An infant has died and 10 adults have been sickened amid a four-state listeria outbreak connected to ready-to-eat meat products, officials said. The outbreak has been tied to ready-to-eat meat produced by Yu Shang Food, Inc. of Spartanburg, South Carolina, the Centers for Disease Control and Prevention said in an update Friday. Read More

Whoever said happy and healthy don't mix probably hasn't tasted the nutritional fare the happiest place on earth has to offer. Sure, Disneyland and adjacent Disney California Adventure (DCA) offer plenty of unhealthy foods like fried Monte Cristo sandwiches, Ghirardelli milkshakes, and cream-covered churros — and it's a major blemish that the park doesn't publish calorie content on its menus or websites. But Disney is known for working harder than most theme parks at providing a wide variety of nutrient-dense foods to choose from. Read More

The internet is awash with advertisements for hair growth supplements promising dramatic results. Do they actually work? Julia Calderone of Well, the personal health news section of The New York Times, explains. Read More

When Mary-Claire King discovered the first gene linked to hereditary breast cancer in 1990, she also got to decide its name. She settled on the four letters BRCA, which had three distinct meanings. The name paid homage to UC Berkeley, where King worked at the time; more to the point, it was a nod to Paul Broca, the 19th-century French physician whose work established a link between family history and breast cancer. It was also an abbreviation for breast cancer. A few years after King discovered BRCA1, a second BRCA gene, BRCA2, was identified. Together, they now have more name recognition than probably any other gene, their profile boosted by research that has shown staggering effects on cancer risk. Awareness campaigns followed. A 2013 New York Times op-ed in which Angelina Jolie revealed she’d had a preventive double mastectomy because of her own BRCA mutation drove many women to seek DNA tests themselves. The BRCA genes became inextricably linked with breasts, as much as the pink ribbons that have become an international symbol of breast cancer. And in driving more women to find out if they have BRCA mutations, it’s helped to greatly reduce the risk of hereditary breast cancer. But in the three decades since the genes were discovered, scientists have learned that BRCA mutations can also lead to cancer in the ovaries, the pancreas, and the prostate. More recently, they have been linked with cancers in other parts of the body, such as the esophagus, stomach, and skin. As many as 60 percent of men with changes in BRCA2 develop prostate cancer, yet men are generally far less aware than women that BRCA mutations can affect them at all. “It’s a branding problem,” Colin Pritchard, a professor of laboratory medicine and pathology at the University of Washington, told me. Men with family histories of breast cancer may not realize that they should get screened. Physicians, too, lack awareness of which men should get tested, and what steps to take when a mutation is found. Now Pritchard and other researchers are working to rebrand BRCA and the syndrome associated with it so that more men and their doctors consider testing. Normally, the BRCA genes produce proteins that help repair damaged DNA throughout the body. Most people who carry mutations that impair the gene’s function are diagnosed with hereditary breast and ovarian cancer syndrome. (Having HBOC means a person is at increased risk for cancer, not that they already have an illness.) Most breast-cancer cases have no known hereditary link, but more than 60 percent of women with a harmful BRCA1 or BRCA2 mutation will develop breast cancer, compared with about 13 percent of the wider female population. Men, of course, can get breast cancer too, but it's rare, even among BRCA-mutation carriers. [Read: Cancer supertests are here] The full significance of the link between BRCA mutations and pancreatic and prostate cancer has become clear only recently—perhaps in the past decade, said Pritchard. The exact risk these mutations impart to men varies widely in studies. But it’s clearly significant: Not only are men with BRCA mutations more likely to develop prostate cancer, they are also more likely to develop the more aggressive forms of the disease. Roughly one in 400 people carry a harmful mutation in BRCA1 or BRCA2, and half of them are men. But women are far more likely to have been tested for the mutations—up to 10 times as likely, according to one study. “Beyoncé’s dad was the only man that I had ever heard of who had it,” Christian Anderson, a 46-year-old social-sciences professor in Washington State who carries a BRCA2 mutation, told me. Anderson got tested after his sister was diagnosed with breast cancer, but countless men like him go undetected. Only about half of Americans get an annual physical, and doctors aren’t always aware of BRCA-screening recommendations for men. Many men who do test for a BRCA mutation report doing it for their daughters, and studies have shown that they tend to be confused about their risks of developing cancer themselves. BRCA-awareness campaigns have led many women to get tested; in the two weeks after Angelina Jolie’s viral op-ed, researchers found that BRCA-testing rates went up by 65 percent. In that case, more people may gotten tested than needed to, but in general, the rise in cancer screenings and elective surgical interventions have helped reduce the rates of deaths from breast and ovarian cancers. Education about the genes’ links to other cancers could do the same for men. To that end, Pritchard argued in a 2019 Nature commentary that Hereditary Breast and Ovarian Cancer syndrome should be renamed King Syndrome after Mary-Claire King. “We need to really rethink this if we're going to educate the public about the importance of these genes for cancer risk for everyone, not just women,” he told me. [Read: I’ll tell you the secret of cancer] As understanding of BRCA’s risks for men has grown, Pritchard’s idea has started to catch on. King, who is now a professor of genome sciences and medicine at the University of Washington, demurred when I asked her whether the syndrome associated with the BRCA genes should be renamed after her, but agreed that awareness campaigns have focused too narrowly on breasts and ovaries. “We need to bring this awareness to men in the same way that we have for 30 years now to women,” she told me. How exactly Pritchard’s plan might be put into action is unclear. Gene names are overseen by an international committee and rarely changed. That’s part of why Pritchard is suggesting that the name of the syndrome associated with BRCA mutations become King Syndrome—no single governing body oversees that. Recently, ClinGen, an international group of researchers that works to parse the medical significance of genes, recommended that HBOC be rechristened BRCA-related cancer predisposition. (Pritchard told me he thinks that name isn’t quite as “catchy” as King Syndrome.) Uncoupling the syndrome associated with BRCA mutations from breasts would likely be only the first step in getting more at-risk men screened for cancer. It would also be an important step in understanding the full impact of BRCA mutations on men. Because fewer men than women have been tested for BRCA mutations, scientists still don’t have a complete picture of their risk. For example, Pritchard told me, it’s only as more attention has been drawn to male BRCA risk that researchers have discovered mutations are linked to especially aggressive forms of prostate cancer. Penn Medicine recently launched a program dedicated to men and BRCA in part to continue this sort of research. [Read: Scientists have been studying cancers in a very strange way for decades] BRCA’s name is a legacy of a time when scientists thought genetics would offer a simple way to diagnose and treat disease—that one specific mutation would point definitively to one specific cancer. But today, “the idea that a gene would only affect one type of cancer risk is probably outmoded,” Pritchard said. The more scientists explore the human genome, the more complex its connections to health appear. It turns out that when genes don’t work like they should, the possible consequences may very well be infinite. Read More

President-elect Donald Trump on Friday nominated Dr. Marty Makary, a pancreatic surgeon at Johns Hopkins University who's made controversial claims about Covid, as commissioner of the Food and Drug Administration. Makary is the chief of Islet Transplant Surgery at Johns Hopkins, according to the university’s website. He also served in leadership at the World Health Organization Patient Safety Program and is a member of the National Academy of Medicine, which is part of the National Academies of Science, Engineering and Medicine. He's also served as a public adviser to Paragon Health Institute, a conservative health care think tank, and regularly appears on Fox News. Read More

Vancouver-based UniDoc Health is releasing a shippable doctor’s office, lab, or even tiny mobile hospital. It’s called the H3 Health Cube, and the company says its AI-powered health clinics will deliver medical care closer to those in rural areas, bringing high-tech diagnostic tools and real-time automated triage assessments to wherever there’s a need. “Limited access to comprehensive medical care affects people globally, particularly remote areas with limited transportation and infrastructure,” Antonio Baldassarre, CEO of UniDoc, said in a statement. “The H3 Health Cube can help to fill the gap for care and reduce the burden placed on hospitals and local clinics by offering robust medical care access independently of existing infrastructure.” Read More

Have you ever wondered why your spouse gets weepy over a TV commercial that leaves you dry-eyed? Or why you are apt to burst into tears at a distant cousin’s funeral while your partner stays stoic? The answer could be that you each cry different types of tears. Read More

Robert F. Kennedy Jr., the nominee to be the next secretary of Health and Human Services, is America’s most prominent vaccine skeptic. An advocacy organization that he founded and chaired has called the nation’s declining child-immunization rates “good news,” and referred to parents’ lingering doubts about routine shots as COVID-19’s “silver lining.” Now Kennedy may soon be overseeing the cluster of federal agencies that license and recommend vaccines, as well as the multibillion-dollar program that covers the immunization of almost half the nation’s children. Which is to say that America’s most prominent vaccine skeptic could have the power to upend, derail, or otherwise louse up a cornerstone of public health. Raising U.S. vaccination rates to where they are today took decades of investment: In 1991, for example, just 82 percent of toddlers were getting measles shots; by 2019, that number had increased to 92 percent. The first Trump administration actually presided over the historic high point for the nation’s immunization services; now the second may be focused on promoting vaccines’ alleged hidden harms. Kennedy has said that he doesn’t want to take any shots away, but even if he were to emphasize “choice,” his leadership would be a daunting test of Americans’ commitment to vaccines. In many ways, the situation is unprecedented: No one with Kennedy’s mix of inexperience and paranoid distrust has ever held the reins at HHS. He was trained as a lawyer and has no training in biostatistics or any other research bona fides—the sorts of qualifications you’d expect from someone credibly evaluating vaccine efficacy. But the post-pandemic era has already given rise to at least one smaller-scale experiment along these lines. In Florida, vaccine policies have been overseen since 2021 by another noted skeptic of the pharmaceutical industry, State Surgeon General Joseph Ladapo. (Kennedy has likened Ladapo to Galileo—yes, the astronomer who faced down the Roman Inquisition.) Under Ladapo’s direction, the state has aggressively resisted federal guidance on COVID-19 vaccination, and its department of health has twice advised Floridians not to get mRNA-based booster shots. “These vaccines are not appropriate for use in human beings,” Ladapo declared in January. His public-health contrarianism has also started spilling over into more routine immunization practices. Last winter, during an active measles outbreak at a Florida school, Ladapo abandoned standard practice and allowed unvaccinated children to attend class. He also seemed to make a point of not recommending measles shots for any kids who might have needed them. Jeffrey Goldhagen, a pediatrics professor at the University of Florida and the former head of the Duval County health department, believes that this vaccine skepticism has had immense costs. “The deaths and suffering of thousands and thousands of Floridians” can be linked to Ladapo’s policies, he said, particularly regarding COVID shots. But in the years since Ladapo took office, Florida did not become an instant outlier in terms of COVID vaccination numbers, nor in terms of age-adjusted rates of death from COVID. And so far at least, the state’s performance on other immunization metrics is not far off from the rest of America’s. That doesn’t mean Florida’s numbers are good: Among the state’s kindergarteners, routine-vaccination rates have dropped from 93.3 percent for the kids who entered school in the fall of 2020 to 88.1 percent in 2023, and the rate at which kids are getting nonmedical exemptions from vaccine requirements went up from 2.7 to 4.5 percent over the same period. These changes elevate the risk of further outbreaks of measles, or of other infectious diseases that could end up killing children—but they’re not unique to Ladapo’s constituents. National statistics have been moving in the same direction. (To wit: The rate of nonmedical exemptions across the U.S. has gone up by about the same proportion as Florida’s.) All of these disturbing trends may be tied to a growing suspicion of vaccines that was brought on during COVID and fanned by right-wing influencers. Or they could be a lingering effect of the widespread lapse in health care in 2020, during which time many young children were missing doses of vaccines. (Kids who entered public school in 2023 might still be catching up.) In any case, other vaccination rates in Florida look pretty good. Under Ladapo, the state has actually been gaining on the nation as a whole in terms of flu shots for adults and holding its own on immunization for diphtheria, tetanus, and pertussis in toddlers. Even Ladapo’s outlandish choice last winter to allow unvaccinated kids back into a school with an active measles outbreak did not lead to any further cases of disease. In short, as I noted back in February, Ladapo’s anti-vaccine activism has had few, if any, clear effects. (Ladapo did not respond when I reached out to ask why his policies might have failed to sabotage the state’s vaccination rates.)    If Florida’s immunization rates have been resilient, then America’s may hold up even better in the years to come. That’s because the most important vaccine policies are made at the state and local levels, Rupali Limaye, a professor and scholar of health behavior at Johns Hopkins University, told me. Each state decides whether and how to mandate vaccines to school-age children, or during a pandemic. The states and localities are then responsible for giving out (or choosing not to give out) whichever vaccines are recommended, and sometimes paid for, by the federal government.   But the existence of vaccine-skeptical leadership in Washington, and throughout the Republican Party, could still end up putting pressure on local decision makers, she continued, and could encourage policies that support parental choice at the expense of maximizing immunization rates. As a member of the Cabinet, Kennedy would also have a platform that he’s never had before, from which he can continue to spread untruths about vaccines. “If you start to give people more of a choice, and they are exposed to disinformation and misinformation, then there is that propensity of people to make decisions that are not based on evidence,” Limaye said. (According to The New York Times, many experts say they “worry most” about this aspect of Kennedy’s leadership.) How much will this really matter, though? The mere prominence of Kennedy’s ideas may not do much to drive down vaccination rates on its own. Noel Brewer, a behavioral scientist and public-health professor at the UNC Gillings School of Global Public Health, told me that attempts to change people’s thoughts and feelings about vaccines are often futile; research shows that talking up the value of getting shots has little impact on behavior. By the same token, one might reasonably expect that talking down the value of vaccines (as Kennedy and Ladapo are wont to do) would be wasted effort too. “It may be that having a public figure talking about this has little effect,” Brewer said. Indeed, much has been made of Kennedy’s apparent intervention during the 2019 measles crisis in Samoa. He arrived there for a visit in the middle of that year, not long after measles immunizations had been suspended, and children’s immunization rates had plummeted. (The crisis began when two babies died from a vaccine-related medical error in 2018.) Kennedy has been linked to the deadly measles outbreak in the months that followed, but if his presence really did give succor to the local anti-vaccine movement, that movement’s broader aims were frustrated: The government declared a state of emergency that fall, and soon the measles-vaccination rate had more than doubled. As head of HHS, though, Kennedy would have direct control over the federal programs that do the sort of work that has been necessary in Samoa, and provide access to vaccines to those who need them most. For example, he’d oversee the agencies that pay for and administer Vaccines for Children, which distributes shots to children in every state. All the experts I spoke with warned that interference with this program could have serious consequences. Other potential actions, such as demanding further safety studies of vaccines and evidence reviews, could slow down decision making and delay the introduction of new vaccines. Kennedy would also have a chance to influence the nation’s vaccine requirements for children, as well as its safety-and-monitoring system, at the highest levels. He’d be in charge of selecting members for the Advisory Committee on Immunization Practices, which makes recommendations on vaccines that are usually adopted by the states and result in standardized insurance coverage. He’d also oversee the head of the CDC, who in turn has the authority to overrule or amend individual ACIP recommendations. Even if he’s not inclined to squelch any determinations outright, Kennedy’s goal of giving parents latitude might play out in other ways. Brewer, who is currently a voting member of ACIP (but emphasized that he was not speaking in that capacity), said that the committee can issue several different types of rulings, some of which roughly correspond to ACIP saying that Americans should rather than may get a certain vaccine. That distinction can be very consequential, Brewer said: Shots that are made “routine” by ACIP get prioritized in doctor’s offices, for instance, while those that are subject to “shared clinical decision-making” may be held for patients who ask for them specifically. Shifting the country’s vaccination program from a should to a may regime “would destroy uptake,” Brewer told me. Those would seem to be the stakes. The case study of vaccine-skeptical governance that we have in Florida may not look so dire—at least in the specifics. But Kennedy’s ascendancy could be something more than that: He could steer the public-health establishment off the course that it’s been on for many years, and getting back to where we are today could take more years still. Read More

On Friday, Florida’s Surgeon General Joseph Ladapo announced that communities in the state shouldn’t add fluoride to drinking water because of what he called the “neuropsychiatric risk associated with fluoride exposure.” Read More

Six foreign tourists, including an unnamed U.S. man, have died of suspected methanol poisoning in Laos, Southeast Asia. The tourists are thought to have fallen ill after drinking alcohol laced with the deadly chemical about a week ago in the backpacking town of Vang Vieng. But methanol poisoning is has not yet been confirmed. Read More

When I was teaching indoor cycling every week, an unexpected benefit of the gig was free ice cream. One of the class regulars had an ice-cream machine at home and sometimes brought samples for me to try, in flavors such as pumpkin and pistachio. I think he did this not only because he was a nice person but also because in class, I was the nicest version of myself: warm, welcoming, and encouraging to the point of profound corniness, despite my usual caustic tendencies. I noticed this friendliness in others too. Two people who met in my class started dating. Strangers who became friends there went out for post-workout coffees. Two of the other class regulars invited me to go skiing with them. Many of the good friends I have at age 35 are people I met in exercise classes I attended regularly. These experiences have convinced me that group fitness classes are the best place to make friends as an adult—an idea supported by research that suggests that the glow of exercise’s feel-good chemicals has interpersonal benefits. Once, countless friendships were born in what the sociologist Ray Oldenburg called “third places”: physical spaces that aren’t a home or a workplace, don’t charge (much) for entry, and exist in large part to foster conversation. Over the past several decades, though—and especially as a result of the pandemic—third places such as bars and cafés have begun playing a much smaller role in social life, depriving American adults of opportunities for chance encounters that can lead to friendships. Perhaps that’s partly why Americans rank improving their relationships among their top New Year’s resolutions. Group fitness classes don’t exactly fit the definition of a third place: They cost money, and the primary activities within them are sweating, grunting, and skipping a few reps when the instructor isn’t looking. But they fulfill many conditions that social-psychology research has repeatedly shown to help forge meaningful connections between strangers: proximity (being in the same place), ritual (at the same time, over and over), accumulation (for many hours), and shared experiences or interests (because you do and like the same things). [From the December 2019 issue: I joined a stationary-biker gang] Sussing out shared interests can be horribly awkward when you meet someone new at work or even at a party. Group fitness classes make it a little easier, Stephanie Roth Goldberg, an athlete psychotherapist in New York, told me. “Automatically, when you walk into a fitness class, you likely are sharing the idea that ‘We like to exercise,’ or ‘We like to do this particular kind of exercise,’” she said. “It breaks the ice differently than standing in a bar or at someone’s house.” Of course, breaking the ice still requires someone to say something, which, if you’re sweaty and huffing, is frankly terrifying. Whether I’m an instructor or a classmate, one simple tactic has never failed me: I simply walk up to someone after class and say, “Hey, good job!” Proximity, ritual, and accumulation all require a certain amount of time, which can be hard to come by in a country that requires and rewards long hours at work. But you’re already making time for exercise class, and it provides those conditions; benefitting from them mostly requires acknowledging that you’ve already set yourself up for friendship. Danielle Friedman, a journalist and the author of Let’s Get Physical, told me that breaking through what she calls the “social code of anonymity” is key to making friends. “If you’ve been going to the same class for a while and start seeing the same people, don’t pretend like you’ve never interacted before,” she said. That kind of friendliness requires adopting the clichéd feel-goodery inherent in many group fitness classes. In my spin classes, I’d cringe whenever I caught myself doling out motivational platitudes—mostly “We’re all in this together!” because I needed the reminder too, as I tried to talk and spin at the same time. Inevitably, though, someone would “Woo!” in response and reenergize the whole room. I’d load up my playlists with high-tempo remixes of early-aughts Top 40 hits and catch people singing along. One of my favorite instructors in a class I attended regularly instituted “Fun Friday,” when we’d warm up by doing silly little relay races or grade-school-style games; my blood ran cold the first time she told us to partner up for this cheesefest, but I had a blast. Everyone did. In a world that prizes ironic detachment, embracing such earnest silliness can feel deeply uncomfortable. But—and you might as well get used to hearing this kind of phrase now, if you’re going to start attending classes—you just have to push through. “When you’re sweating, feeling a little out of control of your physical self, whooping and yelling, there’s a vulnerability,” Friedman said. “If you buy in, then you’ve shared something. There aren’t that many contexts as adults where you have that opportunity to be vulnerable together.” [Read: Why making friends in midlife is so hard] A room full of grown adults flailing, shouting, and running miles without ever going anywhere is a fundamentally ridiculous prospect. Ridiculous things, however, play a crucial role in connecting with others: They make us laugh. Studies show that laughing with others facilitates social connection by helping us feel that we have more in common. The “happy hormones” released during exercise—endorphins, dopamine, and serotonin—are also associated with bonding. In particular, exercising in sync with others promotes close relationships. Even if you don’t find your next best friend at Zumba, getting into a fitness habit of some kind might help you meet people and make friends in other spaces. “The more that people can step out of their comfort zone in one setting, the less intimidating it is to do in other settings,” Goldberg said. Perhaps you’ll even become the version of yourself who inspires people to bring you homemade ice cream. Win-win. Read More

A study suggests that expanded screening for lung cancer could save more lives, especially among Black Americans. A 70-year-old woman who participated in the study says she was saved by earlier screening. NBC News' Anne Thompson. Read More

The 340B program has received its share of criticisms, largely due to the lack of transparency into covered entities who receive the discounts from drug manufacturers. Read More

The last time I sweated through my shirt, I vowed that it would never happen again. Sweat shame had dogged me for too many years. No longer would armpit puddles dictate the color of my blouse. Never again would I twist underneath a hand dryer to dry my damp underarms. It was time to try clinical-strength antiperspirant. The one I bought looked like any old antiperspirant, a solid white cream encased in a plastic applicator. But its instructions seemed unusual: “For best results, apply every night before bed and again in the morning.” Every night? I swiped it across my armpits before bed, and to my surprise, they were dry all the next day. I kept poking them in disbelief—deserts. But I would later discover that there isn’t anything particularly special about this product. Nighttime application improves the effects of any traditional antiperspirant, including those combined with deodorant (the former blocks sweat while the latter masks smell). Research has shown this for at least 20 years; none of the experts I spoke with disagreed. Yet many of us swipe our armpits in the morning before we head out for the day. Somehow, Americans are trapped in a perspiration delusion. Putting on antiperspirant in the evening feels roughly akin to styling your hair right before bed. Both are acts of personal maintenance that people take not only for their own well-being but also in anticipation of interactions with others. This idea is reinforced by ads for antiperspirants, which tend to feature half-dressed actors getting ready in bathrooms or changing rooms; see, for example, the Old Spice guy. These ads also tend to mention how long their products work—24 hours, 36 hours—implying that their effectiveness starts to fade once they are applied. In a recent Secret commercial, a woman rolls on antiperspirant in a daylit bathroom, then scrambles to make her bus, relieved that she is prepared for such sweaty moments for the next 72 hours. What these ads don’t say is that these products need the right conditions to work effectively. Antiperspirant isn’t a film on the surface of the armpit that stops moisture from leaking through, like a tarp over wet grass. Instead, it functions like a bunch of microscopic champagne corks, temporarily sealing sweat glands from spraying their contents. The active ingredient in most antiperspirants is some form of aluminum salt, compounds that combine with moisture on the skin to form “gel plugs” that dam up the sweat glands. These gel plugs prevent not only wetness but also odors, because bacteria responsible for foul smells thrive best in moist (and hairy) conditions, according to Dee Anna Glaser, a dermatologist and board member of the International Hyperhidrosis Society, a group that advocates for patients with excessive sweatiness. Gel plugs are finicky. They need a little bit of sweat in order to form—but not too much. Antiperspirant applied in the morning isn’t ideal, because people sweat more during waking hours, when they’re active. If the armpits are too sweaty in the hours after application, the product gets washed away before it can form the plugs. The body is cooler and calmer during sleep. For gel plugs to form, “baseline sweating is optimal at nighttime before bed,” Glaser told me. Nighttime application has been shown to increase the sweat-reduction ability of normal antiperspirant from 56 percent to 73 percent. But wait, I can already hear you thinking, what happens if I shower in the morning? Here’s the thing: Antiperspirant lasts through a shower. “The plugs won’t wash away much,” even though the residue and scent probably will, Mike Thomas, a former scientist with Procter & Gamble and an advocate for the International Hyperhidrosis Society, told me. After 24 hours or more, the plug naturally dissolves. Reapplying antiperspirant during the day can be beneficial, Shoshana Marmon, a dermatology professor at New York Medical College, told me. Still, it works best if applied to dry armpits that, ideally, stay dry enough for the plugs to form. For most people, Marmon added, putting it on “clean, dry skin at night” provides enough protection to last through the next day. Again, none of this information is new or hard to find. One of the earliest studies demonstrating the value of nighttime application was published in 2004; it showed that applying antiperspirant in the evening, or twice daily, was significantly more effective than morning-only use. Indeed, the stance of the American Academy of Dermatology is that it’s best to put antiperspirant on at night. Media outlets have covered this guidance since at least 2009. For the perpetually sweaty, discovering this guidance only now, after decades of embarrassing photos and ruined shirts, might spark belief in a grand conspiracy: They don’t want you to know the truth about armpit sweat. Indeed, it isn’t mentioned on the labels of most regular-strength antiperspirants. The reasons for this are more banal than nefarious. Most people don’t sweat excessively, so applying antiperspirant the usual way is sufficient. “Manufacturers may keep instructions simple to fit general habits, so the idea of using antiperspirant at night doesn’t always make it into mainstream awareness,” Danilo C. Del Campo, a dermatologist at Chicago Skin Clinic, told me. The difference between antiperspirant and deodorant still eludes many people and, in fact, may bolster the insistence on morning application. Deodorant is essentially perfume and has no impact on sweat production. It’s “best applied when odor control is most needed, typically in the mornings,” Marmon said. When I asked brand representatives why so many antiperspirants don’t mention nighttime use in the directions, they pointed to the potential for confusion. “It’s a bit counterintuitive for people to use antiperspirant at night, because most people think of applying it as part of their morning routine,” Maiysha Jones, a principal scientist at P&G North America Personal Care, which owns brands such as Secret and Old Spice, told me. But, she added, it is indeed best to use it at night. “Antiperspirants are commonly assumed to be a morning-only product and applied during the morning routine,” Megan Smith, a principal scientist at Degree Deodorant, told me. In other words, people are used to applying antiperspirant in the morning because companies don’t tell them about the nighttime hack … but companies don’t tell them because people are used to putting it on in the morning. Omitting helpful instructions just because they might be confusing isn’t doing America’s perspirers any favors. Anyone who’s ever experienced an overly moist underarm can surely be coaxed into shifting armpit maintenance back a measly eight hours. People go to far greater lengths to self-optimize, whether it’s teens adopting multistep skin-care routines, or wellness bros taking dozens of supplements. The science is well established, and the guidance is clear. But the ranks of nighttime swipers may not increase immediately. Routines have to be reset, assumptions picked apart. Some evenings, I find it exhilarating to buck the orthodoxy of personal hygiene. Other nights, it gives me pause. Applicator hovers over armpit, brain stumbles on belief. Will this really last past the sunrise, through a shower, beyond the hustle of the day? Even after learning about the science, “some people just don’t believe,” Thomas said. All there is to do is try. In go the corks, out go the lights. Read More

A urologist convicted of sexual abuse has been sentenced to life in prison, and now hundreds of patients are demanding more accountability from the hospitals where he worked. NBC News' Tom Llamas reports. Read More

In this week’s edition of The Prototype, we look at using drones to protect the rainforest, the newest space billionaire, why you need to get up and move around during the day and more. You can sign up to get The Prototype in your inbox here. This week, the XPrize Foundation announced the winners of its XPrize Rainforest Competition. Since 2019, over 300 teams have been competing for the prize, which was looking for technology that enabled rapid and accurate surveys of rainforest biodiversity to improve conservation efforts. Read More

Certain foods are more likely than others to wreak havoc on your stomach. Cucumbers have carried Salmonella, peaches have been contaminated with Listeria, and eating a salad feels a bit like Russian roulette. Romaine lettuce, tomatoes, and sprouts are all considered high risk for foodborne illnesses. (Scott Faber, a food-safety expert at the Environmental Working Group, put it to me bluntly: “Don’t eat sprouts.”) By comparison, onions have an almost-divine air. They are blessed with natural properties that are thought to prevent foodborne illnesses, and on top of that, they undergo a curing process that acts as a fail-safe. According to one analysis by the CDC, onions sickened 161 people from 1998 to 2013, whereas leafy greens sickened more than 7,000. Onions haven’t been thought of as a “significant hazard,” Susan Mayne, the former head of food safety at the FDA, told me. Not anymore. Late last month, McDonald’s briefly stopped selling its Quarter Pounders in certain states after at least 90 people who ate them fell sick with E. coli. Last Wednesday, the CDC announced the likely culprit: slivered onions. This is the fourth time onions have caused a multistate foodborne outbreak since 2020, in total sickening at least 2,337 people, according to available data. In that same time span, leafy greens have caused eight multistate outbreaks that have affected 844 people. All of a sudden, the United States seems to have an onion problem—and no one knows for sure what is causing it. The investigation into the cause of the McDonald’s outbreak is still ongoing, but the problem likely started where many foodborne illnesses begin: in the field. The culprit, in many instances, is contaminated water used to irrigate crops. An outbreak can also start with something as simple as a nearby critter relieving itself near your veggies. Any additional processing, such as when onions are cut into prepackaged slivers, can give bacteria lots of opportunities to spread. That’s why the FDA considers most precut raw vegetables to be high risk. (As with other foods, cooking onions to 165 degrees Fahrenheit kills pathogens.) But the fact that onions appear to get contaminated with E. coli and Salmonella at all is striking. Onions have long been thought to have antimicrobial properties that can help them fight off bacteria. Hippocrates once recommended that onions be used as suppositories to clean the body, and onions were placed on wounds during the French and Indian War. Medical knowledge has thankfully advanced since then, but the onion’s antimicrobial properties have been documented by modern science as well. In various lab experiments, researchers have found that onion juice and dehydrated onions inhibit the growth of E. coli and Salmonella. And in 2004, researchers found that E. coli in soil died off faster when surrounded by onion plants than when surrounded by carrot plants, a result the authors said might be due to “the presence of high concentrations of antimicrobial phenolic compounds in onions.” Onions have another powerful weapon in their food-safety arsenal: their papery skin, which research suggests may act as a barrier protecting the insides of an onion from surface bacteria. The way that onions are processed should add an additional layer of protection: To extend their shelf life, onions are left to dry, sometimes for weeks, after they are harvested. This curing process should, in theory, kill most bacteria. Stuart Reitz, an onion expert at Oregon State University who has intentionally sprayed onions with E. coli–laced water, has found that the curing process kills off a significant amount of the bacteria—likely because of ultraviolet radiation from the sun and because drier surfaces are less conducive to bacteria growing, Reitz told me. But clearly, onions are not contamination proof. Onion experts I spoke with floated some plausible theories. Linda Harris, a professor of food safety at UC Davis, posited that bacteria could hypothetically bypass an onion’s protective skin by entering through the green tops of the onion and then traveling down into the layers of the onion itself. And although onions might have antimicrobial properties, that might not always be enough to prevent an E. coli infection from taking hold, Michael Doyle, a food microbiologist at the University of Georgia, told me; when it comes to antimicrobial activity, he said, “not all onions are created equal.” And the McDonald’s onions could have become infected simply by way of probability. One of Reitz’s recent studies on the effect of curing found that 2 percent of onions sprayed with E. coli still had detectable levels of the bacteria after being cured. Still, none of this explains why onions seem to be causing more foodborne illnesses now. Harris told me that she and a colleague have “spent a lot of time trying to figure out how these outbreaks happen, and I will tell you: We don’t have an answer.” Unfortunately, we may never understand the cause of the onion’s heel turn. In many cases, regulators are unable to figure out exactly what causes a foodborne outbreak. They failed to find a definitive cause in the three other recent onion outbreaks, and perhaps the same will be true of the McDonald’s debacle. The entire situation demonstrates the maddening inscrutability of foodborne illness. The reality is that although these outbreaks are rare, they can be dangerous. One person died after eating a contaminated Quarter Pounder, and a 15-year-old had to undergo dialysis to stave off kidney failure. Yet for all of the technology and science that goes into food safety—the genome sequencing of foodborne pathogens, blockchain technology that traces crops from farms to store shelves—we continue to be stuck with more questions than answers. America has less of an onion problem than an everything problem. Read More

Robert F. Kennedy Jr.’s false claims linking autism to vaccinations are receiving new scrutiny now that President-elect Donald Trump has picked him to lead HHS. Read More

After activist investor Quentin Koffey’s Politan Capital Management won a proxy battle at med tech company Masimo, the company’s new leadership is suing founder and ex-CEO Joe Kiani as well as shareholder RTW investments. Read More

The loaf in my fridge is the furthest thing from Wonder Bread. Each slice is made of organic whole-wheat flour and has four grams of fiber and just two measly grams of added sugar. It’s studded with so many seeds that I’m always worried about them getting stuck in my teeth. The only service this bread can provide is as a hummus sandwich; it tastes too healthy for a grilled cheese, an egg sandwich, or any other handheld creation. But here’s the thing about my whole-grain, seed-coated loaf of bread: Apparently it counts as an ultra-processed food, just like Twinkies, Coke, and sugary cereals. I was faced with this bread conundrum earlier this month, when I attempted to cut down on ultra-processed foods after hearing so much about their harms. Almost every food is processed in some way—milk is conventionally pasteurized; tomatoes are canned—but ultra-processed foods, or UPFs, are typically made in factories with industrial ingredients, such as emulsifiers and artificial flavors. And they seem to be making us sick. A recent review found “convincing evidence” that ultra-processed-food consumption is tied to type 2 diabetes and fatal heart disease. According to the rubric created by Carlos Monteiro, the Brazilian epidemiologist who coined ultra-processed foods, my loaf of bread was to be avoided: It was mass-produced, laced with an industrial additive, and sliced. In an email, Monteiro confirmed to me that the bread was a UPF primarily because of the industrial additive: wheat gluten. It’s often used to strengthen dough before it is baked. If you get bread from the grocery store, as I did, it’s almost certainly also a UPF. But perhaps that says more about the perplexing, arbitrary criteria for ultra-processed foods than anything about bread itself. Exactly what qualifies as an ultra-processed food is not always clear. Monteiro’s rubric, called NOVA, separates foods into four categories. “Unprocessed foods” include raw vegetables and fruits. “Processed culinary ingredients” are things like cooking oils and honey. “Processed foods” are things like canned vegetables. And “ultra-processed foods” include Skittles, fish sticks, and other junk food, as well as infant formula and flavored yogurts. Drawing the line between ultra-processed and processed foods is especially tricky. NOVA doesn’t lay out specific criteria for, say, bread versus soda, but it does have detailed descriptions of how to spot an ultra-processed food, such as foods that include ingredients “never or rarely used in kitchens,” such as high-fructose corn syrup and hydrolyzed proteins. But even when you read Monteiro’s countless papers outlining the NOVA classification, categorizing food isn’t as simple as you might think. NOVA has called out “pre-sliced bread” as an example of an ultra-processed product, but I couldn’t tell if slicing automatically meant that a food was ultra-processed, or if it was just a signal that a food might be ultra-processed. (With my bread, Monteiro told me that the presence of wheat gluten was “the only marker” of ultra-processing.) But added gluten is hardly the same as hydrolyzed proteins or industrial sweeteners. The fact that a single ingredient—and one as benign as wheat gluten—could lump my bread together with Twinkies made me question the credibility of the entire system. The attributes to look for in bread, like slicing, felt so arbitrary that I started to wonder if I was applying the criteria incorrectly. Nutritionists I contacted struggled too. Marion Nestle, a professor emeritus of nutrition at NYU who has defended the NOVA system, told me she wasn’t sure whether the bread I was eating qualifies as an ultra-processed food, because, despite having an industrial additive mixed in, it was made mostly from actual whole foods. Even Monteiro seemed confused at first. When I sent him the ingredient list, he initially told me that my loaf was just processed (not ultra-processed), until I asked him specifically about the wheat gluten. He then argued that the bread “is much better than the average ultra-processed bread.” But the idea of UPFs is to try to avoid the category entirely. Monteiro’s team appears to have long struggled with the bread quandary as well. Nearly every paper they write on the system classifies bread as ultra-processed, but they’ve argued that “bread, even in typically cheapened degraded forms, is relatively innocuous.” In 2015, the team classified “french bread” as “processed,” but “sliced bread” as “ultraprocessed.” Even if I accepted that my bread was ultra-processed, I still couldn’t understand why it was so bad. Much of the research into the health effects of bread has focused on the nutrients—or lack thereof—in certain products, especially white bread. Mostly, researchers fear that particular additives in bread have not been extensively studied, and that processed bread is easier to chew and swallow, thus prompting people to eat more. I wasn’t even a week into my attempt to cut out UPFs, and I was already feeling exasperated. The situation was made even worse when I went back to the grocery store in hopes of finding a replacement. At first glance, no bread seemed to fit the bill. Although the Real Bread Campaign, an advocacy group focused on reducing consumption of ultra-processed bread, recommends buying natural sourdough from a local baker, or making it yourself, that’s hardly useful advice for the many Americans who don’t even have easy access to a grocery store, let alone a boulangerie. The NOVA system seems, at first glance, like the world’s simplest diet: All you have to do is avoid certain foods. But when that list gets so broad that you can’t eat a slice of whole-grain bread, it becomes unworkable. The same goes for yogurts and cereals—the majority of which are banned too. The bread debacle can seem like a straw man designed to make the whole system look pointless and unworkable. Some food scientists have criticized NOVA for being overly broad and unfairly maligning some healthy foods, but those arguments are also made in bad faith by big food companies to defend an industry that has made billions off making people sick. Monteiro told me that zeroing in on a single food “focuses on the trees and loses the forest.” But the entire exercise—the confusing guidelines, and the lack of clear articulation for why certain attributes of foods are worth avoiding—was weighing on me. This isn’t all NOVA’s fault. The clumsy classifications underscore an even deeper problem with our knowledge—or lack thereof—of UPFs. In short, we don’t know why ultra-processed foods are so bad for us. A recent clinical trial, in which participants ate either ultra-processed or unprocessed diets that were matched for certain key nutrients, found that something beyond the nutrient facts in UPFs makes people eat more and gain weight. What that is remains unclear. Until we understand it, advice on which foods to eat, and which to avoid, will always seem arbitrary and, in the case of bread, a bit silly. I did eventually find some bread in the supermarket that definitely wasn’t ultra-processed. The loaf, if you could call it that, had been imported from Germany. It had just four ingredients, and it smelled like dead grass. There were no air pockets or delectably crunchy crust. When toasted, it didn’t get crispy; it just got hotter and more pungent. For now, I’m going to stick to my regular old healthy bread. Read More

A new report from the CDC finds that vaccination rates for the flu and COVID-19 are low so far this season. The agency has recommended flu and COVID shots for everyone six months and older. Read More

Legendary founder and chairman of Oracle, Larry Ellison, announced earlier this year that the company will be shifting its global headquarters to Nashville, Tennessee. The announcement took many by surprise, given that the company has had a decades-long and well established presence in Silicon Valley and Austin, Texas. This marks one of many changes the technology giant’s leadership has deliberately made in recent years. Among the most prominent initiatives that the company has undertaken is its commitment to increase investment in the healthcare sector. Although Oracle has always offered enterprise technology products for healthcare applications, this became even more pronounced in 2021 when the company decided to move forward with its acquisition of famed electronic health records (EHR) system Cerner in a deal worth nearly $28 billion. Read More

These days, you can easily find vapes in flavors that include “Lush Ice,” “Blueberry Banana,” “Mango Lychee,” “Hot Fudge,” and “Fcuking Fab” (whatever that is). No matter which one you choose, it’s almost certainly illegal. The tiny battery-powered devices that produce a mist of nicotine when you inhale, first popularized by Juul, are not outright banned—at least not for adults—but only a few flavored vapes have gotten the FDA authorization required before they hit the market. That hasn’t stopped hundreds of shadowy companies, many based abroad, from effectively hawking contraband. Vapes are sold to Americans online for as little as $5, and are well-stocked in convenience stores, smoke shops, and even vending machines. With such little oversight, it’s no wonder that about 1.6 million American kids are regularly vaping, leading to panic that they are getting duped into a lifetime of nicotine addiction. The FDA has levied fines, filed lawsuits, and even seized products to keep vapes off of shelves, and the agency has pledged a major escalation in its efforts. Politicians across the political spectrum, including Senators Mitt Romney and Chuck Schumer, have advocated for a vaping crackdown. But not Donald Trump. In 2020, Trump abruptly abandoned a plan to ban flavored vapes, much to the chagrin of public-health officials. Late last month, Trump posted on Truth Social that, if elected, he would “save Vaping again!” The former president may be a deeply flawed messenger, and the vaping industry hardly deserves any sympathy. Many of these companies flagrantly violate the law and overtly market to kids. Even so, Trump has a point. Vapes—as a replacement for cigarettes, anyway—are actually worth saving. Trump said in that Truth Social post that vapes have “greatly helped people get off smoking.” It’s easy to dismiss that as spin. After all, he had received a personal visit from the head of the vaping industry’s lobbying group that same day. However, vapes are indeed a revelation for the 28 million adults in the United States who smoke cigarettes. They work as well, or even better, than all of the conventional products designed to help wean people off of cigarettes. Gum, lozenges, and patches simply deliver nicotine, the addictive chemical that keeps smokers smoking, in a safer way. These so-called nicotine-replacement therapies don’t contain any of the harmful ingredients in tobacco products such as cigarettes. Whenever you might feel an itch to smoke, you can instead use one of these replacements to satiate your craving. But nicotine-replacement therapies don’t work well. Less than 20 percent of people who try to quit smoking using these therapies in clinical trials are actually successful; one study found they aren’t any better than attempting to quit cold turkey. That’s because, for smokers, nicotine gums and lozenges never deliver anything close to the euphoric feelings of puffing on a cigarette. Your average cigarette is just tobacco leaves wrapped in paper with a filter on the end, but it is exquisitely efficient at delivering nicotine to the body. When burned, tobacco creates nicotine particles that hit receptors in the brain within 10 to 20 seconds. Nicotine-replacement therapies deliver nicotine much more slowly—from minutes to several hours—because the drug is absorbed by the mouth or through the skin. But you know what can get close to the experience of smoking? Vapes. They generate an aerosol that can reach deep into the lungs, allowing nicotine to hit the bloodstream at a speed that is “almost identical” to cigarettes, Maciej Goniewicz, an expert on nicotine pharmacology at the Roswell Park Comprehensive Cancer Center, told me. Part of what makes vapes so effective is that they look and work like cigarettes. “People who are addicted to smoking are not just physiologically addicted to the nicotine; they’re also behaviorally addicted to the process of smoking,” Ken Warner, an emeritus professor of public health at the University of Michigan, told me. Vapes even hold their own against the one conventional treatment that’s more effective than the traditional gums and patches: a prescription drug called Chantix. Instead of replacing the nicotine in cigarettes, it blocks the pleasurable effects of nicotine on the brain. According to a recent clinical trial, roughly 40 percent of some 400 people given a vape or Chantix successfully quit smoking after six months. Vaping may be an easier transition for smokers: Chantix isn’t widely used, in large part because of its side effects, which include nausea and vivid dreams. It certainly doesn’t hurt that huffing on a “Fcuking Fab”–flavored gadget can also just be fun. That vapes come in so many flavors is often the reason people start vaping in the first place. It’s not that different from alcohol: Many drinkers would prefer a vodka cranberry over a shot of Tito’s. Just like how it’s not just heavy drinkers who enjoy a vodka cranberry, the same is true of flavored vapes. The attractiveness of flavors is also why kids gravitate toward them, as do adults who have never smoked. Because kids overwhelmingly use flavors, banning them seems like an easy way to reduce vape use. But if public health is about managing trade-offs, the benefits of vapes seem to outweigh the negatives. Although no kids should be vaping, abusing these products is not deadly like cigarettes are. Amid rising public awareness about the dangers of youth vaping, even FDA’s top tobacco official has acknowledged publicly that youth vaping is no longer the epidemic it was a few years ago. But there are other caveats to consider when it comes to the anti-smoking potential of vapes. They are regulated as consumer products and not medicines, so they have not gone through the same rigorous approval process that every other anti-smoking drug has gone through. We still don’t know a lot about how effective vapes might be to help people quit smoking, or how often smokers need to use them to successfully quit. Because vapes are still relatively new, no one can say definitively that they do not carry some long-term risks we do not know yet. The current Wild West of vapes also adds to the potential pitfalls. Vapes also contain known carcinogens, likely because of the chemicals in e-liquids being heated to high temperatures. Some likely carry higher risks than others because of how little standardization there is in the chemicals used. All of these risks have made public-health groups understandably reluctant to embrace their use. The FDA acknowledges that vapes are safer than cigarettes, though they do not endorse them as an anti-smoking treatment. Should the agency get its way, the majority of flavored vapes will eventually be off of store shelves. The head of the FDA’s tobacco center has said that “nothing is off the table.” No matter who wins in November, some of the FDA’s decisions are likely out of the next president’s control: The agency’s decisions on which vapes to green-light doesn’t rest with the commander in chief or the FDA commissioner; rather, they are governed by FDA scientists who are following a legal standard. Still, having a president who embraces vaping could go a long way. Surveys show that a sizable proportion of smokers mistakenly think vapes are more dangerous than cigarettes. That likely keeps many smokers from trying them. Kamala Harris has not weighed in on vaping since becoming the Democratic nominee. (Her campaign declined to comment on her position. And any single-issue vaping voters out there might do well to reconsider their priorities before voting for Trump.) His stance isn’t exactly academically rigorous, nor is it adequately nuanced. But if Trump acknowledges the benefits of vaping while also condemning the lawlessness of much of the current vaping industry, he could help legitimize a product that has been shunned by most of the medical establishment. For now, few reputable companies are willing to invest in making their own vapes, and few doctors are going to recommend them to patients. This all might sound like public-health sacrilege. But given that the overwhelming majority of smokers who try to quit each year fail, “anything that we can add to the tool kit as a way that could help people transition away from smoking is something that is worth exploring,” Jamie Hartmann-Boyce, a professor at the University of Massachusetts at Amherst who has studied anti-smoking drugs, told me. You might cringe at the thought of anyone putting something called “Fcuking Fab” into their lungs, but consider that cigarettes still kill nearly 500,000 Americans each year. Vapes are deeply flawed. Unfortunately, so are the alternatives. Read More

When Eric Brunner, an artist in Philadelphia, was diagnosed with ALS at just 33 years old, he turned to art to spotlight the diverse faces of people living with ALS through 3-D printed images that he hopes will spark a conversation about the disease. WCAU's Matt DeLucia reports. Read More

Success isn’t just about skills—self-awareness and empathy drive collaboration and growth. Build a stronger workplace culture with these essential traits. Read More

When I was taking German in college in the early years of this millennium, I once stumbled upon a word that appeared foreign even when translated into English: Diphtherie, or diphtheria. “What’s diphtheria?” I wondered, having never encountered a single soul afflicted by this disease. Diphtheria, once known as the “strangling angel,” was a leading killer of children into the early 20th century. The bacterial infection destroys the lining of the throat, forming a layer of dead, leathery tissue that can cause death by suffocation. The disease left no corner of society untouched: Diphtheria killed Queen Victoria’s daughter, and the children of Presidents Lincoln, Garfield, and Cleveland. Parents used to speak of their first and second families, an elderly woman in Ottawa recalled, because diphtheria had swept through and all their children died. Today, diphtheria has been so thoroughly forgotten that someone like me, born some 60 years after the invention of a diphtheria vaccine, might have no inkling of the fear it once inspired. If you have encountered diphtheria outside of the historical context, it’s likely because you have scrutinized a childhood immunization schedule: It is the “D” in the DTaP vaccine. Vaccine breakthroughs over the past two centuries have cumulatively made the modern world a far more hospitable place to be born. For most of human history, half of all children died before reaching age 15; that number is down to just 4 percent worldwide, and far lower in developed countries, with vaccines one of the major drivers of improved life expectancy. “As a child,” the vaccine scientist Stanley Plotkin, now 92, told me, “I had several infectious diseases that almost killed me.” He ticked them off: pertussis, influenza, pneumococcal pneumonia—all of which children today are routinely vaccinated against. But the success of vaccines has also allowed for a modern amnesia about the level of past human suffering. In a world where the ravages of polio or measles are remote, the risks of vaccines—whether imagined, or real but minute—are able to loom much larger in the minds of parents. This is the space exploited by Robert F. Kennedy Jr., one of the nation’s foremost anti-vaccine activists and now nominee for secretary of Health and Human Services. It is a stunning reversal of fortune for a man relegated to the fringes of the Democratic Party just last year. And it is also a reversal for Donald Trump, who might have flirted with anti-vaccine rhetoric in the past but also presided over a record-breaking race to create a COVID vaccine. Kennedy has promised that he would not yank vaccines off the market, but his nomination normalizes and emboldens the anti-vaccine movement. The danger now is that diseases confined to the past become diseases of the future. Walt Orenstein trained as a pediatrician in the 1970s, when he often saw children with meningitis—a dangerous infection of membranes around the brain—that can be caused by a bacterium called Haemophilus influenzae type b or Hib. (Despite the name, it is not related to the influenza virus.) “I remember doing loads of spinal taps,” he told me, to diagnose the disease. The advent of a Hib vaccine in the 1980s virtually wiped these infections out; babies are now routinely vaccinated in the first 15 months of life. “It’s amazing there are people today calling themselves pediatricians who have never seen a case of Hib,” he says. He remembers rotavirus, too, back when it used to cause about half of all hospitalizations for diarrhea in kids under 5. “People used to say, ‘Don’t get the infant ward during diarrhea season,’” Orenstein told me. But in the 2000s, the introduction of rotavirus vaccines for babies six months and younger sharply curtailed hospitalizations. To Orenstein, it is important that the current rotavirus vaccine has proved effective but also safe. An older rotavirus vaccine was taken off the market in 1999 when regulators learned that it gave babies an up to one-in-10,000 chance of developing a serious but usually treatable bowel obstruction called intussusception. The benefits arguably still outweighed the risks—about one in 50 babies infected with rotavirus need hospitalization—but the United States has a high bar for vaccine safety. Similarly, the U.S. switched from an oral polio vaccine containing live, weakened virus—which had a one in 2.4 million chance of causing paralysis—to a more expensive but safer shot made with inactivated viruses that cannot cause disease. No vaccine is perfect, says Gregory Poland, a vaccinologist and the president of the Atria Academy of Science & Medicine, who himself developed severe tinnitus after getting the COVID vaccine. “There will always be risks,” he told me, and he acknowledges the need to speak candidly about them. But vaccine recommendations are based on benefits that are “overwhelming” compared with their risks, he said. The success of childhood vaccination has a perverse effect of making the benefits of these vaccines invisible. Let’s put it this way: If everyone around me is vaccinated for diphtheria but I am not, I still have virtually no chance of contracting it. There is simply no one to give it to me. This protection is also known as “herd immunity” or “community protection.” But that logic falls apart when vaccination rates slip, and the bubble of protective immunity dissolves. The impact won’t be immediate. “If we stopped vaccinating today, we wouldn’t get outbreaks tomorrow,” Orenstein said. In time, though, all-but-forgotten diseases could once again find a foothold, sickening those who chose not to be vaccinated but also those who could not be vaccinated, such as people with certain medical conditions and newborns too young for shots. In aggregate, individual decisions to refuse vaccines end up having far-reaching consequences. Evolutionary biologists have argued that plague and pestilence rose in tandem with human civilization. Before humans built cities, back when we still lived in small bands of hunter-gatherers, a novel virus—say, from a bat—might tear through a group only to reach a dead end once everyone was immune or deceased. With no one else to infect, such a virus will burn itself out. Only when humans started clustering in large cities could certain viruses keep finding new susceptibles—babies or new migrants with no immunity, people with waning immunity—and smolder on and on and on. Infectious disease, you might then say, is a necessary condition of living in a society. But human ingenuity has handed us a cheat code: Vaccines now allow us to enjoy the benefits of fellow humanity while preventing the constant exchange of deadly pathogens. And vaccines can, through the power of herd immunity, protect even those who are too young or too sick to be effectively vaccinated themselves. When we get vaccinated, or don’t, our decisions ricochet through the lives of others. Vaccines make us responsible for more than ourselves. And is that not what it means to live in a society? Read More

OBGYN and author of “The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Fact,” Dr. Mary Claire Haver joins TODAY to break down what you need to know about menopause, including the different stages, common symptoms, treatment options and more. Read More

WNBA and Minnesota Lynx star, Napheesa Collier, is using her platform to advocate for reproductive health. Collier, who in the last few years alone has won an Olympic gold medal, competed in the WNBA Finals, given birth to her daughter, and co-founded a new 3-on-3 women’s basketball league, is now a member of “Team Opill,” joining the birth control brand as an ambassador. Opill is the first and only daily birth control pill available without a prescription in the U.S., and is now the first to be available at most major retailers nationwide and online. The over-the-counter daily birth control pill is developed by Perrigo, a leading provider of consumer self-care products. Read More

In the fall of 2021, Tammi Kromenaker started looking for a new home for her North Dakota abortion clinic. For more than 20 years, Red River Women’s Clinic had provided abortion care to the Fargo area, most of that time as the state’s only provider. But now Kromenaker, the practice’s owner and director, was moving it just across the state line to Minnesota. “We had seen the writing on the wall,” she told me. A few months earlier, the Supreme Court had announced that it would take up Dobbs v. Jackson Women’s Health Organization, and North Dakota had a trigger law that would almost completely ban abortion if the justices ruled in favor of Dobbs. “We closed on a new building at 3 p.m. the day before they overturned Roe,” Kromenaker recalled. Over the next 47 days, with the help of $1 million raised through GoFundMe, she oversaw a frantic move and remodel, sneaking around in a hat and sunglasses to keep the new location a secret; another planned clinic had just been set on fire in Wyoming. Meanwhile, Kromenaker’s clinic sued the state of North Dakota to block the trigger ban. Last month, a North Dakota judge struck down the state’s abortion ban in response to Red River’s suit. Kromenaker could now return to providing abortions in Fargo, but she told me she has no plans to. That leaves the state with no dedicated abortion providers. In the aftermath of the Dobbs decision, abortion access has been all but obliterated in 14 states. Perhaps the most obvious consequence is what has happened to brick-and-mortar abortion providers: Clinics have closed, while physicians have fled restrictive states or left medicine altogether. In communities across the country, abortion pills have also been heavily restricted. A push to expand the rights of a fetus has coincided with a rise in pregnancy-related prosecutions, most of which have nothing to do with abortion—210 women were criminally charged in 12 states in the year after Dobbs, the highest number of such cases in a single year since 1973, according to one report. The backlash has been forceful. Since Dobbs, citizens in six states have voted for ballot measures protecting abortion access. Next month, abortion rights will again be on the ballot, in 10 states. In the first presidential election since Roe was overturned, abortion has become a defining issue. Many Republican politicians, including the party’s presidential nominee, Donald Trump, have attempted to court female voters by wavering on their previous anti-abortion positions. (Trump’s wife, Melania, released a memoir this month, in which she underscored her support for abortion rights.) Meanwhile, Democrats, especially the presidential nominee, Kamala Harris, have campaigned heavily on restoring national reproductive rights. But a Democratic woman in the White House or new federal abortion protections won’t turn back the clock to 2021. Call it the Dobbs legacy, or the Dobbs hangover—the effects of America’s eroded abortion access will linger for years, if not decades. [Read: Kamala Harris’s biggest advantage] This summer, on the two-year anniversary of the Dobbs decision, a coalition of groups including Planned Parenthood and the American Civil Liberties Union announced that they were committing $100 million to Abortion Access Now, a campaign to pass federal legislation guaranteeing the right to abortion. Harris has floated one potential path: scrapping the filibuster to push reproductive protections through Congress. (That would probably require Democrats to control both chambers, which does not look likely.) If new federal protections were passed, “you would see overnight relief in a lot of places, depending on the nature of the legislation,” Kimberly Inez McGuire, a co-chair of Abortion Access Now and the executive director of Unite for Reproductive and Gender Equity, told me. New federal protections, however, wouldn’t instantly undo the tangle of abortion restrictions that some states began enacting even before Dobbs was decided. Reproductive health in America is governed by a complex web of laws, regulations, and court decisions at the local, state, and federal levels. When the Supreme Court ended constitutional protections for abortion on June 24, 2022, trigger laws designed to ban abortion went into effect. By the end of the year, states had enacted 50 new abortion restrictions, many of them resulting in near-total bans. No federal law could immediately undo all of these restrictions at once. Around the country, clinics closed, moved, or quit providing abortions; as of March, the U.S. had 42 fewer clinics than in 2020, according to the Guttmacher Institute, a reproductive-health research and policy group. With so many barriers in place, some medical providers have decided that living and working in states with restrictions isn’t worth the emotional and professional toll. In one recent study of ob-gyns in Texas, where abortion is banned with few exceptions, 13 percent of respondents said they plan to retire early, 21 percent said they either plan to or have thought about leaving to practice in another state, and 2 percent said they have already left. An analysis by the Association of American Medical Colleges found that applications for ob-gyn residency programs in Alabama, which has a total ban except in cases of “serious health risk” to a pregnant woman, dropped 21.2 percent in the first full cycle after the Dobbs decision. [From the October 2024 issue: ‘That’s something that you won’t recover from as a doctor’] None of these policies has reduced the number of abortions performed nationally since Dobbs—in fact, the number has increased—but their consequences have ricocheted far beyond abortion. As obstetricians have fled restrictive states, for example, access to other gynecological care has become strained, too. And this month, Louisiana reclassified the two drugs used in medication abortions as Schedule IV controlled substances, a category typically reserved for drugs with a potential for dependency, such as Xanax and Valium. Mifepristone and misoprostol, which can be prescribed by telehealth, have played a significant role in abortion access since Dobbs. In Louisiana’s bid to further restrict the drugs, the state has potentially limited their use in other routine applications, such as treating miscarriages, inducing labor, and stopping potentially fatal postpartum hemorrhaging. Even if new federal abortion protections were passed into law tomorrow, restoring nationwide access would still likely take significant time. Clinics, for instance, need real estate and doctors and lots and lots of capital to open or move—that’s partly why, after a 2016 Supreme Court case struck down a Texas law designed to force clinics out of business, the number of providers in the state a year later remained a fraction of what it was before. After Alabama banned abortion in 2022, WAWC Healthcare, in Tuscaloosa, remained open to provide contraception and prenatal care but eventually lost its abortion provider, says Robin Marty, WAWC’s executive director. Such positions might be filled by recent graduates, but the pool of qualified providers in restrictive states will remain small for years thanks to plummeting residency enrollments—most doctors tend to stay in the state where they do their residency. Recent legal fights in Ohio provide a glimpse of how even sweeping abortion protections don’t automatically undo the effects of restrictions, and could lead to new ones. Last year, Ohio voters approved a constitutional amendment enshrining the right to an abortion. But pro-abortion-rights advocates in the state are still fighting to throw out the state’s six-week ban and a law banning telemedicine in medication abortions, among other restrictions. Meanwhile, a state legislator has introduced a new bill that would withhold state funding from cities and counties that provide funding for local groups that provide abortion-support services such as gas money for patients. The immediate result of any national abortion protection would probably be a protracted legal battle. “Every state has a different assemblage of abortion restrictions,” Inez McGuire said. “A lot of that is going to be fought out through our judicial system. That is a daunting prospect.” Roe’s downfall also opened up space for anti-abortion activists to renew their battle to recognize the rights of the fetus as a person. In February, when the Alabama Supreme Court found that IVF embryos are legally children, anti-abortion activists widely celebrated the decision as a sign that the country was ready to engage in this debate. As support for fetal rights has grown, pregnant people have found their bodily autonomy curtailed even when they’re not deciding whether to continue a pregnancy: According to the nonprofit group Pregnancy Justice, of the 210 cases of pregnant people who faced criminal charges, just five mentioned abortion. The majority alleged only substance abuse. In one, police charged an overdosing pregnant woman with child neglect after administering Narcan. [Helen Lewis: The women killed by the Dobbs decision] Abortion advocates, too, are adjusting to the new reality. Abortion access had been whittled away for decades before Dobbs was decided. But now the constitutional right to an abortion in America is no longer being infringed upon; it just doesn’t exist. Several clinic directors told me that it’s clear to them now that no new law will ever provide unassailable protection. When North Dakota’s ban was struck down by a district court last month, it wasn’t the first time; the same judge blocked a nearly identical abortion ban in 2022, eventually prompting the state legislature to repeal it and pass a new one with minor changes. Just this month, Georgia’s Supreme Court restored a six-week abortion ban that a lower court had overturned while it considers an appeal. “There is no finish line here,” says Katie Quinonez-Alonzo, the executive director of Women’s Health Center, which opened a branch of its West Virginia clinic three and a half hours away in Maryland after Dobbs. “This is work that needs to be done forever.” Kristi Hamrick, the vice president of media and policy for Students for Life of America, told me that the group already has a “Roe 2.0 Rollback plan” in place, ready to deploy at the state and federal levels after the election. “We are prepared legislatively and legally to address the human rights issue of the day, no matter which way the election turns out,” she told me. Some clinics are tired of fighting. “If you had asked me a few weeks ago, I would have said we were completely ready to go should abortion somehow return to Alabama,” Robin Marty told me. Now she’s not so sure. “We worked in extraordinarily hostile conditions” before Dobbs, Marty said. Clinic staff faced daily protesters, in the parking lot and sometimes even at the back door. Anti-abortion activists filed malpractice complaints against them, reported them to the fire department for allegedly having too many people in the clinic, and alleged health-privacy violations after digging through the clinic’s dumpster and finding a piece of paper from a patient’s file. “Having abortion become illegal and then having it return would be even more dangerous right now. If it comes back, they’re going to be even angrier,” Marty said. When Red River first opened, in 1998, the threat of extinction was already in the air. The previous director had chosen to name the clinic after a body of water that runs between North Dakota and Minnesota, so that the reference would still make sense on the other side of the state border. When Kromenaker finally made the move, her life became easier virtually overnight, because Minnesota was among the states that had passed abortion protections after Dobbs. “We ended up in a state where providing this care is more straightforward, more patient-centered and with less stigmatizing restrictions,” Kromenaker said. “We would never take a step back and re-inflict those restrictions on ourselves.” [Read: Abortion pills have changed the post-Roe calculus] The United States cannot easily go back to the pre-Dobbs status quo. In the past two years, too much has changed—more than 100 new legal provisions, dozens of clinics closed, and a cultural gulf that has grown ever wider. For both abortion-rights supporters and opponents, only one possibility remains: to inhabit the reality we all live in now. Read More

It was a surprising pick among many surprising picks. This week, President-elect Donald Trump announced his choice to head the Centers for Medicare and Medicaid Services: Dr. Mehmet Oz, who is as famous for the “America’s Doctor” moniker as he is for the number of dubious health claims he’s made from that perch over the years. Perhaps it shouldn’t have been surprising. After all, Trump endorsed Oz in his unsuccessful Senate bid in 2022, and in 2016 Trump appeared on Oz’s show to undergo a “surreal” on-air physical in lieu of sharing his medical records with the public. Plus, Melania Trump likes him. Read More

Customers of Delta Air Lines will soon be flying high on new menu offerings. The airline giant announced last week that it's rolling out fresh menus in its Delta One, First Class, and Delta Premium Select cabins across many domestic and international flights—with several of the new items aimed at providing travelers with more nutrient-dense foods to choose from. Read More

The little clump of cells looked almost like a human embryo. Created from stem cells, without eggs, sperm, or a womb, the embryo model had a yolk sac and a proto-placenta, resembling a state that real human embryos reach after approximately 14 days of development. It even secreted hormones that turned a drugstore pregnancy test positive. To Jacob Hanna’s expert eye, the model wasn’t perfect—more like a rough sketch. It had no chance of developing into an actual baby. But in 2022, when two students burst into his office and dragged him to a microscope to show him the cluster of cells, he knew his team had unlocked a door to understanding a crucial stage of human development. Hanna, a professor at the Weizmann Institute of Science in Israel, also knew that the model would raise some profound ethical questions. You might recall images of embryonic development from your high-school biology textbook: In a predictable progression, a fertilized egg morphs into a ball of cells, then a bean-shaped blob, and then, ultimately, something that looks like a baby. The truth is, though, that the earliest stages of human development are still very much a mystery. Early-stage embryos are simply too small to observe with ultrasound; at 14 days, they are just barely perceptible to the naked eye. Keeping them alive outside the body for that long is difficult. Whether anyone should is another matter—for decades, scientific policy and regulation has held 14 days as the limit for how long embryos can be cultured in a lab. Embryo models—that is, embryos created using stem cells—could provide a real alternative for studying some of the hardest problems in human development, unlocking crucial details about, say, what causes miscarriages and developmental disorders. In recent years, Hanna and other scientists have made remarkable progress in cultivating pluripotent stem cells to mimic the structure and function of a real, growing embryo. But as researchers solve technical problems, they are still left with moral ones. When is a copy so good that it’s equivalent to the real thing? And more to the point, when should the lab experiment be treated—legally and ethically—as human? Around the 14th day of embryonic development, a key stage in human growth called gastrulation kicks off. Cells begin to organize into layers that form the early buds of organs. The primitive streak—a developmental precursor of the spine—shows up. It is also at that point that an embryo can no longer become a twin. “You become an individual,” Jeremy Sugarman, a professor of bioethics and medicine at the Johns Hopkins Berman Institute of Bioethics, told me. [Read: A woman gave birth from an embryo frozen for 24 years] The primitive streak is the main rationale behind what is often referred to as the “14-day rule.” Many countries limit the amount of time that a human embryo can be kept alive in a petri dish to 14 days. When a U.K. committee recommended the 14-day limit in the 1980s, IVF, which requires keeping embryos alive until they are either transferred or frozen around day five or six, was still brand-new. The committee reasoned that 14 days was the last point at which an embryo could definitively be considered no more than a collection of cells, without potential individual identity or individual rights; because the central nervous system is formed after the 14-day milestone, they reasoned, there was no chance it could feel pain. But the recent rise of advanced embryo models has led some groups to start questioning the sanctity of the two-week mark. In 2021, the International Society for Stem Cell Research relaxed its 14-day guideline, saying that research could continue past 14 days depending on ethical review and national regulations. (The organization declined to set a new limit.) In July, U.K. researchers put out a similar set of guidelines specifically for models. Australia’s Embryo Research Licensing Committee, however, recently decided to treat more realistic models like the real deal, prohibiting them from developing past 14 days. In the United States, federal funding of human-embryo research has been prohibited since 1996, but no federal laws govern experiments with either real or model embryos. “The preliminary question is, are they embryos at all?” Hank Greely, a law professor and the director of the Center for Law and the Biosciences at Stanford University, told me. Allow one to develop further, and “maybe it grows a second head. We don’t know.” (Having a second head is not necessarily a reason to disqualify someone from being human.) In the absence of an ethical consensus, Hanna is at work trying to cultivate his models to the equivalent of day 21, roughly the end of gastrulation. So far, he said, he’s managed to grow them to about day 18. Researchers generally agree that today’s models show little risk of one day becoming walking, talking human beings. Combining sperm and eggs the old-fashioned way is already no guarantee of creating new life; even women in their 20s have only about a 25 percent chance of getting pregnant each month. Making embryos in a lab, sans the usual source material, is considerably harder. Right now, only about 1 percent of embryo models actually become anything that resembles an embryo, according to Hanna. And because scientists don’t have a great idea of what a nine-day-old embryo looks like inside the body, Greely said, they don’t actually know for certain whether the models are developing similarly. [Read: The most mysterious cells in our bodies don’t belong to us] And yet, in the past few years, scientists have already accomplished what seemed impossible not so long ago. Both Hanna and Magdalena Żernicka-Goetz, a developmental and stem-cell biologist at the California Institute for Technology and the University of Cambridge, have created models for mice with brains and beating hearts. Scientists and ethicists would be wise to consider what qualifies as human before human embryo models have beating hearts, too. The most important question, some ethicists argue, is not whether researchers can achieve a heartbeat in a petri dish, but whether they can achieve one with a model embryo implanted in a human womb. “It's no longer so much about how embryos are made or where they come from, but more what they can possibly do,” Insoo Hyun, a bioethicist and the director of life sciences at Boston’s Museum of Science told me. In an experiment published last year, seven-day-old model monkey embryos were successfully implanted in the uterus of three female monkeys. Signs of pregnancy disappeared about a week afterward, but the paper still raised the specter—or perhaps the promise—of a human version of the experiment. Building more realistic embryo models could have enormous benefits—starting with basic understanding of how embryos grow. A century ago, scientists collected thousands of embryo samples, which were then organized into 23 phases covering the first eight weeks of development. Those snapshots of development, known as the Carnegie stages, still form much of the basis for how early life is described in scientific texts. The problem is, “we don’t know what happens in between,” Hanna said. “To study development, you need the living material. You have to watch it grow.” Until recently, scientists had rarely sustained embryos in the lab past day seven or so, leaving manifold questions about development beyond the first week. Most developmental defects happen in the first trimester of pregnancy; for example, cleft palate, a potentially debilitating birth defect, occurs sometime before week nine for reasons that scientists don’t yet understand. It’s a mystery that more developmental research performed on embryo models could solve, Greely said. Better understanding the earliest stages of life could yield insights far beyond developmental disorders. It could help reveal why some women frequently miscarry, or have trouble getting pregnant at all. Żernicka-Goetz has grown models to study the amniotic cavity—when it forms improperly, she suspects, pregnancies may fail. Embryo models could also help explain how and why prenatal development is affected by viruses and alcohol—and, crucially, medications. Pregnant people are generally excluded from drug trials because of potential risks to the fetus, which leaves them without access to treatments for new and chronic health conditions. Hanna has started a company that aims, among other things, to test drug safety on embryo models. Hanna told me he also envisions an even more sci-fi future: treating infertility by growing embryo models to day 60, harvesting their ovaries, and then using the eggs for IVF. Because stem cells can be grown from skin cells, such a system could solve the problem of infertility caused by older eggs without the more invasive aspects of IVF, which requires revving the ovaries up with hormones and surgery to retrieve the resulting eggs. [Read: Christian parents have a blueprint for IVF] Answering at least some of these questions may not require hyperrealistic models of an embryo. Aryeh Warmflash, a biosciences professor at Rice University, is studying gastrulation, but the cells that form the placenta aren’t relevant to his research questions, so his models leave them out, he told me. “In some sense, the better your model goes, the more you have to worry,” he said. Hyun told me he cautions scientists against making extremely complex models in order to avoid triggering debate, especially in a country already divided by ideas about when life begins. But given all the medical advances that could be achieved by studying realistic models—all the unknowns that are beginning to seem knowable—it’s hard to imagine that everyone will follow his advice. Read More

The cost of generic drugs for many people could go up if President-elect Donald Trump follows through on his promise to impose sweeping tariffs on products from China and other foreign countries, policy experts say. Read More

The celebrity doctor’s 2022 financial disclosure for his Senate run details holdings in stocks like UnitedHealth, CVS and Johnson & Johnson — potentially creating conflicts in the way he runs Medicare and Medicaid programs. Read More

Taken on its own, the number is astonishing. According to the CDC, as of August 2023, 40.3 percent of U.S. adults—some 100 million people—met the clinical definition for obesity. But this same estimate, which is based on National Health and Nutrition Examination Survey numbers gathered between 2021 and 2023, also seems remarkably low compared with prior readouts. For the first time in more than a decade, NHANES data hint that our obesity epidemic is no longer growing. The new estimate is almost two percentage points lower than the government’s previous one, which covered the period from 2017 to 2020 and suggested that 41.9 percent of Americans had obesity. The apparent drop has set off a wave of optimism: A recent editorial in The Washington Post, for instance, celebrated the fact that “the obesity crisis might have plateaued or begun to ease,” and in the Financial Times, the data journalist John Burn-Murdoch used his own analysis of the NHANES data to argue that America is already several years beyond its point of peak obesity. Both outlets suggest that this apparent change in public fortune has resulted from the spread of powerful new drugs for treating diabetes and obesity: Ozempic, Mounjaro, and the rest. The past few years have certainly brought dramatic changes—historic breakthroughs, even—to the treatment of weight-related chronic illness. GLP-1s seem to be effective at improving people’s health, and they’re clearly capable of causing major weight loss. According to a survey conducted by KFF at the end of April, 6 percent of all American adults are currently on these medications, and as supply shortages ease and drug prices come down, that proportion is likely to increase—by a lot. It only stands to reason that, at some point before too long, their effects will be apparent in our public-health statistics. But are they now, already? For all the expectations that are attached to the present age of GLP-1s, the past should be a source of caution. This is not the first time that obesity’s relentless spread has seemed to be abating, and it’s not the first time that such news has fit into a tidy narrative of progress in public health. And so far, at least, claims of peak obesity, like predictions of “peak oil,” have been prone to falling flat. Not so long ago, the NHANES data appeared consistent with a different source of hope. Starting back in 2008, analyses began to show, first in children and then in adults, that obesity rates were leveling off. “Americans, at least as a group, may have reached their peak of obesity,” The New York Times asserted in 2010; two years later, NPR reported that “the nation’s obesity epidemic appears to have hit a plateau.” Then, as now, experts had a convenient story to explain the numbers. Barack Obama’s administration was working to realize his campaign promise that the nation’s excess weight could be reduced, if not erased, by targeting what was by then described as America’s “toxic food environment.” Revised nutrition labels put a spotlight on “added sugars,” new rules for food assistance promoted eating fruits and vegetables, insurers were encouraged to set up wellness programs, and chain restaurants were required to post the caloric content of their meals. For a time, this new approach—based less on treating individuals than fixing social policy—appeared to be effective. Food manufacturers committed to improving the formulations of their products. Americans stopped drinking so much soda and consuming so much sugar overall. And, sure enough, NHANES data were showing that the number of people with obesity had stabilized. This seemed connected, at the time. “We’ve halted the progress of the obesity epidemic,” William Dietz, an obesity physician-researcher who was then a CDC official, told the Times. Dietz, who had played a central role in creating the idea that obesity was an “epidemic” in the first place, chalked up that achievement to increased awareness of the problem and improvements to school-lunch programs. Yet this progress turned out to be short-lived. In retrospect, the obesity-rate “plateaus” during those years now appear to be a trend-line blip, if not a statistical mirage. That’s not to say the CDC’s analyses were mistaken. The survey’s error bars were wide, and in those years, any increase in the numbers was not statistically significant. But over time a clear and upward drift became unmistakable. As of 2004, NHANES data showed that about one-third of American adults qualified as having obesity. By 2018, the proportion had moved past 40 percent. Now Cynthia Ogden, the CDC’s branch chief for NHANES analysis, and her colleagues are reporting another flattening, set against a decades-long increase. Once again the error bars are wide, which is why the CDC’s data brief asserts that the apparent drop in the obesity rate, from 41.9 percent to 40.3 percent, is better understood as a new plateau. “We’re not going up at the same level as we did,” Susan Yanovski, a co-director of the NIH Office of Obesity Research, told me, “but I don’t think we can necessarily say that it’s a real decrease.” In the meantime, the new data clearly show that the rate of severe obesity among U.S. adults has continued to increase. If we are indeed at a new plateau for Americans generally, then its cause is not yet clear. David Ludwig, an endocrinologist at Boston Children’s Hospital who has been skeptical of earlier “peak obesity” claims, told me that new drugs such as Ozempic certainly should be having some effect by now. “Even if a notable minority is taking the drugs and losing weight, that’s going to alter the shape of the curve, the prevalence rates, and related statistics,” he said. “So it would be surprising, and very depressing, for us not to see any impact of these extremely costly drugs by this point.” Burn-Murdoch, who seems to be working from the same assumption, points out that the recent improvement in obesity numbers looks better among people with college degrees than anyone else. This is just what you might expect, he argues, because the uptake of GLP-1 drugs is generally associated with education. Yet if the Ozempic effect really were showing up in NHANES data, you’d also expect it to appear first in women, who are much more likely than men to be taking GLP-1s for obesity. This is not borne out in the data: America’s obesity rates appear to have come down (or leveled off) more quickly for men in the past few years. We also don’t know how many Americans were actually taking the drugs at the time of the latest surveys. I asked Ogden when she might expect the drugs to start moving the needle: What proportion of Americans would have to be taking GLP-1s for the national obesity rate to change? “That’s a good question,” she said. “All we can say is what these estimates show us right now, and that we really do need more data to see what’s really happening.” Yanovski was similarly wary of ascribing any recent changes in the trend to GLP-1s. She suggested that other factors might be at play: fewer people eating out; reduced sugar consumption; shrinkflation in the food industry, which results in smaller average portion sizes. (In principle, COVID might have been a factor too, because the disease is much more deadly for those with severe obesity. In that case, though, you’d expect the number of Americans in that category to have dropped, when in fact it has gone up.) And both Yanovski and Ludwig have long been floating the possibility that, even if the food environment remains as toxic as ever, the effects could start to wane as a function of biology. Almost half the variability in body weight is genetic, Yanovski told me, and that fact in itself could put a ceiling on the long-term trend. “You reach a level in which the population, everybody who is at risk for developing obesity, has already done so,” Ludwig said. The final possibility is that this new “plateau” will soon reveal itself to be yet another narrow step on a staircase that is always going up—just another artifact of noise, or else a temporary aberration. Having covered these reports for 15 years, I feel safe in saying that some degree of pessimism should be the default setting. Then again, having covered these reports for 15 years, I’ve never seen an intervention as dramatic as Ozempic, in terms of its power and popularity. Earlier this year, I profiled Barb Herrera, a woman who has had obesity throughout her life, and has tried almost every intervention to reverse it: diets, fen-phen, bariatric surgery. In 2022, her body mass index was measured at 75; after many months of taking GLP-1 drugs, she has lost 255 pounds. If Herrera were included in the next NHANES survey, she’d be recorded with a BMI of less than 28—below the diagnostic threshold for obesity—and classified as “overweight.” How many other Americans have crossed that line? We’ll soon find out. The next NHANES data surveys are slated to begin in January, Ogden told me, with the first results due back in early 2027, including, this time, information on people’s use of prescription drugs. If the nation has really passed the point of peak obesity—and if the GLP-1 drugs really are responsible—then we’ll know soon enough. Read More

Doctors say that once Alzheimer’s takes over the brain there’s little they can do to stop it, but if you catch it early there are medication and lifestyle changes that can help slow it down. Now, new artificial intelligence technology could revolutionize Alzheimer’s detection and spot early warning signs of the disease that are easy to miss. NBC’s Maria Shriver reports for TODAY. Read More

InnovationRx is your weekly digest of healthcare news. To get it in your inbox, subscribe here. President-elect Trump has announced his plans to appoint two key people to healthcare roles in his upcoming Administration: Robert F. Kennedy, Jr. for Secretary of Health and Human Services last Thursday, and Mehmet Oz for administrator of the Centers for Medicare and Medicaid Services on Tuesday. Biopharma stocks, particularly those of vaccine makers, fell on Thursday following the RFK Jr. pick, largely owing to the many false claims that he has made over the years about vaccines. Read More

A person who is “on the couch” is known to be in therapy, but most therapists these days don’t ask their clients to lie down. The first time mine did, I resisted. I didn’t want to be on display or unable to see her reactions. Plus, the idea seemed antiquated. Sigmund Freud was inspired to use the couch more than a century after observing dramatic hypnotherapy demonstrations by his teacher Jean-Martin Charcot. In psychoanalysis, Freud thought a therapist being out of view would help people access emotions or memories that might be repressed. (He also said that he could not “put up with being stared at by other people for eight hours a day.”) Many of Freud’s ideas about the unconscious haven’t held up, but he may have been onto something with the couch, as I discovered when I eventually followed my therapist’s suggestion. The couch might not be for everyone, but it could be worth a try. Today, therapists’ offices still almost always have a couch. For his book, In the Shadow of Freud’s Couch, Mark Gerald, a psychologist trained in psychoanalysis, took portraits of therapists in their offices, and “it was a rare room that did not have a couch,” he told me. “Somebody once mentioned they actually never used the couch with their patients, but if they didn’t have a couch, they wouldn’t feel like a psychoanalyst.” Despite the ubiquity of the therapist’s couch, research on instances when it is and isn’t helpful is limited. Some patients in case studies report that they’ve missed seeing their therapists’ face when they lie down, while others have used the couch to avoid direct face-to-face communication. Even Freud wasn’t always strict about the couch. He also took walks with his patients; he famously analyzed the composer Gustav Mahler during a four-hour walk around Leiden. But for me—and, I suspect, many others—occasionally lying down might provide some relief from the social aspects of talking with a therapist.The relationship between a therapist and a client won’t fully disappear, and that dynamic can be useful to examine in therapy too. Yet many therapy clients place too much emphasis on interpersonal dynamics. On social media, people make jokes about how much they want to get an A+ in therapy or make a therapist laugh; I’ve felt the same pressures myself. That stress could be reduced when you’re lying down and physically incapable of scanning your therapist’s face for signs of approval or displeasure. And in a time when many people have switched to teletherapy, staring at your therapist’s face (or your own) over Zoom can feel like a work meeting gone wrong. On a very simplistic level, the couch offers a change in perspective—literally. The ancient Greeks and Romans reclined during banquets, which created an atmosphere of comfort and intimacy, says Nathan Kravis, a psychiatrist and historian of psychiatry at Weill Cornell Medical College who’s also the author of On the Couch. In the modern world, lying down signifies that the conversation you’re about to have in therapy is a different kind of interaction than those you have with family or friends. It’s a time to confront difficult thoughts, admit shortcomings, or explore desires without the relational obligations to those we know in our “real” life. “Its strangeness is part of the power,” Kravis told me. “It really has no parallel anywhere else in our social world.” Lying down may also better satisfy people’s hunger for a more creative and humanistic form of therapy. Over the past few years, interest in psychoanalysis has made a dramatic comeback, though the approach still makes up a minority of therapy sessions. Other therapeutic methods, such as cognitive behavioral therapy, aim to change thoughts and behaviors that aren’t working for you; psychoanalysis, by contrast, focuses on self-exploration. I did CBT for years, and it’s very effective at solving problems. Yet something about a therapeutic practice that’s not as goal-oriented can be healing. When I started to lie down, I felt that I was choosing to make space for reflection, grief, processing, and developing intimacy with my own mind in a world where such acts are not usually prioritized. Lying down for therapy sessions could make a practice that’s costly in both time and money feel even more indulgent, and I’m sure that some people simply wouldn’t like it. But it’s available to everyone to try at least once. Lying down is a technique, not an end goal, Ahron Friedberg, a licensed psychoanalyst and board-certified psychiatrist, told me. It could be a way of cultivating comfort, intimacy, and reflection, or speaking in a manner that you’re not used to—to yourself or to a therapist. [Read: Plenty of people could quit therapy right now] In Gerald’s office, he provides choices. There’s a chair directly across from where he sits. There’s a couch, recently replaced because the original became saggy from years of use. Some of Gerald’s patients always lie down; others save it for when they’re feeling overwhelmed. One patient usually sits up but will curl up into a ball on the couch when she’s going through a difficult time. Kravis said he talks with a new client face-to-face, then gives them the option of lying down after a session or two. “It’s not mandatory,” he said. “You’re not Velcroed to the couch.” Read More

Vaccination rates for the flu, Covid-19 and respiratory syncytial virus (RSV) are low for adults in the U.S. so far this season, according to a new report from the Centers for Disease Control and Prevention. As of Nov. 9, an estimated 35% of U.S. adults had gotten the new flu vaccine, and nearly 18% had received the new Covid vaccines, CDC data shows. However, the agency noted that many unvaccinated adults reported that they intend to get their shots. Read More

High healthcare costs and the prospect of unexpected medical bills are leading worries for adults and their families. Lowering out-of-pocket costs is the public’s top healthcare priority, according to KFF, an independent source for health policy research, polling, and news. I wrote a year ago about how our hugely expensive healthcare system is harming American society: “In addition to fueling the deficit and adding hundreds of billions to our national debt each year, the high cost of healthcare is crowding out other state budget priorities, undermining the competitiveness of American businesses and hurting American families.” Read More

Is Robert F. Kennedy Jr., Donald Trump’s improbable nominee for secretary of Health and Human Services, actually such a crank? Short answer: yes. But two opinion pieces published in just the past few days argue that while Kennedy is often taken as unhinged, some of his ideas may very well be sound. Take the call for removal of fluoride from the nation’s drinking water. “It’s not an entirely crazy idea,” wrote Leana Wen, the former Baltimore health commissioner, in The Washington Post. Her piece concludes: “Not every proposal from Trump and Kennedy is a five-alarm fire.” The medical-evidence expert (and Atlantic contributor) Emily Oster made a similar argument about fluoride in The New York Times, adding that Kennedy’s dedication to raw milk is also not totally unreasonable. Instead of yelling that he’s wrong, she said, public-health authorities could start “acknowledging that reasonable people may make different choices on a given issue.” Let’s be clear: Many scientists consider Kennedy to be a fool, and a ludicrous pick to run HHS, because the evidence supports that assessment. Wen nods to this in passing—Kennedy has a “long history of antiscience propagandism,” she writes—but otherwise she’s focused on the nitty-gritty of one particular public-health debate. So allow me to fill in some gaps: According to his 2021 book, The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health, RFK Jr. believes that Fauci and Gates are members of a “vaccine cartel” trying to kill patients by denying them hydroxychloroquine and ivermectin. He argues that this cartel secretly funded doctors to produce fraudulent studies showing that the drugs were ineffective against COVID—and that it did so in order to orchestrate global lockdowns and accelerate the construction of 5G cellular networks, which, in Kennedy’s understanding, are very, very bad. I read The Real Anthony Fauci in what may have been a misguided attempt to “do my own research.” It’s hard to summarize the extent of this book’s lunatic claims. Every group imaginable is said to be in on a plot to bring about worldwide totalitarianism and population control: governments, pharmaceutical companies, non-profits, scientists, and, of course, the CIA. Kennedy devotes many pages to casting doubt on HIV as the cause of AIDS, although he finally says he takes “no position” on this theory. The book also repeats threadbare allegations that a vaccine scientist at the CDC destroyed data revealing that the measles, mumps, and rubella (MMR) shot caused a 340 percent increase in autism among Black men, thus continuing a major theme in its author’s activism: Before the pandemic, Kennedy was best known for relentlessly misleading the public about vaccinations. “Pharma and its media shills are working at turning us into ‘Land of the Cowed, Home of the Slave,’” he wrote about the MMR shot in 2019. Physicians like myself should have no trouble dismissing Kennedy. But some of my colleagues are asking Americans to withhold judgment. Last week, former CDC Director Robert Redfield, an infectious-disease doctor, announced, “For sure, I know that Bob Kennedy is not an anti-vaxxer,” after commending Kennedy’s crusade against chronic disease. Other doctors with a public platform—Jay Bhattachrya and Marty Makary, for example—have congratulated Kennedy on his support of free speech and his critique of the medical-industrial complex. And Vinay Prasad, an oncologist at UC San Francisco (and occasional Atlantic contributor), has written paeans to Kennedy’s views on the evils of pandemic restrictions and government censorship of social media. “Some have expressed concern about past statements by Mr. Kennedy,” Prasad acknowledged in a recent post. But “instead of attacking him,” another post explained, “we should acknowledge what he is right about and give guidance.” (Neither Makary nor Prasad responded to requests for comment for this story. Bhattacharya wrote back to say that “politically minded doctors” such as myself “have done much damage to public confidence in public health.”) There’s a name for this phenomenon: “sanewashing.” The concept rose to prominence during the presidential campaign, when liberals accused journalists of smoothing and sanding Trump’s often-rambling and confused statements into a more coherent, palatable form. They would sometimes treat his policy proposals as provocative asides rather than the chaotic assaults on government institutions they actually represented. Through curated clips and paraphrases, the argument goes, news outlets obscured the true extent of Trump’s lunacy. This is what some public-health commentators are now doing for Kennedy. Certain medical professionals may be offering their support out of self-interest: Bhattacharya and Makary are reportedly being considered for roles in the Trump administration. Yet they may also see some valid reasons to give Kennedy a chance. Yes, he gets important details wrong from time to time, but maybe—like Trump himself—it’s best to take him seriously, not literally. I’m ready to acknowledge the merit of Kennedy’s frequent claim that medical regulators are beset by conflicts of interest. Researchers and watchdogs have criticized the FDA, CDC, and other health agencies for operating a “revolving door” between government and industry. Vinay Prasad has long been an advocate on this very issue, and now, through Kennedy, he sees an opportunity to eliminate those conflicts once and for all. Kennedy isn’t a policy wonk, though; he’s a fabulist. Regulators and the pharmaceutical industry want nothing less than to “rob us of our sovereignty,” he said this month. “This is an organized, systematic, devious, nefarious project by these elites to turn the world into a technocracy.” When the problem is framed this way, Kennedy sounds less like a reformer more like someone trapped in a web of conspiracy. I once had more sympathy for these pundits, and their way of thinking: In 2016, I wrote an op-ed suggesting that doctors and their patients should band together in opposition to the conflicts of interests posed by the pharmaceutical industry; and that proponents of conventional and alternative medicine could unite behind a truly populist critique of corporate health care. I believed that more collaboration would moderate our discourse. But instead I’ve watched doctors distort or downplay their prior views in an attempt to find some common ground. Before Prasad was boosting Kennedy’s proposals, for instance, he wondered publicly whether the CDC’s questionable pandemic policies might lower rates of routine childhood vaccinations. Now he finds himself defending America’s leading anti-vaxxer. The sanewashers seem to understand that, if medical experts want any say in public health over the next few years, they will have to engage with the incoming Trump administration’s many eccentrics. But RFK Jr. is indeed a grade-A crank. Why should he have input on anything? This nation has no shortage of public-health and medical experts with thoughts on raw milk or fluoridated water. Some experts will surely agree with aspects of Kennedy’s platform, but they will also bring the credibility, experience, rigor and honesty he lacks. Let’s not pretend that Kennedy’s views have any value whatsoever. Read More

A newly identified chemical byproduct may be present in drinking water in about a third of U.S. homes, a study found. Scientists think it might be toxic but do not yet know. Read More

While the incoming administration may not know exactly how to fix healthcare, the opportunity for substantive, system-wide change may be in front of us. Read More

Recently, in a few cities across the country, Starbucks quietly unveiled a pair of drinks, one resembling a pistachio milkshake, the other a mossy sludge. Unlike with green beverages already on the Starbucks menu, their hue does not come from matcha, mint, or grapes. They are green because they contain actual greens—or, at least, a dried and powdered form of them sold by the supplement company AG1. Now getting a hefty dose of vegetables—including, but not limited to, broccoli, spinach, and, uh, “grasses”—is as easy as ordering an iced AG1 Coconutmilk Blend or its sibling, the Watermelon Blend. Powdered greens are hardly a new concept: Dehydrated, pulverized vegetables, sweetened with natural sugars, have been stirred into shakes and smoothies for decades. But AG1, formerly known as Athletic Greens, is one of many powdered-greens brands that are having a moment. Inescapable on the social-media feeds of wellness influencers, powdered greens are riding the same wave as green juices and Erewhon smoothies. These health-coded, aesthetically pleasing, status-symbol products are cool, pleasant-tasting vectors for plain old vegetables. Powdered greens claim all sorts of benefits, such as more energy, stronger immunity, and a happier gut. But above all, they promise convenience—a “hack” for eating vegetables, as Suja, another powdered-greens company, frames it. The basic premise is that eating vegetables is a slog, but a necessary one. Buying and consuming fresh vegetables—cleaning, chopping, cooking, and chewing them—is apparently so energetically taxing, so time-consuming, so horrible that it’s better to sneak them into tasty drinks, some of which are flavored like candy. Yes, swirling powder into liquid is less strenuous than massaging kale. And drinking food is a faster way to choke down something foul-tasting. There was a time when eating vegetables was challenging and disgusting, but not now. Greens have never been so cheap, tasty, or accessible. There are so many better ways to eat veggies than slurping them down like baby food. The wellness industry is full of products marketed as shortcuts to better health, some more dubious than others. At the very least, powdered greens can be a genuinely useful way to get a solid amount of vegetables. Americans “really under-consume leafy greens,” Anna Rosales, a dietitian and senior director at the Institute for Food Technologists, told me. According to the USDA, only 10 percent of people eat the recommended amount of vegetables, which is roughly 2.5 cups a day. That’s a problem because greens reduce the risk of chronic ailments such as diabetes, obesity, and heart disease. Greens that are dried through freezing instead of heat retain more nutrients and fiber, Rosales said. But green powders should be viewed as a “safety net”—they’re meant to “help us get to a place where we’re closer to the dietary recommendations.” They’re not a replacement for greens, or an excuse to eat less of them. In pretty much every way, normal greens are better than the powdered kind. The classic complaint about vegetables is that people don’t have time to buy and prepare fresh produce. As a working parent, I can relate. Often, grocery shopping and cooking are simply out of the question. How about just grabbing a salad to go? Earlier this year, I wrote about the fast-casual salad chains expanding out of coastal cities and into Middle America. They aren’t all $18-a-bowl places such as Sweetgreen; an exclusively drive-through chain called Salad and Go, based in the Southwest, offers options for less than $7—about the same price as a Big Mac. Standard fast-food chains, some of which waffled on salad in previous decades, now regularly sell it: Wendy’s and Chick-fil-A’s offerings have even been praised for being quite tasty. Growing interest in salad is pressuring restaurants to make them better, or at least more interesting: Caesar salads are mutating to include all sorts of weird ingredients such as tequila and fava beans, as my colleague Ellen Cushing wrote, but “even bastardized ones rock, and people want to buy them.” Even if salad isn’t your thing, ready-made vegetable dishes are easier than ever to get a hold of. Gone are the days when the only options available at fast-casual restaurants were the celery sticks that came with chicken wings. Crispy brussels sprouts, spinach-artichoke dip, and sweet-potato fries (along with salad) are now standard fare at national chains such as Applebee’s, Olive Garden, and Cheesecake Factory. (While not particularly healthy in these forms, they count toward your vegetable intake: Just eight brussels sprouts comprise a single serving.) Even at-home options are better now. It takes about the same time to shake up a cup of greens as it does to heat up a frozen dish of, say, roasted-squash-and-tomato pasta or spinach saag paneer. Many meal-subscription services will ship such dishes directly to your home. Most grocery stores offer precut vegetables to save on cooking prep time (or to eat directly out of the tray). And discount stores such as Dollar General have even begun to sell fresh produce. There are simply more ways than ever to get your greens. Of course, eating at restaurants and subscribing to meal plans are out of budget for a lot of people. Many Americans struggle to meet the fruit-and-vegetable dietary guidelines because of cost, which has only increased with inflation. Regular vegetables aren’t cheap, but neither is the powdered stuff. Powdered greens range from $1 to $3.30 per drink, according to a recent roundup by Fortune; a month’s supply of AG1 would set you back $99. The number of vegetable servings in each unit of green powder depends on the brand, yet even those that offer three or four servings of vegetables per scoop aren’t exactly cost-effective. A 12-ounce bag of frozen broccoli at Walmart, which would supply you with four servings of vegetables, costs a little more than $1. The real allure of powdered greens may not be time or cost, but rather that they feel like a cheat code for health. A company called Kroma Wellness markets its Supergreens Elixir Jar as the “easiest way to nourish your body”; another, Bloom, claims that “you don’t have to make any revolutionary changes to feel your best this year—all it takes is one daily scoop!” Andrew Huberman, a neuroscientist who hosts a popular health podcast, is also the science adviser for AG1, and has called it the “simplest, most straightforward way” to get his daily dose of nutrients. The hard way, in contrast, would be to overhaul your diet and lifestyle so that you consistently eat enough greens—and learn to like them. Doing so is guaranteed to improve your health, but not overnight, and not without significant effort. You certainly won’t experience the immediate sense of accomplishment you get after downing a glass of greens. Even so, as it has become easier than ever to eat vegetables, habits can be hard to break. Children holding their nose while they choke down lima beans is not so different from adults guzzling sweetened greens through a straw. Sometimes, parents add pureed beets to brownies, mash squash into macaroni and cheese, and fold black beans into burgers because children won’t eat them otherwise. Yet this practice is contested: Some argue that kids should just learn to enjoy their vegetables. Adults should do the same. Powdered greens are the latest complication in America’s long, messy relationship with vegetables. At best, vegetables are thought of as side dishes; at worst, they’re the thing you spit into a napkin when no one’s looking. Vegetarians have been mocked for more than a century. That all children hate greens is baked into pop culture. The notion that vegetables are a second-tier food is so pervasive that it’s easy to overlook the fact that vegetables are actually really good now—so good that you don’t need to chug them down in sugary drinks. Powdered greens may be helping some adults get more vegetables, but they perpetuate the underlying problem: They still treat greens as something you have to, rather than want to, eat. Read More

About 167,000 pounds of both fresh and frozen ground beef products have been recalled over possible E. coli contamination, according to the the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS). After the Minnesota Departments of Agriculture and Health noticed a link between a group of reported illnesses and ground beef from Wolverine Packing Co., a meat distributor based in Detroit, Michigan, the FSIS said they worked with the Minnesota Departments to investigate. Read More

CVS Health promoted Dr. Sreekanth Chaguturu to lead its healthcare delivery business a year after the company spent $20 billion on Signify Health and Oak Street Health. Read More

If you had come across the abbreviation GLP-1 a few years ago, chances are you’d have had no idea what it stood for. Intro to Greek lyric poetry? Low-level Great Lakes precipitation? A member of the 1990s rap group Get Low Playaz? These days, the initialism is much more recognizable. The new blockbuster obesity drugs, made famous by Ozempic, are collectively known as GLP-1 agonists, for the hormone they mimic in the body: glucagon-like peptide 1. It’s impossible to hear about the voraciously in-demand drugs without encountering the term. GLP-1 is mentioned 10 seconds into a Good Morning America segment on Ozempic, and frequently turns up in publications as varied as Good Housekeeping and Rolling Stone. Now, of course, the wellness industry is trying to get in on the GLP-1 craze. Supplements that are labeled with the term are everywhere. A brand called Supergut, available at chains such as Target and GNC, markets a “GLP-1 Booster” powder. Lemme, a company owned by Kourtney Kardashian, sells a “GLP-1 Daily” pill. These GLP-1 supplements are marketed as an alternative to obesity drugs—even though they have little in common with the drugs. To the wellness industry, GLP-1’s actual significance doesn’t seem to matter nearly as much as its association with thinness. Stripped of all meaning, GLP-1 can be used to sell just about anything. The obesity-drug boom makes GLP-1 seem almost miraculous. Semaglutide (sold under the brand names Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound) are synthetic versions of GLP-1. They can quiet hunger and food cravings, leading to weight loss. Supplements suggest that they can do the same. Pendulum’s GLP-1 Probiotic gives users “the power to boost this powerful hormone.” Calocurb’s GLP-1 Activator offers “natural appetite management support.” GLP-1 Boost Tea, from Happyself, is “inspired by the benefits of Ozempic & Semaglutide.” Ozempic isn’t the only way to boost GLP-1—the hormone kicks in after every meal. “Eating food will elevate GLP-1,” Richard Bloomer, a supplement expert at the University of Memphis, told me. When food reaches the small intestine, it triggers the release of GLP-1, leading to a feeling of fullness, and stimulates the release of insulin, which lowers blood sugar. GLP-1 supplements claim—correctly!—that a particular blend of nutrients can coax more GLP-1 out of the body. Metabolism Ignite, from a company called Veracity, includes green-coffee-bean extract, which was associated with a small uptick in GLP-1 in one study. Here’s the catch: GLP-1 supplements are like Ozempic in the way that peewee football is like the NFL. The drugs reach “manyfold higher levels of GLP-1” than any food, Dariush Mozaffarian, a professor at Tufts Friedman School of Nutrition Science and Policy, told me. Consider Lemme’s pills, which contain three plant-derived substances, including a lemon extract. In a 30-person, industry-funded study, lemon extract raised GLP-1 levels by 17 percent after participants took the extract for 12 weeks. In comparison, obesity drugs increase GLP-1 by more than 1,000 percent. The synthetic GLP-1 in obesity drugs lingers in the body for weeks after being injected; meanwhile, GLP-1 produced by the body is degraded within minutes, so hunger quickly returns. GLP-1 products, for the most part, are just repackaging common supplement ingredients. Some are bacteria-based: Pendulum, whose chief communications officer is the actor Halle Berry, sells a product called GLP-1 Probiotic, not to be confused with pills from a different company, Codeage, called GLP-1 Probiotic+. Other brands that claim to boost GLP-1 are functionally just selling fiber: Supergut’s product, a powder that can be added to drinks or food, contains six grams of probiotic fiber, about the same as a pear. At best, a GLP-1 supplement might expand on the effects of foods generally considered “good for you,” including unsaturated fats from avocados, nuts, flaxseed, and olive oil; some proteins, such as those from egg whites; and prebiotic fiber from certain legumes, whole grains, and fruits. These have all been shown to raise GLP-1, Mozaffarian told me. But when one takes these supplements, increasing GLP-1 isn’t really the point. What people actually care about is the secondary effect of having high GLP-1—that is, weight loss. But again, that’s hardly guaranteed. Boosting GLP-1 through a supplement “doesn’t really mean a whole lot, because the half-life is so short—but even if it is elevated, we don’t really know if it’s going to cause any of those beneficial effects,” such as weight loss, Bloomer said. Certainly, consuming fiber helps you feel fuller for longer. But you don’t have to be a nutritionist to know that it won’t slim your waistline like the obesity drugs do. In that sense, GLP-1 boosters aren’t so different from any old weight-loss supplement already on the market: They don’t reliably hold up to all the breathless marketing. GLP-1 is just the latest addition to the list of health terms that have been absorbed and watered down by the wellness space. Sometimes they’re jammed together on the label of a single product, as if doing so compounds their healthiness. The marketing copy for Pendulum’s GLP-1 Probiotic manages to fit in references to “metabolic health,” the “gut microbiome,” “postbiotics,” and “gut health,” together with the usual jargon related to GLP-1. If you spend too much time looking at these products, all of these terms start to blur together. Probiotics, electrolytes, protein, adaptogens—does anyone really understand what these words mean, and more important, do they care? Maybe not. But the fact that something sounds healthy makes it good enough to sell products. People may not know what GLP-1 is or does, but it certainly seems like it has something to do with losing weight. The wellness industry commonly uses sly marketing to sell products of dubious effectiveness, but there’s something especially unnerving about its attempt to move into the obesity-drug space. Demand for Ozempic and its kin is tremendous, but many people can’t access these drugs because of cost and supply issues. For people desperate to get on the drugs, GLP-1 supplements may seem like an easy substitute. They might even be convinced that these supplements are the better option: Supergut, according to its marketing, is “non-pharmaceutical, affordable, convenient, and comes with none of the unpleasant side effects” of the obesity drugs, “offering a sustainable approach to achieve lasting results.” Other brands use phrases such as “hunger quieting” and “curbs cravings,” borrowed directly from the Ozempic playbook. Like the obesity drugs themselves, GLP-1 supplements are meant to be taken continuously; most companies offer monthly subscriptions to their products (a six-month supply of Lemme’s pills, for example, costs $378). At one point, it seemed as though the new obesity drugs would doom weight-loss supplements for good. The drugs spurred greater and faster weight loss, in a wider range of people, than any other product in history. In response, the supplement industry has rebranded its offerings to mirror the competition, down to the language it uses. GLP-1 supplements don’t even come close to the real thing. But they sure look like it. Read More

WASHINGTON — When President-elect Donald Trump picked Dr. Mehmet Oz for a powerful executive branch job overseeing Medicare, incoming Senate Finance Committee Chair Mike Crapo, R-Idaho, quickly praised the TV-famous physician and said he looked forward to considering his coming nomination. “Far too often, patients relying on federal government health care programs are forced to accept bureaucratic, one-size-fits-all coverage,” Crapo said. “Dr. Oz has been an advocate for providing consumers with the information necessary to make their own health care decisions.” Read More

Tenet Health and Commure have inked a landmark agreement for enterprise-wide deployment of the latter’s ambient AI platform. The goal behind this partnership is to ease clinical workflows, alleviate physician documentation burdens and ultimately, promote an innovation focused enterprise. Commure is one of the rising giants in the ambient AI space. In addition to significant investments in and development of its own proprietary models and platform, last month, the company announced that it would be acquiring yet another ambient scribing service, Augmedix. Tenet Health is one of the largest healthcare systems and has an expansive reach, boasting more than 50 hospitals, 160+ outpatient centers and more than 530 ambulatory surgery centers. The system employs nearly 6,000 physicians across 50 health system partners and scores of facilities. Read More

The promise of the American food supply is that you can eat anything and not get sick. You can usually assume that whatever you buy from a grocery store or fast-food joint won’t land you in a hospital. But lately, foodborne-illness outbreaks seem to be distressingly regular. On Tuesday, the CDC reported 49 cases and one death linked to McDonald’s Quarter Pounders tainted with E. coli. In the past week, hundreds of waffle and pancake products were voluntarily recalled due to potential Listeria contamination. Listeria, in particular,  has been a problem of late: Earlier in October, more than 11 million pounds of ready-to-eat meat and poultry products were recalled. And an especially bad Listeria outbreak involving Boar’s Head deli-meat products has led to 59 hospitalizations across 10 states and 10 deaths. Many of this year’s outbreaks have occurred in foods that are pre-prepared—those that can be eaten as-is, without further cooking. Foods such as Quarter Pounders and waffles, yes, but also cold cuts, prepackaged salads, and jarred salsa are popular because they are convenient. That convenience comes at a cost. A rule of thumb in food safety is that “the more a food is handled prior to consumption, the higher the chances it can be contaminated,” Lawrence Goodridge, the director of the Canadian Research Institute for Food Safety, told me. Americans are left with a difficult choice: save time or risk getting sick. Many bacteria that cause foodborne illness live among us. Listeria can be found in soil and water, and E. coli and Salmonella are normally found in human and animal digestive tracts. They become a problem when they get into food. Pre-prepared foods are particularly prone to contamination because they are usually processed in large, sometimes even multiple, facilities where microbes have lots of opportunities to spread. “Somebody, somewhere, or a company, has produced the food so that we don’t have to do it at home,” Goodridge said. A factory worker with mud on his shoe, or an employee who didn’t wash her hands after using the bathroom, can be all it takes to start an outbreak. Food-safety practices—such as regular cleaning, temperature control, and strict hygiene standards—are supposed to keep these factories pristine. But occasionally, they fail. Refrigerated facilities keep most bacteria at bay—microbes grow more slowly at lower temperatures—but not Listeria, which thrives in cool conditions. Given enough time to grow, a Listeria colony forms a protective gel over itself, called a biofilm, which makes it especially difficult to get rid of. Meanwhile, E. coli typically gets into produce through water soiled with feces. Usually, contamination occurs at the farm level, but microbes can spread as fresh foods are processed into products such as precut fruit, bags of chopped lettuce, and even prewashed whole greens. When clean produce is washed together with a contaminated batch or sliced with the same equipment, bacteria can spread. Many foods are produced in a central location and then shipped cross-country, which is how a contamination event at a single farm can lead to illnesses nationwide. This may be the reason for the ongoing Quarter Pounder debacle. According to McDonald’s, the E. coli outbreak may be linked to slivered onions, which were sourced from a single supplier that served certain McDonald’s locations in 10 states, as well as some Taco Bell, KFC, and Pizza Hut stores. Centralizing the slivering of onions no doubt increases efficiency at fast-food chains. But it also raises the risk of contamination. In food safety, cooking is known as a “kill step,” because high heat kills most dangerous pathogens. Precut salads and fruit are usually eaten raw. Nobody cooks cold cuts, even though the CDC recommends heating them until they are steaming (who knew?). Even convenience products that are meant to be heated, such as frozen waffles and vegetables, aren’t always prepared properly at home. A toaster may not get a waffle hot enough—Listeria is killed at an internal temperature of 165 degrees Fahrenheit—and thawed frozen vegetables may be eaten without being boiled first, Barbara Kowalcyk, a food-safety expert at George Washington University, told me. To be clear, there’s no need for Listeria hysteria. “On the surface, it looks like there are many more outbreaks,” but there are no data to prove that yet, Goodridge said. Still, some recent outbreaks demonstrate that precautions are working as they should. Listeria was identified in a regular sweep of the waffle factory and products were voluntarily recalled; no cases of illness have been reported. Tools for detecting outbreaks are becoming more sophisticated, Darin Detwiler, a food-safety expert at Northeastern University, told me. A technique called whole-genome sequencing can identify instances in which people have been sickened by the same bacteria, pinpointing the source of an outbreak. Earlier this year, it was used to investigate a Listeria outbreak in Canada that killed three people and hospitalized 15. No food is totally safe from contamination. Practically everything sold in stores or restaurants is handled in some way. Milk is pooled from any number of cows, then pasteurized and packaged. Hamburger patties are usually made with meat from many butchered cows that is then ground, seasoned, and formed. People get lulled into the idea that “the U.S. has the safest food supply in the world,” Kowalcyk said, “but that doesn’t mean that it’s safe.” People can reduce their risk of contracting a foodborne illness by buying whole foods and cooking from scratch when possible, Goodbridge said; it’s probably safer to clean and chop your own head of lettuce. Yet even that is not a guarantee. Foodborne illness also spreads in home kitchens, where cross-contamination of raw meat with other foods, unsafe storage, and food spoilage often occurs. The risks are lower for healthy people, who can usually get through foodborne illness without excessive discomfort. But for vulnerable groups—very young, very old, and pregnant people—foodborne illness can lead to hospitalization, and even death. The recent spate of outbreaks highlights the dilemma plaguing the state of American eating. People are simply too busy and exhausted to cook from scratch. In the daily scramble to get dinner on the table, ready-to-eat food is a lifeline. But with every additional stage of preparation comes an extra helping of risk. Read More