Ultra-processed foods linked with serious heart problems

 

Consuming more daily servings of ultra-processed foods is associated with a higher risk of adverse cardiac events, with Black Americans seeing amplified risk

Peer-Reviewed Publication

American College of Cardiology

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People who consumed over nine servings of ultra-processed foods per day on average were 67% more likely to suffer a major cardiac event than people consuming about one serving of such foods per day, in a study being presented at the American College of Cardiology’s Annual Scientific Session (ACC.26). Ultra-processed foods include many packaged and convenience foods, such as chips, crackers, frozen meals, processed meats, sugary drinks, breakfast cereals and breads.

With each additional daily serving, the risk of adverse events such as heart attacks, strokes and death from coronary heart disease or stroke increases by more than 5%, according to the findings. The association between ultra-processed food intake and adverse events was more pronounced among Black Americans compared with other racial groups.

“Ultra-processed foods are associated with an increased risk for heart disease, and while many of these products may seem like convenient on-the-go meal or snack options, our findings suggest they should be consumed in moderation,” said Amier Haidar, MD, a cardiology fellow at the University of Texas Health Science Center at Houston and the study’s lead author.

The research is among the first large studies to examine ultra-processed food consumption and heart disease risk in a racially diverse population of U.S. adults. The findings align with those of previous studies, most of which have been conducted in Europe, and offer additional context for the more diverse U.S. population.

The study is based on data from 6,814 U.S. adults without known heart disease who enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) between ages 45-84 years. Using food questionnaires, researchers assessed each participant’s daily intake of ultra-processed foods based on the NOVA classification system, which categorizes foods into four groupings ranging from unprocessed or minimally processed (e.g., corn on the cob) through ultra-processed (e.g., corn chips), with more lightly processed items falling in the middle (e.g., corn starch and canned corn). 

Participants in the highest quintile for ultra-processed food intake consumed 9.3 servings of such foods per day on average, while participants in the lowest quintile averaged 1.1 servings per day. Compared with the lowest quintile, participants in the highest quintile were 67% more likely to die from coronary heart disease or stroke or to experience a non-fatal heart attack, stroke or resuscitated cardiac arrest.

“We controlled for a lot of factors in this study,” Haidar said. “Regardless of the amount of calories you consumed per day, regardless of the overall quality of your diet, and after controlling for common risk factors like diabetes, high blood pressure, high cholesterol and obesity, the risk associated with higher ultra-processed food intake was still about the same.”

Haidar said these findings suggest that ultra-processed foods may contribute to cardiovascular risk through mechanisms beyond excess calories or poor overall diet quality, and that paying attention to how foods are processed alongside their nutrient content may be important for heart health.

Overall, each additional daily serving of ultra-processed foods was associated with a 5.1% increased risk of adverse cardiac events. However, this association was amplified among Black Americans, who saw a 6.1% increase in risk with each additional serving compared with a 3.2% increase per serving among non-Black individuals. Researchers said that minority-targeted food marketing and neighborhood environmental factors that make it harder to access less-processed foods have likely contributed to inequities in ultra-processed food consumption and associated health impacts among different racial groups.

There were several limitations to the study. Since the MESA study was not designed specifically to collect data on ultra-processed food intake, researchers said that the dietary questionnaire data relied on self-reporting by participants and assessed processed food intake by number of servings rather than individual food items.

The study also did not focus on the biological mechanisms involved, but previous research suggests that the high energy density, added sugars and fats, and effects on satiety and metabolism from ultra-processed foods drives weight gain, inflammation and the buildup of visceral fat tissue, all of which can contribute to heart disease.

Heidar said one way to reduce risk is to pay attention to the types of foods being consumed and to the food labels. Nutrition labels provide important information about the amount of added sugar, salt, fat and carbohydrates in each serving. These are often higher in ultra-processed foods compared with less-processed foods like plain oatmeal, nuts, beans and fresh or frozen produce.

The ACC published a 2025 Concise Clinical Guidance report in JACC endorsing a standardized front-of-package labeling system to help make sure that healthier choices are more visible, accessible and achievable for all consumers.

This study was published simultaneously in JACC Advances.

Closing your eyes might not help you hear better

 Most people will close their eyes when trying to concentrate on a faint sound. Many of us have been told that keeping our eyes closed helps us hear better — that it frees up our brains’ processing abilities and increases our auditory sensitivity. However, that strategy may sometimes backfire, particularly in environments with a lot of loud background noise.

In JASA, published on behalf of the Acoustical Society of America by AIP Publishing, researchers from Shanghai Jiao Tong University tested whether a person closing their eyes can really hear better in noisy environments.

To test this, volunteers listened to a collection of sounds through headphones amid background noise. Then, the volunteers adjusted the volume of the sounds until they could barely make them out over the background noise.

This test was conducted first with eyes closed, then with eyes open but looking at only a blank screen, then looking at a still picture corresponding to the sound, and finally, looking at a video matching up with the sound they were trying to hear.

“We found that, contrary to popular belief, closing one’s eyes actually impairs the ability to detect these sounds,” said author Yu Huang. “Conversely, seeing a dynamic video corresponding to the sound significantly improves hearing sensitivity.”

To find an explanation for this result, the researchers attached electroencephalography (EEG) devices to the participants to monitor their brain activity. They determined that closing the eyes puts a participant’s brain in a state of neural criticality, which more aggressively filters noises and quiet sounds, including the target sounds those participants were trying to detect.

“In a noisy soundscape, the brain needs to actively separate the signal from the background,” said Huang. “We found that the internal focus promoted by eye closure actually works against you in this context, leading to over-filtering, whereas visual engagement helps anchor the auditory system to the external world.”

The authors emphasize that this result is unique to noisy environments. With a calmer background, the conventional strategy of keeping their eyes closed likely does help people detect faint sounds. But because so much of our lives are spent surrounded by noise, it might be better to face the world with eyes wide open.

The researchers plan to continue their work exploring the relationship between vision and hearing.

“Specifically, we want to test incongruent pairings — for example, what happens if you hear a drum but see a bird?” said Huang. “Does the visual boost come from simply having the eyes open and processing more visual information, or does the brain require the visual and audio information to match perfectly? Understanding this distinction will help us separate the general effects of attention from the specific benefits of multisensory integration.”

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Want to handle stress better? Start with breakfast, sleep, and exercise

 Do you ever feel mentally stuck, like you can’t cope when a stressful situation hits? A healthy breakfast, exercise, and a good night’s sleep might be just what you need to build psychological flexibility, and new research from Binghamton University shows why that matters.

What is psychological flexibility? Psychological flexibility is the ability to adapt your thoughts, emotions, and behaviors to changing situations in a balanced and constructive way. Instead of getting mentally “stuck” when stress hits, psychologically flexible people can step back, process their emotions, and respond constructively.

“You might know someone who stays cool under pressure,” said Lina Begdache, an associate professor of health and wellness studies and lead author of the study. “The kind of person who misses a flight and, instead of panicking, calmly adapts to the situation. This person may still feel stressed, but they’re better able to manage it through psychological flexibility.”

Lina Begdache, associate professor of health and wellness studies at Decker College of Nursing and Health Sciences, studies the interaction between food and mood. Image Credit: Jonathan Cohen.

“People may say that these are resilient people, but they also have what’s called psychological flexibility. They’re able to change the way they think about the situation and then use brain resources to handle the stress.”

Begdache and her colleagues – former Assistant Professor of Physical Therapy Binghamton Jason Cherry and former student Alexander J. Talkachov – conducted an anonymous survey of approximately 400 college students asking questions on diet, sleeping habits, exercise frequency, and more. They found that consistent healthy habits, such as regular exercise and eating breakfast, enhance psychological flexibility, which in turn strengthens mental resilience and helps individuals cope with stress.

Key findings from the study include:

• Eating breakfast five or more times a week is associated with increased resilience through psychological flexibility processes
• People who sleep less than six hours tend to have less resilience and less psychological flexibility
• Exercise, even 20 minutes or more, is associated with psychological flexibility and resilience
• Taking fish oil multiple times a week can help with psychological flexibility

In contrast, low psychological flexibility, or rigidity in thinking and behavior, is associated with poor habits such as fast-food consumption and insufficient sleep.

Begdache said that psychological flexibility allows a person to “step back” and use their brain’s resources to better understand and process their emotions. And people can have more flexibility if they follow certain improvements in their diet and lifestyle.

“When we’re under stress, we feel like we fuse with the stress. We live the stress. But psychological flexibility is like stepping back and thinking, ‘I feel this because of that. What can I do?’ Identifying your emotions sometimes helps you find the solution for these emotions,” said Begdache.

Begdache’s earlier research found that high-quality diets boost resilience while poor diets reduce it. This study adds a critical piece: psychological flexibility is the pathway through which diet and lifestyle shape resilience.

“The new finding here is that diet and lifestyle don’t just make you resilient by themselves. They help you build the psychological flexibility, which, in turn, makes you a resilient person.”

The paper, “Dietary and lifestyle factors and resilience: the role of psychological flexibility as a mediator,” (opens in a new window)was published in the Journal of American College Health.

Extra belly weight, not BMI, was a stronger predictor of heart failure risk, inflammation

 Research Highlights:

• Excess fat stored around the waist (belly weight or visceral fat), indicated by measuring waist size, was more strongly associated with heart failure risk than body mass index (BMI).
• Systemic inflammation played a key role in the relationship between extra weight stored around the waist, or central obesity, and heart failure. About one-quarter to one-third of the link between abdominal fat and heart failure appeared to be explained by inflammation.
• The mediating role of inflammation in the association between central obesity and heart failure suggests that reducing inflammation levels may be a potential treatment strategy to reduce the risk of heart failure in these individuals.
• Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4:00 p.m. ET/3:00 p.m. CT, Tuesday, March 17, 2026

BOSTON, March 17, 2026 — New research suggests that measures of excess weight around the waist (central obesity or visceral fat) may increase the risk of heart failure primarily due to inflammation, according to findings presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026. The meeting is in Boston, March 17-20, and offers the latest epidemiological science on prevention, lifestyle and cardiometabolic health.

In this study, researchers found that measurements of higher levels of visceral fat were more strongly linked to heart failure risk than overall body weight, and higher waist measurements identified higher risk even when body mass index (BMI) appeared normal. The study found that inflammation may help explain why belly fat is especially harmful to heart health, suggesting that where fat is stored in the body may matter more than weight. These findings point to opportunities to identify people at higher risk of heart failure using waist measurements rather than relying only on BMI.

“This research helps us understand why some people develop heart failure despite having a body weight that seems healthy,” said Szu-Han Chen, lead author of the study and a medical student at National Yang Ming Chiao Tung University in Taiwan. “By monitoring waist size and inflammation, clinicians may be able to identify people with higher risk earlier and focus on prevention strategies that could reduce the chance of heart failure before symptoms begin.”

According to a 2025 scientific statement from the American Heart Association focused on risk-based primary prevention of heart failure, systemic inflammation, or inflammation found throughout the body, is a common risk factor for heart disease because it can disrupt the immune system, damage blood vessels and lead to the build up of scar tissue in the heart. The Association has also highlighted evidence that higher levels of inflammation in the body are linked to an increased risk of heart disease, even in adults with normal cholesterol levels.

The study found:

• 112 adults developed heart failure during the median follow-up period of 6.9 years;
• elevated measurements of excess weight around the waist were associated with increased heart failure risk, while high BMI was not;
• higher waist circumference and waist-to-height ratio were each associated with increased heart failure risk;
• over the follow-up period of almost 7 years, participants with higher inflammation levels, as measured by blood tests, were more likely to experience heart failure; and
• inflammation accounted for about one-quarter to one-third of the link between measures of fat stored around the waist and heart failure risk.

“This study highlights the importance of integrating measures of central adiposity such as waist circumference into routine preventive care. Understanding upstream drivers of heart failure risk including central adiposity is key to recognizing and modifying risk,“ said Sadiya S. Khan, M.D., M.Sc., FAHA, volunteer chair of the American Heart Association’s 2025 Scientific Statement: Risk-Based Primary Prevention of Heart Failure. “This study builds on prior research that highlights the importance of excess or dysfunctional adiposity in the development of heart failure, which informed the inclusion of body mass index into the PREVENT-HF risk equations to estimate risk of heart failure. However, future research should identify if central adiposity has greater predictive utility beyond strength of association.” Khan, who was not involved in the study, is also Magerstadt Professor of Cardiovascular Epidemiology and an associate professor of cardiology and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

The researchers noted that they did not have access to participants’ heart failure subtypes, therefore, the findings are about all types of heart failure together. Future research should examine how visceral fat and inflammation relate to different types of heart failure and whether reducing inflammation can help prevent or reduce the risk of heart failure.

Study details, background and design:  

• Analysis included health data for 1,998 African American adults in three counties in urban and rural Jackson, Mississippi, enrolled in the Jackson Heart Study. Participants did not have heart failure at the time of enrollment in the Jackson Heart Study, 2000-2004.
• Participants were ages 35-84 years old at enrollment, with an average age of 58 years; 36% were women, and they were followed for a median of 6.9 years, through December 31, 2016.
• Researchers assessed participants’ body fat using measures including weight, body mass index (BMI), waist circumference and waist-to-height ratio.
• Blood samples were tested to measure high-sensitivity C-reactive protein, a commonly used marker of inflammation in the body.
• This study was conducted under the guidance of Professor Hao-Min Cheng at Taipei Veterans General Hospital and National Yang Ming Chiao Tung University.

The American Heart Association recently launched the Systemic Inflammation Data Challenge to encourage collaboration and deepen understanding of how inflammation contributes to heart disease and related conditions including heart failure.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association/American Stroke Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the release link.
• After March 17, view abstract 72 in the EPI|Lifestyle Scientific Sessions 2026 Online Program Planner
• American Heart Association Scientific Statement news release: More resources and collaboration needed to support prevention and treatment of obesity (Jan. 2026)
• American Heart Association news release: Data challenge explores inflammation’s hidden role in heart disease (June 2025)
• American Heart Association Scientific Statement: Risk-Based Primary Prevention of Heart Failure (April 2025)
• American Heart Association news release: Measure of body roundness may help to predict risk of cardiovascular disease (Sept. 2024)
• American Heart Association health information: Simple ways to reduce inflammation and protect your heart
• American Heart Association health information: What is Heart Failure?
• For more news from the meeting, follow us on X @HeartNews, #EPILifestyle26.

Mediterranean-blood pressure lowering diet (MIND) may slow structural brain ageing

 

The combined Mediterranean and blood pressure lowering diet (MIND) may slow the structural changes related to brain ageing, finds research published online in the Journal of Neurology Neurosurgery & Psychiatry. 

 

This diet is associated with less tissue loss over time, especially grey matter—the brain’s information processing hub, with a key role in memory, learning, and decision-making—and less ventricular enlargement, which reflects brain atrophy, where tissue loss is accompanied by the enlargement of cerebrospinal fluid-filled spaces.

 

The Mediterranean–Dietary Approaches to Stop Hypertension Diet Intervention for

Neurodegenerative Delay diet, or MIND for short, has previously been linked to better cognitive health, note the researchers. 

 

The diet recommends the regular consumption of particular food groups: green leafy vegetables; other vegetables; berries; nuts; whole grains; fish; beans; olive oil; and poultry, plus a moderate intake of wine. And it recommends limiting intake of butter/margarine, cheese, red meat, pastries/sweets, and fried fast foods.

 

But it’s not clear what effect this diet may have on age-related structural changes in the brain which are associated with neurodegenerative disease, such as Alzheimer’s and Parkinson’s diseases, explain the researchers.

 

To explore this further, they focused on 1647 middle aged and older adults (average age 60 at the start of the study) from the Framingham Heart Study Offspring cohort (FOS). All of them had regular health check ups every 4–8 years, with MRI brain scan assessments every 2–6 years from 1999 onwards.

 

They also completed at least 1 food frequency questionnaire (FFQ) at their check-ups between 1991–5, 1995–8, and/or 1998–2001 to assess dietary intake. And they had at least 2 brain MRI scan assessments between 1999 and 2019 with no evidence of a stroke or dementia by the time of their first MRI scan.

 

Their average MIND diet score was just under 7 out of a possible 15, where 15 indicates the highest level of adherence. Those in the top third of adherence were more likely to be women and college educated, and less likely to be current smokers or living with obesity.  

 

And fewer of them had health issues likely to affect brain health, including type 2 diabetes, high blood pressure, and cardiovascular disease. 

 

During an average monitoring period of 12 years, reductions in total brain, grey matter, white matter, and hippocampal volumes, alongside increased cerebrospinal fluid, ventricular volumes, and white matter hyperintensities—bright spots indicative of tissue damage—were evident on the MRI scans of all the participants.

 

But higher MIND diet scores were associated with slower grey matter shrinkage/loss. Each 3 point increase was associated with slower (0.279 cm³/year) loss, equivalent to 20% less age-related decline and 2.5 years of delayed brain ageing.

 

Similarly, each 3-point increase in MIND diet score was associated with slower expansion of total ventricular volume by −0.071 cm³/year, equivalent to 8% less tissue loss and 1 year of delayed brain ageing.

 

The primary dietary contributors to the observed beneficial associations included berries, which were associated with slower increases in ventricular volumes, and poultry, also associated with slower increases in ventricular volumes and a slower decline in grey matter. 

 

On the other hand, higher intake of sweets was associated with faster ventricular expansion and hippocampal atrophy, while fried fast foods were also linked to a greater decline in hippocampal volume. 

 

“MIND-recommended foods rich in antioxidants, such as berries,and high-quality

protein sources like poultry may reduce oxidative stress and mitigate neuronal damage,” suggest the researchers.  “Conversely, fried fast foods, often high in unhealthy fats, trans fats, and advanced glycation end-products, may contribute to inflammation and vascular damage,” they add.

 

Unexpectedly, higher whole grain intake was associated with unfavourable structural changes, including faster declines in grey matter and hippocampal volume, and faster ventricular expansion, while higher cheese intake was associated with slower reductions in grey matter and hippocampal volume and less ventricular enlargement and fewer bright spots.

 

The associations found were consistent across a series of further analyses and stronger in older participants, suggesting that this diet may be more beneficial in those at higher risk of faster brain ageing, or who exhibit larger variation in the rate of brain atrophy, say the researchers.

 

Stronger associations were also observed for those who were more physically active and who weren’t overweight or obese, suggesting that combined lifestyle strategies might help to lower the risk of neurodegenerative disease, they add.

 

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect, and the researchers acknowledge that food frequency questionnaires are subject to recall bias. And the researchers weren’t able to exclude mild cognitive impairment at the time of the first MRI scan, changes in dietary habits over time, or genetic risk factors.

 

As the participants were predominantly White, the findings might not apply to other ethnicities, they point out.

 

Nevertheless, they conclude: “These findings reinforce the potential of the MIND diet as a brain-healthy dietary pattern and support its role in strategies aimed at slowing  neurodegeneration in ageing populations.”

 

No evidence to suggest medicinal cannabis is effective for depression, anxiety or PTSD

  

A landmark Lancet paper published today – the largest-ever review of the safety and efficacy of cannabinoids across a range of mental health conditions – found no evidence that medicinal cannabis is effective in treating anxiety, depression or post-traumatic stress disorder (PTSD). 

The study comes amid findings that 27 percent of people aged 16–65 in the United States and Canada have used cannabis for medical purposes, with about half using it to manage their mental health. 

The study’s lead author, Dr Jack Wilson at the University of Sydney’s The Matilda Centre, said the results call into question the approval of medicinal cannabis for the treatment of depression, anxiety and PTSD. 

“Though our paper didn’t specifically look at this, the routine use of medicinal cannabis could be doing more harm than good by worsening mental health outcomes, for example a greater risk of psychotic symptoms and developing cannabis use disorder, and delaying the use of more effective treatments,” he said.  

The research found evidence to suggest that medicinal cannabis could potentially be beneficial for some conditions – such as the treatment of cannabis use disorder (otherwise known as cannabis dependency), autism, insomnia, and tics or Tourette’s syndrome. 

Dr Wilson said: “But the overall quality of evidence for these other conditions, such as autism and insomnia, was low. In the absence of robust medical or counselling support, the use of medicinal cannabis in these cases are rarely justified.  

“There is, however, evidence that medicinal cannabis may be beneficial in certain health conditions, such as reducing seizures associated with some forms of epilepsy, spasticity among those with multiple sclerosis, and managing certain types of pain, but our study shows the evidence for mental health disorders falls short. 

“In the case of autism specifically, while the study showed some evidence medicinal cannabis could assist with a reduction in symptoms, it is worth noting that there is no one – or universal – experience of autism, so this finding should be treated with caution.” 

The study found that medicinal cannabis was not effective for every type of substance-abuse disorder. While medicinal cannabis may help with cannabis dependence, it was found to increase cocaine cravings among people with cocaine-use disorder 

“Similar to how methadone is used to treat opioid-use disorder, cannabis medicines may form part of an effective treatment for those with a cannabis-use disorder. When administered alongside psychological therapy, an oral formulation of cannabis was shown to reduce cannabis smoking,” Dr Wilson said.  

“However, when medicinal cannabis was used to treat people with cocaine-use disorder, it increased their cravings. This means it should not be considered for this purpose and may, in fact, worsen cocaine dependence,” he said.  

Researchers urge greater regulation for prescribing of medicinal cannabis 

The rapid expansion in medicinal cannabis use and prescribing rates has raised concerns among major medical bodies, including the American Medical Association about the largely unregulated growth in prescribing and the uncertainty surrounding the efficacy and safety of these products. 

“Our study provides a comprehensive and independent assessment of the benefits and risks of cannabis medicines, which may support clinicians to make evidence-based decisions, helping to ensure patients receive effective treatments while minimising harm from ineffective or unsafe cannabis products,” Dr Wilson said. 

The systematic review and meta-analysis included results from 54 randomised controlled trials (RCTs) published over a 45 year period (1980-2025) worldwide. 

Gut health supplement relieves arthritis pain

 

A new study has found that a prebiotic fibre supplement reduced pain, improved grip strength, and lowered pain sensitivity in people with knee osteoarthritis (OA) - with far fewer dropouts than a digital physiotherapy programme.

The INSPIRE clinical trial, led by experts at the University of Nottingham, showed that taking a daily supplement of inulin- a natural dietary fibre found in chicory root, Jerusalem artichokes and other vegetables – significantly reduced pain in people with OA.

The results, which are published in the journal Nutrients, suggest that improving gut health could be a promising new approach to managing one of the most common and debilitating chronic conditions in older adults.

Knee OA affects hundreds of millions of people worldwide and is a leading cause of pain and disability, particularly in older adults. Current treatment options rely heavily on pain medications, which carry risks of side effects, or exercise programmes, which many patients struggle to maintain.

“This study raises the exciting possibility that a simple dietary change - adding a fibre supplement to your breakfast or yogurt - could meaningfully reduce pain and improve physical function,” said Dr Afroditi Kouraki, lead author of the study from the School of Medicine at the University of Nottingham.

The gut microbiome - the trillions of bacteria living in our digestive system, plays a wide-ranging role in people’s health, including how we experience pain. Inulin acts as a prebiotic, meaning it feeds beneficial gut bacteria. This leads to the production of short-chain fatty acids (SCFAs), particularly a compound called butyrate, which can influence inflammation and pain pathways throughout the body.

In the INSPIRE trial, participants who took inulin showed increased levels of both butyrate and glucagon-like peptide-1 (GLP-1) — a hormone released by the gut that has been linked to pain regulation and muscle health. Higher GLP-1 levels were associated with improved grip strength, pointing to a possible gut-muscle connection that could open up exciting new avenues of research.

The six-week randomised controlled trial involved 117 adults with knee OA and tested four groups: inulin alone, digital physiotherapy-supported exercise (PSE) alone, a combination of both, and a placebo. Both inulin and physiotherapy independently reduced knee pain. However, inulin uniquely improved grip strength and reduced pain sensitivity, measures linked to how the nervous system processes pain, while physiotherapy did not.

Strikingly, the dropout rate for the inulin group was just 3.6%, compared to 21% for those in the physiotherapy group - suggesting that a daily dietary supplement may be easier for people to stick with than an exercise programme.

Dr Kouraki said: "Our findings suggest that targeting gut health with a prebiotic supplement is a safe, well-tolerated, and effective way to reduce pain in people with knee osteoarthritis. The very low dropout rate compared to the exercise group is also encouraging from a public health perspective — people were able to fit this supplement easily into their daily lives."

Senior author Professor Ana Valdes from the School of Medicine added: "The link we observed between GLP-1 and grip strength is particularly intriguing and points to a broader gut-muscle-pain axis that warrants further investigation. This could have implications not just for osteoarthritis, but for understanding how gut health influences ageing and physical resilience more broadly."

Professor Lucy Donaldson, Director of Research at Arthritis UK said: “The pain of arthritis can severely impact quality of life. Our recent lived experience survey showed that six  in ten people are living in pain most or all of the time due to their arthritis.

“Researchers are starting to explore the role of the gut microbiome in our experience of pain. This exciting preliminary research highlights how diet and physiotherapy can act in different ways to have benefits for people with arthritis. We know a variety and balance of healthy foods, including fibre, and regular physical activity matter, and we’re glad to be supporting research that explores how they work to help people with arthritis.”

The full study can be found here.