Several healthy diet patterns are associated with reduced risk of type 2 diabetes

 A large new meta-analysis of more than 800,000 participants to be presented at this year’s Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna, Austria (15-19 September) shows that high adherence to three well-established healthy eating patterns is linked to a lower risk of type 2 diabetes, regardless of one’s ethnicity. The study is led by PhD student and Gates Cambridge Scholar Ms Jia Yi Lee, Professor Nita Forouhi, and colleagues from the MRC Epidemiology Unit, University of Cambridge, UK.

The study investigated three healthy dietary patterns: the Mediterranean Diet, the Alternative Healthy Eating Index (AHEI), and the Dietary Approaches to Stop Hypertension (DASH). All three have been recommended for general health and their potential to reduce chronic disease risk.

Through a systematic search of published studies, the authors identified 33 publications reporting the association between these dietary patterns and type 2 diabetes. When all the available evidence was combined, the results showed that people who were in the top 10% for adherence to each dietary pattern had significantly lower risks of developing type 2 diabetes compared to those with the 10% lowest adherence : a 17% lower risk for the Mediterranean Diet, a 21% lower risk for AHEI, and a 23% lower risk for the DASH diet. Importantly, the potential benefits of these dietary patterns did not appear to vary significantly across African, Asian, European, and Hispanic ethnic groups, despite known ethnic differences in dietary culture, as well as diabetes risk.

While some of the lowered risks did not reach statistical significance among Hispanics and mixed ethnic groups, this may be due to the limited data available from non-European ethnic groups in existing studies. Over one-third of the data included in this analysis came from people of European descent, highlighting the need for more research from underrepresented populations.

The authors conclude: “Although more research is needed in specific populations, this study strengthens the evidence that the Mediterranean, AHEI, and DASH dietary patterns may reduce the risk of type 2 diabetes across diverse ethnic groups, and that they can be promoted across all populations.”

This analysis is part of a larger ongoing review examining the associations of various dietary patterns, including plant-based dietary patterns (that include vegetarian and vegan diets) with type 2 diabetes risk. The researchers will further determine whether similar benefits extend across ethnic groups for these other dietary patterns.

A fast daily walk could extend your life:

Walking fast for just 15 minutes per day reduced the risk of death in a large study group of mostly low-income participants.

The research findings, published July 29 in the American Journal of Preventive Medicine, support promoting brisk walking as a strategy for improving health outcomes in all communities.

Although the health benefits of walking are widely recognized, there has been limited research on the effect of factors such as walking pace on mortality, particularly in low-income and Black populations, said the study’s senior author, Wei Zheng, MD, PhD, MPH, the Anne Potter Wilson Professor of Medicine and director of the Vanderbilt Epidemiology Center.

“This is one of the few studies to quantify the effect of daily walking on mortality in a low-income and predominantly Black U.S. population,” said Zheng, who also directs the Division of Epidemiology at Vanderbilt University Medical Center. “By demonstrating the benefits of fast walking — which is a low-cost and largely accessible activity — we provide direct evidence to inform targeted public health interventions and policies to improve health outcomes.”

The study analyzed data from the Southern Community Cohort Study (SCCS), which enrolled about 85,000 participants ages 40-79 between 2002 and 2009. Most participants (86%) were recruited in collaboration with community health centers serving low-income populations across 12 southeastern states. Participants provided baseline information, including daily walking pace and time, demographic and lifestyle factors, and medical history, using structured questionnaires.

 

The current study, led by first author Lili Liu, PhD, MPH, included data from 79,856 of the SCCS participants (racial groups: 66% Black, 30% white, 4% other). In the baseline survey, participants reported the average amount of time per day (in minutes) they typically spend “walking slowly (such as moving around, walking at work, walking the dog or engaging in light exercise)” and “walking fast (such as climbing stairs, brisk walking or exercising).”

 

The cohort was linked to the National Death Index to obtain vital status and cause of death information through Dec. 31, 2022. Over a median follow-up of 16.7 years, 26,862 deaths occurred.

 

The researchers found that fast walking as little as 15 minutes per day was associated with a nearly 20% reduction in total mortality. Slow walking more than three hours per day was associated with a smaller reduction in mortality. The benefit of fast walking remained strong even after accounting for other lifestyle factors, such as leisure-time physical activity levels.

 

In addition to reducing premature death from all causes, fast walking reduced death specifically from cardiovascular diseases — the No. 1 cause of death in the United States. The researchers suggested that fast walking might reduce cardiovascular mortality by improving the heart’s efficiency and output, and by reducing the prevalence of obesity and its associated cardiovascular risks such as hypertension and high cholesterol.

 

“Brisk walking offers a convenient, accessible and low-impact activity that individuals of all ages and fitness levels can use to improve general health and cardiovascular health specifically,” Zheng said.

 

The authors acknowledge that self-reported data on daily walking may have included other types of physical activity, which could introduce misclassification errors. Also, the physical activity data was only collected at baseline, so changes over time could not be considered. The study’s long follow-up and large sample size contribute to “robust and reliable estimates,” they noted.

Higher ultra processed food intake linked to increased lung cancer risk

A higher intake of ultra processed food (UPF) is linked to an increased risk of lung cancer, suggests research published online in the respiratory journal Thorax.

Further research is warranted in different population groups, but limiting consumption of these foods may help curb the global toll of the disease, say the researchers.

Lung cancer is the most common cancer in the world. And in 2020 alone there were an estimated 2.2 million new cases and 1.8 million deaths from the disease worldwide, they note.

UPF typically undergo multiple processing steps, contain long lists of additives and preservatives, and are ready-to-eat or heat. High consumption has been linked to a heightened risk of several health conditions, and the researchers wanted to know if this might also include lung cancer.

They drew on data from the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trials, involving 155,000 participants aged 55–74 who were randomly assigned to either a screening or comparison group between November 1993 and July 2001. Cancer diagnoses were tracked until the end of 2009 and cancer deaths until the end of 2018.

Some 101,732 people (50,187 men and 51,545 women; average age 62) who completed a Food Frequency questionnaire on their dietary habits on entry to the trials were included in the present study. Foods were categorised as: unprocessed or minimally processed; containing processed culinary ingredients; processed; and ultra processed.

The researchers focused in particular on UPF that included sour cream, as well as cream cheese, ice cream, frozen yoghurt, fried foods, bread, baked goods, salted snacks, breakfast cereals, instant noodles, shop-bought soups and sauces, margarine, confectionery, soft drinks, sweetened fruit drinks, restaurant/shop-bought hamburgers, hot dogs, and pizza.

Average energy adjusted UPF consumption was nearly 3 servings/day, but ranged from 0.5 to 6. The three types of food that featured the most were lunch meat (11%), diet or caffeinated soft drinks (just over 7%) and decaffeinated soft drinks (nearly 7%). 

During an average tracking period of 12 years, 1706 new cases of lung cancer were diagnosed, including 1473 (86%) cases of non-small cell lung cancer (NSCLC) and 233 (14%) of small cell lung cancer. 

Case numbers were higher among those eating the most UPF than they were among those eating the least (495/25,434 vs 331/25,433).

After accounting for potentially influential factors, including smoking and overall diet quality, participants in the highest quarter of energy-adjusted UPF consumption were 41% more likely to be diagnosed with lung cancer than those in the lowest quarter. 

Specifically, they were 37% more likely to be diagnosed with NSCLC and 44% more likely to be diagnosed with SCLC.

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge that they weren’t able to factor in smoking intensity, which may have been influential. Dietary information was collected only once, so couldn’t account for changes over time, and the number of cancer diagnoses was small.

But the researchers highlight the low nutritional value of UPF and the excessive amounts of sugar, salt, and fats they usually contain.

“Worse still, over the past two decades, the consumption of UPF has significantly increased worldwide, regardless of development or economic status. The rise in UPF consumption may have driven global increases in obesity, cardiovascular disease, metabolic disorders, cancer and mortality, as these foods are confirmed risk factors for such conditions,” they suggest.

A high intake of UPF may effectively elbow out healthy foods, such as whole grains, fruit, and vegetables, which are known to protect against cancer, suggest the researchers, by way of an explanation for their findings.

“Industrial processing alters the food matrix, affecting nutrient availability and absorption, while also generating harmful contaminants,” they add, highlighting acrolein, which is found in grilled sausages and caramel sweets, and is a toxic component  of cigarette smoke. Packaging materials may also have a role to play, they suggest.

They conclude: “These findings need to be confirmed by other large-scale longitudinal studies in different populations and settings….If causality is established, limiting trends of UPF intake globally could contribute to reducing the burden of lung cancer.”

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Tongue swallowing prevention" maneuvers delay CPR, might contribute to brain injury or death for collapsed athletes

 

Despite widespread public health efforts, the dangerous myth of "prevention of tongue swallowing" continues to persist during cardiopulmonary resuscitation (CPR). New research in the Canadian Journal of Cardiology, published by Elsevier, exposes the mainstream and social media’s detrimental role in perpetuating this misconception, which often leads to critical delays in proper CPR for collapsed athletes.

Concern about “tongue swallowing” leads resuscitators to waste valuable time trying to remove the tongue from the airway path, rather than immediately initiating essential CPR procedures. The findings from this analysis underscore an urgent need for global public health campaigns to correct CPR myths and emphasize the importance of immediate chest compressions. The study systematically analyzed 45 cases of athletes collapsing during sports events (1990–2024) that were caught on video or documented online, focusing on initial resuscitation actions and corresponding media coverage.

Commenting on the main findings of the analysis, lead investigator of the article "The Myth of “Tongue Swallowing” Delays Cardiopulmonary Resuscitation of Athletes With Cardiac Arrest, Yet It Is Often Perpetuated by the Media" Dana Viskin, MD, Department of Cardiology, Tel Aviv Sourasky Medical Center and School of Medicine, Tel Aviv University, says, “Our analysis showed that in 84% of cases where the initial response was visible, inappropriate maneuvers to ‘prevent tongue swallowing’ were performed before proper CPR. These incorrect actions were significantly associated with poor outcomes: 67% of those receiving such maneuvers died or had severe brain injury, compared to 0% when CPR was the first response.”

Media analysis revealed that nearly half (48%) of high-exposure news articles explicitly used the term “tongue swallowing,” with most praising the lay responder for their actions. In articles describing sudden cardiac arrest (SCA) cases, 77% referenced “tongue swallowing” without acknowledging its inappropriateness as a response to SCA, yet only 23% explicitly criticized the intervention.

“Given that some SCA patients, particularly young males with shockable arrest rhythms, may exhibit seizure-like activity at onset – a pattern frequently observed in sports-related SCA – it is understandable how this myth may have carried into the public response to athletic SCA, despite the absence of clinical guideline support for such an intervention,” points out the author of the accompanying editorial "Countering Misinformation in the Response to Sudden Cardiac Arrest in Athletes" Nicholas Grubic, MSc, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto. “Furthermore, signs such as cyanosis and agonal respirations can be mistaken for choking, often prompting bystanders to prioritize airway inspection over initiating CPR. Recent qualitative research has confirmed that such misinterpretations can delay or even interrupt life-saving interventions. Although promoting CPR and automated external defibrillator (AED) knowledge remains a cornerstone of SCA education, teaching the public to recognize the early signs of an arrest is equally critical, as every second without action drastically reduces the chance of survival.”

This research is especially important now, as public CPR education becomes increasingly vital with widespread media exposure to cardiac arrests in sports.

"Our study highlights the dangerous and persistent misconception of ‘tongue swallowing prevention,’ which can delay the initiation of life-saving chest compressions. These delays may cost lives, and yet the media often praise such misguided actions as heroic. We urgently need to re-educate the public and the media and reframe the narrative around CPR, especially in sports," emphasizes Dr. Viskin.

Mr. Grubic adds in conclusion, “Coordinated, evidence-informed communication strategies are essential to counter misinformation and support public understanding, particularly in high-stakes situations such as the response to SCA in athletes. Our public capacity to save lives should not be impeded by misinformed voices – now is the time for the academic, healthcare, and media sectors to join forces and build a healthier information environment for all. Responding to SCA is a team sport that starts with proper education to ensure that everyone is ready to step in, stay focused, and act. Although the prize is not a trophy, it is something much more valuable.”

Healthy diet can slow down chronic diseases in older people

 A healthy diet can slow down the accumulation of chronic diseases in older adults, while inflammatory diets accelerate it. This is shown by a new study from Karolinska Institutet published in Nature Aging.

Researchers have investigated how four different diets affect the accumulation of chronic diseases in older adults. Three of the diets studied were healthy and focused on the intake of vegetables, fruit, whole grains, nuts, legumes, unsaturated fats and reduced intake of sweets, red meat, processed meat and butter/margarine. The fourth diet, however, was pro-inflammatory and focused on red and processed meat, refined grains and sweetened beverages, with lower intake of vegetables, tea and coffee

Just over 2,400 older adults in Sweden were followed for 15 years. The researchers discovered that those who followed the healthy diets had a slower development of chronic diseases. This applied to cardiovascular disease and dementia, but not to diseases related to muscles and bones. Those who followed the pro-inflammatory diet, on the other hand, increased their risk of chronic diseases.

”Our results show how important diet is in influencing the development of multimorbidity in ageing populations,” says co-first author Adrián Carballo-Casla, postdoctoral researcher at the Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.

The next step in their research is to identify the dietary recommendations that may have the greatest impact on longevity and the groups of older adults who may benefit most from them, based on their age, gender, psychosocial background and chronic diseases.

The study was funded by the Swedish Research Council (VR) and the Swedish Research Council for Health, Working Life and Welfare, FORTE, among others. The researchers state that there are no conflicts of interest.

Publication: ‘Dietary patterns and accelerated multimorbidity in older adults’, David Abbad-Gomez, Adrián Carballo-Casla, Giorgi Beridze, Esther Lopez-Garcia, Fernando Rodríguez-Artalejo, Maria Sala, Mercè Comas, Davide Liborio Vetrano, Amaia Calderón-Larrañaga, Nature aging, online xx 2025, doi: 10.1038/s43587-025-00929-8

Facts about the diets:
MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay): A diet designed for brain health and to reduce the risk of dementia.

AHEI (Alternative Healthy Eating Index): A diet that measures adherence to dietary guidelines that reduce the risk of chronic diseases in general.

AMED (Alternative Mediterranean Diet): A modified version of the Mediterranean diet adapted to Western eating habits.

EDII (Empirical Dietary Inflammatory Index): An index that estimates the inflammatory risks of a diet.

A single bout of exercise gives results

 

ECU PhD student Mr Francesco Bettariga found that a single bout of exercise increased the levels of myokines, a protein produced by muscles which have anti-cancer effects, and which could reduce the proliferation of cancer growth by 20 to 30 per cent. 

“Exercise has emerged as a therapeutic intervention in the management of cancer, and a large body of evidence exists that show the safety and effectiveness of exercise as medicine, either during or post cancer treatment,” Mr Bettariga said. 

His research with survivors of breast cancer measured myokine levels before, immediately after and 30 minutes post a single bout of either resistance of high intensity interval training and found that both sets of exercise had a resultant increase in myokine levels. 

While higher levels of myokines were expected in a healthy population, post a vigorous workout, Mr Bettariga investigated whether breast cancer survivors would see the same results, given the impact that cancer treatments and cancer itself often has on the body. 

“The results from the study show that both types of exercise really work to produce these anti-cancer myokines in breast cancer survivors. The results from this study are excellent motivators to add exercise as standard care in the treatment of cancer,” Mr Bettariga said. 

He added that the long-term implications of elevated myokine levels should be further investigated, particularly in relation to cancer recurrence. 

Further research by Mr Bettariga investigated how changes in body composition, following consistent exercise, could impact inflammation, which plays a key role in breast cancer recurrence and mortality by promoting tumour progression. 

Persistent inflammation not only promotes tumour progression by influencing cell proliferation, survival, invasiveness, and metastasis, but also inhibits immune function. Given that the cancer itself and the side-effects of treatments can elevate levels of inflammatory biomarkers, survivors of breast cancer are at increased risk of cancer progression, recurrence and mortality. 

“Strategies are needed to reduce inflammation which may provide a less supportive environment for cancer progression, leading to a lower risk of recurrence and mortality in survivors of breast cancer,” Mr Bettariga said. 

The new research found that by reducing fat mass and increasing lean mass, through consistent and persistent exercise, cancer survivors had a better chance at reducing inflammation. 

“If we are able to improve body composition, we have a better chance of decreasing inflammation because we are improving lean mass and reducing fat mass, which is responsible for releasing anti and pro-inflammatory markers,” Mr Bettariga said. 

Unfortunately, quick fixes to reduce fat mass would not have the same beneficial effects, Mt Bettariga stressed. 

“You never want to reduce your weight without exercising, because you need to build or preserve muscle mass and produce these chemicals that you can’t do through just diet alone.” 
 

Research suggests fresh grapes are a superfood

  A new article appearing in the current issue of the peer-reviewed Journal of Agriculture and Food Chemistry explores the concept of “superfoods” and makes a case that fresh grapes have earned what should be a prominent position in the superfood family.[1]  The author, leading resveratrol and cancer researcher John M. Pezzuto, Ph.D., D.Sc., Dean of the College of Pharmacy and Health Sciences at Western New England University, brings forth an array of evidence to support his perspective on this issue.

As noted in the article, the term “superfood” is a common word without an official definition or established criteria.  Mainstream superfoods are typically part of the Mediterranean Diet and generally rich in natural plant compounds that are beneficial to a person’s health.  Pezzuto addresses the broader topic of superfoods in detail, then makes the scientific case for grapes, noting that fresh grapes are underplayed in this arena and often not included with mention of other similar foods, such as berries.

Grapes are a natural source of over 1,600 compounds, including antioxidants and other polyphenols such as flavonoids, anthocyanidins, catechins, phenolic acids, resveratrol, and more.  Polyphenols are credited with the health benefits of grapes, via antioxidant activity and influencing cellular processes.  It is the whole grape and the unique matrix of these compounds within it that creates the biological effects, not a single component.

Over sixty peer-reviewed studies have been published in the scientific literature on grapes and health.  The role of grapes on cardiovascular health is well established, including promoting relaxation of blood vessels and healthy circulation, as well as modulating cholesterol levels.  Clinical trials also show that grapes support brain health (help maintain healthy brain metabolism and beneficial impacts on cognition), skin health (enhanced resistance to UV radiation and DNA damage in skin cells), gut health (modulating the gut microbiome and increasing diversity in the gut), and eye health (retinal impact via increase in macular pigment optical density).  Finally, in the realm of nutrigenomics – the study of foods on gene expression in the body – grape consumption has been shown to positively alter gene expression in relevant body systems.  Pezzuto suggests that it is these activities at the genetic level that are likely the driving force behind the health benefits of grapes.

“Dr. Pezzuto shows that based on the science, grapes are indeed a superfood, and should be recognized as such,” said Ian LeMay, president of the California Table Grape Commission, “and we are hopeful that using this nomenclature in association with grapes becomes common practice.  Luckily, whether consumed for health or sheer enjoyment as a healthy snack, eating California grapes is a win for consumers.”

 

Beetroot juice lowers blood pressure in older people by changing oral microbiome

 The blood pressure lowering effect of nitrate-rich beetroot juice in older people may be due to specific changes in their oral microbiome, according to the largest study of its kind.

Researchers at the University of Exeter conducted the study, published in the journal Free Radical Biology and Medicine, comparing responses between a group of older adults to that of younger adults. Previous research has shown that a high nitrate diet can reduce blood pressure, which can help reduce risk of heart disease.

Nitrate is crucial to the body and is consumed as a natural part of a vegetable-rich diet.  When the older adults drank a concentrated beetroot juice ‘shot’ twice a day for two weeks*, their blood pressure decreased – an effect not seen in the younger group.

The new study, funded by a BBSRC Industrial Partnership Award, provides evidence that this outcome was likely caused by the suppression of potentially harmful bacteria in the mouth.  An imbalance between beneficial and harmful oral bacteria can decrease the conversion of nitrate (abundant in vegetable-rich diets) to nitric oxide. Nitric oxide is key to healthy functioning of the blood vessels, and therefore the regulation of blood pressure.

Study author Professor Anni Vanhatalo, of the University of Exeter, said: “We know that a nitrate-rich diet has health benefits, and older people produce less of their own nitric oxide as they age. They also tend to have higher blood pressure, which can be linked to cardiovascular complications like heart attack and stroke. Encouraging older adults to consume more nitrate-rich vegetables could have significant long term health benefits. The good news is that if you don’t like beetroot, there are many nitrate-rich alternatives like spinach, rocket, fennel, celery and kale.”

The study recruited 39 adults aged under 30, and 36 adults in their 60s and 70s through the NIHR Exeter Clinical Research Facility. The trial was supported by the Exeter Clinical Trials Unit. Each group spent two weeks taking regular doses of nitrate-rich beetroot juice and two weeks on a placebo version of the juice with nitrate stripped out. Each condition had a two week “wash out” period in between to reset. The team then used a bacterial gene sequencing method to analyse which bacteria were present in the mouth before and after each condition.

In both groups, the make-up of the oral microbiome changed significantly after drinking the nitrate-rich beetroot juice, but these changes differed between the younger and older age groups.

The older age group experienced a notable decrease in the mouth bacteria Prevotella after drinking the nitrate rich juice, and an increase in the growth of bacteria known to benefit health such as Neisseria. The older group had higher average blood pressure at the start of the study, which fell after taking the nitrate-rich beetroot juice, but not after taking the placebo supplement.

Co-author Professor Andy Jones, of the University of Exeter, said: “This study shows that nitrate-rich foods alter the oral microbiome in a way that could result in less  inflammation, as well as a lowering of blood pressure in older people. This paves the way for larger studies to explore the influence of lifestyle factors and biological sex in how people respond to dietary nitrate supplementation.”

Dr Lee Beniston FRSB, Associate Director for Industry Partnerships and Collaborative Research and Development at BBSRC, said:

“This research is a great example of how bioscience can help us better understand the complex links between diet, the microbiome and healthy ageing. By uncovering how dietary nitrate affects oral bacteria and blood pressure in older adults, the study opens up new opportunities for improving vascular health through nutrition. BBSRC is proud to have supported this innovative partnership between academic researchers and industry to advance knowledge with real-world benefits.”

The paper is titled ‘Ageing modifies the oral microbiome, nitric oxide bioavailability and vascular responses to dietary nitrate supplementation’ and is published in the journal Free Radical Biology and Medicine.

Rethink the 10,000 a day step goal

 

• Walking 7000 steps a day can lower the risk of an early death by up to 47 percent
• Health benefits increased with every 1000-step increment up until 7000 steps, at which point the benefits began to taper off

 

A major new study led by the University of Sydney suggests that walking 7000 steps a day offers similar health benefits across several outcomes as walking 10,000.

 

Led by Professor Melody Ding from the School of Public Health, the study was published in The Lancet Public Healthand analysed data from 57 studies from 2014 to 2025 that were conducted in more than ten countries including Australia, USA, UK and Japan.

 

The largest and most comprehensive review to date, the researchers examined the impact that different daily step counts have on the chance of dying from cardiovascular disease and cancer, and developing diseases such as cancer, type 2 diabetes, dementia and depression. Professor Melody Ding says the findings offer a more achievable benchmark for people who struggle to meet traditional exercise guidelines. 

 

“Aiming for 7000 steps is a realistic goal based on our findings, which assessed health outcomes in a range of areas that hadn’t been looked at before,” said Professor Ding.

 

“However, for those who cannot yet achieve 7000 steps a day, even small increases in step counts, such as increasing from 2000 to 4000 steps a day, are associated with significant health gain.

 

“We know daily step count is linked to living longer, but we now also have evidence that walking at least 7000 steps a day can significantly improve eight major health outcomes - including reducing risk of cardiovascular disease, dementia and depressive symptoms.”

 

Health benefits at different step counts

 

The researchers looked at studies in which participants wore step counting devices, such as pedometers, accelerometers and fitness trackers, to track their daily step counts. Starting at 2000 steps, experts compared the health outcomes of people walking more steps a day at 1000 step increments to see whether there was any difference in the risk of early death or other major diseases. 

 

When compared with 2000 steps a day, researchers found that: 

 

• Walking 7000 steps a day reduced the risk of death by 47 percent, which was almost identical to the benefit seen at walking 10,000 steps per day. 
• Dementia risk dropped by 38 percent from walking 7000 steps a day, with only a 7 percent extra reduction at 10,000 steps. 
• Risk of type 2 diabetes fell by 22 percent from walking 10,000 steps a day and reduced to 27 percent at 12,000 steps.
• Significant health improvements were seen when people increased their average daily steps from 2000 to between 5000 and 7000 steps. 

 

“For people who are already active, 10,000 steps a day is great,” said Dr Katherine Owen, co-author and chief analyst of the study from the School of Public Health. “But beyond 7000 steps, the extra benefits for most of the health outcomes we looked at were modest.”

 

The researchers are working with the Australian government to use the evidence from this study to inform future updates to physical activity guidelines.

 

“Our research helps to shift the focus from perfection to progress. Even small increases in daily movement can lead to meaningful health improvements,” said Professor Ding. 

 

Experts are calling for future studies to explore how step goals should vary based on age, health status and region, and to include diverse populations and longer-term data to strengthen the evidence. Professor Ding says this kind of detail is rare and will be useful for health practitioners when tailoring advice for patients.

Inappropriate prescriptions for antibiotics, glucocorticoids and opioids common at urgent cares

 

Urgent care visits commonly result in inappropriate prescriptions of antibiotics, glucocorticoids or opioids, according to a letter in the Annals of Internal Medicine.

Michigan Medicine researchers examined commercial and Medicare Supplemental databases to study 22,426,546 urgent care visits, which resulted in 2,783,924 (12.4%) antibiotic, 2,038,506 (9.1%) glucocorticoid, and 299,210 (1.3%) opioid prescriptions.

In each category, they identified a substantial number of prescriptions that were filled despite being "never appropriate" or "generally inappropriate" given the patients' diagnoses.

"Previous studies had shown that patients continue to receive antibiotics for diagnoses where they may not be indicated, such as for a viral respiratory infection, especially in urgent care settings,” said Shirley Cohen-Mekelburg, M.D., M.S., assistant professor of internal medicine at the University of Michigan Medical School and co-lead author on the article.

“Our findings reveal that this trend of inappropriate prescribing includes other classes of drugs—including glucocorticoids—and a variety of conditions.”

Among the “never appropriate” indications, antibiotics were prescribed for 30.7% of patients diagnosed with otitis media, 45.7% with genitourinary symptoms and 15.0% with acute bronchitis.

Previous studies have shown high rates of inappropriate prescriptions for respiratory tract infections.

The researchers cite one study which found inappropriate antibiotic prescribing in 16% of urgent care visits, compared to 6% and 5% in office and emergency visits, respectively.

Glucocorticoid prescriptions were sorted into categories of “potentially appropriate” or “generally inappropriate,” depending on the diagnosis.

Among the indications for which they were deemed generally inappropriate, glucocorticoids were prescribed in 23.9% of sinusitis, 40.8% of acute bronchitis and 7.9% of otitis media cases.

Urgent care centers prescribed opioids in a variety of generally inappropriate cases, including non-back musculoskeletal pain (4.6% of cases), abdominal pain and digestive symptoms (6.3%), and sprains and strains (4.0%).

The authors attribute these trends to “clinician knowledge, patient demand and lack of decision support.”

They suggest a variety of potential solutions, including drug stewardship programs, electronic health record programs and education.

The article urges that future studies focus on the development of urgent care-tailored stewardship programs.

“Reducing inappropriate prescribing of antibiotics, glucocorticoids and opioids will require a multifaceted approach,” Cohen-Mekelburg said.

“Providers at urgent centers would benefit from greater support and feedback in making these decisions.”

‘Weekend warriors’ with diabetes have a 33% lower risk of cardiovascular mortality

A prospective cohort study examined the associations of different physical activity patterns with all-cause, cardiovascular (CV) and cancer mortality among adults with diabetes. The study found that weekend warrior and regular activity patterns meeting current physical activity recommendations were associated with similarly reduced risks for all-cause and cardiovascular mortality compared to physical inactivity, demonstrating the importance of any physical activity for people with diabetes. The results are published in Annals of Internal Medicine.

 

Researchers from Harvard T.H. Chan School of Public Health, Boston University School of Public Health, Vanderbilt University Medical Center, Capital Medical University, and colleagues studied data from 51,650 adults with self-reported diabetes who participated in the National Health Interview Survey (NHIS) between 1997 and 2018. Current guidelines recommend at least 150 minutes per week of moderate-to-vigorous physical activity (MVPA) distributed across a minimum of three days. Participants were categorized into four activity patterns: inactive (no reported MVPA); insufficiently active (MVPA less than 150 minutes per week); weekend warrior (MVPA 150 or more minutes per week across one to two sessions); and regularly active (MVPA 150 or more minutes per week across at least three sessions). The researchers found that insufficiently active, weekend warrior, and regularly active participants had lower risks for all-cause and cardiovascular mortality compared to inactive participants. Weekend warriors and regularly active participants had a 21% and 17% lower all-cause mortality risk and 33% and 19% lower risks of cardiovascular mortality, respectively, compared with inactive participants. There were fewer differences by cancer mortality compared with physical inactivity. 

 

Heart-healthy habits also prevent cancer, Alzheimer’s, COPD, other diseases

 A new study from Emory University reveals that maintaining optimal cardiovascular health can significantly improve overall physical and psychological well-being.

Published today in the Journal of the American Heart Association, the study synthesizes findings from nearly 500 peer-reviewed studies. It confirms that the benefits of heart-healthy behaviors extend far beyond the heart, positively impacting brain function, vision, hearing, muscle strength, and even reducing the risk of chronic diseases such as cancer and dementia.

“While we recently learned that heart-health and brain health are closely tied, in this review we found that almost every organ system and bodily function from head to toe benefit from a heart-healthy lifestyle,” says Liliana Aguayo, PhD, MPH, research assistant professor at the Emory University Nell Hodgson Woodruff School of Nursing and core faculty member at Emory’s Global Diabetes Research Center, who led the study.  

The review is the first of its kind to systematically examine how the American Heart Association’s Life’s Simple 7™ metrics — which include not smoking, healthy eating, regular physical activity, maintaining a healthy weight, and managing blood pressure, cholesterol, and blood sugar — influence health outcomes across multiple organ systems. The updated Life’s Essential 8™ also includes sleep as a key factor.

Among the key findings were that those with heart-healthy habits:

• Were more likely to maintain their brain and lung function, vision and hearing, and keep their teeth and muscle strength as they age. 
• Experienced lower levels of cortisol and stress and lower frequencies of several chronic diseases, including cancer, COPD, pneumonia, Alzheimer’s disease, dementia, fatty liver disease, type 2 diabetes, depression, and kidney and end-stage renal disease.
• Had a higher self-reported quality of life and a lower risk of adverse pregnancy outcomes, sleep-disordered breathing, metabolic syndrome, erectile dysfunction, functional disability and mobility problems, and all-cause mortality.
• Experienced lower medical expenditures, health care utilization, and non-cardiovascular disease costs.

Eating two eggs a day can actually reduce LDL levels and lower the risk of heart disease.

 From poached to panfried, when it comes to eggs, it’s all sunny side up, as new research from the University of South Australia confirms that this breakfast favourite won’t crack your cholesterol.
 
Long blamed for high cholesterol, eggs have been beaten up for their assumed role in cardiovascular disease (CVD). Now, UniSA researchers have shown definitively that it’s not dietary cholesterol in eggs but the saturated fat in our diets that’s the real heart health concern.
 
In a world-first study, researchers examined the independent effects of dietary cholesterol and saturated fat on LDL cholesterol (the ‘bad’ kind), finding that eating two eggs a day – as part of a high cholesterol but low saturated fat diet – can actually reduce LDL levels and lower the risk of heart disease.
 
CVD is the leading cause of death worldwide, responsible for nearly 18 million deaths each year. In Australia, one person dies from CVD every 12 minutes, accounting for one in four of deaths nationwide.
 
Lead researcher, UniSA’s Professor Jon Buckley, says it’s time to rethink the reputation of eggs.
 
“Eggs have long been unfairly cracked by outdated dietary advice,” Prof Buckley says.
 
“They’re unique – high in cholesterol, yes, but low in saturated fat. Yet it’s their cholesterol level that has often caused people to question their place in a healthy diet.
 
“In this study, we separated the effects of cholesterol and saturated fat, finding that high dietary cholesterol from eggs, when eaten as part of a low saturated fat diet, does not raise bad cholesterol levels.
 
“Instead, it was the saturated fat that was the real driver of cholesterol elevation.
 
“You could say we’ve delivered hard-boiled evidence in defence of the humble egg.
 
“So, when it comes to a cooked breakfast, it’s not the eggs you need to worry about – it’s the extra serve of bacon or the side of sausage that’s more likely to impact your heart health.”

An avocado at night may promote healthier triglyceride metabolism the next morning

 Findings from a newly published randomized controlled trial offer surprising insights for the one in three adults at greater risk of heart disease because of prediabetes. The study explored how snacking on avocado at night affects health markers the next morning, in line with the “second-meal effect” – the idea that the composition of a previous meal can affect how the body processes the next meal.

The results suggest snacking on avocado at night may promote healthier triglyceride metabolism the next morning. Triglycerides are the most common type of fat in the body, but elevated levels can be a sign of insulin resistance, a hallmark of type 2 diabetes characterized by the body’s inability to process and turn food into energy the way it should. Many people with prediabetes have high triglycerides which put them at greater risk of heart disease.

In the study, 27 adults with prediabetes ate three different calorie-matched snacks on separate evenings: 1) one whole avocado (containing fiber and unsaturated fats), 2) a low-fat, low-fiber snack, and 3) a processed snack designed to match avocado’s fat and fiber content. The emerging science shows that eating a whole avocado as a nighttime snack led to slightly lower triglyceride levels before breakfast and significantly lower levels after breakfast (3 hours after the meal), compared to the other snacks.

“Our findings suggest that avocado’s unique nutrient package – its whole-food matrix – may further support heart health by encouraging healthier triglyceride metabolism,” said Britt Burton-Freeman, study author and professor and chair of the Department of Food Science and Nutrition at Illinois Institute of Technology. “While the good fats and fiber in avocados already make them a satisfying snack, this research is making us think about how snacks before bed – something 84% of people consume regularly – can influence how the body handles food later.

It’s really intriguing to find a positive outcome when the snack is avocado given the concerns about late-night eating contributing to increased risk of obesity and cardiometabolic conditions.” 

Participants in the study typically ate their snacks between 8:00 and 9:00 pm, followed by a 12 hour fast overnight. The next morning, they consumed a standardized breakfast and blood samples were collected before and after breakfast to measure triglycerides, glucose, insulin, and inflammatory markers. No significant differences were observed in glucose, insulin, or inflammatory markers. The researchers surmise that testing snack behaviors over several days versus one day may be needed to better understand the impact on these health markers.

Findings from this study, supported by the Avocado Nutrition Center, might not apply to everyone but they offer intriguing insight into the potential benefits of avocado as a nighttime snack—particularly in light of recent research about fruit and vegetable intake for sleep quality, and the connection between avocado consumption and diet quality, sleep, and blood lipids. These three factors—diet, sleep, and blood lipids—are all recognized by the American Heart Association as essential components of cardiovascular well-being.

Walking slightly faster could help older adults stay fit

Frailty is a medically defined condition in older adults that increases vulnerability to everyday stresses, leading to a higher risk of falls, hospitalization and loss of independence. Warning signs of frailty include:

• Unintentional weight loss
• Moving slowly
• Feeling weak
• Persistent tiredness
• Low levels of physical activity

Because most of these signs have a direct link to how active someone is, walking is a particularly effective way to help older adults improve their overall health and quality of life and maintain independence for longer.

But a common question remains: How fast should older adults walk to see real benefits? Traditionally, the “talk test” has been used to guide walking intensity: people are encouraged to walk at a pace that makes it difficult to sing but still allows for comfortable conversation. However, this method is subjective and difficult to apply consistently.

A new study led by researchers at the University of Chicago Medicine found that walking slightly faster — 14 steps per minute more than a person’s usual pace — led to meaningful improvements in physical function among older adults who were frail or at risk of becoming frail. In a second study, the researchers developed and tested a smartphone app designed to accurately measure walking pace, making it easier to integrate this beneficial practice into daily life.

Why study walking pace?

Walking cadence — the number of steps taken per minute — is an intuitive and pragmatic way to measure walking intensity. Daniel Rubin, MD, an anesthesiologist at UChicago Medicine, became interested in cadence because of his clinical experience evaluating older patients preparing for surgery.

“Older adults have a high risk of complications associated with surgery,” he said. “Traditionally, surgical teams have relied on physical function questionnaires to risk stratify patients, but I thought there must be a way to develop more objective metrics.”

Walking faster is healthier

In a secondary analysis of a randomized controlled trial, Rubin and his colleagues studied older adults classified as frail or prefrail. Participants were enrolled in structured walking programs within their retirement communities, guided and assessed by clinical research staff, and cadence was measured by a device fitted to their thigh. One group was encouraged to walk “as fast as safely possible,” while another group walked at their usual comfortable pace.

The study’s results showed clear benefits: those who increased their cadence by at least 14 steps per minute above their usual pace (to roughly 100 steps per minute) experienced substantial improvements in their functional capacity, demonstrated by their ability to walk longer distances in a standardized test.

“People who haven’t experienced frailty can't imagine how big a difference it makes to be able to not get tired going to the grocery store or not need to sit down while they're out,” Rubin said.

An intuitive walking app

Building on these findings, Rubin's team created a smartphone app called “Walk Test,” which they designed specifically for measuring walking cadence accurately.

"We didn't necessarily trust smartphones’ built-in analytics,” Rubin said. “Instead, we built an app that uses a novel open-source method to analyze the data measured by the phone and lets us actively engage users in brief, deliberate walking tests, ensuring accurate measurement.”

Validation testing showed that the app counts steps per minute with exceptional accuracy, closely matching specialized, research-grade accelerometers. Rubin noted that Walk Test was designed for accessibility and user-friendliness in addition to accuracy.

“We wanted to make it as low-barrier as possible so it’s easy for older adults to use without additional equipment,” he said. “The people who need the most help are usually the least well-equipped to get started.”

Practical advice for daily life

The research highlights walking as a widely accessible exercise with substantial health benefits.

"Even casual walking had positive effects on our study participants," Rubin said. But for those who are able, increasing their walking pace judiciously can yield even greater results.

To use cadence to guide your walking intensity, start by measuring your usual walking pace in steps per minute to establish a baseline. From there, try increasing your pace slightly to find a level that still feels comfortable but brisker.

To maintain a steady and elevated cadence, Rubin recommends using a metronome app to match your steps to a consistent beat. While the Walk Test app developed by the research team is not yet available to the public, metronome apps are a simple alternative that can help walkers stay on pace and track progress over time.

These methods can help integrate faster-paced walking into daily routines, offering a simple yet effective strategy to people who want to stay healthier and more independent as they age.

“A smartphone application to measure walking cadence before major abdominal surgery in older adults” was published in Digital Biomarkers in June 2025. Authors include Daniel Rubin, Marcin Straczkiewicz, Emi Yamamoto, Maria Lucia L. Madariaga, Mark Ferguson; Jennifer S. Brach, Nancy W. Glynn, Sang Mee Lee, Margaret Danilovich and Megan Huisingh-Scheetz.

“Walking cadence as a measure of activity intensity and impact on functional capacity for prefrail and frail older adults,” was published in PLOS ONE in July 2025. 

Playing an instrument may protect against cognitive aging

Long-term musical training may mitigate the age-related decline in speech perception by enhancing cognitive reserve, according to a study published July 15th in the open-access journal PLOS Biology by Claude Alain from the Baycrest Academy for Research and Education, Canada, and Yi Du from the Chinese Academy of Sciences.

Normal aging is typically associated with declines in sensory and cognitive functions. These age-related changes in perception and cognition are often accompanied by increased neural activity and functional connectivity – the statistical dependence of activity between different brain regions – in widely distributed neural networks. The recruitment of neural activity and strengthening of functional connectivity are thought to reflect a compensatory strategy employed by older adults to maintain optimal cognitive performance.

Positive lifestyle choices, such as musical training, higher levels of education, and bilingualism, contribute to cognitive and brain reserve, which represents the accumulation of cognitive and neural resources before the onset of age-related brain changes. Cognitive Reserve Theory suggests that this reserve accrued through experience and training can help mitigate the impact of age-related brain decline, leading to better-than-expected cognitive performance. Yet how cumulative reserves influenced by positive lifestyle factors affect neural activity in older populations remains controversial.

To investigate this question, the researchers used functional magnetic resonance imaging (fMRI) to measure brain activity in 25 older musicians, 25 older non-musicians, and 24 young non-musicians who were asked to identify syllables masked by noise sounds. The researchers focused their analysis on neural responses within the auditory dorsal stream, which includes auditory, inferior parietal, dorsal frontal motor, and frontal motor areas, supporting sound-to-action mapping and sensorimotor integration during speech processing.

As predicted, the results revealed reduced age-related declines in speech-in-noise performance among older musicians compared to older non-musicians. During speech-in-noise perception, the older non-musicians showed the typical age-related compensatory increase in functional connectivity in auditory dorsal streams bilaterally (i.e., in both hemispheres of the brain). By contrast, older musicians exhibited a connectivity pattern in bilateral auditory dorsal streams that resembled young non-musicians, with connectivity strength in the right dorsal stream correlating with speech-in-noise perception. In addition, older musicians exhibited more youth-like spatial pattern of functional connectivity during the task, whereas older non-musicians consistently showed a spatial pattern that deviated from young non-musicians.

Taken together, these findings support the “Hold-Back Upregulation” hypothesis, which posits that cognitive reserve from musical training promotes a more youthful functional connectivity pattern, leading to superior behavioral outcomes. Beyond merely compensating for age-related declines, cognitive reserve may work by maintaining the integrity and functional architecture of neural networks, thereby mitigating the adverse effects of aging on cognitive performance. But due to the study design, it was not possible to determine cause-and-effect relationships between musical training and performance in the perception task.

According to the authors, future studies should further test the “Hold-Back Upregulation” hypothesis using different cognitive tasks, such as memory and attention tasks, and investigate other sources of reserve, such as physical exercise and bilingualism. Eventually, these findings may inform interventions aimed at preserving cognitive function and improving communication outcomes in aging populations.

Dr. Lei Zhang adds, “A positive lifestyle helps older adults cope better with cognitive ageing, and it is never too late to take up, and stick with, a rewarding hobby such as learning an instrument.”

Dr. Yi Du adds, “Just like a well-tuned instrument doesn’t need to be played louder to be heard, the brains of older musicians stay finely tuned thanks to years of training. Our study shows that this musical experience builds cognitive reserve, helping their brains avoid the usual age-related overexertion when trying to understand speech in noisy places.”

The freely available paper in PLOS Biology: http://plos.io/3FMpr6l