction, inflammation control, or neurological resilience.”

“Further research into brain health, dementia prevention and emotional wellbeing would also be especially valuable, as healthy aging is ultimately about maintaining quality of life as well as longevity,” she stressed.

Overall, though, all the experts’ takeaway message was the current positive findings ought to encourage us all to tap into our creative interests as much as possible.

“We are increasingly recognising that healthy aging must involve emotional wellbeing, cognitive resilience and quality of life alongside physical health. Creative engagement has the potential to support all of these areas in a meaningful and accessible way,” Baker concluded.

• Recent evidence suggests that a commonly practiced form of surgery for knee osteoarthritis may actually worsen the condition.
• This may be because the initial damage to the meniscus cartilage, which this surgery addresses, is not the only cause of pain and discomfort in knee osteoarthritis.
• Orthopedic experts explain what this may mean for the treatment of this chronic condition going forward.

A common knee surgery — the partial removal of meniscus cartilage — may provide little benefit to people with knee osteoarthritis and may actually worsen their prospects for long-term knee health, according to new research from Finland, whose findings are reported in a correspondence paper published in The New England Journal of Medicine.

Study participants who underwent surgeries to remove torn parts of meniscus cartilage in their knees faired more poorly over the next 10 years than those who had undergone sham surgeries in which no cartilage was removed.

People who received the sham surgery had less knee pain, had increased use of the knee, and experienced less later osteoarthritis compared to those who had had meniscectomies.

The meniscus is a piece of tough, C-shaped rubbery cartilage in the knee that provides shock absorption between the shin bone and the thigh bone. It can tear as the result of a sudden twist.

More commonly, however, tears occur with age, and commonly go hand-in-hand with osteoarthritis. Most older people who have arthritis in the knee also have meniscus tears, and most older people with meniscus tears have arthritis.

Meniscus tears: What is the main source of pain?

For many years, it was assumed that meniscus tears were the source of knee pain.

Cedars-Sinai LA orthopedic surgeon and sports medicine specialist Clint Soppe, MD, who was not involved in the recent research, told Medical News Today: ”I remember 20 years ago, 15 years ago, hearing doctors, some of my mentors, say like, ‘Oh, well, you know, that’s not arthritic pain. That’s meniscus pain.’ The problem is you can’t tell.”

The study’s senior investigator, Teppo L.N. Järvinen, MD, PhD, of the University of Helsinki, however, told us that: “There is now a substantial body of evidence suggesting that we may have been targeting the wrong problem. The meniscal tear is often a visible finding, but does not seem to be the (sole) cause of pain — at best.”

“In middle-aged and older individuals, meniscal tears are extremely common, including in people with no symptoms,” Järvinen added. “That makes it unlikely that the tear itself is usually the main driver of pain.”

“This study fits into a pattern seen across medicine: Widely used treatments can persist despite limited evidence, and when tested rigorously, may turn out to offer little benefit — or even cause harm.”

– Teppo L.N. Järvinen, MD, PhD

Paul Arciero, DPE, of the Health and Human Physiological Sciences Department at Skidmore College, who was not involved in the recent research, agreed, saying that: “Anecdotally, most individuals, both active and sedentary, who have undergone arthroscopic partial meniscectomy report worsening of their pain and mobility over time.”

In relation to this, Soppe cited the advances in our understanding of chronic pain conditions over the past few decades.

According to him, “all these different cell mediators that we didn’t know about or know much about 20, 30 years ago — interleukin inhibitors, cytokines, enzymes, TNF-alpha, metalloprotein — all these things that we know are associated with pain, and probably associated with meniscus-type pain.”

What are the alternatives to meniscus surgery?

“I think one of the most important measures is giving [knee pain] time,” said Soppe.

During that waiting period, he recommended “helping with symptoms using different modalities: anti-inflammatory pills, physical therapy, icing, [and] rest.“

“Cycling a lot of times is helpful, [as well as] injection treatments such as cortisone, hyaluronic acid, and PRP [platelet-rich plasma therapy],” Soppe suggested.

Soppe himself said he still performs meniscectomies but only under very specific circumstances, namely when a patient’s meniscus tear is displaced, out of position, and therefore potentially causing other issues, and only when the above methods, including giving it time time, have failed to help.

He also suggested that for some, osteoarthritis may be sufficiently advanced that full knee replacement is a more sensible option than meniscectomy.

Previous meniscectomy surgery is a known risk factor for successful knee replacement surgery.

Arciero noted that there may still be a place for meniscus repair, saying: “In certain cases of acute, traumatic injury to the knee joint, there remains the necessity to perform appropriate surgery to repair the meniscus. However, in the majority of routine meniscus tears/pain, the evidence shows alternative treatments are more effective long-term.”

‘Sham’ surgery may still provide relief

In the study, the investigators performed diagnostic arthroscopy for participants in the sham group, noted Soppe. That procedure typically involves injecting a saline solution into the knee, slightly inflating it to provide better visibility for the tiny cameras that are to be inserted into the joint.

“They flushed the knee with fluid, which we call lavage of the joint,” he pointed out. “To me, that is not sham surgery, [because] even though they’re not messing with the meniscus, they’re potentially removing these types of cell mediators, like cytokines, interleukens, TNF-alpha, that probably modulate the pain.”

“It’s not exactly sham surgery,” he said, raising the possibility that those participants might have received some unintended pain relief after all.

• On April 30, 2026, the U.S. FDA announced it is considering removing GLP-1 medications from the 503B bulks list. 
• FDA’s 503B bulks list identifies drug substances that outsourcing facilities can use to compound medications.
• Experts agree removing GLP-1s from the 503B bulks list will significantly lower the availability of compounded GLP-1s drugs. 
• Patients may still be able to receive compounded GLP-1s through 503A compounding pharmacies, and consider legitimate alternatives for weight loss. 

On April 30, 2026, the U.S. Food and Drug Administration (FDA) announced it is considering removing glucagon-like peptide-1 (GLP-1) receptor agonists from the 503B bulks list, as there is no current clinical need for pharmacies to be able to compound these medications. 

This could include drugs such as semaglutide (the active ingredient in Ozempic and Wegovy), tirzepatide (the active ingredient in Zepbound and Mounjaro), and liraglutide (the active ingredient in Victoza and Saxenda).

According to the FDA’s announcement, the organization is asking for submitted comments for or against this decision by the end of June 2026 before making their final determination.

Medical News Today spoke with 4 obesity experts to find out more about what the FDA’s 503B bulks list is, the potential future availability of compounded GLP-1 medications, and what alternatives may be available for users who may not be able to afford the brand name drugs. 

What is the FDA’s 503B bulks list? 

According to Douglas Ewing, MD, FACS, DABOM, a board-certified bariatric surgeon and medical director of the Center for Weight Loss and Metabolic Health at Hackensack University Medical Center, and associate professor of surgery at Hackensack Meridian School of Medicine in New Jersey, the FDA’s 503B bulks list identifies bulk drug substances that outsourcing facilities can use to compound medications. 

“These outsourcing facilities, regulated under section 503B of the Federal Food, Drug, and Cosmetic Act, can produce larger batches of compounded drugs than traditional 503A compounding pharmacies, which compound for individual patients with specific prescriptions,” Ewing explained to MNT. 

“The critical difference between a drug on the 503B list and an FDA-approved medication is the level of scrutiny,” he continued.

“FDA-approved drugs undergo a long and rigorous process of clinical trials to prove their safety, effectiveness, and quality before they can be marketed to the public.”

“Compounded drugs, even from 503B facilities, do not go through this same pre-market approval process. While 503B facilities are required to follow current Good Manufacturing Practices (cGMP), the compounded drugs themselves are not FDA-approved.”

Will compounded GLP-1s still be available? 

If semaglutide and tirzepatide are removed from the 503B bulks list, the availability of compounded GLP-1s would drop significantly, Michael Snyder, MD, FACS, FASMBS, DABOM, medical director of the Bariatric Surgery Center at Rose Medical Center, founder and director of the Denver Center for Bariatric Surgery Foundation, and in-house obesity specialist at FuturHealth, told MNT. 

“Most current compounded supply is produced through 503B outsourcing facilities, which would no longer be able to compound them in bulk,” Snyder said.

“There may still be limited use under 503A compounding rules, where a medication is prepared for an individual patient based on a specific clinical indication, but that pathway is much more restricted and not designed for widespread use.”

Jen Manne-Goehler, MD, ScD,assistant professor of medicine at Harvard Medical School, agreed. 

“There may be some forms of compounded GLP-1 drugs still available despite this decision,” Manne-Goehler told MNT.

”Specifically, the FDA’s decision not to include these GLP-1s on the bulk compounding list would not be expected to affect their use by 503A pharmacies. 503A compounding pharmacies compound according to specific patient prescriptions and are required by state boards of pharmacy to comply with standards.”

Because of the popularity and high demand of GLP-1 medications, Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, worried this may drive some people to purchase their medication through a potentially unsafe option.

“What I think will happen is people will try to get the medications from other sources outside the U.S., and that is a little riskier,” Ali told MNT.

“You could not be getting the medication you are buying, you may be getting something different or something maybe even unsafe. So it may increase some risk if people are going to go to sources outside of the U.S. to try to get these medications.” 

Are compounded GLP-1 medications safe?

When asked about the safety of compounded GLP-1 drugs, Ewing said that is a complex question without a simple “yes” or “no” answer. “The safety of compounded GLP-1s can vary significantly depending on the source,” he explained.

“There are legitimate compounding pharmacies that adhere to high-quality standards. However, the lack of FDA approval and oversight for the final compounded products introduces inherent risks.”

– Douglas Ewing, MD, FACS, DABOM

“Concerns have been raised about the potential for contamination, impurities, and incorrect dosages in some compounded products,” Ewing continued.

“There have also been instances of pharmacies using different salt forms of semaglutide, which have not been approved by the FDA and whose safety and efficacy are unknown.” 

Manne-Goehler said that many reports have suggested that the current compounded GLP-1s have a higher number of severe side effects. 

“For instance, one study showed that compounded GLP-1 RAs are associated with a greater risk of adverse events, safety concerns, and product quality issues compared to non-compounded products,” she detailed.

“This may be because lower quality compounding practices can result in issues with drug quality, contamination or differences in the amount of active ingredient. Several medical societies have recommended against the use of compounded GLP-1 therapies.” 

Are there any legitimate alternatives to GLP-1s? 

If compounded GLP-1s become less available, Snyder said there are still legitimate, evidence-based options for weight loss. 

“That includes other FDA-approved medications for weight management, as well as structured medical weight loss programs that combine nutrition, behavioral support, and ongoing clinical monitoring,” he continued.

“We also expect that over time these medications will become more affordable and coverage should expand over time. But, clearly, not soon.” 

Ali said there are other medications available that are maybe available in generic form because they have been around longer, but they do not work quite the same, or maybe not even quite as well as the GLP-1 medications. 

“So there are other options available, but they may be less effective,” he added. 

For those who may be worried about affording the name-brand GLP-1 medications, Ewing said it is always worthwhile to check with your insurance provider about their coverage for weight-loss medications, as formularies can change, and what was not covered before might be now.

“Many pharmaceutical companies offer copay cards and patient assistance programs that can significantly reduce the out-of-pocket cost of brand-name GLP-1s for eligible individuals,” he detailed. “Services like GoodRx can offer significant savings on brand-name GLP-1 medications for those paying out-of-pocket.” 

“It is essential for patients currently using compounded GLP-1s to have an open conversation with their healthcare provider to explore these alternatives and develop a safe and effective treatment plan moving forward,” Ewing added. 

• Researchers found that the narrowing of large arteries was unlikely to result in lacunar stroke, a common form of stroke.
• In contrast, the widening of arteries within the brain was associated with both lacunar stroke and a brain issue known as cerebral small vessel disease.
• The study authors suggest that treatment for lacunar stroke and cerebral small vessel disease should look beyond addressing narrowing arteries and blood clots.

A study has shed new light on what might cause one of the most common forms of stroke, which could have major implications for how doctors treat and prevent it.

The type of stroke under investigation was lacunar stroke, a form of ischemic stroke. Lacunar strokes are smaller in size than other strokes and occur deep within the subcortical areas of the brain.

Lacunar strokes can happen when small blood vessels in these areas become damaged, a process that is also known as cerebral small vessel disease (cSVD). It has been unclear what underlying mechanisms cause this damage in the first place, however.

“This study provides strong evidence that lacunar stroke is not caused by fatty blockage of larger arteries, but by disease of the small vessels within the brain itself,” said study author Joanna Wardlaw, CBE, FRCP, FRSE FMedSci, FRCR, Professor of Applied Neuroimaging at the University of Edinburgh in the United Kingdom in a press release.

“Recognizing this distinction is crucial, because it explains why conventional treatments like antiplatelet drugs are not as effective for this type of stroke and highlights the urgent need to develop new therapies that target the underlying microvascular damage,” Wardlaw explained.

Ischemic strokes occur due to blood vessels becoming blocked, reducing blood flow to the brain. Around 87% of all strokes are ischemic strokes. Roughly a quarter of these are lacunar strokes.

Doctors tend to treat lacunar stroke in the same way as other forms of ischemic stroke, and the typical methods for preventing ischemic stroke aim to stop arteries narrowing and becoming blocked by buildups of fat.

However, the use of medications like aspirin has appeared to be less effective at preventing lacunar stroke than other forms of the disease.

What did the researchers look at?

For the study, published in Circulation, the researchers examined data from a total of 229 stroke patients. Of these, 131 had experienced lacunar stroke with the rest having experienced a mild non-lacunar stroke.

These patients were recruits of the Mild Stroke Study 3, a group consisting of people who had recently experienced strokes in Edinburgh, U.K., between 2018 and 2021.

Each participant underwent a range of clinical assessments and MRI brain scanning at the time of their recruitment to the study. Clinicians then repeated these assessments a year later.

The researchers wanted to investigate how changes to the arteries related to the different types of stroke as well as the cardiovascular health of the participants over time.

They were particularly interested in the narrowing of large arteries, which clinicians have traditionally seen as a major risk factor for all ischemic strokes, as well as the widening and lengthening of smaller arteries within the brain itself.

Narrowing of large arteries not associated with lacunar stroke

The researchers found that the narrowing of large arteries was not associated with lacunar stroke or any markers of cSVD.

However, widening and elongation of the small arteries within the brain did have an association with lacunar stroke. In fact, the patients whose scans showed these changes were four times more likely to have had a lacunar stroke.

These changes in the small arteries within the brain were also strongly associated with nearly all the markers for cSVD that the researchers measured for, as well as a higher risk of having a new silent stroke in the year after the initial assessments.

A silent stroke is a small amount of brain tissue damage that can occur due to restricted blood supply to the area. The word “silent” comes from the fact that they often appear to be symptomless.

More than a quarter of the patients experienced these silent strokes, even after receiving standard treatments to prevent new strokes from occurring.

These treatments include antiplatelet drugs, medication to lower blood pressure, and drugs for controlling blood cholesterol levels.

The authors suggest that solely focusing on these conventional treatments might not be the best choice in every case:

“Although these approaches remain important and should not be discounted, accumulating evidence, consistent with our results, suggests that guideline-based secondary stroke prevention, including antiplatelet therapy and statins, has limited efficacy in preventing the progression of cSVD-related brain damage.”

Possible reasons and limitations for the findings

Ischemic strokes like lacunar strokes occur due to reduced blood flow to parts of the brain. As a result, it may seem strange for there to be an association between lacunar strokes and the widening of small arteries.

The study authors suggest some potential mechanisms behind their findings. One is that there may be a shared genetic link between artery widening, lacunar stroke, and cSVD.

Another possible reason is that the widening and lengthening of certain arteries could result in extra stress being placed on other blood vessels. This could disrupt the flow of blood in these areas as well as damaging them.

Wardlaw explained to Medical News Today how this might work:

“One might think that wider blood vessels would give better blood flow but it can also be that the widening, as here, indicates loss of normal supporting membranes in the blood vessel wall of the large arteries, which means that the blood vessels are ‘baggy’ and less able to control flow. We think this is also what is happening to the small arterioles in the brain.”

Wardlaw said that the team had seen elsewhere that widening “was associated with worse function of the small blood vessels in the brain, which we know is a problem in lacunar stroke and small vessel disease.

“Therefore we think the large artery widening seen in our paper mirrors what is happening in the small arterioles in the brain which become baggy and lose the ability to constrict and dilate to manage blood flow,” she noted.

The authors note that their research was limited by the fact that their patient data all came from the stroke services in one single city. For the results to be generalizable to a wider population, they suggest larger studies looking at patients from a number of different locations are needed.

Changing approaches to post-stroke treatment

The researchers write that treatment for patients with lacunar stroke should aim to improve the functioning of small blood vessels in the brain rather than focusing on the potential clogging and narrowing of arteries.

Following up this research, the LACunar Intervention Trial 3 (LACI-3) is investigating whether two cardiovascular drugs — cilostazol and isosorbide mononitrate — can help target cSVD damage.

“The LACI-3 trial is testing two existing drugs used in heart and peripheral vascular disease that we think can improve the function of the small blood vessels in the brain and thus improve control of blood supply better,” Wardlaw told MNT.

By doing so, the hope is that this will “help to prevent more lacunar strokes and cognitive decline and other bad effects of small vessel disease.”

The trial is currently in its first year of recruitment at 38 different centers across the U.K. The team is aiming to recruit 1,300 people with lacunar stroke receiving treatment for 18 months, with the main outcome to assess being the effect on cognitive decline.

This trial could go some way to supporting the findings of the study and potentially alter the approach of future stroke treatment plans.

• Some existing research has suggested that egg consumption could benefit brain health as we age, with one recent study indicating that eating one egg per week was linked to lower Alzheimer’s risk.
• A new study now claims that eating eggs at least five times a week is linked to a lower likelihood of receiving an Alzheimer’s diagnosis.
• The study authors emphasize that moderate egg consumption is part of a balanced diet, which benefits health overall.
• However, some questions remain in place about whether or nor the relationship between egg intake and brain health is causal.

When it comes to health benefits, eggs have had a fluctuating reputation over time. For years, a belief persisted that their high content of dietary cholesterol might negatively affect cholesterol levels in the human body.

More recent studies, however, argue that dietary cholesterol from moderate egg consumption does not contribute to higher levels of “bad” cholesterol in the human body and thus does not heighten heart disease risk.

In fact, there is evidence to suggest that the high nutritive content of chicken eggs could bring several health benefits, including better protein synthesis in muscles, and increased satiety (the sensation of being full) that can aid weight management.

A study published in in The Journal of Nutrition in July 2024 even found a link between egg consumption and a lower risk of Alzheimer’s disease.

According to this study of 1,024 older adults, eating one egg per week was linked with a 47% lower risk of Alzheimer’s compared with having eggs less than once a month.

Now, new research from scientists at Loma Linda University Health in California — which also appears in The Journal of Nutrition — has drawn similar conclusions, offering further support to the notion that regular moderate egg consumption may help protect brain health and lower the risk of cognitive problems.

The research team acknowledges that “the analyses in this study were supported by an investigator-initiated grant from the American Egg Board.”

Might 1 egg per day keep Alzheimer’s at bay?

In the current study, the researchers analyzed data provided through the Adventist Health Study-2 (AHS-2), which was linked with Medicare claims data files.

AHS-2 totalled a cohort of more than 96,000 people; of these, a little over 39,400 met the selection criteria for the current study.

Looking at participants’ reported dietary habits and the Medicare claims linked to their health diagnoses, the researchers found that people who reported eating eggs at least five times a week had an up to 27% lower risk of receiving an Alzheimer’s diagnosis compared to those who reported no egg consumption.

Compared to no consumption, having eggs 1 to 3 times per month was linked to a 17% lower risk of Alzheimer’s, and having eggs 2 to 4 times per week was linked to a 20% lower Alzheimer’s risk.

Speaking to Medical News Today, first author Jisoo Oh, DrPH, MPH, Associate Professor of Epidemiology in the School of Public Health at Loma Linda University, said that she and her colleagues were keen to study this association because they wanted to gain a better, more granular understanding of the modifiable risk factors for Alzheimer’s disease.

“While there is substantial interest in how nutrition influences brain health, there is still a knowledge gap regarding specific foods, including eggs,” said Oh.

“Eggs are widely consumed and contain several nutrients relevant to brain function, yet the evidence linking egg intake to clinically diagnosed Alzheimer’s disease has been limited,” she added.

“Most prior studies relied on short-term cognitive outcomes or cross-sectional data. The Adventist Health Study-2 provided a unique opportunity to examine this question in a large, well-characterized cohort with long-term follow-up and linkage to Medicare data, allowing us to study incident Alzheimer’s disease more rigorously,” the researcher explained.

How might eggs help support brain health?

While this study hasn’t addressed causation, the researchers hypothesize that eggs may have a protective effect on brain health thanks to the specific nutrients they contain.

Oh mentioned:

• “choline, which is essential for producing acetylcholine, a neurotransmitter involved in memory
• lutein and zeaxanthin, which accumulate in the brain and may help reduce oxidative stress
• omega-3 fatty acids (including DHA), important for neuronal structure and function
• vitamin B12, which plays a role in reducing homocysteine levels and supporting neurological function
• high-quality protein and tryptophan, which are involved in neurotransmitter pathways.”

According to her, “these nutrients may contribute to maintaining synaptic integrity, reducing inflammation and oxidative stress, and supporting overall cognitive resilience.”

“While our study does not directly test mechanisms, the findings are consistent with these biologically plausible pathways,” she noted.

Speaking of whether or not people should up their egg intake in light of these study findings, Oh advised “moderation” and paying attention to context.

“Our findings suggest that including eggs as part of a balanced diet may be beneficial for brain health, but they should not be viewed in isolation or as a ‘silver bullet’,” she cautioned.

“For most people, moderate [egg] consumption, such as a few times per week, appears reasonable and potentially beneficial, especially when part of an overall healthy dietary pattern that includes fruits, vegetables, whole grains, and other nutrient-dense foods.”

– Jisoo Oh, DrPH, MPH

“It’s also important for individuals to consider their overall health profile and dietary needs, ideally in consultation with a healthcare provider,” the researcher added.

Are eggs the key to better brain health as we age?

Other experts also emphasized that we would be remiss to believe that the answer to better brain health as we age is to be found primarily in egg consumption.

After reviewing the study findings, Michelle Routhenstein, MS, RD, CDCES, CDN, a preventive cardiology dietitian at EntirelyNourished, who was not involved in this research, told MNT: “My first reaction was, well what else are [the people in this cohort] eating? That question matters more than most people realize.”

For Routhenstein, it is important to acknowledge that the group this study focused on is already characterized by better overall health thanks to consistently healthy lifestyle habits.

“This was an observational study done in a very specific population, Seventh-day Adventists, who as a group smoke less, drink less, eat more plants, and have lower baseline rates of obesity, diabetes, and cardiovascular disease than the average American,” the dietitian pointed out.

“So when we see that moderate egg intake was associated with lower Alzheimer’s diagnoses in this cohort, we’re looking at what happens when people add eggs to an already protective dietary pattern, not to the typical Western diet,” she maintained.

“Eggs do contain nutrients with real brain health relevance, but we need to assess the full dietary pattern, cardiometabolic health, labs, and individual metabolic markers before drawing any conclusions about what eggs mean for any one person.”

– Michelle Routhenstein, MS, RD, CDCES, CDN

“It is also important to recognize that some of the funding came from the American Egg Board and the headlines need to be in check with the details of the study, what the actual study looked at and found,” the dietitian cautioned.

What are some caveats about egg consumption?

Routhenstein also outlined some potential health drawbacks to upping egg consumption, while stressing that overall it’s not a bad idea to include eggs in our diets.

Whether or not a person should start eating more eggs is always a matter of personal health context, said the dietitian.

“Eggs aren’t a ‘free’ food, but they’re not automatically off-limits either,” she told us. “They do contribute saturated fat and dietary cholesterol, so whether adding an egg makes sense really comes down to what the rest of your diet looks like and whether it keeps you within your daily saturated fat target.”

“It’s also important to recognize that some people are more sensitive to dietary cholesterol than others, they are called ‘cholesterol hyper-responders’,” Routhenstein pointed out.

“In those individuals, egg yolks can raise LDL more significantly, and may need to be limited more carefully, especially if cardiovascular risk is already elevated,” she explained.

How to get brain-protective nutrients if you don’t eat eggs

There are also people who prefer a diet that mostly or completely excludes animal food products, including eggs. According to Routhenstein, there is no reason for them to worry, as long as they are making sure they’re following a nutritious diet overall.

Like Oh, Routhenstein explained that “eggs can support brain health because they contain several relevant brain protective nutrients —from choline [to] lutein, zeaxanthin, vitamin B12, selenium, [and] protein — all of which can play positive roles in memory, brain structure, and brain associated inflammation.”

“That said, the human data we have right now is mostly observational, which means we can see associations, but we can’t say eggs prevent Alzheimer’s disease,” she cautioned.

“And it’s worth knowing that most of these same nutrients can be found in other foods or through a well-planned plant-forward diet,” Routhenstein emphasized.

The dietitian advised that:

“Choline can come from foods like soy, kidney beans, quinoa, and Brussels sprouts. Omega-3s and B12 are worth supplementing, with dosing based on your labs, age, and individual needs. And lutein and zeaxanthin? Dark leafy greens have you covered.”

Eggs and brain health research: Where to from here on?

Concerning the current study, Oh outlined “several important” caveats, including that it was observational in nature, meaning that it cannot establish causation, and that “the study population is relatively health-conscious (Seventh-day Adventists), which may limit generalizability.”

She also noted that “diet was assessed at baseline only, and changes [to diet] over time were not captured” and there was “limited data on very high levels of egg consumption.”

“While the results are encouraging, they should be interpreted as part of a broader body of evidence,” Oh said.

Going forward, Oh noted she would like to see this research replicated in more diverse populations, as well as “studies examining egg consumption earlier in life and long-term cognitive outcomes, more detailed work on specific nutrients in eggs (e.g., choline, DHA) and their independent roles, research incorporating biomarkers and neuroimaging to better understand mechanisms,” and a rigorous exploration of potential causal relationships.

“Ultimately,” she shared, “we hope this work contributes to a more nuanced understanding of how specific foods fit into dietary patterns that support healthy brain aging.”

• Perimenopause, the time of life when a menstruating person’s cycles become disrupted as that person enters menopause, can take people by surprise.
• While information and education about menopause and how it can manifest are becoming more widespread, the start of perimenopause can be harder to identify correctly.
• Board-certified obstetrician-gynecologist Sheryl Ross explains how to figure out whether or not perimenopause has started, and what to do to minimize its impact, including making different dietary and other lifestyle choices.

In perimenopause, the female body begins its transition into menopause, which signals the end of fertility and the beginning of a new stage of life.

Recently, there has been increased awareness of the symptoms of menopause, particularly hot flashes, mood changes, night sweats, vaginal dryness, and brain fog.

However, the start of perimenopause can be hard to pinpoint, though it is generally characterized by more irregular periods and changes in the blood flow at menstruation. Perimenopause can also cause symptoms like vaginal dryness and mood changes.

According to data cited by the Office on Women’s Health, typically, perimenopause occurs in a person’s 40s, and this stage lasts around 4 years, after which menopause fully sets in.

“Perimenopause happens when your ovaries stop functioning consistently, upsetting the normal hormonal rhythm. Symptoms and hormonal changes of this transitional phase usually happen within 10 years of menopause. The 40s can be a time of hormonal unrest and chaos,” Sheryl Ross, MD, board certified OB-GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, told Medical News Today.

Ross shared her medical experience and top tips on how to figure out when perimenopause has started, and what lifestyle changes to adopt for a smooth transition into this next stage of life.

How do you know if perimenopause has started?

Because of this, “it can be challenging to know the difference between these two normal hormonal cycles —perimenopause and menopause,” Ross told us.

According to her, the first step is to be aware of the symptoms associated with it, which are caused by fluctuations in estrogen levels.

These can include:

• irregular, erratic, and heavy periods
• night sweats and hot flashes
• sleep disturbances
• sudden changes in mood with depression and anxiety symptoms
• short-term memory loss and trouble focusing
• vaginal dryness
• low sex drive (low libido).

“Hot flashes and night sweats are known as ‘vasomotor’ symptoms and occur as a result of fluctuating estrogen levels,” Ross told us. “They can occur with the same vengeance and disruption in both perimenopause and menopause.”

According to her, “having hot flashes and night sweats only suggests fluctuating or declining estrogen levels and does not differentiate between perimenopause and menopause.”

Still, she said, “the conversation starts with knowing your symptoms and getting blood tests, including your FSH [follicle-stimulating hormone] and estradiol levels.”

What’s the best diet for perimenopause?

Ross emphasized that perimenopause symptoms can be disruptive and that they can seriously impact a person’s quality of life on a day-to-day basis.

Still, she noted that “simple lifestyle modifications, medications specifically treating each symptom, and hormone therapy” can all help keep any bothersome symptoms in check.

First and foremost, “consulting with a healthcare provider who treats perimenopause and menopause is recommended to be given personalized care and safe treatment options,” she advised.

At the same time, she said: “A healthy lifestyle goes a long way at any time in your life, but especially in this later chapter of life. […] There are simple adjustments you can start to make as soon as you notice hormonal changes in perimenopause.”

According to Ross, dietary changes can be key to staying at the top of one’s game during perimenopause:

“A diet focused on fresh fruits, vegetables, whole grains and fish, with limited alcohol intake and little red meat — similar to the Mediterranean diet — not only benefits your heart, it improves cognitive function. The Mediterranean diet is associated with the highest life expectancy and lowest heart disease rate and is proven to help perimenopausal symptoms.”

On the same note, she emphasized, this is the time to “ditch the fast food,” explaining that “the saturated fats and excessive sodium in fast food give you no ‘value’ whatsoever; in fact, depression is more common in those who eat fast food regularly.”

“Within weeks of removing this food, you will show a decrease in cholesterol levels and even a decrease in weight gain,” Ross suggested.

She also advised that: “Removing or decreasing sweets in your diet will not only limit your calorie intake; it will often reduce your intake of fat. A reduction of sugary foods will immediately reduce blood sugar, which will help in decreasing the bloating and water retention so common in perimenopausal women.”

• Current treatments for inflammatory bowel disease (IBD) focus on reducing inflammation and relieving symptoms through therapies such as medications.
• However, some people with IBD, which includes ulcerative colitis and Crohn’s disease, don’t respond to any type of therapy.
• Two new studies found that a combination of two medications may offer better results in treating IBD than using each drug individually, especially in people where other therapies had previously failed. 

Researchers estimate that more than 4.9 million people globally are living with inflammatory bowel disease (IBD) — an umbrella term for two conditions, ulcerative colitis (UC) and Crohn’s disease, that negatively impact the body’s digestive system.

There is currently no cure for IBD. Current treatments focus on lowering inflammation and symptom relief through the use of medications, lifestyle changes, and surgery, in the hopes of achieving remission.

Unfortunately, not all medications work for everyone with IBD. Past studies show that between one-third to one-half of people with IBD don’t respond to any type of therapy.

Now, two new studies recently presented at Digestive Disease Week® (DDW) 2026 report that a combination of two medications may offer better results in treating IBD than using each drug individually, especially in people where other therapies had previously failed. 

The findings of these studies have yet to be published in a peer-reviewed scientific journal.

Two parallel clinical trials study duo drug

Scientists conducted two Phase 2b clinical trials sponsored by Johnson & Johnson in tandem — DUET-Crohn’s and DUET-UC — which examined the use of a combination fixed-dose co-antibody therapy known as JNJ-4804 that combined the medications anti-IL-23 therapy guselkumab and an anti-TNF antibody called golimumab.  

“We’ve seen an explosion of new kinds of treatments over the last 25 years to treat IBD,” Bruce E. Sands, MD, MS, Dr. Burrill B. Crohn Professor of Medicine at the Icahn School of Medicine, and chief of the Division of the Dr. Henry D. Janowitz Division of Gastroenterology at Mount Sinai Health System, and lead author of the Crohn’s disease study, told Medical News Today.

“But unfortunately, while many of these drugs are quite effective, we’re seeing a plateauing of efficacy over time. We need to keep finding new therapies that work better and hopefully are more durable and also have good safety,” he said.

Studying two-drugs-in-one

“Crohn’s disease and ulcerative colitis are very complex immunologic diseases, and there are a lot of different pathways by which the disease occurs. So we think that if we block more than one of these pathways at the same time, we might get [more] additive benefit. So the DUET studies, both Crohn’s and UC, were designed to explore this by comparing a combination of two therapies to either one of those therapies alone.” 
— Bruce E. Sands, MD, MS

“Importantly, the study only allowed patients to come into the study that had already been on [at] least one previous advanced systemic therapy mechanism,” added Maria T. Abreu, MD, executive director of the F. Widjaja IBD Institute at Cedars-Sinai, and lead author of the ulcerative colitis study. “So, for example, they could have been previously on anti-TNF, they could have previously been on anti-IL-23, [a]nd they could have been on a multiple of these.” 

“Usually the low hanging fruit is to treat patients that have been on nothing,” Abreu explained to MNT. “If they’ve been on nothing, the world is your oyster. Most things help people who have been on nothing. But those patients that have been on previous medications and that medication either lost its mojo, lost its effect, or never had an effect, are more refractory to treatment.” 

“It’s actually possible that the immune system changes because now if you suppress only one thing, the immune system tries to find a way around it to continue this inflammatory response,” she said. “And so they were essentially asking for patients to be enrolled that were the most difficult to treat patients.”

Combo therapy significantly increases clinical, endoscopic response 

Researchers recruited 693 participants for the Crohn’s study and 572 for the UC study. Participants randomly received either a placebo, just golimumab, just guselkumab, or the combination therapy JNJ-4804.

At the conclusion of the UC clinical trial, researchers discovered that for study participants who had previously tried and failed one or more therapies, JNJ-4804 showed improved outcomes when compared with golimumab, as well as similar efficacy to guselkumab across key measures of remission and endoscopic improvement at 48 weeks. While in the CD trial, the highest dose of JNJ-4804 outperformed both individual drugs.

“For patients that have failed two or more mechanisms of action, which we’re getting more and more as we expand our armamentarium, it makes a lot of sense that we’re going to be using combinations of therapy,” Abreu explained.

“Ideally, they will be rational, meaning that the therapies will be complementary in their mechanisms of action and have some thought behind them. And this is really the first foray into that, is using this combination. So I think we’ll be reserving our combination therapies, at least for now, for the patients that are the neediest patients,” she said. 

When will this therapy be available to patients?

Although the results from these trials are promising, people with IBD may have to wait longer before this therapy becomes readily available as standard treatment.

“I think the significance of these studies is not only the direct results that show that this particular combination of anti-TNF and anti-IL-23, golimumab and guselkumab, is more effective than either one alone in the patients who have failed two or more classes of therapies. It speaks more broadly to the idea that combination therapies are a promising direction for the treatment of people with IBD in general.”
— Bruce E. Sands, MD, MS

“And very importantly, at least for this combination, we hope that in future combinations, there’s no increase in safety events, so there’s no more risk to the combination,” Sands said. 

“These were phase 2B studies, so to get approved, this combination will have to enter into phase 3 studies, which are considered the registrational studies that would lead to approval of the drug,” he explained.

“And because they will be large studies and will take a while to conduct, I imagine that we wouldn’t see these approved earlier than two-and-a-half or perhaps three years. But in the meantime, there’s a lot of excitement about that,” he added. 

People with IBD may need to be treated differently

Alyssa Parian, MD, director of the Center for Inflammatory Bowel Disease (CIBD), a comprehensive program offering specialized care for patients with IBD and related colorectal conditions, who was not involved in the study, spoke to MNT about these studies.

“We are already frequently using dual advanced therapy in our practice for patients with severe refractory disease,” Parian said. “These controlled trials help solidify what we are seeing clinically, that these patients have improved response to dual therapy and provide long-term safety data.” 

“The concept of a ‘co-antibody’ therapy that targets two inflammatory pathways at once is a significant step forward. Seeing that this approach may be able to ‘outsmart’ the immune system, as Dr. Abreu mentioned, is very exciting. The fact that the combination therapy shows additive efficacy without increasing safety risks is a critical finding.”
— Alyssa Parian, MD

“Long-term monitoring for durability will be critical as there may be concerns that the immune system may continue to find ways around even dual therapies,” Parian added. 

MNT also spoke with Ashkan Farhadi, MD, a board certified gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, about these two clinical trials. 

Farhadi said it’s very important for researchers to continue to find new treatments for IBD, especially for those people for whom current treatments may not be working. He explained that many times, people with IBD are considered to be a heterogeneous group under one umbrella, but this tells us that maybe they are not one disease. 

“They are different diseases that they present very similar, and we call them all the same,” Farhadi continued. “And this is maybe why some of those patients respond beautifully to one medication and the other one does not.”

Some IBD patients don’t respond to treatments

“In general, over the board, we’re having something in a range of 30-50% or sometimes 58% response rates in all these medications. And then you put them in the context that you’re having 20-30% placebo response over the board, we’re having almost 40% of people who are not responding to particular medicine.”
— Ashkan Farhadi, MD

“And if you even switch (their medication), you may not get a response,” he added. “So it’s kind of natural to think that if you just use two medications, you can get a better response. So it’s not that out of touch, if you want to think about it.” 

• Novo Nordisk announced its rebranded oral semaglutide pill, Rybelsus, will soon be available as the ‘Ozempic pill’ following a formulation change.
• The smaller, reformulated pill will be available in different dosages than the Rybelsus pill, with Novo Nordisk stating it provides the same efficacy and safety profile as the original formulation.
• The healthcare company also states that the Ozempic pill will be available nationwide through pharmacies, telehealth, and mail-order services.
• Pricing is expected to vary by coverage, with insured patients potentially paying $25 for up to 3 months, while self-pay options are estimated between $149 and $299 per month depending on dose.

Semaglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist that mimics a hormone to increase insulin secretion, slow gastric emptying, and reduce appetite.

The medication has Food and Drug Administration (FDA) approval for helping with long-term weight management and treating type 2 diabetes.

For many people, semaglutide is better known as the injectable drug Ozempic. However, many may not be aware that semaglutide has been available in oral form since it was approved by the FDA in 2019.

After previously announcing a rebrand and reformulation to Rybelsus in February 2026 to make the treatment more easily recognizable and bioavailable, Novo Nordisk announced that the “Ozempic pill” will be available for adults with type 2 diabetes in the United States starting Monday, May 4, 2026.

Highlighting that the oral pill can help improve blood glucose control alongside diet and exercise, while also reducing major cardiovascular events in adults with type 2 diabetes at increased risk, the pharmaceutical company adds that the pill will be available through 70,000+ U.S. pharmacies nationwide and select telehealth providers.

Rebrand and reformulation

Novo Nordisk’s Rybelsus was the first oral GLP-1 receptor agonist product approved by the FDA for the treatment of type 2 diabetes. It was available in 3 milligram (mg), 7 mg, and 14 mg tablets.

The oral pill was designed to help improve blood glucose control alongside diet and exercise, while also offering additional cardiometabolic benefits in certain high risk patients.

Now rebranded as the Ozempic pill, the updated formulation is available in different strengths of 1.5 mg, 4 mg, and 9 mg. In the press release, Novo Nordisk states that the Ozempic pill formulation is more bioavailable and works similarly to the Rybelsus tablets, offering the same efficacy and safety profile as the original formulation, but in a smaller pill.

The pharmaceutical company adds that people should take the new formulation the same way as before, so that people who were taking 3 mg should now take 1.5 mg, and so on.

While both injectable Ozempic and oral Rybelsus contain semaglutide and have approval for type 2 diabetes, Novo Nordisk suggest the brand name Ozempic is more synonymous with GLP-1 medications, hence the rename.

“While the oral form of semaglutide has been available for years as Rybelsus, the Ozempic branding is more widely recognized, which may lead to increased patient requests,” Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Medical News Today.

“Additionally, because the oral form has a longer shelf life, it may offer logistical advantages for certain prescribing patterns,” Ali explained.

Oral or injectable?

The choice between oral and injectable formulations is typically down to individual factors and preferences. It is advisable for a person to discuss options with their healthcare professional.

Generally, research suggests that injectable semaglutide achieves significantly greater HbA1c reductions compared to oral forms in those with type 2 diabetes.

Additionally, while the daily oral form may be preferable to weekly injections, research suggests that adverse events occur more frequently with oral semaglutide.

Speaking to MNT, Ali noted the potential advantages and disadvantages of oral GLP-1 medications:

“The primary advantages of oral GLP-1 medications are that they are easier to take, transport, and store. They are also typically less expensive to manufacture, which could lead to lower costs for patients. The disadvantages are that they are slightly less effective than injections and require daily instead of weekly administration.”

Pricing and access plans

Novo Nordisk also outlined pricing arrangements they suggest will improve access to the Ozempic pill. For insured individuals, the medication may be available for $25 for up to a 3-month supply.

Self-pay options, available through Novo Nordisk’s pharmacy and select telehealth providers, are expected to range from approximately $149 to $299 per month, depending on dose strength, defining a month’s supply as one bottle of 30 pills.

This may offer a cheaper alternative to injectable Ozempic, as while a 3-month supply may also be available for $25, self-pay patients can expect to pay $349 per month for doses up to 1 mg and $499 for the 2 mg dose.

“Pricing and insurance coverage are significant factors in medication adherence,” Ali told MNT.

“High out-of-pocket expenses make patients less likely to seek or maintain treatment. Consequently, if costs remain high, individuals in lower socioeconomic areas with limited health coverage will face significant barriers to accessing these medications,” he added.

A shift toward oral GLP-1 treatments?

The rebrand of the Ozempic pill may reflect a broader shift in diabetes care toward GLP-1–based therapies, with the FDA approving Foundayo, an oral GLP-1 receptor agonist from Eli Lily, in April 2026.

While GLP-1-based therapies have traditionally been administered via injection, the oral formulations aim to provide a more convenient alternative for those who prefer not to use injectable medications.

Novo Nordisk adds that the pill is manufactured end-to-end in the U.S. and will be widely distributed through established pharmacy networks. They also note that this is the first time oral semaglutide for type 2 diabetes is being offered through their direct-to-patient service.

“Accessibility is critical, especially as these medications are in high demand and have faced shortages,” Ali highlights. “Lack of access often leads patients to switch to less effective alternatives or discontinue treatment entirely.”

Beyond blood sugar control, Novo Nordisk also states that the Ozempic pill is also approved for reducing the risk of major cardiovascular events, including heart attack, stroke, or death, in adults with type 2 diabetes who are at elevated risk.

“Real-world cardiovascular benefits are linked to weight loss, improved blood pressure, and reduced inflammation,” Ali notes. “Some studies have shown a reduction in major adverse cardiovascular events by 18-20%. Patients with diabetes, obesity, and existing atherosclerotic cardiovascular disease stand to benefit the most.”

• A person’s brain health is affected by their physical and psychological health, experiences from infancy throughout their lifetime, and some environmental factors.
• Healthy lifestyle habits, such as eating a healthy diet, not smoking, not drinking to excess, getting adequate exercise and sleep, and avoiding stress, can all help improve brain health.
• In a statement published last week, the American Heart Association outlined how promoting healthy lifestyle behaviors, improving environmental conditions, and expanding access to health, social, and mental health care can protect brain health and reduce the risk of stroke and dementia.

Worldwide, the number of people ages 65 and over is expected to exceed 1.5 billion by 2050. And the goal is to remain healthy for as many of those years past 65 as possible. With cases of dementia rising, a key part of healthy aging is maintaining cognitive function and a healthy brain.

Last week, the American Heart Association (AHA) published a scientific statement outlining how experiences throughout a person’s life can affect brain health and how a person can improve their brain health.

The statement, which focuses on physical and psychological variables throughout life, highlights strategies that can help a person maintain brain resilience into older age.

“The main takeaway is that brain health is not determined only by age or genetics. It is shaped across the entire lifespan by a combination of physical health, mental health, sleep, lifestyle, social support, environment, and access to care. The American Heart Association statement is important because it reframes brain health as something we can influence much earlier and more broadly than we used to think.”

— Dung Trinh, MD, internist, of MemorialCare Medical Group and Chief Medical Officer of Healthy Brain Clinic in Irvine, CA

Experiences throughout life affect brain health

It has long been known that keeping your heart and blood vessels healthy is key to brain function, but this statement also focuses on other factors that affect brain health.

The statement highlights 10 factors that can adversely impact the health of a person’s brain:

• Early life infections
• Adverse childhood experiences
• Socioeconomic factors
• Chronic medical conditions
• Stress
• Anxiety and Depression
• Pollution and environmental exposures
• Chronic inflammation
• Disruption of the gut microbiome (dysbiosis)
• Poor sleep quality

These factors can affect the body in several ways, in turn affecting brain health.

“Many of the habits we think of as ‘heart healthy’ turn out to be ‘brain healthy’ too. This statement reinforces that idea, while also highlighting factors that do not always get enough attention in research or in everyday clinical care. One of the most important messages is that brain health is shaped across our entire lives and not just in old age. Experiences and choices made early in life can have a real impact decades later,” Melinda (Mindy) Patterson, PsyD, an Assistant Professor of Neurology with the University of Rochester Medicine, told Medical News Today. 

“That also means there is good news: no matter what stage of life you are in, there are steps you can take to lower your risk of stroke and cognitive decline,” she added.

Protecting brain health not just up to individuals

“The AHA statement also reminds us that brain health is not just an individual responsibility. Environment, education, food access, health care access, housing, pollution exposure, and social support all matter. So the future of dementia prevention is both clinical and public health oriented.”
— Dung Trinh, MD

The statement says governments should enforce policies to control air pollution and improve air quality, as pollution from sources such as pesticides and microplastics can lead to neuroinflammation, oxidative stress, and neurodegeneration. It also advocates adherence to routine vaccination schedules to help people avoid infections that can damage brain health.

It highlights that a multifaceted approach to address socioeconomic factors (eg, geographic location, race) and systemic inequalities to promote equitable access to resources and opportunities (eg, safe housing, healthy foods, education, healthcare, and mental health services) is needed to ensure that these social determinants of health do not adversely affect brain health.

How to protect brain health: Sleep, diet, exercise, and more tips

The AHA advises that straightforward lifestyle changes can positively impact brain health, and that both individuals and clinicians play a role.

Trinh echoed Patterson in advising that what is good for the heart is generally also good for the brain.

“First,” he told us, “control vascular risk factors. High blood pressure, diabetes, high cholesterol, obesity, and smoking are major threats to long-term brain health. Blood pressure control is one of the most important modifiable steps we have.”

“Second, prioritize sleep. Poor sleep and untreated sleep apnea can affect memory, attention, mood, inflammation, and vascular health. Sleep should be treated as a brain-health intervention, not as a luxury.”

Both Trinh and Patterson advocated regular physical exercise, with Patterson calling it: “The most important factor in preventing dementia and supporting brain health in the long term.” 

Trinh explained why exercise is so beneficial: “Physical activity improves blood flow, metabolic health, mood, sleep, and cognitive resilience. Even walking consistently can be meaningful.”

Diet is equally important. Trinh noted that the AHA statement highlights the emerging role of gut health and the gut-brain connection, telling MNT that people should “eat in a brain-healthy pattern. I generally recommend a Mediterranean-style diet: vegetables, fruits, legumes, whole grains, nuts, olive oil, fish, and fewer ultra-processed foods and added sugars.”

And he emphasized that people should protect their mental health and social connections.

“Chronic stress, depression, anxiety, and loneliness are not separate from brain health. They are part of the biology of aging. Social engagement, purpose, stress reduction, and treatment of mood disorders should be considered part of dementia-risk reduction,” Trinh added.

“Finally,” he told MNT, “avoid smoking, heavy alcohol use, and substance misuse, all of which can accelerate vascular and neurologic injury.”

Do I have to make these lifestyle changes all at once?

This may seem like an awful lot to think about, but Patterson advised that people do not have to make lots of changes all at once to help protect their brains as they age:

“For many people, reading about all the things that can lower the risk of dementia feels overwhelming. When I work with patients, I encourage them to pick one or two things to focus on and start there. People are much more likely to succeed at making healthy changes when they set small, realistic goals.”

“Instead of trying to change your entire diet at once, try adding one extra serving of vegetables each day, or cut back on sugary foods. Instead of going from no exercise to working out every day, try adding just one active day to your week. Once you hit those smaller goals, you start to build confidence and momentum — and from there, making even more changes becomes much easier,” she told us.

“It’s never too early, and it’s never too late, to start protecting your brain.”
— Melinda (Mindy) Patterson, PsyD

.

• A new study examined the impact of alcohol consumption in healthy adults who did not report drinking more than the accepted ‘low-risk’ alcohol limits. 
• Using MRI scans, the researchers found a correlation between higher alcohol intake and lower brain blood flow.
• Additionally, they saw that this effect was more pronounced in older adults.

Whether someone is grocery shopping or dining out, alcohol is almost everywhere. While moderate alcohol use is considered “low-risk,” more research is coming out that shows there may truly be no safe amount of alcohol.

A new study focused on healthy adults who consume alcohol moderately. The research team wanted to see if drinking has any neurological impact on adults who consume alcohol in a relatively “safe” way.

The findings are published in the journal Alcohol.

Challenging the idea of ‘low-risk’ alcohol intake

Alcohol consumption is common in the United States. According to the National Institutes on Alcohol Abuse and Alcoholism, around 85% of adults 21 and older reported drinking alcohol at least once. 

The Centers for Disease Control and Prevention (CDC) advise limiting alcohol use and says that people who do drink should do so moderately. They recommend that women limit themselves to 1 drink per day and men to 2 drinks per day.

Older, outdated research found that moderate alcohol use could have some health benefits, such as positive psychological benefits and a reduction in heart disease, but newer research is moving away from those hypotheses.

More recent research shows that moderate alcohol use can contribute to DNA damage and may even raise the risk of developing certain types of cancer.  

The researchers in the new study wanted to expand research on the potential impacts moderate alcohol use may have on the brain. 

They studied 45 healthy participants between the ages of 22 and 70 who did not have a history of alcohol use disorder. 

The researchers administered a series of questionnaires to determine the participants’ lifetime alcohol use and to also screen out factors that could impact brain health, such as neurological disorders, psychiatric conditions, and recent substance use.

Next, the researchers used MRI scans to measure cortical thickness, brain volume, and blood flow, also known as perfusion. 

The scientists next analyzed how alcohol consumption related to these brain measurements, including the combined effect of age and total lifetime drinking. 

Reduced brain blood flow, especially in older adults

The analysis of the MRIs and the participants’ self-reported alcohol use showed that moderate alcohol consumption may not be safe. 

The results showed that low levels of alcohol consumption were associated with reduced brain blood flow, which is important for delivering oxygen to the brain.

Also, people who reported higher monthly averages of alcohol consumption showed a greater reduction in blood flow compared to people with lower monthly averages of alcohol consumption. 

Reduced blood flow in the frontal and temporal lobes is significant because these areas control thinking, memory, and language. Over time, this reduced blood flow could contribute to cognitive decline. 

The scientists also found that these effects were amplified in older adults. The combination of getting older and having a higher lifetime alcohol intake was linked to widespread lower blood flow across most regions of the brain.

They also noted that older adults who had a higher average lifetime alcohol intake had thinner brain cortices. A thinner cortex in older adults may increase the risk of cognitive decline or dementia.

The study authors think that oxidative stress is a potential explanation for these findings. Oxidative stress causes cellular damage and is linked to aging and inflammation. 

Lead study author Timothy C. Durazzo, PhD, a professor at Stanford, spoke with Medical News Today and explained what is next for this research.

“[The] next steps are to investigate the associations of low-level drinking with measures of balance, coordination, and dexterity, in a larger group of participants, which are currently underway,” said Durazzo. 

He explained that a much larger study is needed to confirm the study findings: “The number of participants in our study, particularly for the blood flow measures, was very modest […] and requires replication, in a much larger group of participants, to verify the findings of our study.”

Durazzo also told MNT that the findings would not impact current guidelines due to the smaller participant pool.

Findings are a ‘warning signal’

Dung Trinh, MD, internist of MemorialCare Medical Group and Chief Medical Officer of Healthy Brain Clinic, spoke with MNT about the study.

“For many years, the public message was that light or moderate drinking may be harmless, or even beneficial in some cases,” said Trinh. “This study challenges that older idea by suggesting that even alcohol intake within traditional ‘low-risk’ ranges may be associated with measurable brain changes.”

Trinh mentioned that the study was “especially interesting” since its participants were healthy and had no history of alcohol abuse. 

However, he emphasized that the study is “small and observational” and would not impact alcohol intake guidelines at this point.

“It should be viewed as a credible warning signal rather than proof that low-level alcohol directly causes brain damage. The main takeaway is that ‘low risk’ does not mean ‘no risk‘.”

– Dung Trinh, MD

Trinh would like to see further research in this area, including expanding the study to include a larger population and more diverse groups.

• We’ve rounded up the latest research from this past month on the health benefits of vitamin D supplements.
• Among the studies we’ve covered as of late is one on a genetic link between vitamin D supplementation and reduced risk of type 2 diabetes.
• Another study examines the link between higher vitamin D levels and biomarkers of Alzheimer’s disease.
• And lastly, a study examines the effects of vitamin D on the immune system in the context of inflammatory bowel disease (IBD).

Vitamin D, also known as the sunshine vitamin, is often touted as a cure-all, but does its hype live up to the evidence?

Past research has shown that vitamin D, which, in a technical sense, is actually a hormone or prohormone, can benefit health in multiple ways, most notably bone and dental health, the immune system, and cardiovascular health.

However, very high doses of vitamin D have also been linked to health risks such as nausea, vomiting, and weakness, which underscores the importance of seeking medical supervision before taking such supplements.

Medical News Today has compiled three of the latest pieces of research investigating the benefits of Vitamin D and summarized their key findings.

Can vitamin D help prevent diabetes?

Published in the journal JAMA Network Open in April 2026, this study highlighted how vitamin D supplements can affect health outcomes depending on an individual’s genetics.

What did the researchers find?

The researchers found that high dose vitamin D supplementation reduced the risk of type 2 diabetes for some people, but had no significant effect for others.

Particularly, people with the AC or CC variants of the vitamin D receptor gene had a 19% decrease in their risk of prediabetes developing into type 2 diabetes when taking 4,000 IU/day.

However, the researchers and medical experts Medical News Today spoke to underscored the dangers of taking too much vitamin D, while reiterating that these findings would need to be replicated in larger trials.

Diabetes is also a complex condition, where nutrition, genetics, exercise, weight, sleep, and many factors play a role in its development and progression, so a supplement alone is likely to do little in terms of prevention.

Why is this study important?

This study adds to growing evidence that healthcare is evolving toward individualized solutions and precision medicine.

Though genetic testing is not a widespread practice and remains costly, the study makes a case for identifying patients who will benefit the most from a preventive solution or treatment

Vitamin D is also inexpensive and generally safe as a supplement, which could be valuable in efforts to reduce rising rates of type 2 diabetes.

“It’s promising, and my reaction is cautious optimism. The study suggests that vitamin D administration, in high risk individuals with certain genetic types, may be beneficial in preventing diabetes. It shows that in the future, we may be doing genetic testing to help determine if certain therapies can be used,” Jennifer Cheng, DO, chief of endocrinology at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, who wasn’t involved in the study, told MNT.

Can vitamin D help protect against Alzheimer’s?

Published in Neurology Open Access, an official journal of the American Academy of Neurology, in April 2026, this study found that higher vitamin D levels were associated with lower tau protein levels, a key biomarker for Alzheimer’s disease, years later.

What did the researchers find?

Researchers from the University of Galway found that people with higher vitamin D levels in early middle age had lower tau protein levels on brain scans conducted an average of 16 years later.

However, they found no such link between beta-amyloid, another major biomarker for Alzheimer’s, and vitamin D levels in the blood.

Why is this study important?

This study serves as a reminder that modifiable risk factors are crucial in prevention or slowing down disease progression in Alzheimer’s and related dementias. If vitamin D deficiency can be addressed and treated earlier, the researchers hypothesize that this could reduce future dementia risk.

However, the study sample was small and homogeneous, participants had their vitamin D levels checked only once at the beginning of the study, and many other factors, such as lifestyle, may have affected the outcomes.

Steve Allder, MD, a consultant neurologist at Re:Cognition Health in London, the United Kingdom, who was not involved with the study, explained to MNT:

“Higher vitamin D levels may simply be a marker of overall better health rather than the driver of reduced tau pathology. For example, individuals with higher vitamin D are often more physically active, spend more time outdoors, and may have healthier diets, all of which are independently linked to better brain health.”

Can vitamin D help treat IBD?

Published in the journal Cell Reports Medicine, this study suggested vitamin D supplements may benefit those with inflammatory bowel disease (IBD) by helping ‘reset’ the gut’s immune system.

What did the researchers find?

Researchers monitored 48 adults with Crohn’s disease or ulcerative colitis, both of which fall under the umbrella of IBD, for 12 weeks and found that vitamin D helped reduce gut inflammation while promoting a more balanced immune response.

Vitamin D increased levels of the antibodies IgA and decreased levels of IgG, which helped the body recognize good gut bacteria while simultaneously preventing it from launching unnecessary attacks, as is what happens with an overactive immune system.

Why is this study important?

Although exploratory due to its scale and scope, this study could help change how we approach the treatment of inflammatory bowel disease (IBD), adding to the evidence that vitamin D could be an adjunct therapy.

In contrast to traditional treatments, which are based on suppressing the immune system, this study promotes “immune tolerance,” retraining the gut and immune system to coexist peacefully with gut bacteria.

John Mark Gubatan, MD, study author, and gastroenterologist at Mayo Clinic in Jacksonville, Florida, explained to MNT:

“Our exploratory study highlights [that] there could be potential benefits with vitamin D in controlling the interactions between the immune system and gut microbiome in patients with IBD and that further work is needed to understand the exact vitamin D levels and vitamin D supplementation strategies to support this in patients with IBD and other chronic inflammatory diseases.”

If you’d like to read more about our previous coverage on vitamin D, including the link between second heart attacks and vitamin D3 supplements, how vitamin D deficiencies can affect respiratory infection risk, and how vitamin D2 supplements compare to D3, check out our health news hub.

• The use of GLP-1 medications for weight loss continues to rise. 
• One drawback associated with GLP-1 medications is that weight loss not only includes fat loss, but muscle loss as well. 
• A new study found that over time, the majority of weight loss from GLP-1 medication was from fat loss, and not muscle loss.

The use of glucagon-like peptide-1 (GLP-1) receptor agonists for weight loss, like Zepbound and Wegovy, continue to rise. Recent polls report that one out of every eight Americans are currently taking a GLP-1 medication to either help lose weight or treat a chronic disease.

And with the recent approval by the Food and Drug Administration (FDA) of the Wegovy pill for weight loss, researchers expect GLP-1 medication usage to continue to grow. 

One potential drawback associated with GLP-1 medications is that weight loss not only includes fat loss, but muscle loss as well, with some studies finding that about 30% of the weight loss from GLP-1s may be contributed to loss of lean mass, or muscle mass.

Now, a new study published in the International Journal of Obesity has found that, over time, the majority of weight loss from GLP-1 medication was from fat loss, and not muscle loss.

Lean body mass loss lower than fat body mass after 12 months

For this study, researchers analyzed findings and data from 36 previously-conducted studies. The selected studies examined the impact of GLP-1 and dual GLP-1/GIP agonists on weight loss and body composition changes in adults who were overweight or obese, and who may or may not have type 2 diabetes.

Upon analysis, scientists found that after using the medications for 3 months, participants experienced a loss of about 9% of their starting weight.

This weight loss included noticeable decreases in visceral adipose tissue — or abdominal fat — as well as fat body mass, waist circumference, and their body mass index (BMI). 

However, after 3 months, researchers discovered only a modest loss in lean body mass. 

Then after 12 months of GLP-1 usage, researchers reported that participants experienced major reductions in visceral adipose tissue and fat body mass.

And while there was apparent lean body mass loss, scientists found it was relatively modest when compared to the amount of body mass loss.

Not the first study to question GLP-1s and muscle loss

Medical News Today spoke with Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this study. 

Ali commented that this study’s findings align with his clinical experiences.

“Patients primarily lose fat when using these medications,” he explained. ”While some muscle loss may occur, the majority of the weight loss is fat loss.” 

This is not the first study to show that weight loss from the use of GLP-1 medications may be lower than we think. 

A study published in August 2025 found that lean muscle mass loss via a mouse model was less than previous studies had reported, and also found that a good portion of the lean muscle mass decrease came from other tissues, such as the liver, rather than from skeletal muscles.

And research presented at the European Congress on Obesity (ECO 2025) reported that adults taking GLP-1 drugs were able to retain muscle while losing weight by strength training and eating enough protein.

Crucial importance for more studies on GLP-1s and body composition

MNT also had the opportunity to speak with Douglas R. Ewing, MD, FACS, DABOM, medical director of the Center for Weight Loss and Metabolic Health at Hackensack University Medical Center in New Jersey, about this study. 

Ewing commented that as a doctor who treats patients who may be taking a GLP-1 medication, his first reaction to the study’s results was one of measured approval.

“It provides a robust meta-analysis that confirms what many of us have been observing in clinical practice: GLP-1 receptor agonists are effective for weight loss and, importantly, this weight loss appears to be of ‘high quality,” he explained. “This means patients are losing more fat mass than lean body mass, which is a critical factor for long-term health.”

Ewing said it’s crucial for researchers to continue examining how GLP-1 medications impact a person’s body composition for several reasons. He detailed:

“Muscle is more metabolically active than fat. A significant loss of muscle mass can lower a person’s metabolic rate, making it more challenging to maintain weight loss in the long run. Preserving muscle mass is essential for maintaining strength, mobility, and overall physical function. This is particularly important for older adults, who are already at a higher risk of falls and frailty.”

“Rapid weight loss can sometimes lead to sarcopenia, a condition characterized by the loss of muscle mass and function,” Ewing continued. “Continued research can help identify strategies to mitigate this risk, especially in vulnerable populations.“

“If a person loses a significant amount of muscle while on a GLP-1 and then stops taking the medication, they may be more prone to regaining weight, and this regained weight may be primarily fat,” noted Ewing.

How can you retain muscle while on GLP-1 medication?

For readers who may be taking a GLP-1 medication or considering taking one, Ewing offered these tips on how you can help retain muscle while still losing weight:

• prioritize protein: “Protein is the building block of muscle — I recommend patients should eat at least 1.0-1.2 grams of protein per kilogram of their ideal body weight,” Ewing said. Good sources of protein include lean meats, fish, eggs, dairy, tofu, and legumes.
• incorporate resistance training: Ewing said this is non-negotiable. “Strength training at least two to three times per week is vital for stimulating muscle growth and preserving lean body mass,” he explained. “This can include lifting weights, using resistance bands, or doing bodyweight exercises like squats and lunges.”
• don’t neglect aerobic exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking, Ewing advised. “This is not only good for cardiovascular health but also helps with overall energy levels and can make it easier to stay consistent with workouts,” he added. 
• get adequate sleep: Quality sleep is essential for muscle repair and growth, Ewing said.
• work with a team: “I encourage my patients to work with a registered dietitian to create a personalized nutrition plan and a physical therapist or certified trainer to develop a safe and effective exercise routine,” Ewing added. 

• Worldwide, the number of people with obesity has more than doubled since 1990, with at least 16% of all adults now having the condition.
• Many health conditions are linked to obesity, among them cardiovascular issues, breathing problems, type 2 diabetes, and impaired mobility.
• A new study has found that for people with severe obesity and heart failure, losing weight can reverse some of the damage to the heart muscle.
• This, together with the results of another study that found impaired lung function in people with obesity, suggests that losing weight could help people with obesity to improve both their heart and lung health.

The number of people with obesity — having excessive fat deposits and a body mass index (BMI) greater than 30 — continues to increase around the world. Now, more than 16% of all adults worldwide are living with the condition. In the United States, the National Institutes of Health reports that 42.4% (2 in 5) of all adults have obesity.

Heart failure — where the heart does not circulate blood efficiently — is more common in people with obesity than those of a healthy weight. One study found that obesity doubled the risk of heart failure; another that obesity is a factor that causes both heart failure and death from heart failure. 

Heart failure with preserved ejection fraction (HFpEF) — a condition where the heart pumps normally, but does not fill properly because the heart muscle stiffens — accounts for around half of all cases of heart failure, and is more common in people with obesity than other types of heart failure.

Now, a study has found that losing weight can help reverse the effects of HFpEF and improve the contraction ability of heart muscle cells.

In the study, published in Science, researchers found that in people with severe obesity and HFpEF, those who lost more than 2kg/m² of BMI with GLP-1 agonist treatment saw improvements in heart muscle contraction.

Chemical changes in heart muscle tissue due to obesity

The researchers analyzed heart muscle cells (myocytes) taken by biopsy from 80 patients with obesity and HFpEF. They divided them into 2 groups — group 1 was cells from patients with a lower BMI (30 people), and group 2 was those from patients with more severe obesity (50 people).

As well as having substantially higher BMIs, people in group 2 had a greater incidence of other co-morbidities, including insulin resistance and sleep apnea.

Heart muscle cells from patients with HFpEF and severe obesity had a greatly reduced ability to increase force, which affects the ability of the muscle to contract. Cells from those with less severe obesity and HFpEF, and those without heart failure were more able to increase force.

The researchers found that cells from those with HFpEF and severe obesity showed similar changes to cells from people in end-stage heart failure, who were awaiting heart transplants.

The key change researchers discovered was in a protein, troponin-I, that is vital for contraction and relaxation of muscle in people with severe obesity and HFpEF. People who were more obese had greater phosphorylation of troponin-I, which the researchers showed weakened the force of the muscle cells.

David Kass, MD, the Abraham and Virginia Weiss Professor of Cardiology at the Johns Hopkins University School of Medicine, and corresponding author on the study, said that no drugs that might reverse this change had yet been approved by the FDA:

“There have been some efforts along this line, and some drugs worked quite well in cells — even human heart HFpEF cells — but failed in clinical testing where the drug appeared to have no effects at all. More work is needed, both academic and from industry around finding such drugs,” he told Medical News Today.

Linking obesity, heart failure, and impaired lung function

So why does obesity increase risk of heart failure, particularly HFpEF? Naveed Sattar, Professor of Cardiometabolic Medicine at the University of Glasgow, UK, explained to MNT:

“Obesity impacts blood volume, blood pressure, and so the pressures the heart has to work against. It also impacts how much tissue needs to be perfused [provided with blood] and it impacts kidney and inflammation pathways and some aspects of heart function in the left atrium, so that all the collective effects of obesity can lead to signs and symptoms of heart failure even if the main pump — the left ventricle — remains in good order in HFpEF.”

Kass explained how the prevalence of HFpEF has changed:

“When HFpEF was mostly found in older individuals who had poorly controlled chronic high blood pressures and ventricular hypertrophy that formed in response to this, obesity was much less common. Over the past 20 years, we have treated these comorbidities better, while obesity and severe obesity are increasing in prevalence substantially.”

But he reassured that, although the epidemiological association between severe obesity and HFpEF is well established, only around 5% of people with severe obesity in the United States have HFpEF.  

Heart function is not the only thing affected by obesity. A study presented last week at the American Physiology Summit in Minneapolis highlighted that, in older adults, obesity adversely affects lung function. The results of the study have yet to be published in a peer-reviewed scientific journal.

In their study, researchers reported that not only did those with obesity have significantly lower lung capacity, which limits the amount of air that can be inhaled, but they also were unable to fully empty their lungs when exhaling. These issues can cause chronic shortness of breath, wheezing and inefficient breathing, symptoms that are also seen in people with HFpEF.

Losing weight can reduce issues with heart and lung function

In the heart study, a subset of 16 patients, with a mean BMI of 39, undertook a 1.5 year course of weight-loss therapy, using GLP-1 receptor agonists (GLP-1RAs), injectable treatments used to treat both obesity and type 2 diabetes.

Their muscle cells regained contraction abilities and, in those who lost 10% or more of their body weight, their cells recovered to almost normal peak muscle cell force.

Kass suggested why this might have happened: “One possibility [is] that the change in the muscle protein — troponin I — that we highlight in [our study], that increased in tandem with BMI in the HFpEF patients, was reversed in those that lost weight.”

“We also show that in HFpEF patients, the capacity of of the heart muscle to contract to calcium declined in direct relation to the BMI increase; so we are in a way then reversing that same association — lower BMI [led to] greater calcium-tension response,” he added.

However, he cautioned that: “Much still needs to be done to confirm the exact biological changes that occur with the GLP1-RA treatments that are involved.”

Cheng-Han Chen, MD, board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, concurred: 

“Recent research does suggest that GLP-1 receptor agonists may have direct effects on the health and function of heart muscle cells. However, more research is necessary to determine whether these direct effects are responsible for the beneficial effects of GLP-1 RAs, rather than their effects on weight loss.”

“It’s become clear that large scale weight loss is already something many heart failure experts wish for their patients living with obesity with HFpEF, given such meaningful symptom and functional benefits, never mind the potentially many other comorbidity benefits. We now view obesity as a major target in HFpEF management.” 
— Prof. Naveed Sattar

• A study suggests that a 10-minute daily exercise program that a person performs lying down could significantly help to improve balance, agility, and trunk flexibility.
• The researchers suggest the improvements may be driven by changes in neuromuscular coordination, or how the brain and muscles work together, rather than increases in muscle strength or power.
• While the study involved healthy young adults, with the exercises being low intensity and performed in a stable, lying position, it may offer a safe and practical option for fall prevention and early stage rehabilitation.

Maintaining balance in humans is more complex than it may seem and requires proper alignment, whether standing still or moving.

The body coordinates a lot of information to support balance, allowing people to move more easily and put less strain on joints and muscles. However, with poor balance, even simple tasks can feel hard and the risk of falling or experiencing joint disorders increases.

The body’s center of gravity sits relatively high, and much of its mass is concentrated in the head and trunk. To stay upright and move efficiently, these heavier segments must be carefully aligned and supported by coordinated movements of the legs.

This relationship requires that the trunk and lower limbs work together seamlessly. When this coordination is disrupted, it can contribute to low back pain, inefficient movement, and reduced stability.

While many exercise programs target either core strength or leg strength separately, fewer strategies focus on integrating the two systems.

Now, a study published in PLOS One suggests that just 10 minutes of brief, low intensity exercise performed lying down, or in a supine position, that promotes coordination of these two systems could lead to measurable improvements in balance and agility.

A simple program, done lying down

To address this gap, a team led by researchers at Tokyo University of Agriculture and Technology developed a short exercise routine performed entirely in a supine position.

Performing these exercises lying down provides a wider base of support and reduces the effects of gravity, making it biomechanically stable and potentially safer for those in rehabilitation or with balancing difficulties.

The program mainly focuses on muscle control to build coordination between the core and limbs, facilitating easier, safer movement when standing.

The exercises include an abdominal press, to activate core muscles by pressing and tightening, a small bridge, to connect the abs, lower back, and hips so they work together, a leg slide and press, to train the legs to move smoothly and stay controlled, and playing ‘rock-paper-scissors’ with the toes to improve control and strength.

Study author Yoriko Atomi, PhD, Professor Emeritus at The University of Tokyo and Specially Appointed Professor at the Center for Neuroscience and Biomedical Engineering, The University of Electro-Communications, helped develop the exercise program to relieve her own joint pain.

In a background document prepared by Atomi, she emphasizes that maintaining good balance is key to staying independent and avoiding injury.

She suggests that practicing exercises can help maintain or improve balance, and reduce the risk of falls and joint pain, even as the body ages.

“I would like to share that by performing this supine exercise every day of the year as soon as I wake up, I have been able to manage issues such as knee and lower back pain,” Atomi disclosed in the background document.

Key findings of the study

The study involved healthy young adults completing a daily 10-minute session for 2 weeks, and used both randomized crossover and pre–post trial designs.

In the randomized crossover trial, 17 healthy young males completed both an exercise phase and a control phase. The researchers assessed physical fitness, including flexibility, agility, and strength, as well as static balance.

The pre-post study involved 22 males and females performing the program for 2 weeks. Researchers analyzed dynamic balance using motion sensors placed on the body during a side-step agility task.

The results across both experiments were consistent and showed improvements in balance, agility, and flexibility.

Participants showed reduced body sway during standing tasks, especially in more challenging positions with a narrow base of support. Additionally, performance in a side-step test, a measure of quick lateral movement, increased significantly and they improved in sitting trunk flexion, indicating a greater range of motion.

The researchers also found no change in strength or power, as measures such as grip strength, jumping distance, and sprint speed remained unchanged.

Speaking to Medical News Today, Atomi discussed who could benefit the most from this exercise program.

“Based on our healthy young study, we should also be cautious about directly generalizing these findings beyond the different backgrounds we studied,” she told us.

“However, because the exercises are low-load and involve relatively low physical risk, this type of program may also have potential for individuals with reduced physical function, including older adults, sedentary individuals, or those in rehabilitation settings. These groups will need to be studied directly in future research.”
– Yoriko Atomi, PhD

Why the supine position may help

Atomi highlights that the supine position frees the core from its primary function of supporting the body while standing. This makes it easier to study and train how the core and legs work together, because the body is under less strain.

“We chose the supine position because lying down reduces the postural demands placed on antigravity muscles, such as those in the back and lower limbs. This creates a simpler mechanical environment where participants may be better able to focus on coordinating the core muscles of the trunk with lower limb movement,” Atomi told MNT.

“The advantage is that this approach is low-load, relatively safe, and accessible, while still targeting important movement-control strategies that may transfer to standing posture and dynamic tasks.”

“The advantage is that this approach is low-load, relatively safe, and accessible, while still targeting important movement-control strategies that may transfer to standing posture and dynamic tasks.”
– Yoriko Atomi, PhD

The researchers add that the benefits of the exercise program are unlikely due to muscle growth, and instead suggest neuromuscular adaptations, or how well the nervous system coordinates the body and distributes weight efficiently.

“In simple terms, neuromuscular adaptation means that the body becomes better at using the muscles it already has, rather than simply building bigger muscles,” Atomi explained to MNT.

“Over a short period of time, the nervous system can improve how different body segments — such as the trunk and lower limbs — work together, making movement more efficient and coordinated.”

“In this study, we believe participants may have improved how they controlled their relatively heavy trunk and coordinated it with lower limb movement, which may have helped improve balance, flexibility, and agility even without major gains in strength or muscle size,” she added.

The supine position may not only allow the body to focus more on coordination and control, but may also lower physical strain, reduce injury risk, and also make the exercises more accessible to a wider range of people.

Interestingly, motion analysis also showed that after the program, participants stabilized their head and upper body more effectively during movement, suggesting improved central control of balance.

Potential applications

Although the study involved healthy young adults, the findings suggest broader possibilities.

A short, safe, and simple routine like this could be useful for fall prevention programs, early stage rehabilitation, or individuals with limited mobility or balance issues.

“Because the program is low-load, relatively safe, and designed to improve postural control and movement coordination, it may be particularly relevant for fall prevention or rehabilitation,” Atomi said.

“Our current findings are an early step, and future research will focus on testing its effectiveness in older adults and clinical rehabilitation populations to understand better how it can be applied in those settings,” she suggested.

While the findings are preliminary, they suggest that a brief daily exercise routine performed lying down may offer a practical and low risk way to improve balance, flexibility, and movement coordination, without the need for intense training.

The exercise program may also offer an accessible option that people can implement into their daily routine at home.

“Based on practical experience, people may gain at least some benefit from written instructions or illustrated guides alone. However, exercises involving trunk control and coordinated lower limb movement may vary in difficulty depending on the individual,” Atomi told MNT.

“Ideally, the best approach would be initial in-person instruction, along with periodic follow-up to ensure correct technique. If face-to-face supervision is difficult, video-based instruction or online guidance may also be valuable ways to improve understanding and support consistent practice,” she advised.

• For many years, we have heard about the potential health benefits of fish oil due in part to their high concentration of omega-3 fatty acids.
• Past studies have linked the consumption of fish oil to possible protection against several health concerns, including brain diseases like dementia and Alzheimer’s disease.
• A new study has found that fish oil supplements may not be beneficial for people who have experienced repeated mild traumatic brain injuries.
• Researchers believe the build-up of a specific omega-3 fatty acid could potentially disrupt brain healing and assist with the accumulation of the protein tau in the brain, via both human cell and mouse trials.

For many years, we’ve heard about the potential health benefits of fish oil due in part to their high concentration of omega-3 fatty acids.

Past studies have linked the consumption of omega-3 fatty acids or fish oil — either through oily fish or fish oil supplements — to possible protection against several health concerns, including cardiovascular disease, type 2 diabetes, rheumatoid arthritis, depression, and neurodegenerative conditions such as Parkinson’s disease, Alzheimer’s disease, and other forms of dementia.

Now, a new study published in the journal Cell Reports has found that fish oil supplements may not be beneficial for people who have experienced repeated mild traumatic brain injuries (TBI).

Instead, the build-up of a specific omega-3 fatty acid in fish oil could potentially disrupt brain healing and assist with the accumulation of the protein tau in the brain, which is considered to be a hallmark of Alzheimer’s disease, via both human cell and mouse trials.

Fish oil and repeated mild traumatic brain injuriess

For this study, researchers used a combination of models, including one with mice and another with human brain microvascular endothelial cells, to examine how long-term fish oil use might impact the brain. 

“This project developed over several years and was motivated by a broader question,” Onder Albayram, PhD, associate professor in the Department of Pathology and Laboratory Medicine within the Department of Neuroscience at the Medical University of South Carolina, and lead author of this study, told Medical News Today.

“Fish oil is widely used and generally considered beneficial, yet there are also observations in other areas of medicine suggesting that its effects may vary depending on the biological context, particularly during periods of tissue repair,” Albayram explained.

“We wanted to understand whether similar context dependent effects might exist in the brain,” he detailed. “To do this, we needed a model where the brain is actively engaged in recovery over time. Repeated mild head injury provided a useful framework, because it involves a prolonged and often subtle repair process, with elements of resilience and vulnerability.”

“In that sense, the model allowed us to study how dietary factors such as fish oil interact with the brain’s recovery mechanisms,” he continued. “The study evolved step by step, with the findings guiding the next questions.”

EPA linked to reduced brain repair capacity

At the study’s conclusion, researchers found that one specific omega-3 fatty acid in fish oil, eicosapentaenoic acid (EPA), was associated with a reduced repair capacity in the brain, potentially interfering with healing after a brain injury. 

“This was one of the most important parts of the study because it helped us move from observation to mechanism,” Albayram said.

“In the mouse model, several findings pointed toward the neurovascular unit, especially the cerebrovascular endothelial cells, as a vulnerable site after repeated mild brain injury. These cells form the inner lining of the brain’s blood vessels and help regulate blood flow, metabolic exchange, barrier function, and tissue repair. The human brain has an enormous vascular network, so even subtle changes in endothelial function can have meaningful consequences over time.”

– Onder Albayram, PhD

“Based on the mouse data, we developed an in vitro model using human brain microvascular endothelial cells to ask a more focused question: could EPA directly affect the repair capacity of these cells under conditions that allow fatty acid use?,” he continued

“What we found was that EPA, but not DHA, reduced endothelial repair responses, including vascular network formation and wound healing capacity. That was significant because it mirrored the direction of the mouse findings and suggested that EPA may act directly on the vascular repair machinery, rather than being only a secondary marker of injury,” said Albayram.

Long-term fish oil supplementation linked to tau buildup

Additionally, Albayram and his team also correlated long-term fish oil supplementation to vascular-associated accumulation of the protein tau in the cortex, as well as lower neurological and spatial learning. 

“We observed vascular associated tau accumulation in the cortex, which is a recognized but still not fully understood feature in conditions such as chronic traumatic encephalopathy,” Albayram explained.

“In human postmortem studies, tau often accumulates around blood vessels, but it is difficult to determine how this develops over time or whether the vasculature plays an active role in shaping this pathology. Our findings suggest that the cerebrovascular system, including endothelial cells, may be more directly involved than previously appreciated,” he told us.

“Importantly, these vascular changes were accompanied by neurovascular uncoupling, meaning a disruption in the coordination between neuronal activity and blood flow,” he continued. “This was observed alongside deficits in spatial learning and memory, indicating that the vascular and metabolic changes were functionally relevant. Ultrastructural analyses further supported this, showing disruption within the neurovascular unit.”

“Together, these results suggest that under certain conditions, dietary factors may influence how the brain’s vascular system adapts to injury, and that this can be linked to both pathological features, such as tau accumulation, and measurable changes in cognitive function,” Albayram added.

Moving beyond one-size-fits-all health advice

MNT had the opportunity to speak with Dung Trinh, MD, internist for the MemorialCare Medical Group and chief medical officer of Healthy Brain Clinic in Irvine, CA, about this research.

Trinh, who was not involved in the study, commented that its findings do not mean that fish oil is broadly harmful, but they do challenge the assumption that all omega-3 supplements are automatically brain-protective. 

“For patients with repeated mild head injuries, especially athletes, veterans, or people with recurrent falls, the finding that EPA may interfere with brain vascular repair is clinically important and worth paying attention to,” Trinh explained.

“Brain health is complex, and cognitive decline can come from many causes, including Alzheimer’s disease, vascular disease, traumatic brain injury, sleep problems, mood disorders, medications, and metabolic conditions. We need continued research so we can move beyond one-size-fits-all advice and develop more personalized strategies to protect memory, thinking, and long-term brain function,” he added.

Trinh advised readers not to panic about this study’s findings, and not to abruptly stop anything recommended by their physician. 

“This study does not prove that fish oil causes brain damage in the general population,” he continued. “But if someone has a history of repeated concussions or head trauma, they should talk with their doctor about why they are taking fish oil, what dose they are taking, and whether their supplement is EPA-heavy.”

How to follow a brain-healthy diet not dependent on fish oil

Meridan Zerner, MS, RDN, CSSD, LD, CHWC, founder of Meridan Zerner Nutrition in Dallas, TX, offered her top tips on how to follow a brain-healthy diet that is rich in whole foods, without relying on supplements. 

“First, I would gently and respectfully encourage people to pump the brakes a bit and have a deeper conversation with their healthcare provider,” Zerner said.

“This study does not overturn the previous broader recommendations and research. We do know that omega-3s (preferably from food) support the brain’s foundation, but repair is far more complex. It’s not one nutrient — it’s the whole environment: nutrition, sleep, blood flow, and recovery,” she emphasized. 

Zerner offered these starter recommendations for eating a brain-healthy diet focused on whole foods: 

• Eat fatty fish 2–3 times per week. Salmon, sardines, mackerel, herring, and trout are naturally rich in both EPA and DHA in a food matrix that the body may process differently than a concentrated supplement.
• Load up on colorful produce. Berries, leafy greens, beets, and cruciferous vegetables provide antioxidants and polyphenols that support the brain’s vascular health and help to reduce neuroinflammation.
• Include walnuts, flaxseeds, and chia seeds. This is small, but meaningful in that these foods provide ALA, a plant-based omega-3. While the conversion to EPA and DHA is very limited, they contribute to overall anti-inflammatory eating patterns.
• Follow a Mediterranean or MIND diet pattern. Both are supported by strong evidence for cognitive health. They emphasize olive oil, beans, whole grains, nuts, fish, fruits, and veggies which supply the brain with multiple protective nutrients.
• Stay well-hydrated and limit ultra-processed foods. The brain is roughly 73% water, and ultra-processed foods drive inflammation — the opposite of what we want for brain repair.

“This study […] is a smaller mouse study, which for most health scientists means that it raises excellent questions and definitely validates the need for actual human studies,” Zerner said.

“But again, the findings depend a lot on context — this is a rodent study, the effects observed are not universal across all omega-3 fatty acids, the dose of EPA that would create an equivalent dose in human beings is unclear, the number and severity of TBIs isn’t clear and all the mice were male,” she cautioned. 

“I would also defer to the lead researcher himself who said this is not a call for the public to abandon fish oil supplements, emphasizing that ‘biology is context-dependent’,” she added. “However, if you are an athlete in a contact sport, a military service member, or anyone at elevated risk for repetitive mild TBIs, this research does give us reason to pause and ask more questions.”

• Past research has discovered numerous health benefits of music, including improving mood, cardiovascular health, and cognitive function.
• A new study found that scientifically designed music may provide better immediate relief from anxiety than pink noise.
• When paired with auditory beat stimulation (ABS), the researchers saw that those who listened to music for as little as 24 minutes showed significantly reduced anxiety symptoms.

Many people nowadays choose to listen to pink noise, which is background sounds similar to rain or static, to relax, fall asleep, or drown out unwanted sounds such as traffic or neighbors.

But when it comes to easing anxiety, a new study, published in the journal PLOS Mental Health, shows that it may not be the best tool.

To test this, scientists explored how music, particularly music embedded with auditory beat stimulation (ABS), affected anxiety symptoms.

ABS is a technique that uses steady, rhythmic pulses of sound to shift the brain’s rhythm, switching it from a “stressed” to a “relaxed” speed/state.

As part of this study, researchers from Goldsmiths, University of London, and the University of Roehampton in the United Kingdom, and experts from Toronto Metropolitan University and the digital health company LUCID in Canada, examined whether spending more time listening to “meditative” music with embedded ABS led to greater relief in anxiety.

The researchers randomly assigned 144 adult participants, who were already taking anti-anxiety medication, to one of the following four groups:

• control group (24 minutes of pink noise): 36 participants
• 12 minutes of music + ABS group: 41 participants
• 24 minutes of music + ABS group: 33 participants
• 36 minutes of music + ABS group: 34 participants.

They used pink noise as a control group to see if music embedded with ABS actually had an effect on anxiety levels.

The researchers measured the participants’ anxiety and mood before and after the sessions using standardized clinical scales to track the immediate (acute) changes.

Longer listening leads to less anxiety

The researchers found a “dose-response” link between the amount of time people listened to music and their mood.

Participants who listened to music with ABS for 24 minutes experienced the strongest overall reduction in anxiety. People who listened to music for 36 minutes showed a “peak” effect and saw similar improvements in mood and a larger reduction in negative feelings. Those who listened for only 12 minutes did not see as great an improvement.

Participants didn’t only experience lowered anxiety, either. They also reported a general reduction in feelings like irritability, jitteriness, and distress, and felt more emotionally balanced overall.

The fact that all participants were already taking medication for anxiety and that they experienced relief with ABS and music shows that such tools may be a good complementary therapy to already existing treatments.

Medical News Today spoke to four experts — Peter Vernig, PhD, MBA, VP of Mental Health Services at Recovery Centers of America, Michael S. Valdez, MD, physician with a background in neurology and addiction medicine, Connie McReynolds, PhD, licensed psychologist specializing in ADHD, anxiety, and trauma, and Tessa Jesus, MT-BC, board certified music therapist and music integration manager at Youth Villages, to see how this intervention works.

How music helps calm anxiety

Previous research has found that music can benefit cardiovascular health and cognitive health. The effects of music on the brain and mood have also been documented by numerous studies.

“[N]euroscience has studied that music is processed in multiple areas of the brain because not only are we hearing the sounds, but we are processing the words, connecting to memories associated with that song, and potentially experiencing an emotional reaction. The activation in the brain only increases when someone is playing an instrument, singing, or even watching someone play music. We know music changes the brain,” said Jesus.

However, music embedded with ABS operates differently. To achieve this effect, first, the music starts playing at a speed that matches the person’s current heart rate, which is likely elevated due to stress/anxiety.

Then, the music slows to encourage the mood to shift into a calmer state, a phenomenon the researchers called the Iso-Principle. Thanks to the hidden pulses of ABS, the brainwaves then slowly sync up with the slower, more relaxed frequency.

What the study cannot answer yet

The study has a few limitations regarding the longevity of effects and its effectiveness as a standalone therapy.

“The study showed that, under controlled conditions, listening to 24 minutes of ABS music can help shift the brain into a calmer state. Notably, participants in the study were already on medication to treat their anxiety,” Vernig pointed out.

“The harder question [here] is durability. Does the effect last, and for whom?” said Valdez.

“What the study does not examine is the long-term effects of this kind of intervention. Although ABS music may be a helpful tool to cope with spikes in anxiety, it should probably only be used as an adjunct to other established treatments. Think of this like a rescue inhaler for asthma: it reduces acute symptoms, but does not address their underlying cause,” Vernig said.

Another limitation is whether these effects can be attributed to ABS alone or to the music.

“[I]t is important to note that utilizing headphones with good sound quality versus listening from a phone or computer will all have varying effects on the auditory beat stimulation part of this study. It is hard to differentiate whether their results are from the ABS or the music, or both, since a control group with just ABS was not utilized,” said Jesus.

McReynolds pointed out that the sample size could affect the generalizability of the results and that follow-up studies are needed.

“[T]he sample is narrow, consisting of adults with moderate anxiety who were on medication and were recruited online. Including medication dosages would have strengthened the findings, since drugs like SSRIs can cause emotional blunting that may have shaped the results. Like all promising early research, these findings will grow stronger as more independent studies build on them,” she said.

“Future studies could be strengthened by extending beyond self-report to include brain scans or physiological measures to confirm any changes that occurred in the brain,” she added.

• Vitamin D, which is mainly obtained from sunlight exposure, followed by dietary sources such as oily fish and dairy, plays an important role in our overall health.
• Previous studies have linked vitamin D deficiency to a higher risk for certain diseases, including type 2 diabetes.  
• A new study found that vitamin D supplements may help delay or prevent disease progression in those with prediabetes who also have specific variations in their vitamin D receptor gene. 

Vitamin D, obtained through exposure to sunlight and eating certain foods like fatty fish and egg yolks, plays an important role in our overall health. 

Past research shows that vitamin D is important for bone health, including keeping bones strong and helping prevent musculoskeletal issues like weak muscles, and supports the body’s immune system.

Previous studies have linked vitamin D deficiency to a higher risk for certain diseases, including cardiovascular disease, certain cancers, multiple sclerosis, dementia, and type 2 diabetes.  

Now, a new study published in the journal JAMA Network Open reports that vitamin D supplementation may help delay or prevent disease progression in those with prediabetes who also have specific variants in their vitamin D receptor gene. 

Previous research leading to the latest vitamin D study

For this study, researchers analyzed healthcare data from participants of the previous D2d study, which examined the potential effects of vitamin D supplementation on the prevention of type 2 diabetes. 

During the original study, researchers concluded that a 4000 IU daily vitamin D supplement did not result in a significantly lower risk of type 2 diabetes when compared to a placebo. 

However, researchers reportedly still wanted to know whether vitamin D supplementation could help anyone with prediabetes, which led to this study. 

In another D2d-related study, scientists discovered that blood levels of 40 to 50 ng/mL of 25-hydroxyvitamin (OH) D or higher were correlated with a substantial lowering in participants’ diabetes development risk. 

“A number of observational studies had reported an inverse association between the circulating 25(OH)D level and diabetes risk,” Bess Dawson-Hughes, MD, a senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and lead author of this study, told Medical News Today.

“This was plausible because there are known vitamin D receptors in the beta cells in the pancreas, which secrete insulin. The observational data needed to be tested in a randomized controlled vitamin D intervention trial in order to establish that vitamin D actually influenced diabetes risk.” 

Vitamin D lowers diabetes risk in 2 specific gene variants

For this latest study, Dawson-Hughes and her team analyzed genetic data from about 2,000 participants of the original D2d study. 

At the study’s conclusion, researchers found that participants with the AA variant of the Apal vitamin D receptor gene didn’t respond to a daily high dose of vitamin D compared with placebo. 

However, study participants with the AC or CC gene variants did respond, experiencing a 19% lower risk of developing type 2 diabetes when taking a high daily dose of vitamin D.

“If confirmed, this finding defines an effective strategy to lower the risk of type 2 diabetes in adults with prediabetes,” Dawson-Hughes said. “Taking a single vitamin D capsule daily requires relatively little time and effort, is inexpensive, and is generally safe.” 

She also noted that these findings may aid future precision medicine for type 2 diabetes. 

“Our finding, if confirmed, would allow high dose vitamin D to be targeted to individuals with prediabetes who have the genetic potential to benefit,” Dawson-Hughes explained.

“Apart from the concept of genetic responders and non-responders, it appears from work by our lab and others that the relatively high 25(OH)D levels needed to reduce type 2 diabetes risk may, in fact, increase risk of falling in older adults. This underscores the need for clinicians to weigh the potential risk and benefit of treatment with 4000 IU per day of vitamin D in individual patients.” 
— Bess Dawson-Hughes, MD

Promise of potentially more personalized medicine

MNT spoke with Jennifer Cheng, DO, chief of endocrinology at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, about this study, who commented that it’s an interesting study that highlights the importance of having a personalized approach to treating our patients. 

“It’s promising, and my reaction is cautious optimism. The study suggests that vitamin D administration, in high risk individuals with certain genetic types, may be beneficial in preventing diabetes. It shows that in the future, we may be doing genetic testing to help determine if certain therapies can be used.” 
— Jennifer Cheng, DO

“This is promising to have potentially more personalized medicine where genetic types can be analyzed to help determine if certain therapies are recommended or not,” Cheng said. “More research is needed to see if there are other factors that are associated with risk reduction.” 

Cheng said the next areas for research should be additional studies to see how different genetic factors and other factors impact the risk for the development of diabetes. 

“The development of diabetes is so multifactorial and associated with other genetic factors that we are not able to elucidate,” she continued. “Further, research and evaluation should be done to determine what are all the factors associated with increased risk of developing diabetes, to help mitigate those risk factors in high risk individuals.” 

Taking too much vitamin D may come with risks

MNT also spoke with Pouya Shafipour, MD, a board certified family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, who said that it’s important for researchers to continue to find new ways to help people potentially lower their type 2 diabetes risk because it is such a complex condition. 

“And it’s so on the rise that anything we can find to lower it, reverse it, control it, then we can control or reduce heart disease risk, we can reduce cancer, dementia, blindness, (and) nerve pain,” Shafipour detailed.

“[Type 2 diabetes is] a disease that impacts the entire body, so if we can use anything from diet, lifestyle supplements, vitamins, medications, weight loss, improving sleep, to reverse this, we can impact one’s entire life and significantly improve the quality of their life, longevity, and a lot of other disease reversal.”
— Pouya Shafipour, MD

Shafipour also said this study’s findings should be taken with a grain of salt because vitamin D supplementation helps only certain populations with this genetic variant. 

“So people shouldn’t rely on this study and then start taking high doses of vitamin D because mega doses of vitamin D can cause kidney stones, can cause toxicity, especially in people that [have obesity], as it’s a fat-soluble vitamin,” he explained.

“This is where precision medicine comes in, that they should talk to their provider about it, have their levels checked, and really see if it’s something that benefits them particularly, or do they need to take vitamin D for other reasons,” he added. 

• Research suggests the investigational drug asundexian could reduce the risk of recurrent ischemic stroke in those who have recently experienced a stroke or high risk transient ischemic attack (TIA).
• Unlike many existing anti-clotting treatments, it did not increase major or intracranial bleeding, addressing a major limitation of current therapies.
• The drug works by inhibiting Factor XIa, a clotting protein involved in harmful clot formation but less critical for normal bleeding control.
• Findings from a large Phase 3 trial suggest it could represent a new, safer approach to long-term stroke prevention.

Nearly 1 in 4 people who have previously had a stroke will experience a recurrent stroke. To help reduce this risk, clinicians will typically recommend antiplatelet or anticoagulant therapy, in addition to making lifestyle changes.

Prescribing blood thinners can help to prevent future clots and reduce the risk of recurrent, often severe, strokes. They can be particularly crucial for those with atrial fibrillation, or other high risk cardioembolic causes, with research suggesting they can reduce stroke risk by 64%.

However, while these medications are generally safe and can significantly reduce the risk of recurrent strokes, they carry an increased risk of bleeding. In particular, the most dangerous complication of anticoagulant therapy can result in bleeding in or around the brain, known as a hemorrhagic stroke.

Now, a study suggests that a new investigational medication could offer protection without the heightened bleeding risk associated with current treatments.

Published in The New England Journal of Medicine, the findings indicate that asundexian reduced the risk of a second stroke by 26% in people who had recently experienced a clot-related stroke or TIA, without increasing bleeding risk.

A long-standing challenge in stroke prevention

Preventing a second stroke remains a major clinical priority. However, current strategies can create a difficult balance, by aiming to reduce clot formation without exposing individuals to dangerous bleeding complications.

Various proteins, known as clotting factors, play a role in the formation of blood clots. The process of stopping bleeding, known as hemostasis, involves multiple interlinked steps. Therefore, targeting specific proteins may offer a viable option for reducing clot formation without complications.

Asundexian is an oral anticoagulant that inhibits the activity of clotting factor XIa. This protein is mainly involved in the formation of harmful blood clots.

As factor XIa plays a limited role in normal bleeding control, blocking its action may provide a viable option to safely prevent dangerous blood clots while preserving the body’s ability to stop bleeding after injury.

“Asundexian selectively inhibits factor XIa (FXIa), targeting a component of the coagulation cascade that is increasingly recognized as more important for pathologic thrombosis than for physiologic hemostasis,” said Ashkan Shoamanesh, MD, co‑principal investigator of the study and Population Health Research Institute (PHRI) senior scientist, when speaking to Medical News Today.

“This contrasts with existing anticoagulants—such as factor Xa inhibitors—which interrupt core steps required for both thrombus formation and hemostasis,” he said.

“FXI occupies a unique position within the intrinsic pathway, functioning primarily as an amplifier of thrombin generation. In the setting of vascular injury, exposure of abundant tissue factor activates the extrinsic pathway and generates a robust thrombin burst sufficient to achieve hemostasis, with only a limited contribution from FXI,” he continued.

“In contrast, in pathologic states such as atherosclerotic plaque disruption, tissue factor exposure is more modest, and sustained thrombin generation relies more heavily on FXIa-mediated amplification. In this context, FXIa promotes clot propagation and stability, contributing to vaso-occlusive and thromboembolic events,” he further explained.

“This biological distinction allows FXIa inhibition to uncouple pathologic thrombosis from hemostasis,” he added.

Trial results and what this means for stroke treatment

The findings come from the large, international OCEANIC-STROKE Phase 3 trial, which included more than 12,300 participants across 37 countries.

The average age of those in the study was 68 years, with a quarter over 75, and 33% were female. Roughly 95% of participants had recently experienced a non-cardioembolic stroke (a stroke not caused by a heart condition), with the remaining experiencing high-risk TIA.

They were randomly assigned to receive either 50 milligrams (mg) Asundexian plus standard antiplatelet therapy, or a placebo plus standard therapy.

Over the follow-up period, the researchers observed a 26% reduction in recurrent ischemic stroke in those taking Asundexian. Additionally, fewer people experienced major cardiovascular events, disabling or fatal strokes, no increase in intracranial bleeding, or a rise in serious side effects.

“Ischemic strokes account for approximately 87% of the roughly 800,000 strokes occurring in the U.S. each year,” Mike Sharma, MD, MSc, FRCPC, co-principal investigator of the study and a senior scientist at the PHRI, told MNT.

“Despite guideline-recommended therapy, these patients remain at substantial risk of recurrence, with approximately 1 in 10 experiencing another stroke within the first year. In this context, we observed a significant 26% relative reduction in the hazard of ischemic stroke with asundexian. This corresponded to an absolute risk reduction of 1.9% and a number needed to treat of 54 at one year,” he said.

“Notably, this represents a meaningful incremental benefit on top of contemporary secondary stroke prevention strategies. We also observed a 31% reduction in the risk of disabling or fatal strokes. Importantly, these benefits were achieved without an associated increase in bleeding risk.” 
— Mike Sharma, MD, MSc, FRCPC

These benefits were consistent regardless of age, sex, stroke severity, or underlying cause.

The researchers suggest that Asundexian’s ability to reduce stroke risk without increasing bleeding risk may offer a new paradigm in stroke prevention. Commenting on the key clinical takeaways, Shoamanesh told MNT:

“For one, OCEANIC-STROKE demonstrates that meaningful breakthroughs in secondary stroke prevention—with substantial treatment effects—remain achievable on top of existing guideline-recommended therapies.”

“Second, FXIa inhibitors represent a novel class of antithrombotic agents capable of reducing stroke risk without increasing bleeding, thereby providing a substantial net clinical benefit,” he continued. 

“For about 50 years the mainstay of secondary stroke prevention has been aspirin monotherapy. This represents the first significant improvement for most ischemic strokes apart from short term use of dual antiplatelet therapy.”
— Ashkan Shoamanesh, MD

Similarly, Christopher Yi, MD, board certified vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, suggests it may represent a new strategy for secondary prevention after non-cardioembolic ischemic stroke or high risk TIA.

“It should not replace aggressive risk-factor control, statins, blood pressure management, smoking cessation, diabetes control, and appropriate antiplatelet therapy, but it may eventually become an additional tool for selected high-risk patients,” he said.

When will this medication be approved for use?

However, despite the promising results, the study authors caution that Asundexian remains investigational and is not yet approved for clinical use. Further evaluation, regulatory review, and real-world data will be necessary before it becomes widely available.

Additionally, although the trial was large and diverse, certain patient groups, such as those with more severe strokes, were less represented, which may limit how broadly the findings apply.

If approved, Asundexian could provide a safer long-term option for preventing recurrent strokes, particularly for those at high risk of bleeding or unable to tolerate existing therapies.

“Within the framework of trial eligibility, there was no evidence of heterogeneity in treatment effect according to pre-specified subgroups,” Sharma said to MNT.

“For instance, patients benefited similarly irrespective of age, race, sex,  index event type (ischemic stroke versus TIA), history or vascular imaging evidence of atherosclerosis, acute lacunar versus non-lacunar infarction on brain imaging, or ischemic stroke subtype. We expect the results to apply to the majority of patients with non-cardioembolic ischemic stroke.”
— Mike Sharma, MD, MSc, FRCPC

“Taken together, these findings support the broad generalizability of the trial results to the majority of patients with non-cardioembolic ischemic stroke or high-risk TIA encountered in clinical practice,” Sharma said.

“This is further strengthened by the inclusion of patients with moderate-severe stroke severity up to an NIHSS of 15 and those who received acute revascularization therapies, including intravenous thrombolysis or endovascular thrombectomy,” he added.

Yi also suggests that Asundexian is likely to benefit are those with recent non-cardioembolic ischemic stroke or high risk TIA who remain at elevated risk for recurrence despite standard antiplatelet therapy.

“This may include patients with atherosclerotic disease, multiple vascular risk factors, or other markers of high recurrent stroke risk,” Yi told MNT. “It would not necessarily apply to patients with cardioembolic stroke from atrial fibrillation, where established anticoagulation strategies remain the standard of care.”

For now, the findings provide cautious optimism that effective stroke prevention without added bleeding risk may be within reach.

• A new study suggests that regularly drinking four cups of coffee a day could have a positive impact on mood and stress levels.
• Changes in mood and stress were also associated with changes in gut bacteria and the levels of certain metabolites.
• Most of the mood and gut changes occurred alongside drinking both caffeinated and decaffeinated coffee.

Coffee doesn’t just impact your energy levels first thing in the morning; it also influences the makeup of the gut microbiota, which in turn could influence mood and stress levels.

This is according to new research from APC Microbiome Ireland, a research center based at University College Cork, in Ireland. The study is published in Nature Communications.

“Coffee is more than just caffeine,” said study author John Cryan, PhD, Principal Investigator at APC Microbiome Ireland, in a press release. “It’s a complex dietary factor that interacts with our gut microbes, our metabolism, and even our emotional well-being.”

The term gut microbiota refers to all the different micro-organisms such as bacteria that live inside the digestive tract. They are a vital part of the gut microbiome, which refers not only to the microbes but also the environment they live in.

Research has already established that there is a two-way relationship between the gut and the brain, known as the gut-brain axis. This means that changes in the brain can lead to changes in the gut, and vice versa.

Gut microbiota play a key role within this relationship.

“Public interest in gut health has risen hugely,” said Cryan. “The relationship between digestive and mental health is also increasingly being better understood, but the mechanisms behind coffee’s effects on this gut-brain axis have remained unclear.”

Other research has suggested that gut microbes react to coffee, as well as associating different levels of coffee consumption with certain health outcomes. These include reduced risks of some chronic diseases, lower rates of all-cause mortality, and a lower risk of depression.

Researchers have not investigated the effects of coffee drinking and withdrawal over time on drinkers as well as their gut microbiota in depth up until now.

How did the study assess the effects of coffee intake?

The study began with a comparison of one group of 31 non-coffee drinkers with 31 coffee drinkers. Coffee drinkers were people who regularly consumed between 3 and 5 cups of coffee a day.

With each participant, the researchers assessed several parameters with a range of tests, questionnaires, self reports, and stool and urine samples. These included:

• cognitive function
• stress levels
• physical health
• mood
• immune function
• diet
• gut microbiome composition.

After these baseline tests, the non-coffee drinker group played no further part in the study.

The coffee-drinking group then stopped drinking coffee for 14 days, while also abstaining from other sources of caffeine, such as sodas and dark chocolate.

After this time, they reintroduced coffee to their diets. However, half of them (15 people) reintroduced decaffeinated coffee while the other half (16 people) reintroduced caffeinated coffee.

The participants then drank whichever type of coffee the researchers had blindly assigned to them for 21 days. Their instructions were to drink four sachets of instant coffee each day.

The researchers carried out further assessments on this group of participants throughout their period of abstinence from coffee and then again during the 3-week intervention phase.

How coffee reshapes the gut

The researchers found that when participants returned to drinking coffee after the 14-day abstinence period, both caffeinated and decaffeinated coffee were associated with improvements in mood.

The participants’ questionnaires revealed lower levels of stress, depression, and impulsivity after returning to either type of coffee.

Caffeinated coffee alone was associated with reduced anxiety and improved vigilance, attention, and blood pressure. In contrast, decaffeinated coffee was associated with improvements in learning, memory, physical activity, and sleep.

Interestingly, the researchers did not note any differences between the coffee drinkers and the non-coffee drinkers at the start of the study and after the abstinence period when it came to many of these factors. This included blood pressure, stress, anxiety, depression, sleep quality, and physical activity.

Alongside the changes in mood and cognition, the researchers also observed several changes in the guts of the participants.

During the 2-week abstinence period, they noted changes in levels of certain metabolites, which are small molecules that are produced during the process of metabolism.

These levels largely returned after the participants started drinking coffee again, although levels of metabolites closely associated with caffeine did not rise for those drinking decaffeinated coffee.

Overall, the researchers identified nine key metabolites that were closely associated with coffee drinking. These included theophylline, caffeine, and selected phenolic acids, and were “strongly linked to microbial species and cognitive measures.”

There were also clear differences between the gut microbiomes of coffee drinkers compared with nondrinkers. There were higher levels of specific species of bacteria associated with positive health effects in the guts of the coffee drinkers.

These included:

• Cryptobacterium curtum, which is associated with oral health
• Eggertella sp. CAG:209, which is associated with bile acid synthesis
• Firmicutes CAG:94, which is associated with positive emotions in females.

“Our findings suggest that coffee, whether caffeinated or decaffeinated, can influence health in distinct but complementary ways,” said Cryan in the press release.

Only caffeinated coffee linked to lower anxiety

“Our findings reveal the microbiome and neurological responses to coffee, as well as their potential long-term benefits for a healthier microbiome,” said Cryan in the press release. “Coffee may modify what microbes do collectively, and what metabolites they use.”

Medical News Today asked Cryan if it was possible that the coffee drinkers had less stress and depression after drinking coffee again due to the psychological impact of being able to return to a habitual behaviour rather than this being driven by the coffee itself.

Cryan told us that the return to a habitual behaviour can itself have psychological benefits, including reduced stress and improved mood, but that they designed the study to address this.

“We included both caffeinated and decaffeinated coffee, and both groups showed improvements in stress and depression. This suggests that non-caffeine factors, including psychological or behavioural effects, may play a role,” he said.

“However, only caffeinated coffee reduced anxiety and psychological distress, indicating that caffeine-specific biological effects are also involved,“ he added.

“Taken together, the findings suggest that the observed benefits are likely due to a combination of factors, biological effects of coffee compounds — including caffeine and (poly)phenols — microbiome-mediated mechanisms, and psychological effects linked to routine and expectation.”

– John Cryan, PhD

While these early results are of interest, it is important to note that the study was a relatively small one, with only data from 62 participants. The researchers also did not analyze differences due to ethnicity due to the majority of the participants being Caucasian.

The study also only investigated the effects of instant coffee. MNT asked Cryan whether different coffee types or preparation methods might provide different results.

“Different coffee types and preparation methods can significantly influence the chemical composition of the final drink,” he said. “The brew method affects levels of caffeine, (poly)phenols, and other bioactive compounds such as diterpenes and chlorogenic acids.

“In our study, we focused on controlled interventions using standardized caffeinated and decaffeinated coffee to isolate biological effects. However, instant coffee may differ from freshly brewed coffee in its polyphenol profile and processing-related compounds, which could influence how it interacts with the gut microbiome and metabolism,” Cryan explained.

“While we would expect broadly similar directional effects across coffee types, the magnitude and specific microbial or metabolic responses may vary depending on preparation method,” he continued. “This is an important area for future research, particularly in the context of personalized nutrition and microbiome responses.”

For now though, this study provides additional insight into the mysteries of the gut microbiome and the role that one of the world’s favorite drinks may have to play in health.