Category: Health

The data are stark: the typical American diet is shortening the lives of many Americans. Diet-related deaths outrank deaths from smoking, and about half of U.S. deaths from heart disease – nearly 900 deaths a day – are linked to poor diet. The pandemic highlighted the problem, with much worse outcomes for people with obesity and other diet-related diseases.

“We’re really in a nutrition crisis in this country.” says Dariush Mozaffarian, a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University

Now, there’s growing momentum to tackle this problem. The Biden administration will hold the White House Conference on Hunger, Nutrition, and Health on September 28th, and will announce a new national strategy. This comes more than 50 years after a landmark White House conference which helped launch today’s major federal food assistance programs.

“The 1969 conference was transformative,” Mozaffarian says. The programs it ushered in, like the WIC program, have helped feed millions of low-income families.

But this hasn’t been enough to solve the dual problems of food insecurity and diet-related disease. Food policy leaders say it’s time to think anew and build on what we’ve learned. The U.S. can’t “fix” hunger by just feeding people cheap, high-calorie, processed foods – the food that’s so abundant in our food supply, they say. Instead, it’s got to find ways to nourish people with healthy, nutrient-dense foods.

“There’s a lot of enthusiasm and thinking about food more broadly and how we can fix this crisis,” Mozaffarian told NPR. He’s co-chair of an independent task force that includes doctors, chefs, food policy and business experts, as well as farming and health advocates, who are helping form the agenda at upcoming the White House conference.

In a new report, they’ve proposed a wide-ranging set of recommendations to end hunger, advance nutrition and improve health. Here are seven big ideas they’re excited about.

1. Treat food as medicine

There’s a growing movement to integrate food and nutrition into health care, by providing healthy meals and groceries to patients to help prevent or manage diet-related illness.The task force wants to see this kind of work expand.

“We should pay for food-based interventions that are effective,” Mozaffarian says.

For example, there’s mounting evidence that providing prescriptions for fruit and vegetables can spur people to eat better and manage weight and blood sugar. The idea is for health care systems or insurers to provide or pay for healthy groceries, combined with nutrition education, to help patients change their eating habits. It is being piloted around the country.

“Produce prescription programs help improve diet quality and food security,” says task force member Dr. Hilary Seligman, a food insecurity expert and professor of medicine at University of California, San Francisco, noting that they can help with diet-related diseases like high blood pressure and diabetes.

Another idea is to offer medically tailored meals aimed at helping people who are already sick reverse chronic disease. Currently the federal government is running pilot programs that let Medicaid or Medicare pay for the meals in several states.

2. Focus on quality of calories, not just quantity

The U.S. food supply is awash in cheap calories. And when you’re on a tight budget or relying on benefits like SNAP (food stamps), processed foods like chips and soda can set you back less than fresh produce. Of course, eating processed foods also contributes to cardiovascular disease, stroke, diabetes and other chronic illnesses, warns Nancy Brown, CEO of the American Heart Association.

Brown says federal food assistance programs have helped to address hunger. “However, many U.S. food policies and programs focus on improving access to sufficient quantities of food,” she says. Instead, it’s time to modernize these policies and focus on the quality of food, “so people have access to enough nutritious food.”

The task force wants to see food programs redesigned to nudge people towards healthier options. The report points to the GusNIP nutrition incentive program – which, in select communities – gives SNAP participants more money to buy fruit and vegetables. It’s a similar concept to the Double Bucks program which doubles the value of SNAP benefits when used to buy produce at farmers markets and other venues.

“It is important to scale up these efforts to ensure that everyone has access to healthy food options,” says task force member Angela Odoms-Young, a nutrition professor at Cornell University.

The task force recommends that Congress establish a nationwide produce incentive program for all SNAP participants. “These types of programs can help promote equity,” Odoms-Young says, noting that people of color disproportionately suffer from chronic illnesses.

3. Expand access to dietary and lifestyle counseling

The Affordable Care Act mandates that diet counseling be covered by insurers as a preventive care benefit for those at higher risk of chronic disease. The exact details of who is eligible for which services are left up to an advisory group of doctors and health care providers, as well as insurers, and many patients who would benefit may not have access to this service.

“The vast majority of Americans should be getting preventative behavioral lifestyle treatment,” Mozaffarian says. Too often, he says, doctors prescribe drugs for conditions before recommending or trying lifestyle changes. “Doctors go right to the drug,” he says. “I think that’s a big problem.”

The task force recommends that Congress expand Medicare and Medicaid coverage for medical nutrition therapy to people with high blood pressure, prediabetes, celiac disease, HIV/AIDS, cancer and other diet-related conditions. It also calls for expanded coverage of cooking classes and nutrition assistance, as well as coverage of the Diabetes Prevention Program, delivered by telehealth. This behavior-change program has been shown to be more effective than medicine in reducing the onset of Type 2 diabetes among people at high risk.

4. Support food entrepreneurs

People who start food businesses can help nourish their communities and create jobs. The task force calls on the federal government to pass policies that boost new healthy food enterprises, including providing new loans and grants to food and nutrition-related companies centered on health, equity, and sustainability. The idea is to focus especially on businesses owned by people of color and other marginalized groups.

“We don’t need more businesses creating diabetes and obesity,” says Tambra Raye Stevenson, who runs Wanda, a non-profit group that aims to build a pipeline and platform for a million Black women and girls to become local food leaders. “We need entrepreneurs that provide teaching kitchens, community gardens, healthy food retails, wellness studios, nutrition services, healthy consumer products, and urban agricultural centers,” she says.

She points to food entrepreneurs like Amanda Stephenson who opened a specialty food market in an underserved neighborhood in Washington, DC, Fresh Food Factory, and Mary Blackford of Market 7 who is planning a food hall that features Black-owned food and lifestyle businesses. “They are our food she-roes making a positive impact and providing healthy food access for our children and other women,” says Stevenson.

In the lead up to next month’s White House conference, groups like Food Tank, a food think tank, have organized listening sessions with food researchers and entrepreneurs. “For food to be more accessible and affordable, we need entrepreneurs that use science and technology,” says Danielle Nierenberg of Food Tank. She points to innovators like Journey Foods which is helping entrepreneurs bring nutritious foods and snacks to market.

5. Increase the number of new farmers growing healthy foods using regenerative farming techniques

If all Americans began to eat the recommended amounts of fruits and vegetables each day, there would be shortages. That’s because corn and soybeans are grown on most cropland in the U.S.. Now, there’s growing recognition of the need for more specialty crops – including fruits, vegetables, and nuts.

The task force recommends that Congress create a Farmer Corps to support new farmers, building on the Beginning Farmers and Ranchers Development Program. The idea is to provide new farmers with paid internships and apprenticeships to learn about sustainable farming, and funding to cover a living wage and housing. It also is pushing for loans to go to farmers growing with sustainable practices.

Growing the same crop, season after season, as many farmers do, can make lands less productive over time, and deplete nutrients from the soil.”The unfortunate reality is that today we subsidize conventional practices that degrade the soil,”says David Montgomery, a professor at the University of Washington and the author of What Your Food Atewho attended a listening session.

“What we need to sustain agriculture is to incentivize restoring healthy soils and train more farmers to be successful doing that,” he says.

6. Make school meals free for all students

School meals have been a fixture in U.S. schools ever since President Harry Truman signed the National School Lunch Act back in 1946. For decades, the federal government has reimbursed schools for meals they serve, and low-income students can qualify for free or reduced priced meals. Research has shown that low-income children who participate have better health.

Yet, many families who are eligible for free or reduced-priced meals may not receive them, sometimes due to the paperwork, bureaucracy or stigma of participating or enrolling. Amid the pandemic, school meals have been offered for free to all students. Now, the task force says this should be a permanent change.

“Without access to free meals at school, many children go without food at all during the day, and many more do not have access to the nutritious foods they need to thrive,’ says Seligman, of UC, San Francisco. She notes that school meals help not only with kids’ nutrition, but they also reduce absenteeism and improve academic outcomes.

7. Establish a federal ‘food czar’

In order to turn ideas like these into action, the task force recommends the creation of a new role in the federal government, a national director of food and nutrition, a food czar figure, if you will. The new director would help streamline and coordinate the many disparate efforts already underway. The U.S. government spends more than $150 billion each year on food and nutrition related programs, and the health care system also spends billions on treatment of diet related diseases.

“This spending is fragmented across 200 separate actions and 21 different departments and agencies without harmonization or synergy,” the task force concludes. Now, they conclude, it’s time for a new approach.

Like other virtual health technologies, remote patient monitoring grew in the midst of the COVID-19 pandemic. 

One study published in JAMA Internal Medicine earlier this month found a steep incline in its use among traditional Medicare beneficiaries, increasing from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021.

Waqaas Al-Siddiq, CEO of remote patient monitoring firm Biotricity, said consumers are much more aware of the technology since the pandemic and now want to understand how that data is being used to guide their care.

“A couple of years ago, they were looking at devices for personal use and collecting data. Now they’re looking at devices and technologies that are accurate and integrate within their care programs,” he said during a panel discussion at the Connected Health Summit. “How does that information translate? How does that information get to their doctor? How does that doctor use that? A couple of years ago, that last piece was never really at the forefront of the consumers’ minds.”

There are plenty of examples of the “digital front door,” where patients initiate their own care or connect with the health system online, including something as simple as researching symptoms on Google, said Amar Kendale, president of rural-focused hybrid care provider Homeward. 

But some patient populations aren’t as tech savvy or may have other priorities. For instance, he said some older adults value relationships with a provider they already trust. 

“I think that this idea of a digital front door has gotten a little bit overloaded,” he said. “And the premise that a person can self-navigate themselves to the right place to get care, it does place a lot of burden on the consumer.”

Brock Winzeler, president of Freeus, Becklar workforce safety and Becklar connected wellness at health and security tech firm Becklar, said they had a difficult time getting devices into seniors’ homes and encouraging their use during the height of the pandemic. 

So the company decided to focus on engagement and communicating with subscribers as part of their remote patient monitoring program. 

“One of the things that we noticed is beyond just using the peripherals — providing weight, blood pressure, pulse oximetry, all those things — how are they feeling? How did they sleep last night? Did they eat today? These types of questions would help us to assess their overall wellbeing,” he said. 

Meanwhile, there also has to be a balance between using devices people already own, like a smartphone, and developing a new specialty device, said Dan McCaffrey, vice president of digital health and software at Omron Healthcare.

Not everyone has the most up-to-date smartphone, and the people with the greatest health needs may not be early adopters of new technology, McCaffrey noted.

“I always like to start with the clinical outcome and then back into the technology, as opposed to starting with the technology and trying to move into the clinic,” he said. 

There are some crazy crash diets out there. You’ve got the cabbage diet, where people live (or try to live) off of cabbage soup for weeks at a time. You’ve got the gelatin diet of the 70s, where people would try to lose weight by eating only gelatin (it didn’t work and some people got really, really sick). There are dozens of variations of crash diets, and most of them are unsustainable, unhealthy, and ineffective. 

There’s one that’s a little different: the protein sparing modified fast. No less extreme but far more reasonable and effective than the others, the protein sparing modified fast, or PSMF, is an ultra high protein, low-carb, low-fat, low-calorie diet. It’s intended to accelerate fat loss and minimize muscle loss. It is not intended to be a long term way of eating, but rather a short term intervention that can springboard a person into greater sustained weight loss and healthy living. 

Why Do a Protein Sparing Modified Fast?

Because “weight loss” doesn’t tell you anything. Weight is a non-specific measurement of mass that’s comprised of fat, muscle, connective tissue, bone, and water. To “lose weight” can mean you’ve lost mostly muscle. It can mean you lost a bit of fat and lot of muscle, or a lot of fat and bit of muscle. It can mean reduced bone mineral density. It can mean your tendons and ligaments are losing strength. It can mean you just lost a bunch of water weight. But when the average person wants to “lose weight,” they want to lose body fat and keep their muscles.

The protein sparing modified fast “spares” protein (muscle) and accelerates fat loss. It aims (and mostly succeeds) at creating the kind of weight loss people are looking for.

How Do You Do a Protein Sparing Modified Fast?

Emphasize lean protein.

Lean protein is the basis of the protein sparing modified fast. In order to be “protein sparing” and accelerate the loss of fat and limit the amount of muscle ams you lose, the PSMF emphasizes high protein intakes. By increasing protein relative to calories, your diet provides the amino acids your body needs to convert to energy instead of your body taking those amino acids from your own muscle tissue.

Eat at least 1.5 grams of protein per kilogram of body weight. If you’re lifting weights (which you should be to get the most benefit out of the diet), up that to 2 grams protein per kilogram. I’d actually suggest going as high as 2.6 grams per kg, as a recent study showed that this level of protein intake during aggressive dieting minimized muscle loss.

The protective effect of including adequate amino acid intake when dieting is so profound that even infusing starvation patients—people who aren’t eating anything at all—with isolated amino acids can stave off the worst of muscle loss.

Lean protein sources include:

• Lean cuts of beef and pork: top round, 95% lean ground beef, filet, loin
• Chicken and turkey breast
• Lean white fish: cod, haddock, halibut, tilapia, flounder, rockfish
• Shellfish: mussels, oysters, clams, shrimp, crab
• Egg whites
• Whey isolate protein powder
• Low/non-fat Greek yogurt

The best protein sources are whole foods: meat, fish, shellfish, yogurt. They contain more nutrients and are more satiating than isolated protein powders or egg whites. As such, the bulk of your protein sparing modified fast diet should be lean whole food protein. Powders can be used as adjuncts to an already good diet if you need a boost to get up to your desired protein intake.

Minimize fat.

For the purpose of this short term fat loss diet, you choose lean meats and avoid almost all added dietary fat. All the fat you’ll be consuming will come off your own body. This isn’t supposed to be a sustainable diet for life where flavor, nutrient-absorption, and long term health come into play. This is a rapid fat loss diet.

If you insist on it, use only as much fat as you need to cook—to keep things from sticking.

Minimize digestible carbs.

By minimizing digestible carbs (sugars and starches), you speed up the emptying of liver and muscle glycogen, lower insulin levels, and accelerate the loss of body fat. After glycogen is burned through, fat loss begins.

Stay under 30 grams of carbs a day, depending on calorie allowances.

Emphasize non-starchy vegetables.

For micronutrients, variety, and fiber, the PSMF promotes the consumption of large amounts of non-starchy vegetables. Things like asparagus, broccoli, cauliflower, lettuce, spinach, kale, peppers, onions, garlic, and all leafy greens. The catch is that you can’t add all that much extra fat to make it super-palatable. Veggies must be steamed, boiled, or cooked with minimal fat—no more than a half teaspoon or so to really get the full effects.

Keep calories low.

Clinical protein sparing modified fasts allow 800 calories a day. More casual PSMF-style fat loss diets done on your own can be higher calorie, but still very low. Whatever amount of calories you decide is right for you, hit your protein requirements and fill out the rest of the calories with carbs and fat.

Supplement smartly.

I’ve already mentioned whey protein, a great source of lean protein. But there are a few other things to consider taking.

• Electrolytes: sodium, potassium, magnesium become vastly more important on a low-calorie, low-carb diet. Salt your food liberally, as a PSMF will get boring very fast if you’re eating bland food.
• Omega-3s: if you aren’t eating mussels and oysters, which have adequate levels of omega-3s, you need to be taking fish oil, 3-4 grams per day.
• Multivitamin/mineral: a good multivitamin and mineral supplement is a good idea.
• Bone broth or collagen: the glycine in bone broth/collagen will balance out the methionine in all the lean protein you’re eating, and broth is a great way to add flavor and refinement to an otherwise boring diet.

Do glycogen depleting workouts.

You can speed up the effects of the protein sparing modified fast by doing high-rep circuit training that rapidly depletes glycogen.

Keep in mind that glycogen depletion is localized. The muscles you use are the ones that get depleted. Compound movements like squats and deadlifts are more efficient because they’ll deplete multiple muscle sites with the same movement.

Higher intensity elicits greater glycogen depletion. Walking doesn’t deplete much at all, while sprinting depletes a ton. Anytime you increase the intensity, you’re increasing the glycogen burn. Volume also matters. The trick is maintaining intensity over long durations or high volume.

Isn’t Rapid Weight Loss Unhealthy and Unsustainable?

“Slow and steady weight loss” is a myth in my opinion, a grand lie perpetuated on the masses. Rapid weight loss works better, works faster, and leads to greater lasting changes.

Contrary to popular belief, people who lose weight faster tend to keep it off.  The research indicates this as well.

• A 2000 review found that faster, greater initial weight loss improves long term weight loss maintenance, even when that weight is lost using extreme diets like the protein sparing modified fast.
• A 2001 review found that using very low calorie diets to trigger rapid short term weight loss can be highly effective for long term weight maintenance, provided subjects follow up with a “weight-maintenance program” including physical activity, nutritional education, and behavioral therapy. In other words, it works if they make it a lifestyle change.
• A 2004 review of the effect of “lack of realism” in weight loss goals on long term weight maintenance found that “higher dream weight loss goals” were linked to greater weight loss at 18 months. Aim big, get big results.
• Among middle-aged obese women, those who lost weight the fastest were the most likely to keep it off after 18 months.
• There was also a more recent paper where people who lost weight quickly were no more likely than people who lost it slowly to regain the weight in the long term. Members of the fast weight loss group were more likely to hit their short term weight loss goals (12.5% reduction in body weight) and stick with the program. Even though both groups had regained about 70% of the lost weight after three years, the net weight loss in the fast weight loss group was greater.

What’s going on here?

You need to shock the hell out of yourself by the speed at which fat falls off. Only then can you “know” at a guttural level that you need to maintain a healthy lifestyle. This kind of rapid fat loss is what gets you hooked on the possibility that yes, you can actually lose weight. That yes, your obesity or overweight isn’t intractable. In my experience, people who don’t lose a decent amount of weight right away get discouraged, lose faith, and are more likely to give up.

The PSMF is simply one of the fastest ways to lose body fat.

Is the Protein Sparing Modified Fast Diet Safe?

Yes, it’s safe for just about everyone. Anyone can do a protein sparing modified fast for a week and come out okay. Check with your doctor if you have a medical condition, of course, and I would never recommend that kids, teens, or pregnant women (or those actively trying to become pregnant) do one, but everyone else? Go for it. A week is safe. A week is effective. A week will show you how fast you can lose fat.

But if you decide to stay on it for much longer, or even long term, watch for warning signs.

• Thinning hair
• Weak nails
• Trouble sleeping
• Low energy overall, not just in the gym
• Low thyroid function
• Menstrual changes, or even loss of menstruation
• Not recovering from workouts, injuries, or wounds
• Negative mood changes

These all indicate a worsening of your metabolic rate. You’re becoming less virile, less fertile, and less robust in general. Your diet is no longer improving your health. It’s worsening it. It’s time to start eating more food, more fat, and more carbs.

Also, as women tend to be more sensitive to low calorie diets and things like extended fasts, I’d recommend that any women doing a PSMF pay close attention to these symptoms and signs.

Besides, the PSMF isn’t supposed to be a long-term diet. It’s supposed to be a shock to the system. The trick is losing weight rapidly by adopting a healthy way of eating and living. One that you can stick with.

If you have any other questions about the protein sparing modified fast, let me know down below in the comment section, or ask about it on social media and I’ll try to get back to you.

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Aug. 31, 2022 – The FDA on Wednesday granted emergency use authorization to Omicron-specific COVID-19 vaccines made by Pfizer/BioNTech and Moderna.

The agency cited data to support the safety and efficacy of this next generation of mRNA vaccines targeted toward variants of concern.

If you’ve been waiting to get a variant-specific booster shot, you may be in luck as early as next week.

The Pfizer EUA corresponds to the company’s combination booster shot that includes the original COVID-19 vaccine as well as a vaccine designed to protect against the most recent Omicron variants, BA.4 and BA.5.

The Moderna combination vaccine will contain both the firm’s original COVID-19 vaccine and a vaccine to protect specifically against Omicron BA.4 and BA.5 subvariants.

As of Aug. 27, BA.4 and BA.4.6 accounted for about 11% of circulating variants, and BA.5 made up almost all the remaining 89%, CDC data show.

The next step will be a review of the scientific data by the CDC’s Advisory Committee on Immunization Practices, which is set to meet Thursday and Friday. The final hurdle before distribution of the new vaccines will be a sign-off on CDC recommendations for use by agency Director Rochelle Walensky, MD.

“If you’ve not yet received a booster dose or it’s been several months since your last booster dose, now is the time to consider getting one,” Peter Marks, MD, director, FDA Center for Biologics Evaluation and Research, said during a virtual FDA news conference. 

“Also, if you’ve not yet vaccinated your children, now is a great time to consider taking them along to receive their vaccination as well,” he said.

“Unfortunately, COVID-19 continues to cause devastating consequences throughout the country with nearly 400 deaths and over 5,000 new hospitalizations every day,” FDA Commissioner Robert M. Califf, MD, said. “And just yesterday provisional CDC data indicated that US life expectancy fell again in 2021, In large part due to COVID deaths.”

“Regrettably only about half of eligible Americans have received their first booster,” he continued. “So, this is a remarkable opportunity to improve our life expectancy.”

CDC data indicate that those who are up to date on their vaccines are 13 times less likely to die from COVID compared to those who have not received the vaccine and are 3 times less likely to die from COVID compared to those who only had one booster instead of two.

“It’s just painful to see people dying unnecessarily when there’s a free treatment that would prevent their death,” said Califf, noting that protection against death associated with the COVID-19 vaccines “is much more clear than anything I’ve ever seen.”

Protection Now and In the Future

Scientific modeling suggests “that we are looking at a possible fall wave with a peak around Dec. 1,” Marks said. “By giving the booster now, we will hopefully both control the current plateau that we’re in — we’re dropping off very slowly — as well as address this future potential wave that looms out there.”

Califf noted that the new vaccines have another potential long-term benefit, protection against long COVID, “which for young people is increasingly a major concern.”

“I want to make clear that these updated boosters present us with an opportunity to get ahead of the next wave of COVID-19,” Califf said. “And for those who may be wondering, CDC says you may get a COVID-19 booster at the same time as your annual flu shot.”

The FDA will continue to study how well the new vaccines protect again COVID going forward, Marks said.

And another hope is that these next generation vaccines will provide stronger protection, Marks said.

“The idea here is not just to increase the antibodies right now, but also to hopefully give us a longer duration of protection,” he said.

If this holds true, then Americans might need fewer booster shots in the future.

“Hopefully [this] holds us for as much of the entire season.”

Aug. 31, 2022 – COVID-19 booster vaccines targeting the Omicron BA.4 and BA.5 subvariants currently dominating in the United States could be available in the next few days, but their arrival comes with some controversy.

The FDA granted emergency approval to the mRNA boosters from Pfizer and Moderna today. Next up are meetings of the CDC’s Advisory Committee on Immunization Practices on Thursday and Friday that could pave the way for an official CDC endorsement of the vaccines before the weekend.

The U.S. government has already purchased over 170 million doses of the two vaccines to be ready for use after all approvals are in place (with an order of 4 million more doses for children, should those be approved later).

But the expected arrival of the updated vaccines has sparked debate among infectious disease experts and others.

Some have criticized the fact that the new boosters haven’t been tested in humans and say they will wait to get the updated booster or skip it altogether. Others worry that the public will view the new vaccines as rushed, increasing an already reluctant public’s hesitation to get another shot.

Still, many experts applaud the speed with which the updated vaccines were developed and say the safety of the COVID-19 vaccines is well-established. They say this transition to updating vaccines for COVID-19 is being done much like the U.S. updates its flu vaccine annually, tweaking the formula of an established vaccine platform to combat new viruses or variants expected to be circulating.

The Route to the New Boosters

Earlier this year, vaccine makers gave the FDA data on an updated vaccine that targeted BA.1, the Omicron variant that was dominant earlier. But then, the FDA asked the companies to update their vaccines to add an Omicron BA.4/5 component, to create a vaccine that is a bivalent booster – meaning it will cover both the original strain of the virus that emerged from China and the newer  BA.4 and BA.5 subvariants.

This will be the first update to the mRNA vaccines since they became available in December 2020.

The FDA’s Vaccines and Related Biological Products Advisory Committee met with vaccine makers in late June to review data on Omicron-specific COVID-19 vaccine candidates.

For the new boosters, the FDA did not schedule another meeting of its vaccine advisory panel, according to FDA Commissioner Robert Califf, MD. He noted on Twitter that “the agency feels confident in the extensive discussion that was held in June.”

Evidence on Updated Boosters

At the end of June, Pfizer BioNTech and Modernapresented the FDA with human data on the BA.1 vaccine. The companies also presented lab or animal data on the BA.4 and BA.5 vaccine candidates.

Both companies showed that the BA.1 vaccines triggered antibody responses to BA.4 and BA.5, but lower than those for BA.1. 

The companies also presented data that showed the updated shots’ side effects were similar to those of the original vaccine, such as soreness where the shot was given and fatigue.

In mice studies presented to the FDA, Pfizer said its new booster increased the antibody responses to all the Omicron variants, including BA.4 and BA.5.

Results from human clinical trials are coming, but not soon. Moderna just completed enrollment of its BA.4 and BA.5 booster clinical trial, with results expected in the fourth quarter of 2022. Pfizer said it plans to start a trial soon.

Peter Marks, MD, director of the FDA’s Center for Biologics Evaluation and Research, told NPR that the data from the mouse studies suggests the new vaccines may be about 20 times more protective against Omicron than the original shots.

In response to any concerns about safety data in humans from the new vaccine, CDC Director Rochelle Walensky, MD, recently told CNBC that the new shots involve very small changes in the mRNA sequence and that should not impact safety.

Infectious Disease Experts Weigh In

The lack of convincing neutralizing antibody data against BA.4 and BA.5 in people is a problem, says Paul Offit, MD, an infectious disease expert and director of the Vaccine Education Center at Children’s Hospital of Philadelphia. 

“At the very least, what I’d like to see is neutralizing antibody data in people who have gotten this BA.4 , BA.5 vaccine as compared to just getting the monovalent vaccine and to see a dramatic increase in neutralizing antibodies, a 4- or 5-fold increase,” he says.

Offit also questions which groups should get the updated vaccine based on benefit and believes the best approach is to target those most at risk of severe COVID-19, such as older adults, people with serious medical conditions, or those with weakened immune systems.

“Those are the ones getting hospitalized,” he says. He sees the goal of the updated vaccine as preventing serious illness.

Offit, who says he has been vaccinated and boosted, and had a mild COVID-19 infection about 3 months ago, plans to skip this booster.

Eric Topol, MD, executive vice president of Scripps Research and editor-in-chief of Medscape (WebMD’s sister site for medical professionals), applauded the FDA’s “aggressive and expedient” approach, with a BA.5 vaccine available for review just 2 months after the FDA meeting asking for such a vaccine.

He pointed out that mice data is used every year to update the flu vaccine quadrivalent program. “But there’s a concern that it’s not so easy to extrapolate mouse to human for SARS-CoV-2, a virus that’s quite different than influenza,” he wrote online in his online platform Ground Truths.

Another potential concern, Topol and others say, is something called imprinting, also known by the catchy but potentially misleading term “original antigenic sin,” with a person’s first exposure to a virus having an effect on a later response to similar viruses. The worry is people may “train” their immune system to remember the response to the first infection and be less able to respond to future ones when faced with different variants, such as those targeted by the new boosters.

For now, he says, “it’s an unknown, the data are mixed.”

Will the Public Accept It?

Topol has also expressed concern about public trust in the vaccine and the chance that people will view the new boosters as a rush job. As he also pointed out, just 32% of the population has had any of the original booster shots.

Topol’s personal decision? He is about 8 months out from his fourth shot and said he will wait to see more data. He said that is simply his perspective. “Many will be eager to get the new shot. As I said, that’s fine.”

Infectious disease expert William Schaffner, MD, a professor of preventive medicine at Vanderbilt University in Nashville, isn’t as concerned as others about the lack of human data, citing the need to fight the expected winter surge.

“If you need a vaccine to combat what some think will be an increase in [cases in] the winter, you won’t have an updated vaccine in time if you wait for a clinical trial,” he says.

He, too, likens the tweaking of the COVID-19 vaccine to what’s done annually with the flu vaccine.

As for safety, “we know a vast amount about the [vaccine’s] safety and effectiveness,” Schaffner says. “I think the majority of the public health and vaccinology communities are quite content that we are doing these immune-bridging studies that show [updated vaccines] performed similarly to previous vaccines.”

As for safety concerns, he says the risk of myocarditis (inflammation of the heart muscle), which occurred in some teens and young adults with the second dose of the vaccine, was lower with the booster dose. He says it’s reasonable to expect the updated booster to also carry a lower risk of that side effect.

“These tweaks [with the updated vaccine] are so small, it won’t impact safety,” said Katelyn Jetelina, PhD, an epidemiologist and health policy expert who publishes Your Local Epidemiologist,  a newsletter translating science for consumers.

She recognizes the concern about imprinting, but “we need to be responsive to the needs of our immune system right now, in the midst of [an expected] surge,” she said.

Jetelina acknowledges the unknowns, such as how long the updated vaccine could be effective. Because BA.5 is so new, there hasn’t been time to analyze the vaccine in people. In her view, “demanding an effective vaccine and clinical data is simply a fantasy against this rapidly changing virus.”

As for experts who want to focus just on those at risk of severe disease, she says any advance that helps cut the risk of infection is important: “We cannot stop severe disease and death if we don’t stop transmission. Even if we don’t stop transmission perfectly, even if it’s 50%, that still helps a lot.”

She plans to get the updated booster.

By Laurie McGinley, The Washington Post

Aug. 31, 2022 — New coronavirus boosters are just around the corner following authorization Wednesday by federal regulators. The updated shots are designed to provide a stronger shield against the BA.4 and BA.5 omicron subvariants still causing tens of thousands of infections and hundreds of deaths every day in the United States.

The boosters will be part of a campaign by the federal government, to be kicked off within days, to persuade Americans to bolster their immune defenses before a potential surge in covid-19 cases as cooler weather arrives in the fall.

But the updated boosters have generated some controversy and confusion. Here’s what you need to know.

When will the shots be available?

The boosters, after receiving emergency use authorization from the Food and Drug Administration, now have to get the blessing of the Centers for Disease Control and Prevention and its advisers. That review is scheduled for Thursday. If all goes as expected, some shots could be available this weekend, with more available right after Labor Day.

Where can I get one and how much will it cost?

The new boosters, which are intended as single shots, will be available at the same places where the previous boosters and vaccines have been available – at doctors offices, hospitals, pharmacies and community health clinics.

Like the other coronavirus shots, the updated boosters have been purchased by the federal government and will be free to consumers.

Who are the boosters for?

The CDC is expected to recommend the shots for the same ages authorized by the FDA: 12 and older for the new booster from Pfizer and its German partner, BioNTech, and 18 and up for the Moderna booster. Officials are expected to consider use of the updated booster in younger children later. Anyone who has received the two-shot primary series of the mRNA vaccines and the single-shot Johnson & Johnson vaccine will be eligible, regardless of whether they received any – or all – of the recommended booster shots.

The existing vaccine will continue to be used, but only for the initial two-shot series of the mRNA, not as a booster.

If I just got a booster of the original vaccine, should I get the new one right away?

No. The FDA said people who recently received their initial vaccine or a booster should wait two months before getting the updated booster. Getting the new booster too soon could limit its effectiveness.

What are the side effects of the boosters?

Side effects are not expected to differ from those associated with the current vaccine, which include redness and swelling at the vaccine site, as well as occasional fatigue, headache and muscle soreness, according to the CDC. More serious reactions are rare.

The Washington Post’s Lena H. Sun contributed to this report.

 

WEDNESDAY, Aug. 31, 2022 (HealthDay News) — Munching handfuls of microwave popcorn might be perfect for movie night, but your snack could be loading your body with potentially harmful “forever chemicals,” experts warn.

Many microwave popcorn bags are lined with PFAS (perfluoroalkyls and polyfluoroalkyl substances), and evidence has shown that these chemicals will leach into the snack during popping.

Studies have found “high levels of these compounds in the blood of people who ate microwave popcorn regularly, so it does get into the bloodstream,” said Dr. David Heber, founding director of the UCLA Center for Human Nutrition.

PFAS compounds are called forever chemicals because they break down very slowly, accumulating both in the environment and within human bodies.

The chemicals are commonly found in drinking water supplies throughout the United States, and can be found in the blood of 97% of U.S. residents, the federal government estimates.

“There’s been a lot of attention on drinking water, but food is also a major source of exposure and studies have shown that consuming microwave popcorn and fast food is correlated with higher PFAS levels in the body,” said David Andrews, a senior scientist with the nonprofit Environmental Working Group.

PFAS chemicals originally were developed in the 1950s as part of the nonstick coating of pans, Heber said.

They’ve since been added to many consumer products, including cleaning solutions, waterproof makeup, firefighting foam and stain-resistant coatings for carpets and upholstery.

Microwave popcorn manufacturers add PFAS to the lining of the bags to keep the oil that pops the corn from soaking out, Andrews said.

The PFAS also help keep the bag from burning, Heber said.

“You know sometimes if you leave the popcorn in a lot longer, you’ll end up with blackened kernels that have burned?” Heber said. “Well, that’s hot enough to also burn the paper, so this protects the paper from starting a fire in the kitchen.”

But during the popping process, PFAS leach into the popcorn, making the snack one of the most notorious means by which the chemicals enter human bodies, Andrews said.

Aug. 31, 2022 – People who lift weights understand they’re playing a long game.

Once they get past the “newbie gains” – the quick and exciting increases in muscle strength and size – it takes time, effort, and patience to keep making progress.

Whether they know it or not, they’re also playing the longevity game.

A growing body of research shows that resistance training adds years to both lifespan and “healthspan” – the period of life when we’re in good health.

A 2022 study review from Japanese researchers linked “muscle-strengthening activities” to a 15% lower risk of dying.

Resistance exercise was also linked to a lower risk of cardiovascular disease (17%), cancer (12%), and diabetes (17%).

We’ve known for a long time that strength is an excellent predictor of future health. Lots of research has shown that, if all else is equal, stronger men and women have a much lower risk of dying during a given period than people with less strength.

This new research shows that strength training offers similar protection, regardless of the results of that training. So even if you don’t think you’re getting as strong or as lean as you’d like to be, you should keep it up – because chances are, you’re still helping your health in a big way.

How Strength Training Helps as You Age

For longevity, strength training seems to be especially effective for older adults, says Tufts University professor Roger Fielding, PhD, who’s been studying the role of exercise in the aging process since the early 1990s.

“With aging, we see clear deficits in muscle function and bone health,” he says. “That all can be slowed, attenuated, or reversed with appropriate exercise.”

His concept of “appropriate” has changed a lot in the past 3 decades. “When I first started studying this stuff, we would try to give people a very formalized prescription” for strength training, he says.

That strength training prescription typically included a lot of sets (three per exercise), moderate reps (eight to 12 per set), and relatively heavy weights. It also required professional supervision in a well-equipped gym, which was both unappealing and impractical for most of the target population.

“What I’ve learned is that even lower-intensity strength training, at home, without a lot of specialized equipment, has some benefits,” he says.

Which benefits? That’s harder to say.

The research linking resistance exercise to lower mortality comes from large, population-wide surveys, looking at tens or even hundreds of thousands of people. The broad category of “muscle-strengthening exercises” can include anything from calisthenics in the living room to a serious bodybuilding or powerlifting program.

They’re also based on self-reporting by the people studied. Because of that, “we should be careful how we interpret some of these studies,” Fielding says.

How Much Strength Training Should You Do?

That warning seems especially appropriate for the study’s most surprising conclusion: The maximum longevity benefit comes from one or two resistance exercise sessions a week totaling 30 to 60 minutes.

The study adds that it’s unclear why more strength training would have diminishing or even negative returns.

Robert Linkul, owner of Training the Older Adult in Shingle Springs, CA, thinks the answer is perfectly clear.

“Less might be more for the beginning lifter,” he says. That’s why his new clients typically begin with two 50-minute workouts a week. But after 3 months, they need to train three times a week to continue seeing gains.

He currently has 14 clients who have been with him at least 16 years. Most of them started in their 50s and are now in their 60s or 70s. If there were any downside to working out more than two times a week, he’s pretty sure he would’ve seen it by now.

Live Longer and Move Longer, Too

Linkul says that his training program includes a lot more than lifting. Clients start each workout with 10 to 15 minutes of mobility and warmup exercises. That’s followed by 15 minutes of strength training and 15 minutes of high-intensity resistance training (HIRT).

HIRT uses functional exercises – lifting and carrying dumbbells or kettlebells; pushing or pulling a weighted sled – to improve strength and endurance at the same time.

“Most of the clients I get are training for real-life function,” Linkul says.

Falling is one of their biggest concerns, and for good reason: According to the World Health Organization, it’s the second-leading cause of unintentional injury-related deaths worldwide, behind only traffic accidents.

Their other major concern is losing their independence, which often follows a fall. “They want to feel they’re not near using a cane or a walker or being stuck in a wheelchair,” he says. “The more we train, the further we get from that.”

That’s where strength training offers its most unique advantages, according to a 2019 study from researchers at McMaster University. Resistance exercise is “particularly potent for maintaining mobility in older adults,” the study says.

Training for Life

Traditional aerobic exercise also offers many of the same benefits, including longer life and a lower risk of cardiovascular disease, cancer, and diabetes.

But there’s no need to choose one or the other. As a recent study noted, combining aerobic and strength exercises leads to a lower risk of early death than either of them separately.

Which makes perfect sense to Fielding.

“Usually, people who’re physically active aren’t just doing strength training alone,” he says. “Some exercise is better than no exercise,” and more is usually better than less. “People have to find things they like to do and want to do and are able to do consistently.”