Wastewater samples have detected a significant escalation in an enterovirus called D68, which, in rare cases, has been linked to acute flaccid myelitis, or AFM. The illness affects the nervous system and causes severe weakness in the arms and legs. This most often occurs in young children. 

“We are detecting EV-D68 nucleic acids in wastewater across the country now, and the levels are increasing,” said Alexandria Boehm, program director of WastewaterSCAN, a nonprofit monitoring network and a professor of civil and environmental engineering at Stanford University.

That’s the first clue to suggest that the nation might see an increase in AFM this year, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security and author of “Crisis Averted: The Hidden Science of Fighting Outbreaks.”

“The second clue,” she said, “is that the time of year is right.”

Historically, September has been the biggest month for AFM cases.

Anyone who’s ever had the sniffles probably had an enterovirus; they’re that common. Most of the time, the viruses cause mild symptoms, such as a runny nose, cough, headache and generalized feelings of “meh.”

The D68 enterovirus strain started causing more serious problems in 2014, when the U.S. saw, for the first time, a spike in pediatric AFM. That year, 120 kids were diagnosed.

There’s no cure or specific treatment for the paralysis. Even with years of intensive physical therapy, many are left with life-altering disabilities.

A viral mystery

Though a few dozen cases have been reported every year since then, larger waves of AFM have followed an every-other-year pattern, spiking again in 2016 (with 153 cases) and in 2018 (with 238 cases).

The pattern stopped in 2020 when the nation went into lockdown because of the Covid pandemic, drastically reducing viral spread. That year, just 32 cases were logged. The spread of D68 picked up again in 2022 as lockdowns were lifted.

Curiously, a rise in AFM cases didn’t follow.

“We saw the virus that was previously driving the AFM cases, but we didn’t see the AFM cases associated with it,” said Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, who treated some of the earliest AFM cases in 2014.

It’s a mystery that any virologist would appreciate. While experts try to predict how viruses will behave, the bugs are always working to stay a few steps ahead.

It could be that the virus itself has changed, or that more people in the U.S. have been exposed and now have a level of immunity to D68. “We’re still trying to figure it out,” Messacar said.

So far in 2024, 13 AFM cases have been confirmed, according to the Centers for Disease Control and Prevention. Since 2014, 758 cases have been logged.

The implication is that hundreds of families and their children have been left with lasting, life-altering paralysis because of a virus.

Some recovery after years of physical therapy

The Kagolanu family in Los Altos, California, was in a heated game of Monopoly one Friday night in November 2014 when 7-year-old Vishnu’s head began, inexplicably, to tilt to one side. Vishnu admits that even though he was losing the game, this wasn’t attention-seeking behavior.

“My dad was like, ‘Hey, what are you doing? Move your head back straight,'” Vishnu, now 17, said. “I just thought, I can’t do that.”

Within an hour, Vishnu lost all ability to move his arms and legs. “I couldn’t get myself off the floor,” he said.

Vishnu was one of the first to be diagnosed with AFM in 2014. At that time, no one had connected the dots between D68 and the “mystery illness.”

“We didn’t understand what was going on. Even the doctors couldn’t find out what was going on,” said Saila Kagolanu, Vishnu’s mother. “That was the worst experience of my life.”

Doctors warned Vishnu’s family that he might never regain function of his arms and legs. The poor prognosis crushed Vishnu. He’d always thrived as “king of the playground” when it came to sports and other physical activities.

“Seeing my legs go progressively smaller every day” was devastating, he said. “I couldn’t move.”

Vishnu spent years undergoing physical therapy to regain the ability to walk. That was successful. Otherwise, there’s not much doctors can do. His right shoulder remains limp.

Testing a possible treatment

“We all get really frustrated every time we get to this point, and we don’t have antiviral medicines that are readily available,” said Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville. “We don’t have much to offer these kids.”

Creech and his colleagues are working toward a solution. They’ve begun safety studies of a monoclonal antibody that would, ideally, stop D68 in its tracks.

“In mouse studies, it prevented infection that would lead to AFM,” Creech said. The study is expected to take years before the treatment is considered safe and effective.

Meanwhile, young people like Vishnu Kagolanu are attempting to move on and even inspire others with AFM. In recent years, he started a nonprofit called Neurostronger, which works to raise funds for and increase awareness of kids with neurologic conditions.

“Growing up with AFM is hard,” Kagolanu said. “But at the same time, there are ways to get around some of those obstacles. There are ways to find joy.”

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“I’m not sure that people are aware of this,” said Dr. Thomas Sollecito, chief of oral medicine at the University of Pennsylvania.

Hormonal changes — mainly a sharp drop in estrogen — can reduce bone density and saliva production and harm your gums. All of that can affect your teeth.

Oral care experts say there are ways to counteract these effects and keep your menopausal mouth healthy.

Menopause, perimenopause and dental symptoms

Menopause happens when a woman goes 12 consecutive months without a menstrual period. But some of the hormone-related dental problems may begin during perimenopause, when the ovaries gradually make less estrogen, said Dr. Maiara Hister-Cockrell, a dentist with the University of Texas Health San Antonio.

One of the biggest concerns is less saliva, which Sollecito called “one of the most important fluids in our body.”

When the saliva flow slows, it can cause dry mouth, which brings a greater risk of mouth soreness, oral yeast infections and cavities. Those risks are even higher when people take medicines for high blood pressure or diabetes that can also cause dry mouth, Hister-Cockrell said.

Less saliva also means less of its bacteria-killing enzymes and tooth-strengthening minerals, said Dr. Sally Cram, a periodontist in Washington, D.C.

When your mouth is dry, she said, “those bacteria are proliferating and you’re more prone to get tooth decay.” And if decay festers, tooth loss is possible.

Decreasing bone density and receding gums exacerbate these problems. If the socket that holds the tooth is less dense, Sollecito said, it’s more vulnerable to bone loss. And gum recession can leave some tooth surfaces without the enamel that protects them from cavities.

Women in this phase of life are also more likely to develop periodontal disease, when plaque and bacteria collect under gums and around teeth.

“Gum tissue starts to get red and swollen,” said Cram, a spokesperson for the American Dental Association. “It bleeds and it starts pulling away from the teeth, creating deeper crevices around the teeth that are clearly harder to keep clean.”

Some people experience “burning mouth syndrome.” Hister-Cockrell said a burning sensation can extend to the tongue, palate and lips.

“As you could well imagine,” Sollecito added, “this could all really spiral out of control.”

What can you do?

The first line of defense, experts said, is good oral hygiene and nutrition. Eat a balanced diet low on sweets and high on calcium-rich foods. Brush carefully with fluoride toothpaste at least twice a day and floss regularly.

“An electric toothbrush can be more helpful than manual toothbrushing,” Cram said. “See your dentist regularly and ask them: Am I doing a good job? And if I’m not, what could help me do a better job?”

Patients should also ask their dentists whether they should be seen more than twice a year, as well as consider in-office fluoride treatments to strengthen the surface of their teeth and prescription high-fluoride toothpaste.

At home, experts said, treating dry mouth is a priority. So stay hydrated.

“None of us really probably drink enough water throughout the day,” Cram said.

People can also use over-the-counter dry mouth sprays, lozenges or rinses. In severe cases, Sollecito said they can ask their dentist about prescription medications that increase the amount of saliva in the mouth but come with side effects. There are also prescription medications for burning mouth syndrome.

“The bottom line,” Cram said, “is most oral conditions and problems during menopause are totally preventable” by paying attention, taking good care of your teeth at home and regularly going to the dentist.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

More recently, Consumer Reports found a concerning amount of the toxic metal in a third of cinnamon powders purchased from more than a dozen grocery stores in the Northeast.

There is no safe limit of lead to consume. At the same time, completely eliminating the heavy metal in food isn’t feasible, because lead is a naturally occurring element in the Earth’s crust. Trace amounts can infiltrate the food supply in various ways, including in places where foods are grown, raised or processed, experts say.

However, the recent findings raise questions about why the Food and Drug Administration hasn’t already proposed limits on lead in foods meant for young children.

“This issue with the cinnamon and the lead and other issues with heavy metals in baby and children’s food is all emblematic of a larger problem that I think the FDA is trying to get a handle on,” said Laurie Beyranevand, director of the Center for Agriculture and Food Systems at Vermont Law and Graduate School. “I’m not sure if the FDA is doing it as quickly as people would feel comfortable with.”

After a major FDA investigation late last year into lead-contaminated apple cinnamon fruit puree, the FDA began screening cinnamon imports, followed by several warnings and recalls of some brands for elevated lead levels.

That prompted Consumer Reports to test brands across 17 mainstream and niche grocery stores.

It found high levels of lead in 12 products, with levels reaching 3.5 parts per million.

The United Nations’ Food and Agriculture Organization has a proposed international safety standard of 2.5 ppm for spices that include cinnamon.

Anything above 1 ppm would trigger a recall in New York — the only state in the U.S. that regulates heavy metals in spices — Consumer Reports noted.

“There are some products in here that are up to three times that, which is concerning,” said Dr. Adam Keating, a pediatrician with Cleveland Clinic Children’s.

Keating’s primary concern is with children and pregnant women who ingested the cinnamon on a regular basis as opposed to just a single instance.

“A single sprinkle of cinnamon in a dose in one dish would be different than if they were eating the product every day,” said Keating, who was not involved in the Consumer Reports testing. “Regular ingestion of lead is the main concern that we have, particularly with children and pregnant women, because the most profound effect of lead is developmental delays and learning problems.”

The FDA currently does not set limits for heavy metals in spices, including cinnamon, although it does set limits for certain foods, such as candy made with sugar.

Last year, the agency proposed limits on lead levels in processed baby food that it says could reduce exposure to the contaminant by as much as 27%. Those guidelines are not expected to be finalized until next year, however.

“I’m not totally sure why they have not done that yet,” Beyranevand said. “Maybe it’s difficult to do in a number of different products, but it feels like at least with cinnamon, given the prevalence of the findings and the fact that there’s been so much lead, it feels like it would move the agency to set some sort of action level.”

The FDA did not immediately respond to a request for comment.

Lead exposure can be harmful to people of all ages, Keating said, but it is particularly dangerous for children. High levels of lead can lead to serious health problems in kids, including learning and behavior issues, reduced IQ and damage to the brain and nervous system, according to the FDA and the Centers for Disease Control and Prevention. Additionally, lead exposure can cause hearing and speech problems.

Many children may not have any obvious symptoms, Keating said. He recommended that parents get their children in for routine lead screening at 1 and 2 years of age.

Consumer Reports advised people to check their homes for the products and throw them out.

The consumer product testing group also said that people might consider sticking with mainstream brands.

Of the 12 products that contained high levels of lead, 10 of them were from relatively unfamiliar brands sold mainly in small markets specializing in international foods, according to the report’s findings.

The FDA has wound down some of its response efforts to its cinnamon applesauce investigation but will continue to monitor other products in stores for high lead levels.

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The Emmy Award winner, known for his roles on “The Dick Van Dyke Show,” “Chitty Chitty Bang Bang” and “Mary Poppins,” is still holding his own in the gym. But he didn’t always live this way. “If I’d known I would have lived this long, I would have taken better care of myself,” he told CBS News in 2023.

Now that he’s lived nearly 10 decades, including a legendary career that’s earned him the respect of multiple generations, here’s what the actor has shared about how he manages his health.

He regularly works up a sweat

At 98, Van Dyke has got an impressive gym routine. “My wife, god bless her, makes sure I go to the gym three days a week and do a full workout,” the actor told CBS News, referring to wife Arlene Silver.

He called the gym his “secret weapon,” in an exclusive with Entertainment Tonight.

But looking after his physique isn’t something he took up recently. On top of a career chock-full of dance, in 1974, Van Dyke revealed he also did yoga on The Dick Cavett Show. “I do it in the morning when I get up,” he said at the time. He called it both relaxing and strenuous — particularly the sit-ups. “It’s a great exercise, but it’s tiring. It’s hard.”

He previously struggled with alcohol use

Van Dyke publicly revealed he was dealing with alcoholism and checked into a hospital for three weeks to address his addiction in 1972. After that, he worked to change the stigma about the disease.

“It’s a physical disease,” Van Dyke said on The Dick Cavett Show in 1974. “It has nothing to do with the person not being mature enough not to drink too much. It’s a true addiction, like a heroin addiction.”

While he barely drank in his 20s, as invitations to parties mounted in his 30s, he found himself drinking more and eventually realized he had problem, he added.

In 2016, he told Oprah Winfrey that alcohol was his crutch in social settings. “I was very shy — with strangers — I couldn’t talk to people,” the then-90-year-old said. “And I found if I had a drink, it would loosen me up. The barriers went down, and I became very social. That’s what got me started.”

A friend once warned him about his drinking habits, but Van Dyke shrugged him off, he told Dick Cavett. Van Dyke estimates that he drank heavily for about seven years. So, by the time he realized he needed help, he was in too deep and had to work at his recovery for many years.

Van Dyke said he’s long tried to pinpoint the exact moment his drinking habits shifted but can’t. “When did I go from the point when I drank with my friends at a party or something to the point where I’d began to drink way ahead of them?” he wondered.

Now that he’s sober, he doesn’t miss it. “I like life too much without it. Now that I’m completely free of it, I don’t have any desire to ever drink again.”

He quit smoking

Once Van Dyke sought help for alcoholism, he also addressed his smoking habits. “Trying to quit smoking, that was twice as hard,” Van Dyke said on the Really No Really podcast in 2023.

“It was much worse than the alcohol,” he added, saying it took him “forever” to quit. “I’m still chewing the nicotine gum. It’s been 15 years, I think.”

He suffered from mysterious headaches

In 2013, Van Dyke was forced to cancel public appearances for health reasons.

That April, the entertainer was set to receive the Lifetime Achievement Award for Bettering Humanity through Comedy from New York’s 92Y, but he had to pull out. His reps said he was dealing with “fatigue and lack of sleep resulting from symptoms of a yet-to-be diagnosed neurological disorder,” according to Entertainment Tonight.

That same month, the star took to X to share additional details and ask for advice: “My head bangs every time I lay down. I’ve had every test come back that I’m perfectly healthy. Anybody got any ideas?”

The following month, he shared an update revealing he suspects his dental work was to blame, TODAY.com previously reported. “It seems that my titanium dental implants are the cause of my head pounding,” he wrote on X. “Has anyone else experienced this? Thanks for all your replies.”

He does work he still looks forward to

In addition to looking after his health and making necessary life changes, it seems the final key to Van Dyke’s longevity is contentment. “If I’m not enjoying myself, I’m really bad. I am,” Van Dyke quipped to CBS News.

“It’s such a blessing to find a way of making a living that you love, that you’d do for nothing. I feel so sorry for people who hate their jobs. I look forward to going to work every morning,” he said.

Van Dyke’s legendary career is still bringing him joy, as it did when he first broke out on the scene. He says that’s because he’s never wasted a moment doing something he didn’t love. “Get your living done first and have the nerve to try something,” he advised.

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The research is among the first to find a relationship between escalating doses of the drugs — amphetamines, in particular — and a greater likelihood of psychotic symptoms. 

The drugs include Adderall, Vyvanse and generic amphetamines, such as dextroamphetamine.

The link between amphetamines and psychosis isn’t new. Amphetamines increase levels of dopamine in the brain. The neurotransmitter plays a number of roles in the body, including in memory, motivation and mood, but it’s also implicated in psychosis.

The drugs “can flood the brain with dopamine, and when you flood the brain with dopamine you potentially can cause psychosis,” said Dr. Jacob Ballon, a psychiatrist and co-director of the INSPIRE Clinic at Stanford Medicine, a clinic specializing in patients with psychosis. 

What hadn’t been established was that the risk of psychosis rose with higher doses, a phenomenon known as a “dose-response relationship.”

“That’s what this study provides,” said Dr. Will Cronenwett, vice chair for clinical affairs in psychiatry at Northwestern Medicine.

“The United States is having sort of an amphetamine moment right now,” Cronenwett said. “The popularity and use of amphetamines is high and getting higher.” 

Stimulant use in the U.S. has skyrocketed in recent years, particularly among adults. A study published this year in JAMA Psychiatry found that prescription rates for amphetamines for attention-deficit hyperactivity disorder had risen 30% from 2018 to 2022 in people ages 20 to 39. Among people ages 40 to 59, rates rose 17%. 

In a statement to NBC News, a spokesperson for Takeda Pharmaceuticals, the maker of Vyvanse, said, “Takeda believes it is important for patients to take our medicines in accordance with U.S. Food and Drug Administration (FDA)-approved labeling guidance and in consultation with their prescribing health care provider.”

Teva Pharmaceuticals, the maker of Adderall, didn’t respond to a request for comment. 

High doses

The lead study author, Dr. Lauren Moran, a psychiatrist and researcher at McLean Hospital, a teaching hospital that is a part of Mass General Brigham in Boston, said it’s not uncommon for people to develop psychosis related to amphetamines.

“We’ve seen this a lot,” Moran said. “We are seeing college students coming in being prescribed stimulants who didn’t have much of a psychiatric history developing new onset psychosis.” 

In the new study, Moran and her colleagues reviewed electronic health records from Mass General Brigham from 2005 through 2019, focusing on teens and adults ages 16 to 35 — the typical age range for the onset of psychosis or schizophrenia. They identified 1,374 cases of patients who were hospitalized with first episodes of psychosis or mania, compared with 2,748 patients who were hospitalized for other psychiatric conditions, such as depression or anxiety. 

They also looked at whether the patients had been prescribed stimulants in the past month and, if so, at what dosages.

Patients taking the highest dosages — more than 40 milligrams of Adderall, 100 mg of Vyvanse or 30 mg of dextroamphetamine — were 5.3 times more likely to develop psychosis than patients taking no stimulants. 

The medium dosage — 20 mg to 40 mg of Adderall, 50 mg to 100 mg of Vyvanse or 15 mg to 30 mg of dextroamphetamine — was linked to a 3.5 times higher risk. It’s not clear whether taking less than 20 mg of Adderall, 50 mg of Vyvanse or 15 mg of dextroamphetamine is associated with an increased risk of psychosis, Moran said.

There was no increased risk of psychosis with another ADHD drug, Ritalin, which isn’t an amphetamine.

Moran said that, according to an analysis of national insurance claim data, about 6% of patients taking amphetamines are prescribed the highest dosages and about 22% are prescribed the medium dosages.

Cronenwett said the risk of developing psychosis from an amphetamine remains rare, around 1 in 1,000. Still, people taking high doses should be aware of the risks. 

“I would counsel patients who have a personal or family psychiatric history of serious mental illness, including things like bipolar disorder with mania or schizophrenia,” he said. “If these sorts of illnesses are in the family tree, then that’s somebody who might want to be very careful about how much of these medicines they use and in what doses.” 

Ballon agreed.

“There may be some folks out there who are receiving stimulants for whom they’re not necessarily that effective,” he said. “What ends up happening is the doses get escalated to seek that level of effectiveness and in so doing put people at this increased level of risk.”

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A woman known as the “Potomac Lice Lady” says there are a few things parents should know that can help if their children get lice.

“All it takes is a few seconds for that bug to crawl from one head to the next head,” said Lauren Salzberg, who treats up to 20 people a day for lice at her salon in Gaithersburg, Maryland.

“There’s not enough hours in the day and enough of me to go around. I see probably over 1,500 people a year,” she said. “I would have to attribute it to the fact that there have been changes in the lice policies.”

In the past, a student with lice would be sent home from school immediately.

But guidelines from the Centers for Disease Control and Prevention and American Academy of Pediatrics now say schools should keep a child in class until the end of the day, and allow them to return to school the next day as long as they’ve started treatment for lice — even if they still have lice or eggs in their hair.

“Unnecessary days off cause a burden to the students, families, and communities, and far outweighs the risks associated with head lice,” the CDC said.

Salzberg disagrees with that policy.

“When you have other illnesses — pink eye, strep, the flu — right? Those are very contagious. Children are sent home,” she said.

Lice, which are parasitic insects that feed on human blood, are also contagious in the sense that they spread through direct contact with the hair of a person infested with lice.

Adult lice can live for up to a month on a person’s head, laying up to 10 eggs a day.

Common lice myths

• Myth #1: Lice are attracted to people with poor hygiene. Getting lice has nothing to do with a child or person’s cleanliness. In fact, clean hair makes it easier for bugs to cling to someone’s head.
• Myth #2: Boys don’t often get lice because they usually have shorter hair. Anyone who has hair can get lice.
• Myth #3: Using over-the-counter lice treatments can prevent lice. Salzberg said there’s no benefit to using medications if you don’t have lice and using them more than necessary can make them less effective when you really need them.

Lice facts and prevention tips

1. Lice don’t fly, jump or hop. They crawl from person to person.
2. The insects are attracted to the scent of human hair. Using a special preventative spray with rosemary oil can help disguise the scent and detract the bugs.
3. Putting long hair up in a bun or braids makes it harder for lice to get in your hair.
4. Lice and their eggs are brown, not white.

Tips for treating lice

Parents who have had to deal with lice infestations know just how difficult it is to get the bugs out of a child’s hair.

After 15 years in business, Salzberg has it down to a science.

“You can win the war on lice, but you have to have the right weapon,” she said.

“The drugstore combs are wide so when they’re going, you know, through the hair, they’re just missing the eggs. And if you don’t get all of the eggs out of the hair, the eggs will hatch seven to 10 days later and you’re back in the same cycle.”

Instead, she tells parents to use a special lice treatment to saturate the hair and a professional-grade metal comb with tighter teeth that you can buy online.

“I feel that a lice comb should be given out by the schools as a school supply, and if every parent was given the instruction to do proper lice checks, then we wouldn’t have this problem.”

This year’s theme is “No Judgement. Just Help.”

Monica Johnson, the director of the 988 & Behavioral Health Crisis Coordinating Office, said that the day was put in place because not many people know about the resource.

988 is the national three-digit number that anyone can call or text when they are experiencing any thoughts of suicide or having any behavioral stress, Johnson said.

“That could be concerns about substance abuse,” Johnson said. “It could be feelings of depression, sadness, loneliness, grief – it could be whatever is divine for that individual in a crisis.”

Johnson explained that there is a difference between someone calling 911 for help and calling 988 for help. While people might be used to calling 911 for all emergencies, 988 is specifically for mental health crises.

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“You’ll be connected to a trained crisis counselor that can help you or someone else that you may be calling on behalf of where you don’t need to involve local law enforcement,” Johnson said.

In 2023, there were 856,000 youth and 1.5 million adults who attempted suicide.

“Suicide is preventable,” Johnson said. “It is a public health concern.”

Johnson explained some of the signs that someone might be going through a mental health crisis. Some examples include not wanting to go to work, not being able to engage with others at social events or struggling to connect with friends and family.

For more information, visit the Substance Abuse and Mental Health Services Administration website about getting help through 988.

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Pharmacies began giving out the vaccines — which are recommended for everyone ages 6 months and older — last month. The Centers for Disease Control and Prevention recommends getting a flu shot either this month or next, since flu activity typically picks up in the fall, with cases reaching their peak sometime from December to February. 

It takes around two weeks for the vaccine to become fully effective. 

“You really want to think about getting your appointment or making your plan to get vaccinated sometime around the last half of September through the end of October,” said Dr. Judith O’Donnell, chief of infectious diseases at Penn Presbyterian Medical Center in Philadelphia.

This year’s flu shots are trivalent, meaning they protect against three flu viruses: two versions of influenza A and one type of influenza B. For more than a decade, flu shots in the U.S. also protected against a fourth strain of influenza B, but that strain hasn’t circulated since March 2020, so the Food and Drug Administration’s vaccine advisory committee elected this year to exclude it.

What to know about flu shots

Although most people need one dose of the vaccine, children up to 8 who haven’t been vaccinated for flu before should get two shots at least four weeks apart. The CDC recommends that unvaccinated children get their first shot right away.

Because adults ages 65 and up have the highest risk of severe illness from flu, they should ask for certain shots that produce a stronger immune response than a standard flu vaccine. The CDC recommends three options for this age group: Fluzone High-Dose, Flublok or Fluad. The first two are high-dose vaccines, meaning they contain a greater amount of antigen, an ingredient that triggers an immune response. Fluad, meanwhile, contains an ingredient that helps boost the immune response, called an adjuvant. 

“You have to really shop around and figure out where that’s available, because it won’t be available everywhere,” said Amanda Joy, a physician assistant at MedStar Health, a health care provider in the Washington, D.C., area. She suggested calling ahead to doctor’s offices or pharmacies.

Last year, around 25,000 people died of the flu in the U.S. and 400,000 were hospitalized.

The effectiveness of flu vaccines at preventing doctor’s visits tends to vary from year to year. Scientists choose which strains to target based on what’s circulating in other parts of the world, but it’s not a guarantee that those strains will dominate in the U.S.

“In an optimal year, you get up to about 80% [effectiveness]. In a bad year, maybe 30%,” said Dr. Michelle Barron, senior medical director of infection prevention and control at UCHealth.

Australia offers a window into what the U.S. can expect, since its flu season lasts from around June to September. This year, there weren’t an outsized number of hospitalizations or deaths.

“It looks like it was a fairly typical flu season. It didn’t necessarily start early, which was our concern last year,” Barron said.

Although some people with egg allergies may be hesitant to get flu vaccines, given that most are egg-based, the shots are still safe for that group. Joy said people with lingering concerns can seek out Flucelvax, a vaccine that’s developed using mammalian cells instead. 

Covid and flu shots can be administered at the same time

Health experts expect flu and Covid to deliver a one-two punch during the fall and winter, as they have in past years. Although the summer wave of Covid cases hasn’t died down yet, experts anticipate another wave this winter, perhaps at the same time that flu cases peak.

The new Covid vaccines target the KP.2 variant, which became dominant in the U.S. at the end of April. A genetically similar strain, KP.3.1.1, has since taken over, but the latest vaccine should still offer better protection against it than previous Covid shots.

The shots are recommended for everyone 6 months and older. Children up to 4 years old should get at least one dose of the new formula, and potentially two or three if they’ve never been vaccinated before, according to the CDC.

Everyone else should get one dose. People who recently had Covid can wait to get their shot until three months after their infection, since they’re likely to have some immunity already. 

The Covid and flu shots can be safely administered at the same time, in the same arm or different ones. The CDC recommends getting both at once for convenience, though it’s unclear if this brings additional advantages. A small study published in April found that co-administering Covid and flu shots boosted the antibody response to Covid in blood samples, but experts aren’t sure if that translates to more protection.

Getting the shots at once might also slightly increase side effects, according to a CDC study, though the reactions are still generally mild.

“You may feel some aches and some chills and maybe a low-grade temperature if you get them both together, but you could also get that from each individually,” Joy said.

She added that when finding a time to get any vaccine, it’s best to hold off if you’re feeling unwell.

“You may not get the full response you want if you’re getting vaccines while you’re sick, so it’s much better to wait ‘til you’re healthy,” she said.

How much do the shots cost?

Flu shots are available at doctor’s offices, pharmacies, health clinics and through some workplaces.

CVS and Walgreens have both Covid and flu vaccines in stock, but Walmart pharmacies only offer flu shots right now. Walmart said it’s prepared to administer Covid shots as supply becomes available. 

People with insurance shouldn’t have to pay out-of-pocket for the vaccines as long as they get them from an in-network provider. Covid and flu shots are also covered for children without insurance through the government-run Vaccines for Children Program. 

Adults without insurance may be able to find free or low-cost vaccines at some federally qualified health centers or state or local health departments, but supply can be limited. Otherwise, the Covid vaccine costs around $150 to $200 — a difference from past years, when they were free regardless of insurance status. The CDC’s Bridge Access Program, which paid for Covid shots for uninsured adults, ended in August.

Flu vaccines can range from $25 to more than $100, depending on the shot.

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The man, identified by his family as Steven Perry, tested positive for the virus known as EEE or triple E, and was hospitalized with severe central nervous system disease, the New Hampshire Department of Health and Human Services said on Tuesday.

Perry was a resident of Hampstead, a town in southern New Hampshire about 45 miles north of Boston.

The 41-year-old was healthy and had no underlying medical conditions, his family told affiliate NBC Boston. However, Perry’s disease progressed rapidly, and he went to the hospital on Aug. 12.

Perry died one week later at Massachusetts General Hospital on Aug. 19, 2024, according to his obituary.

“It is with heavy hearts that the family acknowledges that Steven left those that he loved far too soon after being stricken by a sudden and rare brain infection,” the obituary read.

Previously, Perry tested positive for eastern equine encephalitis, a rare infection caused by a virus spread to humans through the bite of an infected mosquito, TODAY.com previously reported.

It is the first human case of eastern equine encephalitis in New Hampshire in 10 years. The last human EEE infection reported in the state was in 2014, when authorities identified three cases, including two deaths, the DHHS said.

EEE cases have also been reported in Massachusetts, Vermont, Wisconsin and New Jersey.

So far in 2024, at least five human cases of eastern equine encephalitis have been confirmed in the U.S. All five were the more severe (neuroinvasive) form of the disease, according to the latest data from the U.S. Centers for Disease Control and Prevention.

At this time, the case count is on par with previous years. Only a handful of cases are reported in the U.S. annually — in 2019, there were 38, the highest in a decade, TODAY.com reported previously.

Most people infected with EEE do not develop symptoms. If symptoms do occur, these typically begin two to 10 days after being bitten by a mosquito and include fever, chills, muscle aches, and joint pain.

EEE can also cause severe neurologic disease. About 5% of people infected with the virus develop severe swelling of the brain or the spinal cord, Dr. Daniel Pastula, chief of neuro-infectious diseases and global neurology at the University of Colorado School of Medicine, previously told TODAY.com.

Symptoms of neuroinvasive EEE include a high fever, behavioral changes, vomiting, seizures and coma. About 30% of people with EEE will die, per the CDC. However, many survivors are left with lasting mental and physical problems.

Most cases are reported between July and September, with activity peaking around August. As the end of summer approaches and the U.S. enters peak mosquito season, the threat of mosquito-borne diseases looms.

“We believe there is an elevated risk for EEEV infections this year in New England given the positive mosquito samples identified,” New Hampshire state epidemiologist Dr. Benjamin Chan said in a release.

In Massachusetts, several communities are on high alert due to a recent case of EEE in a man in his 80s. The case has prompted officials to spray for mosquitoes and some towns to enact voluntary curfews and nighttime park closures.

What’s more, the U.S. is also seeing increased activity of another mosquito-borne virus, West Nile. As of Aug. 27, there have been 289 cases of West Nile virus reported in 33 states, per CDC data.

There is no treatment or vaccine for eastern equine encephalitis. Preventing mosquito bites is the best way to protect yourself against EEE and other mosquito-borne diseases.

The CDC recommends people take the following steps:

•  Use an EPA-registered insect repellent
• Wear pants and long sleeve shirts outdoors
• Limit activity outdoors from dusk to dawn, when mosquitoes are most active

This story first appeared on TODAY.com. More from TODAY:

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Under the new pricing plan, a month’s supply of the lowest dose, 2.5 milligrams, will cost $399, while a month’s supply of the 5 mg dose will cost $549. That’s down from a monthly list price of $1,059, regardless of the dosage.

The lower-cost doses will be offered only through Lilly’s telehealth platform, LillyDirect, however, and they won’t be covered by insurance, meaning patients will need to pay for them in cash. Patients who opt for the lower-cost doses also won’t qualify for Lilly’s discount savings program. 

Lilly said it’s able to charge the lower price because the drug will be sold in vials rather than single-dose auto-injector pens, which means patients will need to draw the medicine out of the vial with a syringe. (The 2.5 and 5 mg doses will still be available in the auto-injector pens as well, just not at the new discounted price.)

Frustrated Zepbound users have been advocating for vial options for some time, as they believe Lilly’s ongoing supply problems stem from the complicated manufacturing process required for the auto-injector pens. Some patients have instead looked to compounded versions of the weight loss drug, which typically come in vials and are less expensive. 

“These new vials not only help us meet the high demand for our obesity medicine, but also broaden access for patients seeking a safe and effective treatment option,” Patrik Jonsson, president of Lilly USA, said in a press release.

Dr. Maria Daniela Hurtado Andrade, an endocrinologist at the Mayo Clinic in Jacksonville, Florida, questioned who would benefit from the lower-cost versions. The $399 price for the lowest dose is still almost $5,000 a year — an insurmountable cost for many racial and ethnic minorities, she said. 

“The majority of patients will not be able to afford the medication, still,” Hurtado Andrade said.

The move to only cut the prices of the lowest doses, she added, may also backfire. People may feel negatively about being limited to the lower doses, while the more effective options are reserved for the wealthy and those who can afford them.

“We’re only giving people a taste of hope,” she said.

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Dr. Shauna Levy, a specialist in obesity medicine and the medical director of the Tulane Bariatric Center in New Orleans, called it an “overall win” for the obesity community. 

“I am excited to see how Novo Nordisk responds to this because I think they have no choice but to also lower the price of their medications,” she said.

Lilly and Novo Nordisk, the maker of Ozempic and Wegovy, have been under pressure to lower the cost of their hugely popular — but pricey — weight loss drugs.

In July, President Joe Biden and Sen. Bernie Sanders, I-Vt., the chair of the Health, Education, Labor, and Pensions Committee, wrote in an op-ed in USA Today that both drugmakers “must stop ripping off Americans with high drug prices.” 

In an interview in June, Sanders called the higher prices of Novo Nordisk’s medications “absurd” and said he was spearheading a public pressure campaign to get it to lower its prices. Novo Nordisk CEO Lars Fruergaard Jørgensen has agreed to testify before Sanders’ committee next month. 

Novo Nordisk and Sanders’ office didn’t immediately respond to a request for comment.

Who can get the lower-cost vials?

Lilly said the lower-cost vials of Zepbound will provide patients with another option, particularly people without insurance, those whose insurance won’t cover the cost of the drug or those who don’t qualify for the company’s discount savings program. Zepbound’s savings program excludes people on government-run insurance programs such as Medicare and Medicaid.

Doctors can send prescriptions for the vials to LillyDirect, which will ship them directly to patients, the company said. The vials will be available on LillyDirect in all 50 states, it said. Lilly will provide instructions on how to use the vials and will also make syringes available for purchase if people want them. 

Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in North Carolina, said one issue he has had with using LillyDirect is supply. 

“We tried to utilize that when they first announced it, and they didn’t have any supply,” said McGowan, who spoke to NBC News on Monday and wasn’t told about Lilly’s new pricing announcement. “It was no better than any other pharmacies.”

Lilly says the move to vials should help free up supply. It has chosen to make only two of its six doses available for lower prices. The 2.5 mg dose is considered the “starter” dose — the one patients take first before they move up to higher doses until they reach their so-called maintenance doses. 

McGowan said most patients in his practice stay on the 10 mg or 15 mg doses of Zepbound, although that often depends on supply. He said that none of his patients use the 2.5 mg or 5 mg doses long-term but that he believes they would if the prices were lower. 

That having been said, “patients who are responding well to the high doses want to stay on the high doses,” he said. “We don’t want to step down and risk weight recurrence.”

Hurtado Andrade said she also worries about the transition from pens to vials, saying some patients, including older adults, may find it difficult to use a syringe.

“It may be a roadblock,” she said. “The pens are very straightforward. You have to press one button to get the dose you need every week.”

For D Scott, 46, of Las Vegas, said she doesn’t like the idea of drawing up medication with a syringe.

Scott, who asked that only the initial of her first name be used, said she had been overweight her entire life. After years of diet and exercising, she was prescribed Zepbound about a month ago. 

Her insurance doesn’t cover the medication, but she can get it for $550 a month out of pocket through Eli Lilly’s discount savings program. However, the program runs until only the end of December, so she will need to either reapply for the savings program — if Lilly lets her — or pay the full cost herself afterward.

The vials would provide a new, lower-cost option once her Zepbound discount card runs out at the end of the year — if she can get over using a syringe.

“I also take medicines that make me a little shaky, so drawing out medicines is not ideal,” she said. 

This story first appeared on NBCNews.com.  More from NBC News:

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• Ozempic maker defends high U.S. price: It’s ‘helping’ reduce the cost of obesity

“If you look at just the cost of obesity in the U.S., it’s a disease that costs Americans more than $400 billion a year,” Lars Fruergaard Jørgensen said in an interview on “NBC Nightly News,” “And we are actually providing products that’s actually helping take that cost burden off.”

Tune into “NBC Nightly News” at 6:30 p.m. ET/5:30 p.m. CT tonight for more.

Jørgensen, who spoke to NBC News before the company’s “quiet period” ahead of their last earnings report, called accusations that the company is operating as a drug cartel “unfounded.”

His comments come ahead of a highly anticipated Senate committee hearing in September, where he is scheduled to testify about the U.S. pricing of the drugmaker’s hugely popular diabetes and weight loss drugs.

Vermont Sen. Bernie Sanders, chair of the Health, Education, Labor and Pensions Committee, told NBC News in June that he plans to ask Jørgensen why the drugmaker charges up to 10 to 15 times more for Ozempic and Wegovy in the U.S. than it does in other countries. Novo Nordisk charges around $1,300 a month for Wegovy in the U.S., according to a HELP Committee report, while the drug can be purchased for $186 a month in Denmark; $137 in Germany; and $92 in the United Kingdom.

“It is clear that Novo Nordisk is ripping off the American people,” Sanders said.

The cost of obesity-related care in the U.S. is substantial.

A report published last year from KFF, a nonprofit group that researches health policy issues, found that in 2021, people with employer-based health insurance who were overweight or had obesity had an average of $12,588 in total annual health costs, which is more than double the $4,699 in health spending for those who were not overweight or didn’t have obesity. People who are overweight or have obesity also face higher out-of-pocket costs: an average of $1,487, compared to $698 for those without those conditions.

Still, Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said at Ozempic and Wegovy’s current prices, the savings that could be gained from reducing the burden of obesity-related care aren’t enough to make up for the large increase in spending on the drugs.

“For many people, these drugs might be a very good option for improving their health, but it is unlikely that they will reduce total spending,” Dusetzina said. “In general, the price of these drugs would need to come down a lot in order to have a chance for them to produce overall savings in health care spending.”

A complex health care system

Jørgensen said that he “volunteered” to come speak with the committee about the cost of Ozempic and Wegovy at the September hearing. His announcement to do so came three days after Sanders threatened to hold a vote to subpoena the company’s president, Doug Langa.

Jørgensen said he plans to talk about the “complexities of the U.S. health care system, which is a system we take part in but we cannot change.”

“That takes policy change,” he said, blaming insurance companies and pharmacy benefit managers, or PBMs, for the high out-of-pocket costs patients pay for the drugs.

PBMs work with insurers to negotiate rebates, or discounted prices, from the drug companies, in exchange for including the drug in their coverage. But as PBMs become more consolidated and hold more influence over what drugs patients are covered for, experts say they may be inflating drug costs.

In July, the Federal Trade Commission published an interim report on how PBMs are driving up costs for patients.

“I do acknowledge that some patients have poor insurance,” Jørgensen said. “And if you have poor insurance, it can be difficult to afford your medicines. And for those we have patient support programs where we try to help them out.”

Jørgensen also said the U.S. needs to have a “discussion around what’s the value of these medicines” for patients.

Cynthia Cox, a vice president at KFF and the director of its program on the Affordable Care Act, said that while the drugs can prevent and reduce a number of obesity-related diseases, the cost of the medications remains expensive and it’s unclear how long people will need to stay on them to maintain weight loss and improved health.

“​​The widespread use of these drugs for weight loss is still relatively new, so I’m not sure there is enough long-term data to fully weigh the costs and benefits,” Cox said.

This article first appeared on NBCNews.com. Read more from NBC News here:

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Here are some of their top tips for getting a good night’s rest.

4 tips for a good night’s rest from sleep experts

1. Consider these 5 signs you might need a sleep divorce

A sleep divorce is not as drastic as it sounds. It simply means sleeping apart from your partner, whether in separate beds or separate bedrooms, to get the best sleep, Shelby Harris, a licensed clinical psychologist and director of sleep health at Sleepopolis, told Make It in 2022.

“I actually recommend that couples sometimes do this, and it doesn’t mean that their relationship is in trouble,” Harris said. “It just means they’re actually valuing their relationship and their health as well.”

You may want to consider a sleep divorce if you, and/or your partner:

• Snore loudly
• Have different sleep patterns/schedules (early bird vs. night owl)
• Move a lot while sleeping
• Are a light sleeper or find that alarms interrupt your sleep
• Have different preferences when it comes to temperature of the room, bedding, etc.

Harris suggested trying to problem-solve first to see if you can sleep in the same bed peacefully. And if you decide to implement a sleep divorce, make sure it’s a mutual decision presented respectfully and that your sleeping arrangements are similar (not one partner sleeping on the couch while the other sleeps in a cozy bed).

2. Try a sleep expert’s bedtime routine

Dr. Richard Schwab, chief of the division of sleep medicine at the University of Pennsylvania Perelman School of Medicine, shared his sleep routine with Make It in 2022.

“I think the most important thing in terms of what I should do for my sleep is go to bed at the same time and get up at the same time, each day,” Schwab said.

His preferred sleep time is 11:30 p.m. and he usually wakes up at 6:30 a.m.

Schwab also determined through trial and error how many hours of sleep he needs each night. “I need about six or seven and half hours of sleep, and if I don’t get that I’m going to be sleepy,” he said.

To get optimal sleep, Schwab recommended setting the ambience in your room by making sure it’s your preferred temperature and light exposure. He also got a larger bed to accommodate his wife and children.

3. Make these simple changes if you’re a night owl with a 9-to-5 job

“We all have a slight genetic orientation to one of two types, either being a morning person or an evening person,” Rebecca Robbins, an assistant professor of medicine at Harvard Medical School’s Division of Sleep Medicine, told Make It in December of 2023.

Yet, the common 9-to-5 work schedule of many jobs just doesn’t align with the internal clocks of night owls, and that can be difficult.

Here are seven ways that Robbins suggests thriving at work as a night owl:

• Head outdoors and get enough sun exposure during the day
• Avoid caffeine in the afternoon
• Aim to follow the same sleep and wake time daily
• Use blue light devices like “happy lights” at work
• Workout in the morning
• Get certain things done in the evening like passion projects
• See if you can change your work schedule

4. Remember melatonin is a bit more effective for sleep than magnesium

Two popular supplements touted for prompting sleep are melatonin and magnesium, but of the two, one is more effective, according to licensed clinical psychologist Shelby Harris.

“Melatonin is the most common natural sleep aid that can help gradually shift the body’s circadian rhythm when taken properly,” Harris said in February.

“Before taking magnesium or melatonin for sleep, it’s important to establish proper sleep hygiene and habits.”

These are some suggestions Harris shared for developing good sleep hygiene:

• Stick to a consistent sleep schedule
• Relax before you plan to go to bed
• Stay off of your electronic devices directly before bedtime
• Don’t drink caffeine at least eight hours before sleeping

This “can all be helpful in enhancing your body’s natural melatonin production, thus making it easier to fall asleep.”

Are you stressed about money? Sign up for CNBC’s new online course. We’ll teach you how to be more successful and confident with your money, and practical strategies to boost savings, get out of debt and invest for the future. Start today and use code EARLYBIRD for an introductory discount of 30% off through September 2, 2024.

Plus, sign up for CNBC Make It’s newsletter to get tips and tricks for success at work, with money and in life.

In a post on Branyas’ X account, her family wrote in Catalan: “Maria Branyas has left us. She has gone the way she wanted: in her sleep, at peace, and without pain.”

The Gerontology Research Group, which validates details of people thought to be 110 or older, listed Branyas as the oldest known person in the world after the death of French nun Lucile Randon last year.

The next oldest person listed by the Gerontology Research Group is now Japan’s Tomiko Itooka, who is 116 years old.

Branyas was born in San Francisco on March 4, 1907. After living for some years in New Orleans, where her father founded a magazine, her family returned to Spain when she was young. Branyas said that she had memories of crossing the Atlantic Ocean during World War I.

Her X account is called “Super Catalan Grandma” and bears the description: “I am old, very old, but not an idiot.”

At age 113, Branyas tested positive for COVID-19 during the global pandemic, but avoided developing severe symptoms that claimed tens of thousands of older Spaniards.

At the time of her death she was living in a nursing home in Catalan town of Olot.

Her family wrote that Branyas told them days before her death: “I don’t know when, but very soon this long journey will come to an end. Death will find me worn down from having lived so much, but I want to meet it with a smile, feeling free and satisfied.”

Doctors are trying to figure out why it’s becoming increasingly common: Colorectal cancer rates among younger people are rising by 1% to 2% every year.

It’s a lesser-known and less-funded cancer, which is why one survivor is sharing his story – in hopes that his ordeal can help save someone else.

Survivor only noticed 1 symptom of his colorectal cancer

For Jeff Harris, a diagnosis of stage-three colorectal cancer at just 40 came as a huge surprise.

The husband and father of two was shocked because he showed almost no signs of serious illness – except one concerning symptom that is common among colon cancer patients.

“I felt fine. I had rectal bleeding one day. That was significant and was something… I was like, ‘That’s not good,’” he said.

A colonoscopy showed a large mass on his colon.

“Time kind of stood still,” he recalled.

He soon went in for surgery, which revealed his cancer wasn’t just in his colon.

“Woke up from surgery and my surgeon said, ‘Well, everything was fine, except it was more in your rectum than it was your colon. So, it was kind of just kind of both. Rectosigmoid junction,” he said, referring to a zone where the rectum and colon meet.

After surgery came chemotherapy. He did 10 rounds of infusions, 28 rounds of radiation and oral chemotherapy. Today, his scans show no evidence of disease.

‘Alarming’: Why are colorectal cancers becoming more common?

Harris is not alone. He’s met many folks much younger than him – even in their late 20s and early 30s – who have colorectal cancer.

“Some of them, you know, aren’t with us today. So, it’s alarming,” he said.

John Marshall, the chief medical officer at Lombardi Comprehensive Cancer Center, is among doctors trying to figure out why colorectal cancer rates are on the rise among younger people.

The leading theory relates to the bacteria that grow in the mouths and guts of all humans. Everyone has their own “microbiome” made up of bacteria and other microbes that can be helpful or harmful to their health.

“We evolved over time to include bacteria in our mouths and our GI [gastrointestinal] tracts. Think of it as your own personal soil,” Marshall said. “So, our leading theory is: Just like we’re changing our air and we’re changing our water with the world around us, we are probably also changing the world inside of us, our own microbiome.”

Colorectal cancers show up in different locations than colon cancers.

“They’re all in that bottom part of the question mark of the colon,” Marshall said. “Whereas normal, older colon cancer can be seen anywhere throughout the colon.”

Colorectal cancer symptoms and screening: ‘Don’t worry about the colonoscopy’

According to the Colorectal Cancer Alliance, the most common symptom is no symptom at all.

Colorectal cancer symptoms could include blood in your stool, a change in bowel habits, abdominal pain, weakness or fatigue and weight loss.

“There’s still stigma around it because people don’t want to talk about colons, rectums, poops and all that,” Harris said.

It’s important to talk about the signs of colorectal cancer. Reluctance to talk about a sensitive area of the body can slow the process of getting diagnosed and treated.

Routine screenings can help identify potential cancer in earlier stages when it’s easier to treat. Doctors may even be able to remove concerning polyps – small tissue growths – before they turn cancerous, according to the American Cancer Society.

Doctors say everyone should begin screenings for colon cancer when they’re 45, regardless of whether they have symptoms or not. People who have a family history of the disease or other risk factors should get screenings even earlier in life.

Screenings can be done with a traditional colonoscopy, but there are less invasive options.

“I will tell anybody that has any kind of symptoms. Get it checked out. Don’t worry about the colonoscopy. It’s not bad. Colonoscopy is a walk in the park compared to cancer treatment,” Harris said.

Dr. Marshall says it’s important to figure out what’s going on – and figure it out fast.

The Colorectal Cancer Alliance has advice on how to talk to your doctor about screenings. There’s also information on financial help for people who can’t afford screenings.

Colorectal cancer prevention

Dr. Marshall says the colorectal cancer trend is scary. His best advice?

“It really comes back to a Mediterranean diet. A little less meat. It’s not evil, but less of it. Lots of fruits, nuts, little coffee chaser. And keep moving, keep exercising,” he said.

Other lifestyle changes that can help include minimizing processed foods.

Fundraiser planned in Potomac, Maryland

In 2022, Harris rang the hospital bell marking that he’s cancer-free. Since then, he’s shown no evidence of disease.

Now, he is focused on living, spreading the word and fundraising.

The Colorectal Cancer Alliance is hoping to raise much-needed funds to research the disease.

They’re holding the first-ever Contactors Against Cancer golf tournament on Aug. 25-26, 2024, at Avenel Farm in Potomac, Maryland. Edwin McCain and Ryan Cabrera will be part of the two-day event. Here’s more information.

Although the study was small, it’s the first head-to-head look at people’s blood levels after they consume products with erythritol or sugar (glucose). 

“We compared the results, and glucose caused none of the problems,” said Dr. Stanley Hazen, a cardiologist at the Cleveland Clinic and the lead author of the study, published Thursday morning in the journal Arteriosclerosis, Thrombosis, and Vascular Biology. 

Erythritol is one ingredient on a growing list of nonsugar sweeteners found in low-calorie and sugar-free foods. Erythritol and xylitol are sugar alcohols that are sweet like sugar but with far fewer calories. Erythritol is often mixed with another sweetener, stevia, and xylitol is often found in gum, mouthwash and toothpaste. 

Earlier studies from Hazen’s lab — one published last year and the other in June — found potential links between the sugar alcohols and an increased risk of heart attacks and strokes. The research suggested both sugar alcohols might make blood platelets stickier and therefore more susceptible to clotting and blocking veins or arteries, in turn contributing to heart attacks and strokes.

For the new research, Hazen’s team analyzed the heart effects of erythritol and regular sugar — in this case, simple glucose — by enrolling two groups of healthy middle-aged male and female volunteers: 10 who consumed the erythritol and 10 who consumed sugar.

Both groups fasted overnight. In the morning, their blood was drawn to measure platelet activity. Then, half the volunteers drank glasses of water with 30 grams of glucose mixed in, and half drank glasses of water with 30 grams of erythritol. Hazen said 30 grams of erythritol is an amount typical of erythritol-sweetened foods. 

Around 30 minutes after each group consumed the sweetened drinks, their blood was drawn and retested. Researchers found the people who consumed erythritol had increased platelet aggregation — meaning the blood was more likely to clot. Adults who drank the normal sugar drink had no changes in platelet aggregation. 

The researchers measured a 1,000-fold increase in blood erythritol levels in the group given the erythritol drink. Those who drank glucose water didn’t have any changes in blood erythritol levels, and their blood glucose levels were only slightly increased. The finding stood out to Hazen, because it far exceeded the trace levels of erythritol that occur naturally in the blood. 

“The amount in sugar substitutes is thousands of folds higher than what is made in our bodies, so to call it ‘natural,’ it’s not,” he said. “Your best recommendation is to avoid the sugar substitutes, and sugar alcohols in particular, because there’s an acute increase in the likelihood of clotting events once you ingest them.”

The Food and Drug Administration considers artificial sweeteners, including erythritol and xylitol, as GRAS, or generally recognized as safe. Hazen hopes mounting evidence about the sugar alcohols might trigger the FDA to look more closely at the data. 

Outside the U.S., the concerns have drawn interest among food regulators. Last year, for instance, the European Food Safety Authority recommended that the European Commission request data about how much erythritol is in food, which could help clarify the risks. 

Do the findings indicate that erythritol is worse overall than high-calorie sugar? Valisa Hedrick, a registered dietitian at Virginia Tech, said a diet high in sugary foods can lead to elevated blood glucose levels that are also linked to stroke and clotting risks. Hedrick wasn’t involved in the Cleveland Clinic study.

The study has several important limitations. Beyond the small number of participants, it measured the effects of erythritol and glucose at only one point in time, as opposed to over months or years of consistent consumption, Hedrick noted.

And the amount of glucose in the sugar water — about 30 grams — is the equivalent of about 120 calories of sugar. Sugary beverages, especially juices and sodas, often contain more sugar. 

For example, a 12-ounce can of Coca-Cola contains 39 grams of sugar, and 12 ounces of Mountain Dew contains 46 grams. 

Michael Goran, a professor of pediatrics at the University of Southern California’s Keck School of Medicine, said it might also be worth comparing erythritol to both fructose and glucose. The combination of fructose and glucose is more typical of sugary juices and sodas than glucose alone, he said. Goran wasn’t part of the new study.

Hazen’s study looked at glucose alone. 

Although the Cleveland Clinic study didn’t find negative effects from consuming sugar, the researchers agreed the data doesn’t mean sugar is in the clear. Higher amounts of sugar may cause similar platelet effects, especially in people with diabetes, who can’t effectively regulate high blood glucose.

Hazen’s study focused specifically on healthy people, not people with diabetes.

It could also be important to analyze whether heart effects differ when people consume food with erythritol compared with water with erythritol, said Dr. Michelle Pearlman, a gastroenterologist who is CEO and a co-founder of the Prime Institute in Miami.

“Factors such as protein, fat, fiber and other nutrients might influence this response,” she said. 

Ultimately, said Hedrick of Virginia Tech, the new study underscores the need for more research comparing the health effects of sweeteners versus sugar.

Hazen and his colleagues concluded the research by urging further studies focusing on erythritol’s heart risks, particularly in people already at higher risk of strokes and clotting.

This story first appeared on NBCNews.com. More from NBC News:

• Which foods contain aspartame? The artificial sweetener is now considered a “possible carcinogen.”
• Ultraprocessed foods linked to depression in women.
• Plant-based meat alternatives may be healthier for the heart than real meat, study suggests.

The alert came Friday after the PAHO, which is the main international health agency for the Americas, reported the first deaths associated with the virus — including fetal deaths associated with “possible instances of vertical transmission,” in which a virus is transmitted mother-to-child during pregnancy.

At least 8,078 confirmed Oropouche cases, including two fatal cases, have been reported in the Americas. The cases are concentrated in Bolivia, Colombia, Cuba, Peru and Brazil — the country with the most confirmed cases and where the two deaths were reported.

Two young women in Brazil, ages 21 and 24, are believed to have died because of the virus. According to PAHO, they both died a few days after having first experienced sudden symptoms such as fever, muscle aches, pain behind the eye sockets, headaches and vomiting, among other symptoms. A third case is being investigated in Brazil as a possible third death from Oropouche.

At least 7,284 cases have been confirmed in Brazil, according to PAHO. That’s 90% of all confirmed Oropouche cases in the Americas and a significant jump from the 832 cases Brazil reported last year.

Among other fatal cases still under investigation in Brazil are one case of fetal death, one miscarriage and four cases of newborns with microcephaly, a birth defect in which a baby’s head is smaller than expected. Microcephaly is also associated with the Zika virus, another mosquito-borne disease.

A mother in Brazil who experienced symptoms consistent with Oropouche sought medical attention on June 6 after she noticed lack of fetal mobility, PAHO said. Oropouche genetic material in umbilical cord blood and organ tissue was detected after the fetal death was confirmed. A similar case was reported soon after, involving a mother who miscarried after having experienced bleeding symptoms related to the virus. Brazilian health officials who were conducting a study on four newborns with microcephaly found the babies already had antibodies against Oropouche virus.

Based on those cases, PAHO had issued a previous alert on July 17 “about possible cases of pregnant mother-to-child transmission of Oropouche virus,” according to the U.S. Centers for Disease Control and Prevention, which emphasized that it is still “not clear if infection with Oropouche virus was the cause of negative health outcomes for the fetuses.”

The CDC said it’s working with PAHO and other international partners to learn more about the potential risks of Oropouche during pregnancy.

There are no to vaccines or specific antiviral drugs to prevent or treat Oropouche infections. Treatment is focused on relieving patients’ symptoms, according to PAHO.

Oropouche virus symptoms are similar to those of dengue, according to the CDC. They include headaches, fever, muscle aches, stiff joints, nausea, vomiting, chills and sensitivity to light. In severe cases, the virus can also cause the tissues surrounding the brain and the spinal cord to swell.

In certain patients, symptoms may also include rash, vomiting and bleeding — typically in the form of nosebleeds, bleeding gums or blood speckles under the skin, according to PAHO.

Symptoms typically start four to eight days after a person is bitten. Even though symptoms tend to last three to six days, the infection can last up to three weeks.

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Young people, especially women, are increasingly talking on social media about gastrointestinal distress, such as irritable bowel syndrome or chronic bloating. Some experts say that’s mostly a good thing, because it may help others seek help for a topic that has been taboo.

But they stress it’s important to realize that many people are being paid to promote sometimes unproven products and there is rampant misinformation. Here’s what else medical professionals suggest you do if you’re experiencing digestive discomfort.

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Why are more young people talking about digestive problems online?

It’s not clear whether there’s a rise in digestive troubles overall. Some experts attribute the trend to an uptick in anxiety after the pandemic in an already-anxious generation.

Ample research and science shows that our brain and gut are connected through nervous systems. That means when your brain is anxious or you’re feeling depressed, it can relay those signals to your gut, which can make it harder for your gastrointestinal tract to function properly.

The causes of irritable bowel syndrome are unknown, but experts say the nervous system has a big effect on the condition and stress can make symptoms worse.

Dr. Nina Gupta, a gastroenterologist based in Chicago, said managing her patients’ conditions often includes managing their mental health.

When should you go to the doctor?

That depends on the level of your discomfort, said Dr. Uma Naidoo, Massachusetts General Hospital’s director of nutritional and lifestyle psychiatry. She studies the connection between food and the brain.

Abrupt changes in bowel habits are concerning, she said, and may require further evaluation.

“For example, someone that didn’t really have digestive issues as a child or throughout their life and then all of a sudden is finding a very severe and significant change in their bowel habits,” she said. “These are all things that we would want someone to talk to their doctor about.”

And if you see blood in your stool — no matter the quantity or degree of frequency — or have ongoing diarrhea for more than a couple of weeks, seek care immediately.

What can I do to relieve digestive pain?

Naidoo said some mindfulness practices like stress management, meditation and breathwork can help. Food sensitivities can trigger IBS symptoms, so adjusting your diet and exercising more also may make a difference.

“Simply doing something like finding a good probiotic that they take, or adding probiotics and fermented foods to their diet slowly and steadily can be good,” she said. “Stress management is a huge part of this. In combination with dietary adjustment, it can be very powerful.”

However, if symptoms worsen or are unmanageable at home, that should be a sign to seek professional help.

That’s the pitch from a new cluster of companies selling high-tech scans to healthy people interested in learning more about their wellness.

These whole-body MRI scans aren’t cheap. Startup companies like Prenuvo charge between $1,000 to $2,500 for various scanning options, none of which are currently covered by insurance.

Proponents say consumer-driven medical scans are the next logical step in preventive medicine. The industry has received a big publicity push from celebrities and influencers like Kim Kardashian, who posted about her Prenuvo scan last year.

But many medical experts say the companies are selling expensive, unproven technology that may cause extra worries and unnecessary treatment, while driving up costs for the U.S. health system.

Here’s what to know before considering a scan:

What is an MRI?

MRI stands for magnetic resonance imaging. It’s a type of medical scan that uses magnetic fields to produce detailed images of organs, bones and other structures inside the body. Unlike many other types of scans, MRIs don’t use radiation.

Doctors will order an MRI to help diagnose cancer, brain injuries, damaged blood vessels and other medical conditions. Full-body scans can take an hour or more, with patients lying motionless inside a cylindrical tube.

Medical societies only recommend routine, full-body scans for certain high-risk groups, such as people who have a heightened genetic risk of cancer.

“MRIs are great for what they’re typically used for,” said Dr. Ernest Hawk, a vice president at the University of Texas MD Anderson Cancer Center. “But now you’re moving them much earlier into an average risk population and that’s where you can run into these questions that haven’t been answered.”

Why are people paying for them now?

Companies like Prenuvo say their scans can help identify more than 500 medical conditions that can go undetected at a typical doctor’s visit.

The company charges $999 to scan the torso, $1,799 for the head and torso or $2,499 for the entire body. Several other companies offer similar services and pricing.

Prenuvo’s chief medical officer, Dr. Daniel Durand, says customers can decide for themselves if the price is worth it.

“We’re trying to give people the opportunity to be more proactive about their health,” Durand said.

Along with the scans and a reader-friendly summary of the results, customers can consult with a nurse or physician employed by Prenuvo to talk about next steps.

The company says it doesn’t pay for endorsements but will sometimes “provide a complimentary scan for an unbiased review.”

What are the potential downsides of MRI screening services?

Many radiologists say the likelihood of finding a serious problem, such as a cancerous tumor or brain aneurysm, in someone with no symptoms is very low. Instead, scans are likely to flag growths that are usually harmless. Definitively ruling out a problem could require additional tests, appointments and even surgeries.

“You’re going to end up finding a lot of incidental things,” said Dr. Mina Makary, a radiologist at Ohio State Wexner Medical Center. “That’s going to create more psychological stress or trauma for the patient, including additional costs for tests and procedures that may have risks.”

Experts also worry that people who undergo MRI scans may start skipping other routine exams, such as mammograms.

“You’ve gone through a scan and it didn’t find anything so you say ‘Gee, I don’t need to do the other routine things my doctor recommends that have been proven to extend life,” said Hawk.

What do medical authorities say?

The American College of Radiology does not recommend MRI screening in people without symptoms, stating that there is “no documented evidence” the technique is “cost-efficient or effective in prolonging life.”

The Food and Drug Administration has not approved any MRI machines for preventive screening, but doctors are free to use the devices however they choose.

There are examples of imaging practices that were once considered experimental but have subsequently become standard practice. Prenuvo executives say their approach could follow a similar path.

“The evidence will evolve over time but patients don’t necessarily want to wait 30 years to be in a position to benefit from it,” said Prenuvo’s Durand.

When will we know if MRI screening helps people live longer?

The studies needed to show such a benefit would have to be very large and long, tracking a diverse population for years, according to experts.

Prenuvo recently announced plans to screen 100,000 people and study their health over time. The study isn’t expected to wrap up until 2034 or later.

Most people enrolling in Prenuvo’s study are expected to pay a $2,200 fee. But eventually academic or government studies could offer individuals a chance to participate in such research without paying out-of-pocket.

“This is a great area in which to participate in a research study that might provide the information you’re seeking, while also helping answer whether this is beneficial or not,” Hawk said. “But doing so outside of a study makes no sense.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Every day, about 9,500 people are diagnosed with skin cancer in the United States, adding up to nearly 3.5 million people every year, according to the American Academy of Dermatology Association. The AADA also says skin cancer is the most commonly diagnosed cancer in the country.

So how much sunscreen should you really use? And how often should you reapply it? Here’s what to know.

What does a sunscreen’s SPF rating mean?

According to Hopkins Medicine, a sunscreen’s sun protection factor or SPF is a measure that tells you how many harmful ultraviolet rays the cream absorbs or reflects away from your skin.

Contrary to popular belief, an SPF rating is not an indicator of how long you can stay out in the sun before protection wears off, rather it indicates how much longer it takes skin with sunscreen to start to redden compared to without it, the FDA notes.

For day-to-day use, Hopkins Medicine recommends using sunscreen with an SPF of 30 or higher. However, if you spend time outdoors, such as at the beach, an SPF of 60 or greater might be better for you.

What is the difference between UVA and UVB rays?

According to the FDA, UVA rays are one of the strongest types of ultraviolet radiation coming from the sun. UVA rays go deeper into the skin than UVB, and cause skin aging, age spots and wrinkles.

UVB rays meanwhile are the ones that produce sunburns. Most of these rays are absorbed by Earth’s atmosphere.

UVA rays have the longest wavelengths, followed by UVB, and UVC rays which have the shortest wavelengths. While UVA and UVB rays are transmitted through the atmosphere, all UVC and some UVB rays are absorbed by the Earth’s ozone layer. So, most of the UV rays you come in contact with are UVA with a small amount of UVB.

Who needs to wear sunscreen?

The FDA recommends anyone over the age of six months use sunscreen with an SPF of 30 or higher.

Due to the greater risk of developing rashes and side effects, the agency does not recommend children under 6 months old to use sunscreen. Instead, it recommends limiting their sunlight exposure between 10 a.m. and 2 p.m and using protective clothing in case of direct sun exposure.

How much sunscreen should I apply?

Probably more than what you’re currently applying.

According to Hopkins Medicine, about 1 ounce of sunscreen covering your palm is enough to protect your face, neck, arms and legs. To protect your face and neck, meanwhile, HM recommends about a half teaspoon.

How often should I reapply sunscreen?

According to the FDA, how often you should reapply boils down to the SPF rating of your sunscreen.

Since an SPF rating indicates how much longer it takes skin to begin to burn with sunscreen applied compared to how long it takes to start reddening without it, the lower the SPF is, the more often it’s recommended to reapply.

In general, the FDA recommends reapplying sunscreen every two hours or more often if you’re sweating or swimming.

Should I use sunscreen indoors?

Yes. Even if you are inside, dermatologists recommend applying sunscreen.

Because UVA rays do not get absorbed by glass, it is recommended to apply sunscreen if you’re next to a window, use a digital screen or are inside your car. However, you may not need to reapply sunscreen as frequently until you step outside, Hopkins Medicine writes.

Should I use sunscreen at night?

No. While sunscreen is effective at blocking UV light from the sun, its SPF molecules could create larger pores in your skin if worn at night so it is important you wash it off before bedtime and use night cream instead.

However, little research has investigated the potential contaminants in tampons and whether they pose a health risk. And a new, first-of-its kind study has many wondering: Are tampons safe?

The recent research out of UC Berkeley found that many tampons on the market, including organic and non-organic, may contain toxic metals, such as lead and arsenic. The researchers looked at tampons sold both in the United States and Europe.

“Some tampons had higher concentrations of one metal, lower concentrations of another,” Jenni A. Shearston, Ph.D., the lead author on the paper, tells TODAY.com. “There wasn’t a specific tampon that we tested that seemed to have … a lower concentration of all the metals.” 

Dr. Mitchell Kramer, chair of OB-GYN at Huntington Hospital Northwell Health, tells TODAY.com that the study is “groundbreaking” and indicates a need for tampon manufacturers to conduct more testing on their products.

“It certainly requires more evaluation. … I think it has potentially some significant impact moving forward in terms of how tampons are produced and the effect on the users,” Kramer says.

That said, it’s unclear what the potential health impact, if any, may be of using tampons containing these metals.

“We don’t know if any of these metals are absorbed vaginally, which is key when it comes to exposure,” Dr. Jennifer Lincoln, an OB-GYN and author of the book, “Let’s Talk about Down There: An OB-GYN Answers All of your Burning Questions … Without Making You Feel Embarrassed for Asking,” tells TODAY.com via email.

Shearston — a postdoctoral scholar at UC Berkeley School of Public Health and department of environmental science, policy and management — adds that one of the limitations of the study is that they do not know if the metal can even seep out of the tampons.

“We only tested whether or not these metals are present in tampons,” she says. “We don’t know whether they come out.”

Here’s what to know about the study:

Tampons and toxic metals

The paper published was in the journal “Environment International,” and researchers looked at 30 different tampons from 14 brands to determine the metal levels in the tampons. They found “measurable concentrations” of all 16 metals they looked for — including some toxic metals, such as lead and arsenic — in all the tampons tested.

However, the research does not conclude that the tested tampons and others on the market are not safe. Shearston hopes people don’t “panic” about the study.

“We just need more information,” she says. “What I would like to encourage people to do is support more research and ask more questions about this to try to make research on menstrual products and menstruation a priority.”

The levels of metals varied based on the type, where they were purchased and if they were generic or name brand.

“These metals were found in different amounts, with some higher in organic tampons (like arsenic) and others in conventional tampons (such as lead),” Lincoln explains. “We don’t know what brands were tested as this was blinded in the study, which I know is frustrating.”

Lincoln, who was not involved in the study, notes it’s somewhat surprising that this study is a first, but that the findings make sense.

“I was not surprised that metals were found in organic tampons as well, since they can be absorbed from the soil, and organic farming still uses pesticides,” she says.

Are tampons safe?

Yes, it is still safe to use tampons, the experts say.

“People do not need to panic,” Kramer says. “We haven’t established that these products are dangerous or causing people to get really sick. I don’t think that’s the case. I think these levels of these heavy metals are very low.”

A press release also notes that “it’s unclear if the metals detected by this study are contributing to any negative health effects.” Shearston says she and her colleagues are currently investigating “if metals can come out of the tampons.”

“We’re doing some leaching experiment,” she says. “We’re also testing tampons, these same products, for other chemicals.”  

Lincoln also stresses that it’s too soon to say what the findings mean for consumers looking for the safest tampons.

“Per this study, the average amount of lead found in tampons was actually very small, and far lower than what is considered concerning in our food or water,” she explains. “This doesn’t negate the study’s findings, but it’s an important perspective when people are deciding if they want to continue using tampons or not.”

Are non-toxic and organic tampons safer?

All tampons tested had some degree of toxic metals, including those claiming to be non-toxic and organic. In fact, these were higher in arsenic than conventional tampons.

“I do hope this demonstrates for people that organic is not always necessarily better, especially with period products,” Lincoln says.

An organic label on a tampon doesn’t have as much meaning as it might on food, for example.

“It doesn’t carry a lot of information to have a tampon that’s labeled as organic,” Catherine Roberts, an associate editor of health at Consumer Reports, who covered organic tampons, tells TODAY.com. “It can mean a lot of different things.” 

Lincoln adds that you should choose period products based on what works best for you.

“This study shouldn’t be the reason we all throw out our tampons ASAP, but it is important that people decide what feels right for them,” she says. “It’s important to realize what period products you use is a personal choice. Not everyone feels comfortable with pads or cups or period underwear, and for them, tampons are clutch.”

Using tampons safely

For tampon users worried about their exposure to metal, Kramer suggests wearing tampons less often and rely on other menstrual products.

“Instead of wearing tampons 24/7 during the period, maybe alternate between that and a sanitary pad,” he says. “There are certain things you can try to mitigate some of the exposure.”

There are other things consumers can consider when selecting tampons to avoid unknown ingredients.

“Unfortunately, it doesn’t seem like shopping for particular brands or looking at particular labels is necessarily going to help you avoid (heavy metals),” Roberts says. 

Roberts says people can:

• Buy fragrance-free tampons
• Select tampons with fewer components
• Skip tampons with polyester, polypropylene, polyethylene or other plastic materials

“Fragrances are a big black box regulatorily,” Roberts says. “You can add fragrance and you don’t have to disclose what’s in them.”  

Still, Kramer hopes people do not panic about the findings.

“Tampons have been around for a very long time. We haven’t seen people coming in with heavy metal toxicity, and this is very different than the toxic shock syndrome issue,” he says. “That was a bacteria that had nothing to do with heavy metals.”

Tampon alternatives

If you’re interested in trying other types of period products, look into these tampon alternatives:

Menstrual cups

One popular brand is the Diva Cup. These are cups that you insert into the vagina to collect the menstrual fluid.

Menstrual discs

Similar to a cup, these products use a bag with a rim to collect the period fluid.

Period underwear

These resemble normal underwear but they contain extra material to absorb the menstrual fluid.

Reusable pads

These are cloth pads that you can put in your underwear to absorb the fluid but can also be washed and reused, unlike standard pads, which you throw away.

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Transplants of the so-called voice box are extremely rare, and normally aren’t an option for people with active cancer. Marty Kedian is only the third person in the U.S. ever to undergo a total larynx transplant – the others, years ago, because of injuries – and one of a handful reported worldwide.

Surgeons at the Mayo Clinic in Arizona offered Kedian the transplant as part of a new clinical trial aimed at opening the potentially lifechanging operation to more patients, including some with cancer, the most common way to lose a larynx.

“People need to keep their voice,” Kedian, 59, told The Associated Press four months after his transplant – still hoarse but able to keep up an hourlong conversation. “I want people to know this can be done.”

He became emotional recalling the first time he phoned his 82-year-old mother after the surgery “and she could hear me. … That was important to me, to talk to my mother.”

The study is small — just nine more people will be enrolled. But it may teach scientists best practices for these complex transplants so that one day they could be offered to more people who can’t breathe, swallow or speak on their own because of a damaged or surgically removed larynx.

“Patients become very reclusive, and very kind of walled off from the rest of the world,” said Dr. David Lott, Mayo’s chair of head and neck surgery in Phoenix. He started the study because “my patients tell me, ‘Yeah I may be alive but I’m not really living.’”

Lott’s team reported early results of the surgery Tuesday in the journal Mayo Clinic Proceedings.

The larynx may be best known as the voice box but it’s also vital for breathing and swallowing. Muscular tissue flaps called vocal cords open to let air into the lungs, close to prevent food or drink from going the wrong way – and vibrate when air pushes past them to produce speech.

The first two U.S. larynx transplant recipients – at the Cleveland Clinic in 1998 and the University of California, Davis, in 2010 – had lost their voices to injuries, one from a motorcycle accident and the other damaged by a hospital ventilator.

But cancer is the biggest reason. The American Cancer Society estimates more than 12,600 people will be diagnosed with some form of laryngeal cancer this year. While today many undergo voice-preserving treatment, thousands of people have had their larynx completely removed, breathing through what’s called a tracheostomy tube in their neck and struggling to communicate.

Although the earlier U.S. recipients achieved near normal speech, doctors haven’t embraced these transplants. Partly that’s because people can survive without a larynx – while antirejection drugs that suppress the immune system could spark new or recurring tumors.

“We want to be able to push those boundaries but do it as safely and ethically as we can,” Lott said.

Head-and-neck specialists say the Mayo trial is key to helping larynx transplants become a viable option.

“It isn’t a ‘one-off,’” but an opportunity to finally learn from one patient before operating on the next, said Dr. Marshall Strome, who led the 1998 transplant in Cleveland.

This first attempt in a cancer patient “is the next important step,” he said.

Other options are being studied, noted Dr. Peter Belafsky of UC Davis, who helped perform the 2010 transplant. His patients at high risk of larynx loss record their voice in anticipation of next-generation speech devices that sound like them.

But Belafsky said there’s “still a shot” for larynx transplants to become more common while cautioning it likely will take years more research. One hurdle has been achieving enough nerve regrowth to breathe without a trach tube.

Kedian was diagnosed with a rare laryngeal cartilage cancer about a decade ago. The Haverhill, Massachusetts, man underwent more than a dozen surgeries, eventually needing a trach tube to help him breathe and swallow — and struggled even to muster a raspy whisper through it. He had to retire on disability.

Still the once gregarious Kedian, known for long conversations with strangers, wouldn’t let doctors remove his entire larynx to cure the cancer. He desperately wanted to read bedtime stories to his granddaughter, with his own voice rather than what he called robotic-sounding speech devices.

Then Kedian’s wife Gina tracked down the Mayo study. Lott decided he was a good candidate because his cancer wasn’t fast-growing and — especially important — Kedian already was taking antirejection drugs for an earlier kidney transplant.

It took 10 months to find a deceased donor with a healthy enough larynx just the right size.

Then on Feb. 29, six surgeons operated for 21 hours. After removing Kedian’s cancerous larynx, they transplanted the donated one plus necessary adjoining tissues – thyroid and parathyroid glands, the pharynx and upper part of the trachea – and tiny blood vessels to supply them. Finally, using new microsurgical techniques, they connected nerves critical for Kedian to feel when he needs to swallow and to move the vocal cords.

About three weeks later, Kedian said “hello.” Soon he’d relearned to swallow, working up from applesauce to macaroni and cheese and hamburgers. He got to say hi to granddaughter Charlotte via video, part of his homework to just keep talking.

“Every day it’s getting better,” said Kedian, who moves back to Massachusetts soon. His tracheostomy remains in place at least a few more months but “I’m pushing myself to make it go faster because I want these tubes out of me, to go back to a normal life.”

And just as Lott had assured him, Kedian retained his beloved Boston accent.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The event, which took place at Aruba’s pristine Eagle Beach, drew from a pool of vacationers who applied after receiving a QR code while staying at hotels on the island.

Participants sat for more than an hour — disconnected from phones — during the beach’s sunset with a calming breeze.

However, the event was not a total paradise.

Contestants were given heart monitors to track their heart rate. The competition threw “curveballs” at contestants to see if they could remain on island time amid turmoil around them.

“We would like throw in these curveballs to try to get people to get their heart rate accelerated,” White said in an interview with NBC Local. “So we have like kids run through kicking sand or starting a squirt gun fight.”

White said he had a blast hosting the event, and that people kept asking him how he would prepare for such an event.

White just advised people to remain calm and focus on the beautiful Caribbean island around them.

“I mean, it’s pretty hard to get worked up while you’re down there. Everyone’s on island time it’s just like the most relaxing, incredible place,” White said.

The winner of the competition will be named the “World’s Greatest Relaxer” when the competition airs in August.

The top three winners will also get amazing prizes for their relaxing performance:

• Gold – “The Ultimate Aruba Vacation” includes a four-night stay at the iconic Ritz Carlton, Aruba, two round-trip flights to Aruba, and dinner for two at Infini, the hottest culinary ticket on the island.
• Silver – “The Ultimate Aruba Weekend”: a three night stay at the Renaissance Wind Creek Aruba, a full spa day at the world-famous Renaissance Island, and dinner for two at the buzz-worthy OLIVIA.
• Bronze –  “The Ultimate Rejuvenation Package”: a romantic cruise with Pelican Adventures, private island tour with Isla Aruba, and relaxing massage for two from Aruba Wellness Therapies, to be redeemed during the remainder of their stay.

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Backward walking — also called retro-walking — is exactly what it sounds like: the act of walking in reverse. It involves walking backward while maintaining proper posture and balance. The movement engages different muscles than forward walking, activating the glutes, hamstrings and calves and stretching the quads and hips.

Walking backward has benefits beyong toning, too. It can help improve coordination and is a great way to switch up your workout routine and challenge your mind and body in a new way. Here are even more reasons to add it to your routine.

Backward walking challenges your brain

Backward walking offers a nice change of pace to your regular walking routine, keeping things interesting and preventing boredom. By challenging your body to move in an unfamiliar way, you are training your brain and muscles to adapt quickly.

“Walking backwards is not a ‘secret’ or ‘miracle’ exercise, but, it definitely provides some benefits,” Dr. Rand McClain, sports medicine physician and owner of the Regenerative & Sports Medicine clinic in Santa Monica, California, tells TODAY.com. “The most obvious difference between walking backwards versus walking forward is that walking backwards requires more focus and coordination, challenging the body and brain.”

“Different muscles are used to walk backwards and some of the same are used, but in a different sequence and balance,” McClain adds. ”That not only affects the muscles — typically getting them to work harder than they are used to — but affects the brain and the nervous system in new ways that help activate direct pathways involved in the movement itself as well as indirect pathways that help the brain grow and develop new neurons and synapses (a concept often referred to as neuronal or simply brain ’plasticity’).”

Backward walking benefits

The primary muscles used to propel you forward are the quads, hamstrings and calf muscles. Walking backward, on the other hand, engages the glutes, hamstrings and even the shins, which help to maintain balance. When you walk backward, you also naturally engage your core muscles to maintain stability and balance. This can contribute to better posture and spinal alignment over time.

As you walk in reverse, you are challenging your joints and muscles to move in a different range of motion. The increased mobility gained from walking backward can make everyday movements more comfortable and effortless, whether it is reaching for something on a high shelf or bending down to tie your shoes.

According to one study, people who walked backward improved their balance, length of their steps and speed of their steps. The same study showed that backward walking can actually put less strain on the joints compared to walking forward. So, if your knees, ankles or feet are feeling store or stiff, try walking backward to loosen things up.

Another study found that walking backward on a treadmill helped stoke patients improve their cardiopulmonary fitness, increased their walking speed and improved their balance.

Walking backward can help in developing coordination, strength, flexibility, cardiovascular fitness and “extra” calorie burning (due to it being more difficult), says McClain. “Also, it can often provide an alternate source of exercise for someone with injury or degeneration (arthritis) because walking backwards can often avoid using those injured or degenerated muscles or joint components (ligaments, arthritic areas and menisci) that walking forward aggravate,” he adds.

3 easy ways to add backward walking to your routine

•  Start small: Ease into it by simply walking backward throughout your day. You can walk backward down a hallway in your house, from the kitchen to the family room, or down the driveway to get your mail.
• Try intervals: During your daily walk, walk forward for 5 minutes and then walk backward for 1 minute. Repeat this routine a few times. If you want to incorporate even more backward motion, make the interval lengths equal by walking for one block or one minute forward, and then one block or 1 minute backward, alternating every minute.
• Use the treadmill: If you walk indoors on a treadmill, it’s a great opportunity to incorporate some backward walking with assistance. Since treadmills have handrails, they provide more stability and will help with balance as you get used to the new movement. Step on the treadmill backward, start the belt at a low speed (slower than you typically walk forward), and rest your hands lightly on the handrails before stepping on the belt.

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Wastewater samples have detected a significant escalation in an enterovirus called D68, which, in rare cases, has been linked to acute flaccid myelitis, or AFM. The illness affects the nervous system and causes severe weakness in the arms and legs. This most often occurs in young children. 

“We are detecting EV-D68 nucleic acids in wastewater across the country now, and the levels are increasing,” said Alexandria Boehm, program director of WastewaterSCAN, a nonprofit monitoring network and a professor of civil and environmental engineering at Stanford University.

That’s the first clue to suggest that the nation might see an increase in AFM this year, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security and author of “Crisis Averted: The Hidden Science of Fighting Outbreaks.”

“The second clue,” she said, “is that the time of year is right.”

Historically, September has been the biggest month for AFM cases.

Anyone who’s ever had the sniffles probably had an enterovirus; they’re that common. Most of the time, the viruses cause mild symptoms, such as a runny nose, cough, headache and generalized feelings of “meh.”

The D68 enterovirus strain started causing more serious problems in 2014, when the U.S. saw, for the first time, a spike in pediatric AFM. That year, 120 kids were diagnosed.

There’s no cure or specific treatment for the paralysis. Even with years of intensive physical therapy, many are left with life-altering disabilities.

A viral mystery

Though a few dozen cases have been reported every year since then, larger waves of AFM have followed an every-other-year pattern, spiking again in 2016 (with 153 cases) and in 2018 (with 238 cases).

The pattern stopped in 2020 when the nation went into lockdown because of the Covid pandemic, drastically reducing viral spread. That year, just 32 cases were logged. The spread of D68 picked up again in 2022 as lockdowns were lifted.

Curiously, a rise in AFM cases didn’t follow.

“We saw the virus that was previously driving the AFM cases, but we didn’t see the AFM cases associated with it,” said Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, who treated some of the earliest AFM cases in 2014.

It’s a mystery that any virologist would appreciate. While experts try to predict how viruses will behave, the bugs are always working to stay a few steps ahead.

It could be that the virus itself has changed, or that more people in the U.S. have been exposed and now have a level of immunity to D68. “We’re still trying to figure it out,” Messacar said.

So far in 2024, 13 AFM cases have been confirmed, according to the Centers for Disease Control and Prevention. Since 2014, 758 cases have been logged.

The implication is that hundreds of families and their children have been left with lasting, life-altering paralysis because of a virus.

Some recovery after years of physical therapy

The Kagolanu family in Los Altos, California, was in a heated game of Monopoly one Friday night in November 2014 when 7-year-old Vishnu’s head began, inexplicably, to tilt to one side. Vishnu admits that even though he was losing the game, this wasn’t attention-seeking behavior.

“My dad was like, ‘Hey, what are you doing? Move your head back straight,'” Vishnu, now 17, said. “I just thought, I can’t do that.”

Within an hour, Vishnu lost all ability to move his arms and legs. “I couldn’t get myself off the floor,” he said.

Vishnu was one of the first to be diagnosed with AFM in 2014. At that time, no one had connected the dots between D68 and the “mystery illness.”

“We didn’t understand what was going on. Even the doctors couldn’t find out what was going on,” said Saila Kagolanu, Vishnu’s mother. “That was the worst experience of my life.”

Doctors warned Vishnu’s family that he might never regain function of his arms and legs. The poor prognosis crushed Vishnu. He’d always thrived as “king of the playground” when it came to sports and other physical activities.

“Seeing my legs go progressively smaller every day” was devastating, he said. “I couldn’t move.”

Vishnu spent years undergoing physical therapy to regain the ability to walk. That was successful. Otherwise, there’s not much doctors can do. His right shoulder remains limp.

Testing a possible treatment

“We all get really frustrated every time we get to this point, and we don’t have antiviral medicines that are readily available,” said Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville. “We don’t have much to offer these kids.”

Creech and his colleagues are working toward a solution. They’ve begun safety studies of a monoclonal antibody that would, ideally, stop D68 in its tracks.

“In mouse studies, it prevented infection that would lead to AFM,” Creech said. The study is expected to take years before the treatment is considered safe and effective.

Meanwhile, young people like Vishnu Kagolanu are attempting to move on and even inspire others with AFM. In recent years, he started a nonprofit called Neurostronger, which works to raise funds for and increase awareness of kids with neurologic conditions.

“Growing up with AFM is hard,” Kagolanu said. “But at the same time, there are ways to get around some of those obstacles. There are ways to find joy.”

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More than two-thirds of U.S. children and teens who saw a doctor for pink eye left with a prescription for antibiotic eye drops, their research found. The American Academy of Ophthalmology recommends that doctors do not routinely give out antibiotics for what’s also called conjunctivitis, which usually clears up on its own.

Antibiotics don’t work at all on viruses — the most common cause of pink eye. And even mild eye infections from bacteria will resolve on their own in most cases, the medical group says.

Pink eye is highly contagious and causes red, swollen and sometimes itchy eyes. Often, a chilled, wet towel and artificial tears are enough to ease symptoms.

For their study, researchers used a nationwide database of insurance claims from 2021. Nearly 45,000 children received care for pink eye at a doctor’s office, eye clinic or emergency room and 69% were prescribed antibiotics, which come in drops and ointments.

Whether they were treated or not, return visits to the doctor for pink eye were rare, under 4%, according to the study published Thursday in the journal JAMA Ophthalmology.

Doctor’s offices gave antibiotics the most — 72% of patients, compared to ERs at 57% and eye clinics at 34%.

That could be because eye clinics have the tools to figure out what is actually causing the pink eye and treat accordingly, said Dr. Rupa Wong, a pediatric eye doctor at Honolulu Eye Clinic and spokesperson for the ophthalmology group.

Dr. Daniel Shapiro, a pediatric emergency doctor and co-author of the study, said he understands why parents might be alarmed when their child has an infection.

“The eye looks red and nasty and so it’s pretty striking and scary,” said Shapiro, of the University of California, San Francisco.

But antibiotics shouldn’t be overused if they aren’t going to help, he said.

The study didn’t dig into the specifics of why the antibiotics were prescribed or the outcome. But the fact that return visits were rare in either case suggests that patients are not at higher risk of complications or serious problems if they don’t get a prescription, Wong said.

“There are more supportive measures we can take to make your child feel comfortable without resorting to antibiotic eye drops,” Wong said.

We’re talking 60-plus — women and men. And we’re talking about hitting the gym and weight training. Don’t be put off, Bamman says.

“Resistance training is in many ways the true fountain of youth,” Bamman said in an interview with The Associated Press. “I like to say the fountain of youth is the water cooler in the gym.”

Of course, there are biological limits. But Bamman says the bulk of age-related decline in strength, flexibility and endurance is behavioral — putting too few demands on the body, not too many.

“When I tell somebody that in four to six months your strength and muscle mass and overall muscle function is going to elevate to the levels of people 30 to 35 years younger, that hits home,” he said.

So you know you’re too sedentary and the birthdays keep piling up. You suspect resistance training would be beneficial. But perhaps you’re intimidated. Don’t be.

Getting started

Check with medical professionals to make sure there are no health problems that stand in your way.

Then find a gym. Larger gyms offer a social component with things to do on a day off from weight training. And Bamman suggests getting a trainer.

“It’s actually quite safe, but it does require proper progression,” Bamman said. “You have to have a good instructor who can teach the movements properly.”

Bamman, a research scientist at the Florida Institute for Human & Machine Cognition, said finding a fully qualified trainer can be tricky.

“We need more rigorous certification of trainers,” he said. “The problem is that you can go online tonight and pay $50 and get some certification as a trainer.”

Done and dusted in an hour

Bamman suggests resistance training twice a week. Three times is even better, and he recommends non-weight-training days in between. For instance, work out on Monday, Wednesday and Friday, and let Tuesday and Thursday be days of rest.

He suggests 10 different exercise movements — eight is sufficient. Do 10 repetitions of each movement. Do this three times, described as three sets. Then move on to the next movement.

When you reach the 10th repetition, you should feel you can’t do many more. If you could have done 10 more reps, you might want to increase the resistance.

Bamman says machines are better for beginners, but free weights — barbells or dumbbells — may be more effective as you gain confidence.

Before the weights, start with a 5-10 minute warmup — on the treadmill, stationary bike or elliptical machine — to get the blood flowing. You can add a few minutes on the mat for stretching and abdominal work.

Then come the weights.

“Sometimes you see people who sit on the machine, do a set and then play with their phone for three or four minutes. We like to keep them moving.”

Women may benefit even more than men

Women may benefit from resistance training even more than men because it’s a way to fight osteoporosis, the loss of bone density.

“Women are on a disadvantaged trajectory for bone loss, particularly in susceptible areas such as the hips and lower back,” said Bamman, who completed his doctorate at the University of Florida College of Medicine.

“But the strength-training benefits for both sexes are really important. There are no sex differences in the ability to respond. In gaining muscle mass and strength in untrained people, men and women track the same.

Yasuko Kuroi is 72 and started resistance training about 20 years ago.

“I saw the men in the gym and thought I could do that, too,” she said, speaking at a municipal recreation center in Tokyo.

The body demands work

In a few words: Use it or lose it.

Bamman cautions against pampering yourself and criticized even health care professionals “who baby seniors.” Of course, common sense is required.

“Our human body is a demand-based system,” he explained. “If you chronically impart a low demand on the body, we have adaptations to low demand. That’s why we lose muscle mass, that’s why we get weaker. We’re not demanding much.”

“But if you put high demands on the system — like resistance training — now the body has to adapt to these higher demands. The body says: ‘To adapt to these new demands I’ve got to make my bones stronger. I’ve got to make my muscles bigger.”

Bamman used the example of space flight, or extended bed rest, where people rapidly lose strength.

“Bed rest or space flight is essentially expedited aging,” he said. “All of our systems as we age are capable of responding and adapting. They just need the stimulus.” He said he’s seen positive effects for people in their 70s and 80s, and even for some in their 90s.

Bamman is 57 and joked he’s getting “closer in age to the people I study.” He also emphasized there are no shortcuts.

“These programs that roll out for older adults — seated exercises and the like. This is gimmicky and they don’t impart enough demands on the body,” he said.

An analysis of data from more than 500 children and teens with hypertension revealed an association between shorter-than-recommended sleep times and high blood pressure, according to the study, published in Pediatrics.

While hypertension in kids has been declining, the Centers for Disease Control and Prevention estimates that 1 in 7 young people ages 12 to 19 have hypertension.

The study doesn’t prove that shortened sleep times cause hypertension, but doctors don’t typically think of sleep when they counsel parents about high blood pressure, said the study’s lead author, Dr. Amy Kogon, an assistant professor at the University of Pennsylvania Perelman School of Medicine.

Data for the study came from children and teens seen at a clinic at the Children’s Hospital of Philadelphia, where Kogon is a pediatric kidney specialist.

“We usually target things like diet and exercise,” Kogon said. “This is another thing parents might want to think about, particularly if the child has high blood pressure.”

Major risk factors for hypertension in children and teens include being overweight, not getting enough physical activity and a poor diet, according to the American Heart Association.

The majority of middle and high school kids in the U.S. are sleep-deprived. In fact, according to the CDC, nearly 60% of middle school kids and more than 70% of high schoolers aren’t getting enough sleep.

As many as a third of elementary school kids get less than the recommended amount of sleep, Kogon said.

The number of hours of sleep children and teens should get depends on age. The American Academy of Sleep Medicine recommends:

• 10 to 13 hours per night for children under age 6.
• 9 to 12 hours per night for children ages 6-12.
• 8 to 10 hours per night for ages 13 to 18.
•  7 to 9 hours per night for ages 18 and older.

It’s important to control blood pressure early in life because the longer someone has hypertension, the higher the risk of developing heart disease, said Dr. Barry Love, director of the congenital cardiac catheterization program at Mount Sinai Kravis Children’s Heart Center.

“We know that high blood pressure is associated with the early onset of coronary disease and stroke,” said Love, who wasn’t involved in the new study. “We think that the damage to blood vessels happens over time.”

For the new study, researchers at Children’s Hospital of Philadelphia examined the medical records of 539 kids, average age 14.6 years, who were referred to pediatric kidney clinics because of high blood pressure readings. The kids were asked when they went to bed and when they got up in the morning. They were also asked to wear ambulatory blood pressure measuring devices, which took readings every 20 minutes while they were awake and every 30 minutes during sleep.

The further sleep duration was from recommended levels, the more likely it was for kids to experience high blood pressure during the day. Kids who went to bed late were also more likely to have hypertension. The findings were consistent regardless of the kids’ ages, sexes and BMI categories.

Too much sleep was also linked to blood pressure issues. Normally, blood pressure drops by around 10% during sleep, but that was less likely when kids slept longer than the recommended amount.  

Why can’t kids sleep?

Anxiety causes sleep problems for about 25% of children ages 1 to 6, according to a University of Michigan C.S. Mott Children’s Hospital National Poll. Those kids were less likely to have bedtime routines and more likely to leave on videos or TV shows, their parents reported in the poll, which was released Monday.

Another possible cause of sleep problems: An estimated 59% of kids weren’t turning off their electronic devices at night, the poll found.

It’s not so much the light from the devices that causes problems but rather what the kids are viewing on such devices. Apps like TikTok and Instagram can spoil sleep because they are “difficult to put down and are also stimulating,” Kogon said.

Reading a book on a device, for example, “is probably not the same as flipping through social media,” Kogon said.

Parents shouldn’t allow cellphones in kids’ bedrooms at night, Kogon said. She also suggests kids not have any kind of electronics or TVs in bedrooms.

Dr. Mariana Bedoya, an assistant professor of allergy, immunology, pulmonology and sleep medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville, Tennessee, said other ways to help improve sleep include:

• Quitting caffeine at least six hours before bed.
• Keeping to regular sleep schedules.
• Avoiding naps for older kids.

“I tell patients not to change their sleep schedule by more than an hour and a half to two hours over the weekend,” said Bedoya, who wasn’t involved in the new study.

Love said it’s tough for kids to get enough sleep these days. “Is it that kids are worrying or eating bad things?” he asked. “There are so many things distracting them from sleep.”

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Choose the right type of chocolate and you also get a rare dessert that gets approval from dietitians.

June is National Candy Month, though chocolate really rules in October for Halloween, December for the holiday season, February for Valentine’s Day and spring for Easter.

But people love it year-round: the average American eats almost 10 pounds of chocolate per year, according to Forbes.

Many might not know chocolate comes from a fruit tree and is made from a seed — the cocoa bean, the National Confectioners Association notes.

What is the healthiest chocolate?

Of the three types of chocolate — dark, milk and white — dark chocolate is the healthiest, nutrition experts say.

“The health benefits of chocolate products are all thanks to the cocoa bean, which contains numerous phytochemicals shown to have anti-inflammatory, anticancer, and antihypertensive properties,” Whitney English, a registered dietitian at Whitney E. RD in Palo Alto, California, tells TODAY.com.

“The more cocoa solids a product contains, the more nutritious it is. Dark chocolate contains the most cocoa bean solids and therefore is the most nutrient-dense.”

Dark chocolate also has a higher content of flavonoids than milk or white chocolate, says Elisabetta Politi, a registered dietitian at the Duke Lifestyle and Weight Management Center in Durham, North Carolina.

Flavonoids function as antioxidants to block the damaging effects of free radicals, which have been linked to increased risk of heart disease and cancer, she notes.

“Additionally, flavonols, a type of flavonoids in dark chocolate, may affect the function of the immune system by reducing inflammation,” Politi tells TODAY.com.

Is 70% dark chocolate healthy?

Both experts recommend choosing chocolate with at least 70% cocoa content because it will have less added sugar and more phytochemicals than chocolate with less cocoa.

A 70% chocolate bar will list cocoa beans or one of its derivatives — cocoa solids or cocoa liquor — as the first ingredient, Politi says. If sugar is listed first, it means cocoa makes up less than 50% of the bar, she adds.

Dark chocolate benefits

Cocoa beans contain protein and are a great source of minerals like iron and magnesium, plus manganese, copper, zinc and phosphorus, TODAY.com previously reported. You get a bit of fiber, too — about 3 grams per 1 ounce of dark chocolate, according to the U.S. Department of Agriculture.

Chocolate is rich in polyphenols, beneficial compounds produced by plants.

Higher chocolate intake is associated with a lower risk of future heart problems, researchers reported in the journal Heart.

Reviews of studies have found chocolate consumption “significantly reduced” triglycerides — a type of fat in the blood — and can modestly lower blood pressure.

Cocoa flavanols protect against vascular disease and appear to improve blood flow to the brain, a study published in Scientific Reports noted.

Chocolate also has benefits for the mind.

Dark chocolate “contributes to producing the feel-good hormone serotonin and contains magnesium, which is linked to reducing anxiety” and relieving stress, Keri Glassman, a registered dietitian in New York, notes.

Eating 85% cocoa dark chocolate may also boost mood via the gut-brain connection, with dark chocolate having a prebiotic effect on healthy bacteria in the gut and possibly improving negative emotions that way, a study found.

Could it make you smarter? There’s a “surprisingly powerful” correlation between chocolate intake and the number of Nobel laureates in various countries — perhaps because chocolate “enhances cognitive function,” a study published in The New England Journal of Medicine found.

For example, Switzerland was the top performer when it came to both the number of Nobel laureates and the amount of chocolate its residents eat, the authors noted. (Other experts were very skeptical of the correlation.)

Dark chocolate side effects

When Consumer Reports tested 28 dark chocolate bars from a variety of brands in 2022, it found cadmium and lead in all of them — two heavy metals harmful to health. The levels weren’t extremely high, but they were detectable, the organization said when it released its test results.

The National Confectioners Association countered that chocolate is safe to eat and all the products tested were “in compliance with strict quality and safety requirements.”

Any harms from heavy metals seem to be outweighed by other positive compounds in dark chocolate, English notes.

If heavy metals are a concern, Politi suggests choosing milk chocolate, or varying both milk and dark.

Dark chocolate contains caffeine — about 23 milligrams in a 1-ounce square, according to the U.S. Department of Agriculture. If you eat four squares, that’s about the same amount of caffeine as drinking a cup of coffee.

And it’s still candy — it has fat and sugar, with 170 calories per ounce, so eating too much can lead to weight gain.

How much chocolate per day is OK to eat?

Politi recommends sticking to 1 ounce per day, or the size of a dental floss case.

English says a few squares of chocolate a day is a reasonable amount for most people.

How do you eat dark chocolate if you don’t like it?

If it’s too bitter, try putting two small pieces in your mouth and let them melt over your tongue, which helps discover the complexity of the dark chocolate flavor, Politi advises.

A dark chocolate bar that contains sea salt or dried fruit may also taste less bitter than plain dark chocolate, even if they contain the same amount of cocoa, she adds. Politi personally loves chocolate with orange flavor added.

Yogurt with fresh berries and some dark chocolate chips sprinkled on top is another option, English notes.

Both dietitians are fans of dipping fruit in melted chocolate.

Is chocolate unhealthy or healthy?

Dark chocolate contains nutritious components and its benefits likely outweigh any potential drawbacks as long as it’s consumed in moderation, English says.

If a person enjoys a sweet treat at night, choosing a few squares of dark chocolate over a bowl of ice cream is more beneficial, but it’s likely less healthful than a bowl of blueberries, she explains.

“If someone loves a treat at the end of a meal, I think a small amount of dark chocolate is a guiltless choice, which has been shown to provide health benefits,” Politi adds.

“(But) I wouldn’t say chocolate is a health food.”

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“I didn’t think much of it,” Salvador, now 21 of New Orleans, tells TODAY.com. “It was just getting bigger.”

As it grew, he worried that the mass was a sign something was seriously wrong. In the fall, he asked his mom about it, and she examined it. Concerned, she took Salvador to a hospital, and he eventually learned that he had stage 1 testicular cancer. He’s sharing his story so other young people with cancer feel less alone.

“Maybe someone will relate to it,” Salvador says. “Maybe somebody will find hope in my story.” 

A lump that keeps growing

Over the summer of 2020, Salvador noticed the bump but thought his body had just changed.

“I thought it was normal,” he says. Then it began growing, and he became worried. In October, he mentioned it to his mom, who believed they should visit the hospital.

“They did some scans. They did some checks,” Salvador recalls. “They said, ‘Yes, this is cancerous.’”

The doctors recommended removing both testicles, but Salvador’s mother balked at this. She hoped to someday have grandchildren and thought that this plan was too aggressive for her teen son. The two visited a doctor at Children’s Hospital of New Orleans for a second opinion. Doctors there shared some welcome news.

“They were like, ‘OK, we’re going to do the best to save one (testicle),’” Salvador recalls. “But the other one definitely has to come out.”

The doctor removed the testicle and several lymph nodes during surgery and diagnosed Salvador with stage 1 rhabdomyosarcoma, a type of soft tissue cancer that can occur in connective tissue or muscle, according to the National Cancer Institute.

“The biggest surgery was the one where they took out my lymph nodes,” he says. “They opened up the whole chest area, stomach area.”

Following that surgery, Salvador underwent radiation for a month and then eight months of chemotherapy with infusions once a week. Treatment felt tough at times.

“I lost my hair. I was nauseous,” he says. “I was pretty weak.”

Following the completion of chemotherapy, Salvador was cancer free. He had another surgery where they gave him a prosthetic testicle. While going through cancer treatment as a teen felt difficult, he was able to enjoy his final year in high school.

“(My) hair grew back,” he says. “My late senior year, everything went back to normal.” 

Testicular cancer

While Salvador’s cancer grew in his testicle, it’s not the same type of cancer often associated with testicular cancer diagnosis, such as the type that Lance Armstrong had, Dr. Pinki Prasad, oncologist and hematologist at Children’s Hospital New Orleans and one of Salvador’s doctors, tells TODAY.com.

“Ronal actually had a type of sarcoma, rhabdomyosarcoma, that can be found very often in the … testicular region,” she explains, adding that it’s more common in children than adults.

This type of cancer doesn’t have many noticeable symptoms other than a lump on the testicles — “usually painless, but it’s a bump that gets bigger with time and doesn’t get better,” Prasad says. “Sometimes it will be painful, and that’s what brings this to (their) attention.”

She estimates that, in 90% of cases of testicular rhabdomyosarcoma, a lump is the only sign. Prasad adds that “very rarely do we see pain with urination, blood in the urine.”

While Prasad says all pediatric cancers are considered rare, including testicular rhabdomyosarcoma, she urges boys to be aware of their bodies and say something if they notice any changes.

“Once they hit puberty, they should be checking their testicles at least once a month,” she says. “No one is going to know outside of them if there’s any changes, and so it’s really important for them to get used to knowing what’s normal for them.”

Treatment for testicular rhabdomyosarcoma includes surgery to remove the testicle with the cancer and lymph nodes, which can be followed by radiation and chemotherapy.

Like any cancer, patients diagnosed with rhabdomyosarcoma in early stages have good outcomes with lower risk of recurrence. Still, Prasad says doctors closely monitor people for several years.

“They resume their normal lives pretty quickly. They go back to school. They do all the things they want to do,” she says. “We do follow them for a very indefinite amount of time, and most of these patients are survivors.”  

With testicular cancer, people often feel hesitant to share symptoms with their family or doctor.

“There is a stigma,” Prasad says. “Most of these patients who have some sort of a testicular tumor do end up having a testicle removed, which can lead to some body issues.”

Prasad notes that prosthetic testicles are available, and more than half of her patients opt to have one. 

College and beyond

For years, Salvador hoped to become a doctor. After graduating from high school, he started college and is studying pre-med.

“I want to be a cardiologist,” he says. “When I was younger, I used to have a lot of heart issues, and I used to always see cardiologists. They always looked so happy.”

This summer, Salvador plans to work at his family’s business and read for fun. He hopes his story encourages others to be aware of their health.

“It’s important for everybody to learn about their bodies, how to examine it on their own,” he says. “It’s important to know how to take care of yourself.” 

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The workout is simple: Set the treadmill to an incline of 12 (or lower — choose a challenging incline for your fitness level!) at a speed of 3 miles per hour and walk for 30 minutes.

The routine doesn’t require a lot of time, but if done consistently it can improve endurance and aid in weight loss. One of the reasons why it is so popular is that it can deliver these results with absolutely no running required!

Walking is lower-impact and less likely to cause injury than running, and has many important benefits, such as lowering blood pressure and cholesterol, boosting metabolism, improving mental health by reducing anxiety and depression, and even lowering the risk of some cancers.

The 12-3-30 trend took off when health and beauty influencer Lauren Giraldo posted about it on YouTube in 2019 and then again on Tiktok in 2020, sharing that the workout helped her lose 30 pounds and keep it off.

“I used to be so intimidated by the gym. It wasn’t motivating, but now I go do this one thing and I can feel good about myself,” she said on TikTok. “I look forward to it. It’s my me-time.”

Giraldo’s emphasis on self-care and attainable fitness goals has resonated with a wide audience. Her initial post has over 2.8 million likes.

The influencer, who is not a fitness expert, chose the numbers 12, 3 and 30 because the highest incline on the treadmill at her gym was 12, she didn’t enjoy running and three miles per hour felt like a good, brisk walking pace to her, and her grandmother always advised to exercise at least 30 minutes each day.

Clearly, the incline and intensity in the workout are personal to her, so people should consider their own fitness level and goals when trying it, and make adjustments as needed.

Physical therapist Vijay A. Daryanani, a certified personal trainer at Spaulding Outpatient Center, a hospital that partners with Harvard Medical School, says the simplicity of walking for 30 minutes is an attainable goal that’s appropriate for most people.

“I think the 3 mph for speed is good for most people, but the incline is a critical piece,” Daryanani tells TODAY.com.

He recommends that people pay close attention to their posture while walking on an incline.

“When I’m training someone, I will adjust the incline safely and with guidance to maintain posture, balance and stride. Inclining a treadmill is similar to walking up hills, which places different stresses on the musculoskeletal system,” he says.

Here’s what to know about preventing injury and walking for weight loss if you’re ready to try the 12-3-30 workout yourself.

What is the “12-3-30” workout?

Giraldo’s workout is guided by three settings on the treadmill:

• Incline: 12
• Speed: 3 mph
• Time: 30 minutes

According to Giraldo’s TikTok video, she does the workout approximately five times per week and it helped her drop 30 pounds. “I obviously noticed the changes in my body, but I was most happy with the changes that I felt mentally,” she said. “I was proud of myself every day for getting on the treadmill and having my ‘me time’ for 30 minutes. I feel accomplished every time I do it.”

For Giraldo it served another important purpose: getting her comfortable stepping foot in the gym. “The thing about 12-3-30 is it made the gym so much less of a scary place. I feel confident in the gym now, and I sometimes incorporate weights and other exercises into my workout,” she said.

Benefits of the “12-3-30” workout

As previously reported by TODAY.com, walking comes with a myriad of health benefits including: Improving cardiovascular health and blood pressure, controlling blood sugar and reduce your risk of diabetes, increasing your metabolism, aiding in weight loss and maintenance and increasing your aerobic capacity.

The U.S. Department of Health and Human Services recommends moderate-intensity aerobic exercise for 150 to 300 minutes a week. Doing the 12-3-30 workout five times a week will get you into the low end of that range.

Walking is also a low-impact alternative to running, which is good for people with joint issues, but adding the incline to your walks increases the intensity and makes it a more challenging workout. It also has toning benefits for the lower body. “Walking on an incline will engage your leg muscles more than walking on level ground,” TODAY fitness contributor Stephanie Mansour previously wrote on TODAY.com. “This will make for a more intense workout for your glutes, hamstrings and quads, while also increasing your heart rate.”

Is the “12-3-30” workout safe?

At first, Giraldo couldn’t make it the full 30 minutes. “I definitely had to work up to the 30 minutes. I couldn’t get through it without losing my breath and started out by taking a break after the 10 or 15-minute mark,” she said.

Although 12-3-30 is a relatively straightforward treadmill workout, it isn’t something you should just jump right into, Dr. Dennis Cardone, osteopathic sports medicine specialist and chief of primary care sports medicine at NYU Langone Health, tells TODAY.com.

“If someone is working that hard with this workout and they are a 20-something, young and healthy, and they are struggling, you see it was a pretty significant workout,” Cardone says. “It’s just too much too soon and it should really have a recovery day as well.”

That’s not to say that there can’t be benefits to adding an incline to your workout. “It certainly adds more stress to a workout in the sense that people are getting more of a workout in a shorter period of time; the muscles are working harder,” says Cardone.

But, he adds, the risks may outweigh the benefit when it comes to adding a significant incline to your workout.

“The problem is people don’t think that walking is a stressor. They think ‘what’s the big deal using an incline? I’m only walking.’ But it really is a big stressor: low back, hamstring, Achilles tendon, knee, plantar fascia … these are the areas where we see some significant injury related to inclining a treadmill,” he says. “As a general observation, anytime anybody begins or changes a workout or adds something like an incline, they have to follow the rule to do it slowly, otherwise they are certainly at significant risk for an overuse injury.”

Can you lose weight with the “12-3-30” workout?

Giraldo says that she lost 30 pounds with the 12-3-30 workout and has kept it off for years.

Gradual, steady weight loss of about 1 to 2 pounds per week is optimal for keeping the weight off, according to the Centers for Disease Control and Prevention. “Generally to lose 1 to 2 pounds a week, you need to burn 500 to 1,000 calories more than you consume each day, through a lower calorie diet and regular physical activity,” the Mayo Clinic explains.

Walking for 30 minutes burns about 125 calories for a 150-pound person — and adding an incline will increase that calorie burn. So with healthy diet changes, the 12-3-30 workout has the potential to burn the calories needed for steady, gradual weight loss.

Want to give it a try? Follow these guidelines for a safe and effective workout

“(Giraldo) did well, but most people never make it there because they will get an overuse injury and will be taken out of the game. It’s a great goal, but it’s just not realistic for most of the population,” says Cardone. “If you just do one activity — we don’t have to bash just this one — but whatever activity, if you keep doing it day in and day out, it’s just a setup for injury.”

So instead of jacking that incline way up, here is the safe way to try Giraldo’s workout:

• Don’t be fooled by the treadmill: “People think the treadmill is so safe; it’s not outdoors, it’s a soft, forgiving surface. But it’s not that different from walking up a hill; you’re not protecting yourself that much more by being on a treadmill as opposed to being out on a road,” warns Cardone. “Thirty minutes walking up a mountain, it’s pretty tough when you think about it. People feel a little overconfident about the treadmill.”
• Adjust the numbers to meet you where you’re at. “Don’t incline so rapidly, maybe don’t even start at 30 minutes; 3 mph is reasonable, but maybe slow down your duration of workout and incline to work up to that,” suggests Cardone. “Start flat on a treadmill, and do 0-3-30. Once that is comfortable for you, then start inclining, don’t go to 12 right away. Over 3 weeks start slowly progressing your incline, maybe 10-20 percent per week.”
• If you’re new to fitness, start on flat ground. “If someone is outdoors and starting their workout program, whether it’s walking, jogging, interval training, don’t look for a hill,” says Cardone. “First, tolerate flat. Once you’re doing that, then if you want to add some hills into your workout, fine. But don’t go looking for hills at the start of a program.”
• Gradually increase incline: “Slowly progress your incline, start at the lowest setting and it’s a gradual increase, like any other workout in terms of increasing mileage or intensity,” says Cardone. “This workout starts at a 12-degree incline, so I’d say go at 4-degree intervals. So gradually increase it over a 3-week period to get to that 12 degrees.”
• Don’t do it every day. “Almost whatever the routine is, the general rule is there should be a recovery day or at least alternating with some other activity in order to try to avoid overuse injuries,” says Cardone. “I wouldn’t discourage people from doing some sort of activity most days of the week, just not the same activity. Have a recovery day where you are doing some sort of alternate activity, maybe that might be the elliptical trainer, a bicycle or in the swimming pool, whatever you have available.”
• Supplement with strength and stretching. The bent posture of walking uphill places stress on your low back, Achilles tendon, calf muscles, plantar fascia and hamstring muscles, says Cardone. “Those are stubborn problems and people don’t want those kind of injuries, once they kick in, they are tough to treat,” he says. He suggests doing core-strengthening exercises as well as stretching those areas specifically to help reduce your risk of injury while walking or running.
• Consider something lower impact. If you are just getting into fitness, Cardone advises starting with lower-impact workouts. “Bicycling, elliptical trainer, swimming, cross-training type activities, are even safer. Those are great activities to start a workout routine and build up your cardiovascular endurance; you’re not doing a lot of impact, it’s a little more forgiving on the joints and also on muscle tendons,” he says. “So maybe do the treadmill 2 or 3 days a week and the other days these other activities; that is going to keep people out of trouble.”

How many times a week should I do the “12-3-30” workout?

Even if you’re following these guidelines, the workout should still be done at most, every other day, alternating with other lower-impact activities.

In order to get the benefits you seek from any exercise — whether that be weight loss, toning or overall health — the key is to find a program you can stick with, said Cardone. That means the fitness routine you choose not only needs to be safe, so you’re not sidelined by an injury, but “it has to be something they enjoy, and if they are only doing one activity they are going to burn out, not just physically, but mentally,” he says.

More viral workout trends:

• The Taylor Swift treadmill strut
• The ab dance
• The stomach vacuum
• Cozy cardio

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Following years of public outcry about the high cost of inhalers, the two drugmakers — along with a third, GlaxoSmithKline —  have committed to capping the out-of-pocket cost at $35 a month. GSK’s cap is expected to take effect by Jan. 1.

The moves mirror similar steps taken by insulin manufacturers last year following the passage of the Inflation Reduction Act.

Like insulin, the cost of inhalers in the U.S. is significantly higher than in other wealthy countries. An investigation by the Democratic-led Senate Committee on Health, Education, Labor and Pensions noted AstraZeneca charges $645 in the U.S. for the same inhaler it charges $49 for in the U.K. Teva Pharmaceuticals, another major inhaler manufacturer, charges $286 in the U.S. for an inhaler that costs $9 in Germany.

Caycee Shapland, 29, from Omaha, Nebraska, spends at least $80 each month on her 4-year-old son Jackson’s Symbicort, an inhaler from AstraZeneca, to manage his asthma. He also takes albuterol, also from AstraZeneca, for his asthma.

Despite having health insurance, Shapland said the cost can balloon to $350 a month — a significant financial burden — depending on the severity of Jackson’s asthma.

“Going down from at least $80 a month to $35 a month is astronomical,” Shapland said. “I mean, feeding three young boys 5 and under is $300 a week on our groceries alone. So, it’s a lot of money.”

Dr. Alan Baptist, the division chief of allergy and immunology in the department of internal medicine at Henry Ford Health in Detroit, said the price caps for inhalers should provide significant financial relief for the 30% of his patients who can’t afford their medication.

“I applaud the companies for putting that out and I was surprised by it,” Baptist said.

High prices and lack of access to inhalers, he said, play a role in the racial disparities seen in asthma care, both in Detroit and nationwide.

While asthma rates are slightly higher in Black Americans than in white Americans, “when you look at the outcomes, the adverse events, it’s so much worse,” he said. Black children were 4.5 times more likely to be hospitalized for asthma than white children, and 7.6 times more likely to die from asthma, according to the federal Office of Minority Health.

‘Chaos for patients’

More than 27 million people in the U.S. have asthma, including 5 million children, according to the Asthma and Allergy Foundation of America.

Dr. Steven Stryk, an allergist-immunologist and associate professor of internal medicine at Oakland University William Beaumont School of Medicine, said that while the price caps are a big deal, he remains skeptical until he sees how they’re implemented.

“I think what you’ll find is most doctors saying I’ll believe it when it happens,” he said.

According to a spokesperson for AstraZeneca, both privately insured and uninsured patients will be eligible for the $35 price cap, which will apply to all of the inhalers the drugmaker sells in the U.S.

A spokesperson for Boehringer Ingelheim said the $35 cap will be automatically applied at the pharmacy counter for the majority of eligible patients with commercial insurance. For those without insurance or whose pharmacies aren’t participating, they’ll be able to visit the company’s website starting Saturday, where they can enroll in a copay card that will reduce the out-of-pocket cost to $35.

GSK’s price cap will go into effect later this year, a spokesperson said, and will be available to all patients, regardless of income.

People enrolled in government insurance programs, such as Medicare and Medicaid, won’t be eligible for any of the price caps due to federal restrictions.

Out-of-pocket costs for inhalers can vary widely, depending on the medication and insurance coverage, said Dr. Megan Conroy, a pulmonologist and critical care specialist at Ohio State University’s Wexner Medical Center. “It really creates a lot of chaos for patients.”

Kiowa Rix, 27, of Warren, Michigan, found herself with a $500 out-of-pocket price tag for her son Lucas’ inhaler — Flovent, from GSK — in February, when her insurance stopped covering the medication. The 6-year-old has severe asthma and needs to use an inhaler twice a day.

Lucas’ doctor switched him to a different inhaler, from Merck, which cost $80 a month. Rix is now switching him to Symbicort, which will be capped at $35.

“It makes me feel a little better that they’re realizing they’re overcharging,” Rix said of the price caps going into effect. “You shouldn’t have to go through all these hoops just to get something lowered that you or your child needs.”

While the price caps are significant, it’s unclear whether they’ll apply to the cost of all of a patient’s asthma drugs, or $35 per inhaler.

Patients, said Conroy of Ohio State, often require a rescue inhaler for quick relief, as well as a long-acting or maintenance inhaler to prevent symptoms.

“Patients have multiple medical comorbidities that they’re treating, and a longer list of medications beyond just inhalers for their respiratory disease, some of which carry similar stories of high copays,” she said.

Devastating consequences

The price caps should at least provide a sense of relief to families that qualify, said Dr. Ixsy Abigail Ramirez, a pediatric pulmonologist at University of Michigan Health. Some families, she said, have been forced to consider skipping, delaying or going without the medication because of the high cost, which can add up to thousands of dollars a month.

“Am I going to pay for food and the roof over my head this month? Or am I going to pay for an inhaler that my child requires to breathe so that we don’t end up in the hospital incurring other costs?” she said.

Cole Schmidtknecht typically spent around $5 for his inhaler. According to his father, Bil, one day when he tried to refill his prescription, he was told it would cost more than $500, which he couldn’t afford. Cole suffered a severe asthma attack days later, leading to a fatal cardiac arrest. He was 22.

“Had he had an affordable option in front of him, he’d have probably been here today,” said Bil.

Baptist, of Henry Ford Health, said that while the price caps are a step in the right direction, they don’t go far enough.

“In some ways, it’s just a Band-Aid on the bigger problem that we have,” Baptist said. “The real problem is the outrageous cost of pharmaceutical and drug prices in the United States.”

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The most common type of dementia, Alzheimer’s disease, affects nearly 6 million Americans and is expected to rise to 14 million by 2060 due to our aging population. Cognitive decline — an impairment of memory, decision-making and ability to learn — develops due to aging neurons and the slowing down of the speed at which the brain functions. It’s directly linked to the aging process and leads to worsening memory, attention and brain processing. 

Beyond the calories that are burned by running all the many functions of the brain, there are specific foods that help support our brain’s activity. Here’s what to know about so-called brain foods.

New research on foods and brain aging

A new study published in the journal Nature Aging points to specific nutrients that can contribute to slower aging in the brain. The 100 participants between 65 and 75 years old completed questionnaires, underwent various physical and cognitive tests, MRI scans and had their blood plasma drawn after fasting.

Researchers found that one group had signs of slower aging and also ate a specific nutrient profile. The nutrients in the blood that were prevalent in participants with slower aging were:

• Fatty acids, found in seafood and some healthy cooking oils
• Antioxidants, found in berries, garlic, tomatoes, nuts and plenty of other fruits and vegetables
• Carotenoids, found in spinach, kale, carrots, broccoli and some fruits
• Vitamin E, found in fruits, vegetables, seafood, seeds and nuts and more
• Choline, found in egg yolks, beef, dairy and some veggies

Many foods that make up the Mediterranean diet are high in these nutrients, the researchers noted. While most previous research on foods and brain health have relied on food questionnaires, this research is one of the first to use blood biomarkers, brain scans and cognitive testing.

What is the No. 1 best food for brain health?

As a registered dietitian, I would say this is the best food to boost your brain health:

Fatty fish

Studies have shown that eating just one seafood meal per week has been linked with a lowered risk of both Alzheimer’s and dementia. Our brains are mostly made up of omega-3 fatty acids called EPA and DHA, so it makes sense that foods that contain these fats would help support brain health.

Omega-3 has been shown to help protect the brain with its anti-inflammatory effects, ability to help create new neurons, and power to help clear the brain of plaques, one of the signs of Alzheimer’s. The best-known sources of EPA and DHA on the planet are high-quality seafood, like wild Alaskan salmon, sablefish and halibut. Sardines are another source of omega-3s. Wild-caught seafood is sustainably caught and also has lower contaminants than farm-raised seafood.

What foods help with brain health?

Eggs

The micronutrient choline is finally getting the attention it deserves for its role in brain health, including memory, thinking, mood and more. Higher levels of choline intake are thought to support brain function, which may decrease the risk of some types of dementia, including Alzheimer’s. One of the best dietary sources of choline is the egg. One large egg provides 150 milligrams, about 25% of the daily requirement for men and 35% for women.

You’ll find choline (plus nearly half of an egg’s protein and many other vitamins and minerals) in the yolk, so be sure to eat the whole egg. According to the American Heart Association, eggs can be included as part of a heart-smart diet for healthy adults. 

Walnuts

Research has found that eating walnuts may be linked with improved cognitive function and memory in groups at high risk for age-related cognitive impairment, and reduced risk of Alzheimer’s disease. The nut is also linked with a reduced risk of other diseases, such as cardiovascular disease or Type 2 diabetes, which are both risk factors for developing dementia. Whether you’re munching on walnuts for heart or brain health, you can feel good knowing that you’re covering both bases. 

Berries

Known for being rich in antioxidants and polyphenols, berries contain several disease-fighting compounds. Research has found that eating berries has a protective effect against cardiovascular disease, cancer and Alzheimer’s. A major contributor to Alzheimer’s and other chronic diseases is inflammation. Both strawberries and blueberries have anti-inflammatory benefits.

A study on strawberries found that when older adults, ages 60 to 75, were given the equivalent of 2 cups of strawberries daily for 90 days, they showed improvement in memory and learning tests. In a similar study, participants who ate the equivalent of 1 cup of blueberries daily were tested on verbal learning and task switching and had significantly fewer errors on both tests at 45 and 90 days. 

Prunes

Known for their gut health and bone benefits, prunes are also great for your brain. Prunes are high in potassium and a source of vitamin B6 and copper, all micronutrients that contribute to normal functioning of the nervous system. What’s more, studies on prunes show that the dried fruit has anti-inflammatory, antioxidant and memory-improving characteristics. The benefits are likely due to the high content of anthocyanin, a blue plant pigment. 

Citrus fruits

One of the markers of Alzheimer’sdDisease is neurodegeneration. The peel of a small citrus fruit from Okinawa, Japan called shikuwasa lime (also called citrus depressa) is rich in a plant compound called nobiletin. Nobiletin has been found to protect nerve cells and provide anti-inflammatory benefits and is looking promising as a potential treatment for Alzheimer’s. The good news is that this important compound can also be found in mandarins, oranges, tangerines and grapefruits. 

Cocoa powder and dark chocolate

Cocoa beans are rich in flavanols, which help fight inflammation in our body and can increase blood flow to the brain. Choosing dark chocolate over milk chocolate helps you get more of the protective polyphenols.

Extra virgin olive oil

As the staple of the Mediterranean diet, extra virgin olive oil is rich in polyphenols and vitamin E. A 2023 study done at the Harvard T.H. Chan School of Public Health found that daily consumption of more than half a tablespoon of EVOO had a 28% lower risk of dying from dementia compared to never or rarely consuming olive oil. The study also found that replacing just one teaspoon of margarine or mayo with the same amount of EVOO daily was associated with an 8 to 14% lower risk of dying from dementia. 

Tips to sharpen your memory 

In addition to what we eat, there are other habits to work on to support brain health, Dr. Andrew Budson, author of “Why We Forget and How to Remember Better,” tells TODAY.com.

Here are some strategies to remember things better:

• Focus your attention on whatever it is that you want to remember.
• Organize whatever it is that you want to remember, whether it is by reviewing the sights, sounds, smells, thoughts, and feelings of an experience or the material you need to memorize for a presentation or exam.
• Understand what you want to remember, such as the deeper meaning or implications of an episode of your life or the individual elements of your presentation or exam
• Relate what you are learning to things you already know or have experienced

In addition to the tips above, you may want to ditch some habits that can hinder memory over time, Budson says. These include:

• Not correcting bad habits immediately. Break bad habits right away or they will become part of your routine. For example, don’t leave your keys, wallet, cell phone where they are difficult to find— even once —or you may find yourself frequently hunting around the house looking for them.
• Not paying attention to where you are or what you are doing. This is the No. 1 reason people have trouble finding their car, keys, phone, etc. Stop and pay attention to where you parked and where you put down your keys, for example.
• Not engaging in aerobic exercise regularly. Aerobic exercise releases growth factors from the brain that help to grow new brain cells in the hippocampus, the part of the brain that forms new memories.
• Being sedentary and watching too much television. There are new studies that suggest that even when controlling for vigorous exercise, it is still important to not be sedentary and not to watch more than one hour of television per day.
• Eating too much unhealthy food. Everyone can get away with eating dessert, red meat, butter, soda, refined sugar and flour once in a while, but it is important that the majority of one’s diet be from the Mediterranean menu, including fish, olive oil, fruits, and vegetables, nuts and beans, and whole grains.
• While Budson doesn’t recommend any particular supplements for brain health, he does encourage people to have their vitamin D and B12 levels checked by your physician at least once every decade after age 40. Both vitamin D and B-12 are necessary for proper memory function.

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Americans under the age of 30 reported lower levels of happiness from 2021 to 2023 than those over the age of 60, according to this year’s World Happiness Report.

Jonathan Haidt, a social psychologist at New York University’s Stern School of Business, lays the blame squarely on our devices.

His new book, “The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness,” argues that the constant access to social media that phones have given us has led to social comparison, sleep deprivation and loneliness in Gen Z.

And it’s touched a nerve: his book is currently No. 3 on the New York Times nonfiction bestseller list.

Of course, as high-profile as the book has become, not everyone agrees with its thesis. Some critics argue blaming smartphones is an oversimplification and not fully supported by evidence

Zach Rausch, lead researcher to Haidt and an associate research scientist at NYU-Stern School of Business, says kids who had access to social media and iPhones in elementary and middle school are more anxious and less productive.

“The goal of technology is that it’s a tool that we use to meet our goals,” he says. “If it’s not doing that, it ends up using us at the cost of our goals.”

But, there are ways to curb these negative effects. Here are three things you can do today to increase your happiness and stay focused.

1. Buy an alarm clock.

Your phone being the last thing you interact with before bed and the first when you wake up can adversely affect your sleep and add to stress levels.

Purchasing an alarm clock and keeping your device outside your bedroom can create some physical and mental distance from social media.

2. Use your phone to meet with people in person.

Oftentimes, conversations on Instagram or text don’t cross over from digital to physical.

“We used flip phones to connect with each other in order to eventually meet in person,” Rausch says. “The online world is kind of the opposite. We connect in order to stay there. And our argument is that that’s not sufficient.”

Yale University happiness professor Laurie Santos echoes this sentiment.

“Every available study of happy people suggests that happy people are more social, they spend more time physically around other people, and they invest time in their friends and family members,” Santos, who teaches “The Science of Wellbeing” course at Yale told CNBC Make It.

3. Silence notifications.

Adolescents get 237 smartphone notifications a day, according to a 2023 study which surveyed 203 teens and tween between ages 11 and 17. Almost a quarter, 23%, arrived during school.

Silencing your notifications can help you stay present and productive during the hours it matters most.

Rausch emphasizes that getting rid of smartphones is not a panacea for depression. But, using your phone in a more thoughtful way can help you pursue activities that are proven to increase your happiness, like in-person social connection, and get more done.

“It’s not that we need to reject technology outright,” he says. “It’s that as technology is rapidly changing the way that we live our lives we need to press pause and think about how we want this to be in our lives. Is it fulfilling us? Is it helping us flourish? Is it helping us meet our goals? And, if not, what can we do to change it?”

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Sign up today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

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According to NBC News report published this week by the Centers for Disease Control and Prevention revealed new details of the outbreak, which occurred in July 2022 at a nine-person family reunion in South Dakota.

One family member brought meat to the reunion from a black bear hunted in northern Canada. The meat had been frozen in a household freezer for 45 days. Hunting black bears is legal in Canada and many U.S. states.

The family made kebabs with the thawed meat, alongside grilled vegetables. According to the CDC, the family had a hard time determining whether the kebabs were fully cooked, because the meat was dark in color. So it was unintentionally served and eaten rare.

A week later, one family member — a 29-year-old man in Minnesota — developed a fever, severe muscle pain and swelling around the eyes. He was hospitalized twice for his symptoms.

The man tested positive for antibodies to Trichinella, a type of roundworm. Five other family members also developed symptoms such as fevers, headache, stomach pain, diarrhea, muscle pain and swelling around the eyes.

Two others who’d been exposed did not develop symptoms, and the CDC could not confirm whether the ninth person had been exposed to Trichinella.

The CDC tested the remaining frozen meat and detected larvae from the same roundworm species.

The agency presumed that all six family members had trichinellosis, a disease caused by eating undercooked meat contaminated with Trichinella larvae.

Such infections are rare. From January 2016 to December 2022, the CDC identified seven trichinellosis outbreaks in the U.S. involving 35 probable or confirmed cases. Most were linked to bear meat.

Trichinellosis is not the same parasitic infection that presidential candidate Robert F. Kennedy Jr. recently revealed he once suffered from. Kennedy said the brain infection he got comes from pork tapeworm larvae.

Two of the infected people at the family reunion ate the vegetables without the meat, the CDC said. Trichinella-infected meat can result in cross-contamination, so meat and its juices should be separated from other foods during cooking.

Three of the family members were hospitalized, each of whom had consumed the bear meat. They received a treatment called albendazole, which kills parasitic worms and their larvae.

All six people recovered from the disease.

The CDC report warns that freezing meat won’t kill all species of Trichinella. The bear meat at the family reunion, for instance, was contaminated with a species found in Arctic bears that’s resistant to freezing.

“Persons who consume meat from wild game animals should be aware that that adequate cooking is the only reliable way to kill Trichinella parasites,” the report’s authors wrote.

The CDC recommends cooking wild game meat to an internal temperature of at least 165 degrees Fahrenheit, which should be verified with a meat thermometer — not by looking at the color of the meat.

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Nutritionists highly recommend starting your morning with foods that will keep you energized throughout the day like protein shakes and whole grain oats, experts told CNBC Make It last January. And cereal doesn’t fit that category.

“I never recommend cereal to my patients to have for breakfast, simply because it’s processed. I don’t recommend anything that’s processed,” said Dr. Nancy Rahnama, an internist and clinical nutritionist.

But cereal is a convenient choice if you’re short on time, Rahnama acknowledged. If you have only enough time to grab a bowl of cereal, reach for ones that are high in fiber and low in sugar, she advised.

Here is a list of cereals that are high in nutrients like fiber and protein and low in added sugar, according to a recent report by Healthnews.com.

Cereals with the most nutrients, lowest added sugar

Healthnews.com worked with nutrition scientist Lauryna Nelkine to compare the ingredients of the 15 most popular cereals in America, “taking into account their sales volumes and ratings on major American retailing platforms,” the report states.

These are the cereals that had the most nutrients, vitamins and minerals to support health, and the lowest amounts of added sugar.

• Highest in dietary fiber: Post Raisin Bran — 9 grams of fiber per serving
• Highest in protein: Special K Protein — 7 grams of protein per serving
• Highest in calcium and vitamin D: Multi Grain Cheerios — 200 milligrams of calcium and 4 micrograms of vitamin D
• Lowest in added sugar: Corn Flakes, Corn Chex and Special K Protein — 4 grams of sugar per serving each

Cereals with high levels of added sugar

Here are the cereals that stood out as having the highest amounts of added sugar (with 12 grams of added sugar per serving each):

• Lucky Charms
• Frosted Flakes
• Cinnamon Toast Crunch
• Froot Loops
• Reese’s Puffs
• Fruity Pebbles

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Sign up today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

Plus, sign up for CNBC Make It’s newsletter to get tips and tricks for success at work, with money and in life.

“The last thing you want is for people to go home and remember the beach trip because they got sick,” Dr. John Torres, NBC News senior medical correspondent, said on TODAY.

Leaving food unrefrigerated for a prolonged period can cause certain bacteria, like E. coli and and salmonella, to grow and make those consuming the food sick with diarrhea and vomiting. Between 40 and 140 degrees Fahrenheit is known as the food “danger zone” for this reason, according to the U.S. Department of Agriculture.

Even if you use a cooler, you may not be able to completely prevent the temperature of your food from reaching above 40 degrees Fahrenheit. That’s why Torres recommends leaving certain items at home and choosing safer beach foods instead.

Foods not to bring to the beach

Cold cuts that require refrigeration

If you’re packing sandwiches made with deli meats or cold cuts — such as sliced turkey, ham, chicken, roast beef, salami, bacon or bologna — these need to be refrigerated until they are ready to eat, says Torres.

Although deli meats are often cured and processed to help prevent spoilage and contamination, they can still contain bacteria that can make you sick and multiple rapidly in warm temperatures, TODAY.com previously reported.

Keeping them in a cooler can make this food choice less risky, but once you take them out of the refrigerated environment, eat them right away.

Fresh salads

Fruits and vegetables contaminated with salmonella, E. coli, listeria and other bacteria are responsible for a large chunk of foodborne illness in the U.S., according to the U.S. Centers for Disease Control and Prevention.

Washing produce can reduce the amount but doesn’t entirely eliminate dangerous bacteria, which love to multiply in warm, most environments — like an airtight container holding salad on the beach.

Anything mayo-based

“Mayo-based potato salad is always one of those big things that cause a lot of issues,” says Torres.

Although it’s bought from a non-refrigerated shelf, mayonnaise does need to be refrigerated, and any salad or dish containing mayo can only be left out at temperatures above 40 degrees Fahrenheit for two hours before it should be discarded, according to the USDA.

Ideally, mayo-based foods should be refrigerated until they are served, says Torres. So it’s probably wise to avoid bringing these dishes to the beach entirely and enjoy them at home instead.

Raw meat

Grilling is a favorite beach activity for many. But bringing a bunch of raw hamburger meat or chicken that will sit around at various temperatures before it is barbecued is not the best idea due to the risk of bacteria growing. In general, Torres recommends against bringing raw or uncooked meats to the beach ever.

If you do decide to bring raw meat, store it properly in a cooler below 40 degrees Fahrenheit until it’s ready to be cooked, and keep it sealed and separate from any other foods that won’t get cooked in the cooler.

According to USDA guidelines, beef should be cooked to a minimum internal temperature of 145 degrees Fahrenheit, poultry to 165 degrees Fahrenheit and fish to 145 degrees Fahrenheit.

Precut fruits

Precut fruit is notorious for containing foodborne pathogens, such as salmonella. These include include papayas, peaches, and a major culprit, melon — including honeydew, cantaloupe and an all-time beach favorite, watermelon.

Cutting the fruit can transfer bacteria on the surface of the fruit into the flesh, where it can grow and multiply, especially in hot beach weather, TODAY.com previously reported.

Sliced fruit can also get warm faster and draw insects, says Torres. Instead of buying presliced fruit for your next beach trip, bring the whole thing and cut it up at the beach instead — just make sure you have clean hands and use a clean knife and cutting board.

Food safety tips for the beach

Many foods can be totally safe for the beach as long as you practice certain food safety precautions. Here’s some advice to keep in mind from Torres and the USDA:

• Perishable foods should never sit out of refrigeration for more than two hours, and if temperatures are 90 degrees are higher, no more than one hour.
• When packing, take food out of the fridge or freezer and put it immediately into the cooler. Aim to keep food refrigerated right up until you eat it.
• Try to avoid leftovers by only packing the amount you plan to consume.
• If you do choose to bring raw meat, season it at home, and keep it tightly wrapped in a place where any juices that may drip cannot get on to other foods, such as the bottom of the cooler.
• Pack drinks in a separate cooler from food so the food is exposed to warm temperatures less often.
• Try to fill your cooler all the way, packing extra ice if necessary, as this will keep its contents cool for longer.
• Bring a food thermometer if you are cooking at the beach.

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The male worker had been in contact with cows at a farm with infected animals. He experienced mild eye symptoms and has recovered, U.S. and Michigan health officials said in announcing the case Wednesday.

A nasal swab from the person tested negative for the virus, but an eye swab tested Tuesday was positive for bird flu, “indicating an eye infection,” U.S. Centers for Disease Control and Prevention officials said.

The worker developed a “gritty feeling” in his eye earlier this month but it was a “very mild case,” said Dr. Natasha Bagdasarian, Michigan’s chief medical executive. He was not treated with oseltamivir, a medication advised for treating bird flu, she said.

The risk to the public remains low, but farmworkers exposed to infected animals are at higher risk, health officials said. They said those workers should be offered protective equipment, especially for their eyes.

Health officials say they do not know if the Michigan farmworker was wearing protective eyewear, but an investigation is continuing.

The first case happened in late March, when a farmworker in Texas was diagnosed in what officials called the first known instance globally of a person catching this version of bird flu from a mammal. That patient also reported only eye inflammation and recovered.

Since 2020, a bird flu virus has been spreading among more animal species — including dogs, cats, skunks, bears and even seals and porpoises — in scores of countries.

The detection in U.S. livestock earlier this year was an unexpected twist that sparked questions about food safety and whether it would start spreading among humans.

That hasn’t happened, although there’s been a steady increase of reported infections in cows. As of Wednesday, the virus had been confirmed in 51 dairy herds in nine states, according to the U.S. Agriculture Department. Fifteen of the herds were in Michigan.

The CDC’s Dr. Nirav Shah said the case was “not unexpected” and it’s possible more infections could be diagnosed in people who work around infected cows.

U.S. officials said they had tested 40 people since the first cow cases were discovered in late March. Michigan has tested 35 of them, Bagdasarian told The Associated Press in an interview.

Health & Wellness Apr 25

More cows are being tested and tracked for bird flu. Here's what that means

Health & Wellness May 14

There's bird flu in US dairy cows, but raw milk drinkers aren't deterred

Shah praised Michigan officials for actively monitoring farmworkers. He said health officials there have been sending daily text messages to workers exposed to infected cows asking about possible symptoms, and that the effort helped officials catch this infection. He said no other workers had reported symptoms.

That’s encouraging news, said Michael Osterholm, a University of Minnesota epidemiologist who has studied bird flu for decades. There’s no sign to date that the virus is causing flu-like illness or that it is spreading among people.

“If we had four or five people seriously ill with respiratory illness, we would be picking that up,” he said.

The virus has been found in high levels in the raw milk of infected cows, but government officials say pasteurized products sold in grocery stores are safe because heat treatment has been confirmed to kill the virus.

The new case marks the third time a person in the United States has been diagnosed with what’s known as Type A H5N1 virus. In 2022, a prison inmate in a work program picked it up while killing infected birds at a poultry farm in Montrose County, Colorado. His only symptom was fatigue, and he recovered. That predated the virus’s appearance in cows.

More severe symptoms of seasonal allergies this spring are likely due to a warmer winter and an earlier start of allergy season, says Dr. Purvi Parikh, an allergist and immunologist with the Allergy & Asthma Network.

And the cause of this longer, more intense allergy season? Climate change.

“There’s higher amounts of pollen due to rising greenhouse gasses and more CO2 in the air, which plants thrive off of,” Parikh tells CNBC Make It.

Allergens like pollen, dust and mold can cause swelling in your nasal passages, Shelby Harris, a licensed clinical psychologist and director of sleep health at Sleepopolis, told CNBC Make It in April of 2023.

“Your body mistakes allergens as a threat to the body, so then you have histamine that is released and that essentially can make you have the nasal swelling, the congestion and the scratchy throat,” Harris said.

Here are some effective ways to alleviate your allergy symptoms and still enjoy the spring.

1. Optimize your home to reduce pollen spread

Peak pollen times are in the early morning, so it’s best to keep your windows closed during those hours. Having your windows shut can prevent allergens from entering and circulating in your living space.

“When coming home, change clothes, take off shoes and shower to avoid bringing pollen into [the] house with you,” Parikh says.

Harris also provided seven tips for keeping your home as pollen-free as possible:

• Avoid using ceiling fans in your bedroom to reduce dust circulation
• Vacuum often
• Change your sheets once a week
• Use an air purifier
• Keep your hamper with your clothes you’ve worn outside out of your bedroom
• Use hypoallergenic bedding
• Try not to dry clothes outdoors if you can

2. Use these recommended medications

If you’re experiencing allergy symptoms, Parikh suggests grabbing medications from your local pharmacy, noting that even generic brands can work if well-known brands are sold out.

Here are a few of the allergy medications that she recommends:

• Claritin
• Zyrtec
• Xyzal
• Allegra
• Flonase
• Astepro
• Alaway
• Pataday

“Any cough, wheezing, chest pain [or] shortness of breath should not be treated with over-the-counter medications and [you] should see a physician,” Parikh says.

“This could be asthma which is deadly, and allergies are the most common cause.”

3. Try local honey

There are only a small number of studies that have tested the effectiveness of local honey on alleviating allergy symptoms, and lack of funding may be the reason, Dr. Timothy Wong, board-certified family medicine doctor and medical expert for JustAnswer, told Make It last April.

“Unfortunately when you’re not using medications that have billions of dollars of funding for research and development, you don’t get as many clinical trials,” Wong said.

A small study with 40 participants in 2013 found that eating honey each day, in combination with allergy medication as needed, was associated with less allergy symptoms after eight weeks, compared to taking just allergy medication on its own.

The logic behind using local honey specifically for allergy symptoms is that “if you ingest the pollens that bring you discomfort, you build up an immunity against them,” Andew Cote, head beekeeper at Andrew’s Honey, told CNBC Make It.

“One spoon a day every morning is the recommended dosage,” Cote added.

It’s better to start eating local honey a few weeks before you began experiencing allergy symptoms the previous year, Wong said.

Children under the age of one should not be given honey, the American Academy of Pediatrics strongly warns. And people who are allergic to bees and wasps should also avoid trying local honey for their allergies, Wong said, because “there are some cases where people who have bee allergies can also get allergies from honey.”

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Wastewater samples have detected a significant escalation in an enterovirus called D68, which, in rare cases, has been linked to acute flaccid myelitis, or AFM. The illness affects the nervous system and causes severe weakness in the arms and legs. This most often occurs in young children. 

“We are detecting EV-D68 nucleic acids in wastewater across the country now, and the levels are increasing,” said Alexandria Boehm, program director of WastewaterSCAN, a nonprofit monitoring network and a professor of civil and environmental engineering at Stanford University.

That’s the first clue to suggest that the nation might see an increase in AFM this year, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security and author of “Crisis Averted: The Hidden Science of Fighting Outbreaks.”

“The second clue,” she said, “is that the time of year is right.”

Historically, September has been the biggest month for AFM cases.

Anyone who’s ever had the sniffles probably had an enterovirus; they’re that common. Most of the time, the viruses cause mild symptoms, such as a runny nose, cough, headache and generalized feelings of “meh.”

The D68 enterovirus strain started causing more serious problems in 2014, when the U.S. saw, for the first time, a spike in pediatric AFM. That year, 120 kids were diagnosed.

There’s no cure or specific treatment for the paralysis. Even with years of intensive physical therapy, many are left with life-altering disabilities.

A viral mystery

Though a few dozen cases have been reported every year since then, larger waves of AFM have followed an every-other-year pattern, spiking again in 2016 (with 153 cases) and in 2018 (with 238 cases).

The pattern stopped in 2020 when the nation went into lockdown because of the Covid pandemic, drastically reducing viral spread. That year, just 32 cases were logged. The spread of D68 picked up again in 2022 as lockdowns were lifted.

Curiously, a rise in AFM cases didn’t follow.

“We saw the virus that was previously driving the AFM cases, but we didn’t see the AFM cases associated with it,” said Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado, who treated some of the earliest AFM cases in 2014.

It’s a mystery that any virologist would appreciate. While experts try to predict how viruses will behave, the bugs are always working to stay a few steps ahead.

It could be that the virus itself has changed, or that more people in the U.S. have been exposed and now have a level of immunity to D68. “We’re still trying to figure it out,” Messacar said.

So far in 2024, 13 AFM cases have been confirmed, according to the Centers for Disease Control and Prevention. Since 2014, 758 cases have been logged.

The implication is that hundreds of families and their children have been left with lasting, life-altering paralysis because of a virus.

Some recovery after years of physical therapy

The Kagolanu family in Los Altos, California, was in a heated game of Monopoly one Friday night in November 2014 when 7-year-old Vishnu’s head began, inexplicably, to tilt to one side. Vishnu admits that even though he was losing the game, this wasn’t attention-seeking behavior.

“My dad was like, ‘Hey, what are you doing? Move your head back straight,'” Vishnu, now 17, said. “I just thought, I can’t do that.”

Within an hour, Vishnu lost all ability to move his arms and legs. “I couldn’t get myself off the floor,” he said.

Vishnu was one of the first to be diagnosed with AFM in 2014. At that time, no one had connected the dots between D68 and the “mystery illness.”

“We didn’t understand what was going on. Even the doctors couldn’t find out what was going on,” said Saila Kagolanu, Vishnu’s mother. “That was the worst experience of my life.”

Doctors warned Vishnu’s family that he might never regain function of his arms and legs. The poor prognosis crushed Vishnu. He’d always thrived as “king of the playground” when it came to sports and other physical activities.

“Seeing my legs go progressively smaller every day” was devastating, he said. “I couldn’t move.”

Vishnu spent years undergoing physical therapy to regain the ability to walk. That was successful. Otherwise, there’s not much doctors can do. His right shoulder remains limp.

Testing a possible treatment

“We all get really frustrated every time we get to this point, and we don’t have antiviral medicines that are readily available,” said Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville. “We don’t have much to offer these kids.”

Creech and his colleagues are working toward a solution. They’ve begun safety studies of a monoclonal antibody that would, ideally, stop D68 in its tracks.

“In mouse studies, it prevented infection that would lead to AFM,” Creech said. The study is expected to take years before the treatment is considered safe and effective.

Meanwhile, young people like Vishnu Kagolanu are attempting to move on and even inspire others with AFM. In recent years, he started a nonprofit called Neurostronger, which works to raise funds for and increase awareness of kids with neurologic conditions.

“Growing up with AFM is hard,” Kagolanu said. “But at the same time, there are ways to get around some of those obstacles. There are ways to find joy.”

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The oldest living person of Japanese descent in the United States, according to the Gerontology Research Group, Miwa prefers to focus on the times when she was happiest. She’s lived through the Spanish flu, prohibition, Black Tuesday, World War II, and the losses of her parents, siblings and friends, and still the supercentenarian’s go-to piece of longevity advice is: Don’t dwell.

Miwa is part of the nisei — the second-generation Japanese Americans sent to internment camps during World War II — who often say “gaman,” which translates to “enduring the seemingly unbearable with patience and dignity,” Alan Miwa, her son, tells TODAY.com. It’s often loosely translated to “perseverance,” “patience,” or “tolerance.”

These feelings, Alan Miwa suspects, are born from the resilience of many from his mother’s generation — who had much to endure. Shikata ga nai (仕方がない), a Japanese phrase meaning, “It cannot be helped,” or, “Nothing can be done about it,” is a common saying among them, too, he adds.

Yoshiko Miwa was born Yoshiko Tanaka on Feb. 28, 1914, in Guadalupe, California, to Japanese immigrants. She was the fifth of seven children. When her mother and infant brother died in 1919, her father struggled to care for his family and tend to the farm he owned. So Yoshiko Miwa and her siblings were sent to live at the children’s home founded by their parish, Guadalupe Buddhist Church.

She went on to graduate from Santa Maria High School in 1932, and she studied business at the University of California, Berkeley, graduating in 1936. She married Henry Miwa in 1939.

During the Second World War, the pair and their families were sent to Poston Internment Camp in Arizona before relocating to Hawthorne, California, after the war. When they, along with many other Japanese people, had difficulty finding work upon their release in 1945, her husband founded a plant nursery business, and in 1963, Yoshiko Miwa got her nursing license.

Yoshiko Miwa has three sons, 10 grandchildren, 20 great-grand children and one great-great-grandchild.

These days, Alan Miwa says she’s in good health and lives in a care facility, where she gets her hair done weekly and attends church services on Sundays.

In addition to a positive spirit, keeping your mind and body active is the key to a long life, Yoshiko Miwa has said in the past. Ahead she shares a few other aspects of her life that she believes have led to her longevity.

She keeps an ever-expanding roster of hobbies

When Yoshiko Miwa retired, she’d walk 4 miles each morning. In 1990, at 76, she walked a 20K as part of the March of Dimes Walkathon. She’s an avid reader, she practices ikebana (flower arranging), sumi-e (Japanese ink art), sashiko (Japanese stitching), sewing, furniture refinishing and reupholstery.

These days, though, her favorite activity is sleeping, she tells TODAY.com via email.

She wrote an autobiography

After taking a writing course, Yoshiko Miwa penned an autobiography. In it, she recalls her travels to Rome, Japan, Paris and Niagara Falls. She describes life in the children’s home and the long walks to school, her siblings and her childhood with her parents.

“We had a big pasture for the horses and cows to graze on,” she wrote of her family’s farm her in autobiography. “Some days, my sister and I would wander around the pasture to pick wild violets that grew there.”

She loves to eat noodles

Yoshiko Miwa’s a fan of any kind of noodles, eating them every day. “When I was in the children’s home, the cook used to make noodles and I used to love them,” she says. “Today, I like spaghetti, udon, ramen, soba and any other kind of noodles.”

Her faith energizes her

Yoshiko Miwa is grateful to Rev. and Mrs. Issei Matsuura of the Guadalupe Buddhist Church, who took her in when her mother died of the Spanish flu.

Yoshiko Miwa was 4 years old when her father turned to the church for help. “The church then started a children’s home and taught us Buddhism, Japanese language, Japanese culture and responsibility,” she recalls. “I’ve always been indebted to Rev. and Mrs. Matsuura.”  

… And her family does, too

The Miwa family travels together and hosts reunions. “I’ve been fortunate that my sons, my grandchildren, my great grandchildren and relatives have always been there for me,” says Yoshiko Miwa.

“Because my mother died so young, I have never enjoyed the warmth and love of a family unit,” she wrote in her autobiography. “Later, when I had my children, I keenly felt the wholesomeness of a complete family.”

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Since March 25, when the bird flu virus was confirmed in U.S. cattle for the first time, weekly sales of raw cow’s milk have ticked up 21% to as much as 65% compared with the same periods a year ago, according to the market research firm NielsenIQ.

That runs counter to advice from the Food and Drug Administration and the Centers for Disease Control and Prevention, which calls raw milk one of the “riskiest” foods people can consume.

Health & Wellness May 10

Farmers will now get paid to test their dairy cows for bird flu

Health & Wellness May 1

Cottage cheese and sour cream are safe amid bird flu outbreak, FDA says

Apr 24

Dairy cattle must be tested for bird flu before moving between states, agriculture officials say

“Raw milk can be contaminated with harmful germs that can make you very sick,” the CDC says on its website.

As of Monday, at least 42 herds in nine states are known to have cows infected with the virus known as type A H5N1, federal officials said.

The virus has been found in high levels in the raw milk of infected cows. Viral remnants have been found in samples of milk sold in grocery stores, but the FDA said those products are safe to consume because pasteurization has been confirmed to kill the virus.

It’s not yet known whether live virus can be transmitted to people who consume milk that hasn’t been heat-treated.

But CDC officials warned last week that people who drink raw milk could theoretically become infected if the bird flu virus comes in contact with receptors in the nose, mouth and throat or by inhaling virus into the lungs. There’s also concern that if more people are exposed to the virus, it could mutate to spread more easily in people.

States have widely varying regulations regarding raw milk, with some allowing retail sales in stores and others allowing sale only at farms. Some states allow so-called cowshares, where people pay for milk from designated animals, and some allow consumption only by farm owners, employees or “non-paying guests.”

The NielsenIQ figures include grocery stores and other retail outlets. They show that raw milk products account for a small fraction of overall dairy sales. About 4,100 units of raw cow’s milk and about 43,000 units of raw milk cheese were sold the week of May 5, for instance, according to NielsenIQ. That compares with about 66.5 million units of pasteurized cow’s milk and about 62 million units of pasteurized cheese.

Still, testimonies to raw milk are trending on social media sites. And Mark McAfee, owner of Raw Farm USA in Fresno, California, says he can’t keep his unpasteurized products in stock.

“People are seeking raw milk like crazy,” he said, noting that no bird flu has been detected in his herds or in California. “Anything that the FDA tells our customers to do, they do the opposite.”

The surge surprises Donald Schaffner, a Rutgers University food science professor who called the trend “absolutely stunning.”

“Food safety experts like me are just simply left shaking their heads,” he said.

From 1998 to 2018, the CDC documented more than 200 illness outbreaks traced to raw milk, which sickened more than 2,600 people and hospitalized more than 225.

Raw milk is far more likely than pasteurized milk to cause illnesses and hospitalizations linked to dangerous bacteria such as campylobacter, listeria, salmonella and E. coli, research shows.

Before milk standards were adopted in 1924, about 25% of foodborne illnesses in the U.S. were related to dairy consumption, said Alex O’Brien, safety and quality coordinator for the Center for Dairy Research. Now, dairy products account for about 1% of such illnesses, he said.

“I liken drinking raw milk to playing Russian roulette,” O’Brien said. The more times people consume it, the greater the chance they’ll get sick, he added.

Despite the risks, about 4.4% of U.S. adults — nearly 11 million people — report that they drink raw milk at least once each year, and about 1% say they consume it each week, according to a 2022 FDA study.

Bonni Gilley, 75, of Fresno, said she has raised generations of her family on raw milk and unpasteurized cream and butter because she believes “it’s so healthy” and lacks additives.

Reports of bird flu in dairy cattle have not made her think twice about drinking raw milk, Gilley said.

“If anything, it is accelerating my thoughts about raw milk,” she said, partly because she doesn’t trust government officials.

Such views are part of a larger problem of government mistrust and a rejection of expertise, said Matthew Motta, who studies health misinformation at Boston University.

“It not that people are stupid or ignorant or that they don’t know what the science is,” he said. “They’re motivated to reject it on the basis of partisanship, their political ideology, their religion, their cultural values.”

CDC and FDA officials didn’t respond to questions about the rising popularity of raw milk.

Motta suggested that the agencies should push back with social media posts extolling the health effects of pasteurized milk.

“Communicators need to make an effort to understand why people consume raw milk and try to meet them where they are,” he said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The following content is created in partnership with Kaiser Permanente. It does not reflect the work or opinions of the NBC Washington editorial staff. Click here to learn more about Kaiser Permanente.

According to the CDC, 1 in 6 adults have the expectation that they’ll become a caregiver within the next two years, a profoundly rewarding albeit challenging experience. And while most caregivers are familiar with the essential tasks of providing physical care and managing medication, there are lesser-considered resources that that can significantly impact the well-being of both the caregiver and the care recipient; primarily, mental health services and exercise. These underappreciated resources can play a vital role in preventing falls, injuries, and mental health challenges, ultimately improving quality-of-life and potentially saving lives.

The role of exercise in caregiving

Falls are a leading cause of injuries among seniors and are also a considerable risk for anyone with limited mobility. In fact, about 36 million falls are reported among older adults each year, resulting in more than 32,000 deaths. Caregivers often play a critical role in helping their loved ones avoid accidents, and exercise can serve a critical role in helping them help their loved ones. Regular exercise is a powerful yet underutilized tool in fall prevention; a study found that when older adults participated in group exercise, it significantly reduced their rate of falls by 82 percent and lowered their risk of falling by 96 percent. That’s because exercise programs tailored for those with limited mobility improve strength and balance, reducing the risk of falls. Caregivers can encourage their loved ones to participate in activities like Tai Chi or chair yoga, which are gentle yet effective. Caregivers themselves can also benefit from exercise, which helps them maintain mental wellness and physical health—a fit caregiver is better equipped to provide care and support without risking injury or exhaustion.

Yvette Morris, a strength and balance class instructor at Kaiser Permanente Gaithersburg Medical Center, notes the effectiveness of a quality, all-levels class: “I make sure that I have all kinds of modifications–so it doesn’t matter if you’re in a wheelchair or if you’re in a walker, I make sure that we can do the exercises. I’ve seen individuals come in that have been in a walker, and the next thing you know they’re walking with a cane.”

The role of mental health resources

Caregiving is a multifaceted journey that requires consideration of not only physical, but also emotional and psychological well-being. Mental health resources are critical for patients and caregivers, both of whom experience mental and physical demands that can lead to burnout, depression, and even suicidal ideation. For caregivers, mental health and well-being means avoiding exhaustion and burnout, enhancing patient outcomes by providing consistent high-quality care, and being better equipped to support and communicate with their patient or loved one about their needs. For patients who may be experiencing pain, isolation, health-related limitations, and more, accessing mental health support can substantially improve quality of life, and can even be lifesaving. Look for health care providers that offer resources like support groups, find local and online resources to connect with other caregivers or patients, and embrace therapy for psychological well-being. Integrated care systems, such as Kaiser Permanente’s, also alleviate much of the stress of traditional health care bureaucracy by consolidating multiple resources under one roof and even facilitating support groups and other therapies.

By embracing these sometimes overlooked but critical resources, caregivers can enhance the quality of care they provide, safeguard their own well-being, and potentially save lives. The importance of maintaining the spirit and resilience that caregiving demands cannot be overstated, nor the morale and resilience that patients need for a good quality of life.

For assistance with life care planning, access to telehealth services, and caregiver support, Kaiser Permanente is here every step of the way. Click here to learn more about Kaiser Permanente and how they can support you and loved ones throughout your caregiving journey.

The money is also intended to encourage testing of both dairy cows and the people who work closely with them — a key step, experts said, in understanding the true scope of bird flu, also known as H5N1, across the U.S.

“Incentives work very well to get a better understanding of epidemiology,” said Katelyn Jetelina, who tracks illnesses for a website called “Your Local Epidemiologist.”

Right now, there is no requirement for dairy cows to be tested unless they’re being moved across state lines, according to a recent federal order. Otherwise, the decision is left to farmers.

So far, only about 80 cows among the 26,000 dairy herds in the U.S. have been tested under the federal order, which went into effect at the end of April, Department of Agriculture Secretary Tom Vilsack said Friday in a media briefing. It was unclear how many of those 80 had tested positive.

As of Friday, 42 herds in nine states — Colorado, Idaho, Kansas, Michigan, New Mexico, North Carolina, South Dakota, Ohio and Texas — had been affected by the outbreak.

“Those 42 family farm operations are suffering, and we want to make sure we’re there to provide help and assistance,” Vilsack said.

The USDA will offer $98 million to affected farms over the next four months, which could equate to as much as $28,000 per farm, Vilsack said.

Jetelina called the program “a fantastic step” but “way overdue.” The outbreak among dairy cattle was first announced at the end of March.

“The incentive program is a huge leap forward,” especially for smaller farms, said Dr. Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory. It’s likely not enough, however, for larger farms that could lose upward of $3 million with a bird flu outbreak, he said.

“This is not going to get fixed tomorrow,” he said. But incentives “like this lay the groundwork for it to be better, and it also gives us precedent if and when we deal with the next large outbreak.”

The Department of Health and Human Services will put in an additional $101 million to ramp up monitoring of people who have been exposed to sick animals, contact tracing and genetic testing of the virus to watch for mutations.

Part of those funds will also go toward wastewater surveillance of the virus. The Centers for Disease Control and Prevention is expected to start posting that data publicly as early as Monday, a CDC spokesperson told NBC News.

A separate monitoring system called WastewaterSCAN, which tracks 191 sites in 41 states, is showing high levels of influenza A in the Midwest and Northeast. That’s unusual for mid-May, well past the typical flu season. The bird flu is a type of influenza A virus.

Those findings prompted the WastewaterSCAN researchers to look more closely at wastewater sites in Texas, where it’s believed the bird flu outbreak began.

Further testing indicated that, at the sites in Texas, “what we were seeing was most likely attributable to an H5 influenza virus,” said Marlene Wolfe, an assistant professor of environmental health at Emory University and program director for WastewaterSCAN.

While wastewater testing can detect influenza A, it can’t distinguish whether the virus came from a human or an animal, according to the CDC.

The findings, coupled with recent announcements that fragments of the bird flu virus had been detected in 1 in 5 samples of pasteurized milk, indicate that bird flu may be spreading undetected. Further testing confirmed that the milk, along with other pasteurized dairy products including sour cream and cottage cheese, were safe to eat or drink.

Just one person, a dairy worker in Texas, has tested positive for the virus during the current outbreak. His illness was mild, and his only symptom was pinkeye.

But experts have suggested that other cases could be going undetected. Friday’s incentives announcement included a $75 payment to any farm worker who agrees to give blood and nasal swab samples to the CDC.

Meanwhile, experts said the risk of bird flu spreading among the general public remains low.

“Stay aware, but only let it take up a small part of your brain,” Jetelina said. “There is a good probability that this will fizzle away.”

This story first appeared on NBCNews.com. Read more from NBC News here:

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After being diagnosed with stage 4 cancer, the high school football coach and counselor started chemotherapy in 2023, but he had to stop abruptly when the drug he received, cisplatin, became harder to find as part of a nationwide shortage of chemotherapy drugs.

“I just keep wondering, ‘What if we had gotten the cisplatin? Could it have slowed his cancer down? she tells TODAY.com. “Would he have been able to coach even more? Would he have been stronger? Would he have felt better? … It’s always a second guess.” 

In 2022, Jeff Bolle, of Milwaukee, learned he had bile duct cancer, which has a dismal long-term survival rate. At the time, doctors hoped that surgery and chemotherapy could prolong his life. He was in good health prior to his diagnosis, which made everyone feel optimistic.

He underwent surgery and four rounds of chemotherapy before the chemotherapy shortage stopped his treatment in May 2023 — two rounds short.

As the months passed and his cancer progressed unchecked, Jeff Bolle became sicker. In late September 2023, doctors realized “there was really nothing else they could do, which was hard to hear,” Connie Bolle recalls. There was no immunotherapy. There was no other chemotherapy.”

Jeff Bolle died on Dec. 29, 2023, seven months after losing access to his chemo drugs.

Last summer, Jeff Bolle shared his story with TODAY.com to raise awareness of the chemotherapy shortage. He also shared his desire to coach at least one more football season. He achieved that — and it was even sweeter than he could have imagined.

“The Marquette University High School ended up winning the division one state championship football title, and they were not predicted to be the one (to win),” Connie Bolle says. “Jeff made it to every single one of the games.”

Stage 4 cancer diagnosis

When Jeff Bolle felt the twinge of back pain in October 2022, he thought he pulled a muscle while exercising. But later that year, he was diagnosed with stage 4 bile duct cancer.

He underwent surgery, where doctors removed most of the tumor, and then started immunotherapy and chemotherapy, even though he knew he would likely never be cured.

“My doctor said it was the type of cancerous growth you’ll never really get into remission,” Jeff Bolle told TODAY in 2023. “Their thoughts were that they could get most of the tumor out and they could use chemo … to hold it off.”

The Bolles understood this. Still, it felt devastating when Jeff Bolle stopped treatment because of the chemotherapy shortage.

“He was never able to get on cisplatin (again),” Connie Bolle says. “His cancer was just continuing to grow, and his bile ducts were getting compromised because the cancer was pushing on them even more. He was really getting so very sick. It was horrible.”

Although he felt too weak to work as a counselor, Jeff Bolle continued coaching football. Prior to becoming sick, he’d ride to practice on his motorcycle, wearing sleeveless shirts to show off his biceps. He often hit the weight room with the players and challenge them to bench presses. Even when sick, Jeff Bolle continued to show up for his players at least several times a week and at games.

Eventually, he needed a wheelchair to attend the games and sat on the sidelines, but he coached the defensive backs for as long as he could. No matter what, he always rated the game film after. In fact, Connie Bolls recalls that during one stay in the intensive care unit, he brought his laptop to grade a football game.

Connie Bolle says she believes he lived to finish this season.  

“He knew how important it was for these high school kids,” she says. “Some of the seniors had journeyed with Jeff for four years.”  

The team kept winning, ending up at the state championship in November.

“I don’t know how Jeff did it because he could barely stand honestly. At that point, he was probably down to about 140 pounds,” Connie Bolle says. “The cold was just intense, and he went up and down the sideline with his walker.”  

Chemotherapy shortage

Last year, cancer patients, like Jeff Bolle, and oncologists faced some grim news: Many chemotherapy drugs and agents used in oncological imaging had become increasingly difficult to find.

The most impactful shortages were of chemotherapeutic agents carboplatin and cisplatin, often used in cancers that can’t be cured, Dr. William Dahut, chief scientific officer of the American Cancer Society, told TODAY.com in 2023.

But shortages of cancer therapeutics are not new.

“What we’re experiencing right now is really the latest of multiple waves of shortages that have really gone back a decade,” Mark Fleury, Ph.D., who works in policy development and emerging science at the American Cancer Society Cancer Action Network, tells TODAY.com.

“We have many drugs that have never really left shortage and some that cycle in and cycle back out (of shortages).”

Last summer, NBC News reported that 14 drugs used in cancer treatment were hard to come by. In April 2024, the U.S. Food and Drug Administration website indicates that 15 oncology agents are currently in shortage.

Asked about the status of the chemo shortage, FDA spokesperson Chanapa Tantibanchachai shared an email statement with TODAY.com that says:

“The FDA recognizes the potential impact that lack of availability of certain products may have on health care providers and patients. While the agency does not manufacture drugs, and cannot require a pharmaceutical company to make a drug, make more of a drug, or mandate who a pharmaceutical company chooses to sell its product to (among lawful purchasers), the public should rest assured the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or reduced availability of certain products.”

FDA Commissioner Dr. Robert Califf told NBC News in May 2023 that the main reason for the chemo shortage is there’s not enough profit in producing these drugs, many of which are generic and do not have a patent. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology,” Califf said.

While carboplatin and cisplatin are “still listed in shortage,” Fleury says last year the FDA allowed imports of cisplatin that helped assuage that shortfall, and the drugs are now being produced more widely in the U.S.

“We’re not seeing the type of shortage that we did,” Fleury says. “We qualify it as in shortage, but … patients are getting their drugs.”

How chemo drug shortages affect cancer patients

Cancer patients felt the shortages. A survey by the American Cancer Society Cancer Action Network published in December found that 10% of all cancer patients were impacted, but the “shortages were not felt equally,” Fleury says.

For example, people on Medicaid experienced a tougher time, with 22% reporting a cancer drug shortfall affected their treatment. Some reported struggling to find pain medications or other therapies not directly used to treat their cancer but still important, he notes.

“Folks just had no idea whether they were going to get their next treatment or not, whether the dose was going to be cut in half,” Fleury says. “These are drugs … have really formed the backbone (of cancer care) and in some case have pretty high efficacy. And if they’re not available, you’re entering uncharted territory.”

While patients grappled with a high “mental toll,” they also faced “logistical tolls,” too, with some patients driving around to find treatment, he says.

“There are patients today who need help,” Fleury adds. “We need to figure out how to better manage the crisis that we’re in, but we also need to address some of the underlying causes, which keep us in this constant state of crisis.”

Lawmakers have taken some steps to address this issue. While many bills often provide short-term solutions, the Senate Finance Committee has been “doing a deeper dive” to address constant shortages, Fleury explains.

“The government has an important role to solve this,” Fleury says. “(But) that’s not to say that the private sector can’t.”

A lasting impact

By Dec. 14, 2023, Jeff Bolle was in hospice at home. Connie Bolle knew he was nearing the end on Dec. 28, when he agreed to stay in a hospital bed on the first floor because he was too weak to get to their bedroom on the second floor. He died the next day.

“He only spent one night in it,” she says. “That was the sign of defeat.”

At his funeral, his players shared what Jeff Bolle meant to them.

“They said such amazing things about the strength and determination and perseverance (they learned) from Jeff and kindness and love and compassion,” she says.

Connie Bolle believes that her husband would be humbled hearing about the impact he had on his students. She also believes he would be proud that his story raised awareness of the shortage of cancer therapeutics.

“He really cared about other people not getting these chemotherapy drugs,” she says. “He would still be sad today that people are still dealing with this.”

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The proposal had come after wide-ranging studies found an association between some of the ingredients in hair-smoothing and hair-straightening products, which are used mostly by Black women, and cancer. 

It is unclear why the FDA has not released its proposed ban. The agency did not respond to requests for comment by NBC News. 

The FDA has previously told NBC News, “the Unified Agenda estimates the action date for the NPRM as April 2024. We are still developing the proposed rule and cannot comment further about questions of timing or content at this time.”

In 2022, a decadeslong study by the National Institutes of Health of more than 33,000 Black women showed an increase in uterine cancer among those who regularly used hair relaxers. 

Several women who had uterine cancer or other severe illnesses joined class-action lawsuits against major beauty product manufacturers, including L’Oreal and Revlon. Thousands of women allege that the hair products’ ingredients caused them to develop uterine cancer or other severe health problems. 

Revlon did not comment on this article. Previously, Revlon told Reuters that the company does not “believe the science supports a link between chemical hair straighteners or relaxers and cancer.”

A L’Oreal spokesperson told NBC News on Wednesday it doesn’t have formaldehyde in its products and that it would welcome the FDA ban.

“Our highest priority is the health and wellbeing of all our consumers,” the company said in a statement. “Our products are subject to a rigorous scientific evaluation of their safety by experts who also ensure that we strictly follow all regulations in every market in which we operate.”

Formaldehyde is used in many household products, including some topical medicines and cosmetics such as some nail polishes, hair gels, baby shampoos and others. Not all chemical hair-straighteners include it, but many do include components that, once heated, can release formaldehyde. It is highly toxic and linked to certain cancers, according to the National Cancer Institute.

“About 50% of products advertised to Black women contain these types of chemicals, compared to maybe only 7% that are advertised to white women,” Harvard T.H. Chan School of Public Health’s Tamarra James-Todd said in a radio interview in 2020. 

According to the FDA’s comments on the proposal, the use of products containing formaldehyde and other formaldehyde-releasing chemicals “is linked to short-term adverse health effects, such as sensitization reactions and breathing problems, and long-term adverse health effects, including an increased risk of certain cancers.”

Last year, Democratic Reps. Ayanna Pressley of Massachusetts and Shontel Brown of Ohio sent a joint letter to the FDA commissioner urging more regulation over hair relaxers marketed toward Black women. 

“As a result of anti-Black hair sentiment, Black women have been unfairly subjected to scrutiny and forced to navigate the extreme politicization of hair,” Brown and Pressley wrote. “Hence, generations of Black women have adapted by straightening hair in an attempt to achieve social and economic advancement.”

In an exclusive statement to NBC News, Pressley urged the FDA to finalize the ban. 

“The FDA’s proposal to ban harmful chemicals in hair relaxers is a win for public health — especially for the Black women whose health has been disproportionately put at risk due to systemic racism and anti-Black hair sentiment,” she said. “We have been pressing for this and the Administration should finalize this rule without delay.”

Melanie Benesh, the vice president of government affairs for the Environmental Working Group, a consumer product advocacy group, described the field of cosmetics as the “Wild, Wild West of regulation” since the FDA has historically had more limited authority over them, “compared to other items under their jurisdiction, like food and drugs,” Benesh said.

Her organization petitioned the FDA in 2011 and in 2021 to ban hair products with formaldehyde. Because the FDA has been long aware of the issue, she added, “this is one thing that they have clear authority to do. They can ban ingredients that are clearly adulterating products, that are clearly making that product unsafe for use.”

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The agency has been conducting tests on 297 pasteurized retail dairy products after findings last week showed that fragments of the virus had gotten into the commercial milk supply.

The tests showed that the products didn’t contain live virus that could make people sick, the FDA said Wednesday.

The new results, though still preliminary, “affirm the safety of the U.S. commercial milk supply,” Don Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition, said during the briefing. The samples come from 38 states.

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The USDA will test ground beef for bird flu. Here's what to know

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What to know about the latest bird flu outbreak in the US

In addition, the FDA has tested powdered infant and toddler formulas and found no evidence of bird flu virus. It was unclear how many formula samples were tested.

Prater said the latest findings confirm that the pasteurization process inactivates the virus, making it unable to infect people. The FDA is also testing raw milk for live virus, though it strongly advises against drinking raw, unpasteurized milk.

Bird flu has now been detected in 36 dairy herds in nine states: Colorado, Idaho, Kansas, Michigan, New Mexico, North Carolina, South Dakota, Ohio and Texas.

Those cases appear to have all originated among herds in Texas, then spread as cattle were moved across state lines to other farms.

In affected herds, about 10% of the cows show symptoms, Dr. Rosemary Sifford, chief veterinary officer at the U.S. Department of Agriculture, said during the call. Most recover on their own within about two weeks, she said.

Sifford said that it appears the virus spreads between cows through affected raw milk, which contains high levels of the virus.

There is no evidence yet that this strain of the bird flu, called H5N1, spreads easily from person to person. But the concern is that the longer the virus spends in mammals, it could mutate into a form that does.

For now, Sifford said, that doesn’t seem to be happening.

“We are not seeing any changes in the virus that would indicate it is in a position to be more easily spread between people,” Sifford said.

The risk to the general public remains low, said Dr. Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases.

One person, a dairy worker in Texas, has been diagnosed with the virus since the outbreak was detected in dairy cows. The person’s case was mild and the only symptom was conjunctivitis, or pink eye.

The Centers for Disease Control and Prevention said Wednesday that more than 100 people have been asked to monitor themselves for symptoms for 10 days after coming into contact with an infected animal.

Around 25 have been tested for the virus, Daskalakis said.

He said there is no indication of “unusual flu activity in people, and that includes avian influenza.”

But there have been reports that other cases may have gone undetected.

Multiple dairy workers in Texas were sick with fevers, body aches, upset stomach and eye infections at the same time the bird flu was working its way through cows in Amarillo, Dr. Barb Petersen, the veterinarian who discovered what was making the animals sick, previously told NBC News.

No hospitalizations or deaths have been reported.

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Bird flu has been found in nearly three-dozen dairy herds across nine states. The new testing is the latest effort by the USDA to track and understand how the virus is spreading among livestock.

Two studies will test if particles of the bird flu virus, called Type A H5N1, is found in beef for sale in the states where dairy cows have tested positive or in the muscles of dairy cows sent to slaughter. A third will test how cooking meat at different temperatures affects the virus using a bird flu surrogate.

A week ago, the U.S. Food and Drug Administration confirmed it found non-infectious remnants of the bird flu virus in pasteurized milk. The particles are inactive and pose no threat to consumers, experts said.

Health & Wellness Apr 25

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Scientists say there’s no evidence to suggest people can get bird flu by consuming food that’s been pasteurized or properly cooked.

The virus was first found in dairy cows this spring, and since then, H5N1 was detected in the lung tissue of a dairy cow culled and sent to slaughter.

So far, officials with the U.S. Centers for Disease Control and Prevention have not seen signs that the virus is changing to be more transmissible to people. Two farmworkers have been infected with bird flu since the outbreak began.

AP Health Writer JoNel Aleccia contributed to this report.

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Previously, the task force had said women could choose to start breast cancer screening as young as 40, with a stronger recommendation that they get the exams every two years from age 50 through 74.

The announcement Tuesday from the U.S. Preventive Services Task Force makes official a draft recommendation announced last year. The recommendations were published in the Journal of the American Medical Association.

“It’s a win that they are now recognizing the benefits of screening women in their 40s,” said Dr. Therese Bevers of MD Anderson Cancer Center in Houston. She was not involved in the guidance.

Other medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — instead of every other year — starting at age 40 or 45, which may cause confusion, Bevers said, but “now the starting age will align with what many other organizations are saying.”

Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second-most common cause of cancer death for U.S. women. About 240,000 cases are diagnosed annually and nearly 43,000 women die from breast cancer.

The nudge toward earlier screening is meant to address two vexing issues: the increasing incidence of breast cancer among women in their 40s — it’s risen 2% annually since 2015 — and the higher breast cancer death rate among Black women compared to white women, said task force vice chair Dr. John Wong of Tufts Medical Center in Boston.

“Sadly, we know all too well that Black women are 40% more likely to die from breast cancer than white women,” Wong said. Modeling studies predict that earlier screening may help all women, and have “even more benefit for women who are Black,” he said.

Here are more details on what’s changed, why it’s important and who should pay attention.

When should I get my first mammogram?

Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk. They should have the X-ray exam every other year, according to the new guidance. Other groups recommend annual mammograms, starting at 40 or 45.

The advice does not apply to women who’ve had breast cancer or those at very high risk of breast cancer because of genetic markers. It also does not apply to women who had high-dose radiation therapy to the chest when they were young, or to women who’ve had a lesion on previous biopsies.

What about women 75 and older?

It’s not clear whether older women should continue getting regular mammograms. Studies rarely include women 75 and older, so the task force is calling for more research.

Bevers suggests that older women talk with their doctors about the benefits of screening, as well as harms like false alarms and unnecessary biopsies.

What about women with dense breasts?

Mammograms don’t work as well for women with dense breasts, but they should still get the exams.

The task force would like to see more evidence about additional tests such as ultrasounds or MRIs for women with dense breasts. It’s not yet clear whether those types of tests would help detect cancer at an earlier, more treatable stage, Wong said.

Does this affect insurance coverage?

Congress already passed legislation requiring insurers to pay for mammograms for women 40 and older without copays or deductibles. In addition, the Affordable Care Act requires insurers to cover task force recommendations with an “A” or “B” letter grade. The mammography recommendation has a “B” grade, meaning it has moderate net benefit.

So far, the risk to humans remains low, officials said, but scientists are wary that the virus could change to spread more easily among people.

The virus, known as Type A H5N1, has been detected in nearly three dozen dairy herds in eight states. Inactive viral remnants have been found in grocery store milk. Tests also show the virus is spreading between cows, including those that don’t show symptoms, and between cows and birds, according to the U.S. Department of Agriculture.

Starting Monday, hundreds of thousands of lactating dairy cows in the U.S. will have to be tested — with negative results — before they can be moved between states, under terms of a new federal order.

Here’s what you need to know about the ongoing bird flu investigation:

Why is this outbreak so unusual?

This strain of what’s known as highly pathogenic avian influenza has been circulating in wild birds for decades. In recent years, it has been detected in scores of mammals around the world. Most have been wild animals, such as foxes and bears, that ate sick or dying birds. But it’s also appeared in farmed minks. It’s shown up in aquatic mammals, such as harbor seals and porpoises, too. The virus was even found in a polar bear in northern Alaska.

The virus was discovered in ruminants — goats and then dairy cows — in the U.S. this spring, surprising many scientists who have studied it for years.

“When we think of influenza A, cows are not typically in that conversation,” said Richard Webby, an influenza expert at St. Jude Children’s Research Hospital.

How long has bird flu been spreading in cows?

Flu viruses are notorious for adapting to spread among new species, so detection in dairy cows raises concerns it could spread to people, Webby said.

Scientists confirmed the virus in cows in March after weeks of reports from dairy farms that the animals were falling ill. Symptoms included lethargy, sharply reduced milk supply and changes to the milk, which became thick and yellow.

Finding remnants of the virus in milk on the market “suggests that this has been going on longer, and is more widespread, than we have previously recognized,” said Matthew Aliota, a veterinary medicine researcher at the University of Minnesota.

Apr 24

Dairy cattle must be tested for bird flu before moving between states, agriculture officials say

Apr 12

As bird flu spreads in the US, is it safe to eat eggs? What to know about the risk to humans

Under pressure from scientists, USDA officials released new genetic data about the outbreak this week.

The data omitted some information about when and where samples were collected, but showed that the virus likely was spread by birds to cattle late last year, said Michael Worobey, an evolutionary biologist with the University of Arizona.

Since then, it has spread among cattle and among farms, likely through contact with physical objects such as workers' shoes, trucks or milking machines, Worobey said.

And then the cows spread the virus back to birds, he said.

“The genetic evidence is as clear as could be,” Worobey said. "Birds that are sampled on these farms have viruses with clear mammalian adaptations."

What do scientists say about efforts to track the outbreak?

Several experts said the USDA's plans to require testing in cows are a good start.

“We need to be able to do greater surveillance so that we know what's going on,” said Thomas Friedrich, a virology professor at the University of Wisconsin's veterinary school.

Worobey said the ideal would be to screen every herd. Besides looking for active infections, agriculture officials also should be looking at whether cows have antibodies to the virus, indicating past infections, he said.

"That is a really accessible and quick way to find out how widespread this is,” he said.

More testing of workers exposed to infected animals is also crucial, experts said. Some farm owners and some individual workers have been reluctant to work with public health officials during the outbreak, experts have said.

“Increased surveillance is essentially an early warning system,” Aliota said. “It helps to characterize the scope of the problem, but also to head off potentially adverse consequences."

How big a risk does bird flu pose for people?

Scientists are working to analyze more samples of retail milk to confirm that pasteurization, or heat-treating, kills the H5N1 virus, said Dr. Don Prater, acting director of the FDA's food safety center. Those results are expected soon.

While the general public doesn't need to worry about drinking pasteurized milk, experts said they should avoid raw or unpasteurized milk.

Also, dairy farm workers should consider extra precautions, such as masking, hand washing and changing work clothes, Aliota said.

So far, 23 people have been tested for the virus during the outbreak in dairy cows, with one person testing positive for a mild eye infection, CDC officials said. At least 44 people who were exposed to infected animals in the current outbreak are being monitored for symptoms.

What are scientists' concerns for the future?

David O’Connor, a virology expert at the University of Wisconsin-Madison, likened recent bird flu developments to a tornado watch versus a warning.

“There are some of the ingredients that would be necessary for there to be a threat, but we’re not there,” he said. As with a tornado watch, "you wouldn’t change anything about how you live your daily life, but you would maybe just have a bit of increased awareness that something is happening.”

Worobey said this is the kind of outbreak “that we were hoping, after COVID, would not go unnoticed. But it has."

He said ambitious screening is needed "to detect things like this very quickly, and potentially nip them in the bud.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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A London-based dentist has sparked an online debate after advising against three situations that many regard as good times to brush your teeth.

The video, posted by Dr. Shaadi Manouchehri, clinical director at Smart Dental and Aesthetics Clinic in the U.K., has garnered more than 12 million views on TikTok, leaving many incredulous that they were brushing wrong all this time.

She recommends not brushing your teeth directly after vomiting and eating breakfast or sweets.

“I’ve ALWAYS brushed after vomiting,” one shocked TikTok user exclaimed.

“So then why have we ALWAYS been taught to brush out teeth after meals?” one quipped.

“Ah, yes, the three times I want to brush my teeth more than any other time,” another lamented.

So, do other dentists agree with Manouchehri’s assessment? TODAY.com spoke with a few experts to find out.

Acid and brushing your teeth

The argument against not brushing your teeth in certain scenarios is “all about the acid,” Dr. Tien Jiang, assistant professor of oral health policy and epidemiology at Harvard School of Dental Medicine, tells TODAY.com via email.

Many people think cavities come from sugar, but it’s not the direct cause, she says. It’s acid, which can remove the minerals, a process called demineralization, from the tooth’s outer layer, also known as enamel.

“Acid can come from many places — vomit … carbonated drinks, sucking on lemons, etc.,” Jiang explains.

The bacteria that break down the food you eat also release acid. As a result, “it’s natural for the pH of our mouths to drop when we eat, while the bacteria get to work to break down our food.”

Brushing while there’s too much acid in the mouth can damage your teeth.

“People should never brush when your mouth has a very low pH because you don’t want to then scrub that acid into your teeth,” Dr. Beth Caunitz, a dentist in New York City, New York, tells TODAY.com.

Should you brush directly after vomiting?

Many of the experts TODAY.com interviewed recommend waiting to brush your teeth after vomiting.

“Vomit contains stomach acids, which can soften and dissolve the outer layer of your teeth,” says Dr. Diana Nguyen, chief of clinical general dentistry at UCSF School of Dentistry.

“If you brush after vomiting, you’d actually be spreading the acid around to more of your enamel and risk stripping layers of enamel off your teeth with your toothbrush, which can cause the teeth to appear more yellow over time.”

One easy hack that she recommends is a simple homemade rinse.

Add a teaspoon of baking soda to a cup of water, swish it around in the mouth and then spit it out, she says. “This can help buffer the acids and protect your teeth.”

Rinsing after vomiting also reduces how long your teeth will be exposed to acid. A fluoride mouthwash in particular can help re-mineralize the enamel, and then you can brush your teeth sooner, adds Dr. Carlos González-Cabezas, professor and associate dean for academic affairs at the University of Michigan School of Dentistry.

Should you brush after you eat breakfast?

“When we eat, the mouth becomes acidic, as the bacteria in our mouth also feed on the food we eat and metabolize this to an acid, therefore dropping the pH of the mouth,” Manouchehri tells TODAY.com.

“If we brush straight away, we are rubbing this acid onto the teeth, which … can be damaged,” she says.

Our saliva naturally buffers this acidic state over approximately 30 to 60 minutes, so she recommends waiting at least that long to brush.

Jiang agrees: “Waiting 30 (minutes) after eating anything (not just breakfast or sweets) to brush is a normal instruction.”

“In these conditions, tooth enamel is softened, so you could actually damage your teeth by brushing them right after eating,” she explains. “In the meantime, you can drink water and rinse with mouthwash to help clear food particles away from your teeth and gums.”

However, Gonzalez-Cabezas says the impact on the enamel of brushing right after eating is likely minimal. The most important thing is that you brush your teeth at some point every morning.

Should you brush immediately after eating sweets?

Some experts recommend waiting at least an hour after eating sweets to brush your teeth to give your mouth time to wash away the acid, according Mayo Clinic.

Anything with sugar can increase the amount of acid in your mouth, but examples include soft drinks, sports drinks, sour candies, and citrus juices and fruits.

People should also avoid brushing right after having carbonated beverages, as they’re acidic, Caunitz warns.

Instead of brushing your teeth after eating sweets, Caunitz recommends drinking a glass of water because the water will rinse off all the unwanted acid.

However, Gonzalez-Cabezas says that brushing your teeth after eating sweets helps remove potentially harmful sugars that can damage the enamel sooner. Thanks to the toothpaste, brushing right after will also provide fluoride to your teeth, which promotes remineralization.

For those who enjoy sweets or snacking on sugary foods, Nguyen recommends the following:

• Drinking plenty of water
• Using a toothpaste that contains a remineralizing agent like fluoride
• Visiting your dentist regularly to monitor for tooth decay and other dental conditions

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