Reducing sedentary behavior, increasing physical activity protects against bone loss&fractures

 A new review by the International Osteoporosis Foundation (IOF) Rehabilitation Working Group underscores the powerful impact of lifestyle behaviours—specifically physical activity and sedentary behaviour —on bone health across the human lifespan. 

While exercise has long been recognized for its role in strengthening bones and reducing fracture risk, emerging evidence reveals that prolonged sitting and inactivity can harm skeletal health, even among individuals who engage in regular physical activity. 

The study 'The Impact of Sedentary Behavior and Physical Activity on Bone Health: A Narrative Review from the Rehabilitation Working Group of the International Osteoporosis Foundation' synthesizes findings from epidemiological studies, systematic reviews, and meta-analyses, examining how physical activity and sedentary behaviour influence bone mineral density (BMD) and fracture risk in children, adolescents, adults, and older populations.

Key findings include:

• Physical activity – especially weight-bearing and resistance training – improves bone mineral density and helps reduce fracture risk in both younger and older populations.
• Sedentary behaviour – independent of overall activity levels – has harmful effects on bone health, increasing fracture risk, particularly in frail or pre-frail individuals.
• Even light-intensity activity can yield measurable benefits when it replaces sedentary time, especially in older adults and postmenopausal women.
• Early and continuous promotion of physical activity, aligned with World Health Organization (WHO) guidelines, provides an effective strategy for maintaining skeletal health and preventing osteoporotic fractures.

The evidence demonstrates that physical activity and sedentary behaviour are independent, modifiable factors influencing skeletal health. Clinical practice and public health policy should address both — not only encouraging physical activity, but also actively reducing prolonged sedentary time.

Professor Olivier Bruyère, Co-chair of the IOF Rehabilitation Working Group and Lead Author of the publication, stated:  

“This review highlights a critical message for populations worldwide: bone health depends not only on engaging in regular physical activity, but also on reducing the hours we spend in sedentary behaviour. In children and adolescents, too much sitting time can undermine bone development, while in adults and older individuals, inactivity accelerates bone loss and fracture risk. Importantly, even light daily activity—such as walking—can provide measurable benefits, particularly for older adults and postmenopausal women.”

IOF President Professor Nicholas Harvey and IOF CSA Chairman Professor Eugene McCloskey jointly underscore the significance of the study’s clinical and policy implications: 

“The findings highlight the imperative for early intervention and sustained promotion of physical activity throughout the life course, in alignment with WHO recommendations. We therefore urge governments, healthcare providers, and policymakers to implement comprehensive public health strategies that not only encourage active lifestyles but also systematically reduce sedentary behaviours across all populations and age groups, in order to ensure optimal skeletal health and fracture prevention.”

Evidence That Prenatal Acetaminophen Linked to Increased Risk of Autism and ADHD

 Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children. The study, published today in BMC Environmental Health, is the first to apply the rigorous Navigation Guide methodology to systematically evaluate the rigor and quality of the scientific literature.

Acetaminophen (often sold under the brand name Tylenol®, and known as paracetamol outside the United States and Canada) is the most commonly used over-the-counter pain and fever medication during pregnancy and is used by more than half of pregnant women worldwide. Until now, acetaminophen has been considered the safest option for managing headache, fever, and other pain. Analysis by the Mount Sinai-led team of 46 studies incorporating data from more than 100,000 participants across multiple countries challenges this perception and underscores the need for both caution and further study.

The Navigation Guide Systematic Review methodology is a gold-standard framework for synthesizing and evaluating environmental health data. This approach allows researchers to assess and rate each study’s risk of bias, such as selective reporting of the outcomes or incomplete data, as well as the strength of the evidence and the quality of the studies individually and collectively.

“Our findings show that higher-quality studies are more likely to show a link between prenatal acetaminophen exposure and increased risks of autism and ADHD,” said Diddier Prada, MD, PhD, Assistant Professor of Population Health Science and Policy, and Environmental Medicine and Climate Science, at the Icahn School of Medicine at Mount Sinai. “Given the widespread use of this medication, even a small increase in risk could have major public health implications.”

The paper also explores biological mechanisms that could explain the association between acetaminophen use and these disorders. Acetaminophen is known to cross the placental barrier and may trigger oxidative stress, disrupt hormones, and cause epigenetic changes that interfere with fetal brain development.

While the study does not show that acetaminophen directly causes neurodevelopmental disorders, the research team’s findings strengthen the evidence for a connection and raise concerns about current clinical practices.

The researchers call for cautious, time-limited use of acetaminophen during pregnancy under medical supervision; updated clinical guidelines to better balance the benefits and risks; and further research to confirm these findings and identify safer alternatives for managing pain and fever in expectant mothers.

“Pregnant women should not stop taking medication without consulting their doctors,” Dr. Prada emphasized. “Untreated pain or fever can also harm the baby. Our study highlights the importance of discussing the safest approach with health care providers and considering non-drug options whenever possible.”

With diagnoses of autism and ADHD increasing worldwide, these findings have significant implications for public health policy, clinical guidelines, and patient education. The study also highlights the urgent need for pharmaceutical innovation to provide safer alternatives for pregnant women.

Meal timing, especially delayed breakfast, in later life may matter for health and longevity

 As we age, what and how much we eat tends to change. However, how meal timing relates to our health remains less understood. Researchers at Mass General Brigham and their collaborators studied changes to meal timing in older adults and discovered people experience gradual shifts in when they eat meals as they age. They also found characteristics that may contribute to meal timing shifts and revealed specific trajectories linked to an earlier death. The results are published in Communications Medicine.

“Our research suggests that changes in when older adults eat, especially the timing of breakfast, could serve as an easy-to-monitor marker of their overall health status. Patients and clinicians can possibly use shifts in mealtime routines as an early warning sign to look into underlying physical and mental health issues,” said lead author Hassan Dashti, PhD, RD, a nutrition scientist and circadian biologist at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system. “Also, encouraging older adults in having consistent meal schedules could become part of broader strategies to promoting healthy aging and longevity.”

Dashti and his colleagues—including senior author Altug Didikoglu, MSc, PhD, of the Izmir Institute of Technology in Turkey—examined key aspects of meal timing that are significant for aging populations to determine whether certain patterns might signal, or even influence, health outcomes later in life. The research team analyzed data, including blood samples, from 2,945 community-dwelling adults in the UK aged 42–94 years old who were followed for more than 20 years. They found that as older adults age, they tend to eat breakfast and dinner at later times, while also narrowing the overall time window in which they eat each day.

Later breakfast time was consistently associated with having physical and mental health conditions such as depression, fatigue and oral health problems. Difficulty with meal preparation and worse sleep were also linked with later mealtimes. Notably, later breakfast timing was associated with an increased risk of death during follow-up. Individuals genetically predisposed to characteristics associated with being a “night owl” (preferring later sleep and wake times) tended to eat meals at later times.

“Up until now, we had a limited insight into how the timing of meals evolves later in life and how this shift relates to overall health and longevity,” said Dashti. “Our findings help fill that gap by showing that later meal timing, especially delayed breakfast, is tied to both health challenges and increased mortality risk in older adults. These results add new meaning to the saying that 'breakfast is the most important meal of the day,’ especially for older individuals.”

Dashti noted that this has important implications as time-restricted eating and intermittent fasting gain popularity, where the health impacts of shifting meal schedules may differ significantly in aging populations from those in younger adults

Grain foods: healthier diet patterns, metabolic health and everyday accessibility

  With so much confusion around what makes a grain food truly healthy, new research now offers a clearer picture: a combination of grain foods can support better nutrition and metabolic health when they deliver on nutrient density. A new study published in Nutrients, which analyzed the diets of more than 14,000 Americans over five years, found that both whole and refined grain foods play a role in improved diet quality, nutrient intake and everyday accessibility.

 

Conducted by researchers at the Center for Public Health Nutrition at the University of Washington, the peer-reviewed study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2023. The analysis found that many everyday grain foods – including some breads, cereals and tortillas – ranked surprisingly high for nutrient density and affordability. The findings offer a more nuanced view of grain foods, moving beyond assumptions and highlighting a broader range of options that can support health.

 

Using two new nutrient profiling models to evaluate carbohydrate quality and overall nutrient density, the Carbohydrate Food Quality Score CFQS-3 and the Nutrient Rich Food (NRF9.3) index, the study identified which grain foods qualify as “healthy grain foods” based on higher levels of fiber, protein and essential nutrients, and lower amounts of added sugars, saturated fat and sodium. This approach revealed that both whole and refined grain foods can meet the mark, contributing meaningfully to diet quality and health. People who consumed more of these healthy grain foods had better overall nutrient intake, healthier eating patterns and more favorable markers of metabolic health.

 

Key findings include:

• Improved diet quality and nutrient intake. People who consumed more healthy grain foods had better overall diet quality and higher intakes of fiber, protein, iron, calcium, potassium and magnesium.
• Includes both whole and refined grain foods. Both types scored highly for nutrient density, with many refined or enriched options – like certain breads, cereals and tortillas – delivering strong nutritional value alongside whole grain choices.
• Part of healthier overall eating patterns. People who ate the most healthy grain foods also consumed more fruits, vegetables and lean proteins, suggesting these grain foods may support or reflect broader healthy habits.
• Linked to better metabolic health. Adults with higher intakes of these grain foods were less likely to be obese and had lower fasting insulin levels, a key marker of metabolic function.
• No added cost. Healthy grain foods were no more expensive than less healthy options and were often more affordable per gram or calorie.

 

“Healthy grains are a critical component of healthy diets" said Dr. Adam Drewnowski, Professor of Epidemiology at the University of Washington. “Our evaluation took whole grain content into account, along with fiber, vitamins and minerals. By delivering key nutrients such as fiber, iron, B vitamins and folate, grain foods can make a meaningful contribution to healthier eating patterns among all population groups.”

 

As nutrition guidance continues to evolve, this study adds important clarity around the role of grain foods in supporting public health. The findings highlight the value of balance – not just in overall eating patterns, but in the types of grain foods we include. Recognizing the nutritional contributions of both whole and refined/enriched options offers a more inclusive and realistic path to better outcomes for Americans’ diet and overall health. To learn more, visit GrainFoodsFoundation.org.

 

Scrolling while on the toilet linked to higher risk of hemorrhoids

 Survey participants who reported using a smartphone while on the toilet had a higher risk of hemorrhoids than non-users. Chethan Ramprasad of Beth Israel Deaconess Medical Center, U.S., and colleagues present these findings in a new study in the open-access journal PLOS One on September 3, 2025.

Every year in the U.S., hemorrhoids lead to nearly 4 million visits to the doctor or emergency room and more than $800 million in healthcare spending. Hemorrhoids involve swollen veins in the anal or rectal area and can cause pain and bleeding. Anecdotal evidence has linked smartphone use on the toilet with increased risk of hemorrhoids.

However, few studies have explored whether smartphone use on the toilet is actually associated with hemorrhoid risk. To help clarify, Ramprasad and colleagues conducted a study of 125 adults undergoing screening colonoscopy. The participants answered online survey questions about their lifestyle and toilet habits, and endoscopists evaluated them for hemorrhoids.

Among all participants, 66 percent reported using smartphones on the toilet, and they tended to be younger than non-users. After statistically accounting for other factors thought to possibly be linked with hemorrhoid risk—such as exercise habits, age, and fiber intake—the researchers found that participants who used a smartphone on the toilet had a 46 percent higher risk of hemorrhoids than non-users.

Time spent on the toilet was significantly higher for smartphone users than non-users; 37 percent of smartphone users spent more than 5 minutes at a time on the toilet compared to just 7.1 percent of non-users. Reading news and using social media were the most commonly reported smartphone activities on the toilet. Interestingly, straining while using the toilet was not associated with increased hemorrhoid risk, in contrast to some prior studies.

On the basis of the findings, the researchers suggest that smartphone use may inadvertently prolong toilet time, potentially increasing pressure in anal tissues, which may then lead to hemorrhoids.

This study could help inform clinicians’ recommendations to patients. Future research could also expand on these findings, such as by tracking patients over time and exploring interventions to limit prolonged smartphone use on the toilet. 

Trisha Pasricha, senior author of the study, adds: “Using a smartphone while on the toilet was linked to a 46 percent increased chance of having hemorrhoids. We're still uncovering the many ways smartphones and our modern way of life impact our health. It's possible that how and where we use them—such as while in the bathroom—can have unintended consequences.”

“This study bolsters advice to people in general to leave the smartphones outside the bathroom and to try to spend no more than a few minutes to have a bowel movement. If it's taking longer, ask yourself why. Was it because having a bowel movement was really so difficult, or was it because my focus was elsewhere?”

“It's incredibly easy to lose track of time when we're scrolling on our smartphones—popular apps are designed entirely for that purpose. But it's possible that constantly sitting longer on the toilet than you intended because you're distracted by your smartphone could increase your risk of hemorrhoids. We need to study this further, but it's a safe suggestion to leave the smartphone outside the bathroom when you need to have a bowel movement.”

Some sugar substitutes linked to faster cognitive decline

 Highlights:

• The study followed 12,772 adults with an average age of 52
• Researchers tracked seven artificial sweeteners typically found in ultra-processed foods like flavored water, soda, energy drinks, yogurt and low-calorie desserts
• People who consumed the highest total amounts of these sweeteners had faster decline in overall thinking and memory skills compared to people who consumed the lowest amounts
• The faster decline equaled about 1.6 years of aging
• Researchers found a link in people under 60 but not older than 60
• While the study found links, it does not prove that sweeteners cause cognitive decline

MINNEAPOLIS – Some sugar substitutes may come with unexpected consequences for long-term brain health, according to a study published in the September 3, 2025, issue of Neurology®, the medical journal of the American Academy of Neurology. The study examined seven low- and no-calorie sweeteners and found that people who consumed the highest amounts experienced faster declines in thinking and memory skills compared to those who consumed the lowest amounts. The link was even stronger in people with diabetes. While the study showed a link between the use of some artificial sweeteners and cognitive decline, it did not prove that they were a cause.

The artificial sweeteners examined in the study were aspartame, saccharin, acesulfame-K, erythritol, xylitol, sorbitol and tagatose. These are mainly found in ultra-processed foods like flavored water, soda, energy drinks, yogurt and low-calorie desserts. Some are also used as a standalone sweetener.

“Low- and no-calorie sweeteners are often seen as a healthy alternative to sugar, however our findings suggest certain sweeteners may have negative effects on brain health over time,” said study author Claudia Kimie Suemoto, MD, PhD, of the University of São Paulo in Brazil.

The study included 12,772 adults from across Brazil. The average age was 52, and participants were followed for an average of eight years.

Participants completed questionnaires about diet at the start of the study, detailing what they ate and drank over the past year. Researchers divided them into three groups based on the total amount of artificial sweeteners they consumed. The lowest group consumed an average of 20 milligrams per day (mg/day) and the highest group consumed an average of 191 mg/day. For aspartame, this amount is equivalent to one can of diet soda. Sorbitol had the highest consumption, with an average of 64 mg/day.

Participants were given cognitive tests at the start, middle and end of the study to track memory, language and thinking skills over time. The tests assessed areas such as verbal fluency, working memory, word recall and processing speed.

After adjusting for factors such as age, sex, high blood pressure and cardiovascular disease, researchers found people who consumed the highest amount of sweeteners showed faster declines in overall thinking and memory skills than those who consumed the lowest amount, with a decline that was 62% faster. This is the equivalent of about 1.6 years of aging. Those in the middle group had a decline that was 35% faster than the lowest group, equivalent to about 1.3 years of aging.

When researchers broke the results down by age, they found that people under the age of 60 who consumed the highest amounts of sweeteners showed faster declines in verbal fluency and overall cognition when compared to those who consumed the lowest amounts. They did not find links in people over 60. They also found that the link to faster cognitive decline was stronger in participants with diabetes than in those without diabetes.

When looking at individual sweeteners, consuming aspartame, saccharin, acesulfame-k, erythritol, sorbitol and xylitol was associated with a faster decline in overall cognition, particularly in memory.

They found no link between the consumption of tagatose and cognitive decline.

“While we found links to cognitive decline for middle-aged people both with and without diabetes, people with diabetes are more likely to use artificial sweeteners as sugar substitutes,” Suemoto said. “More research is needed to confirm our findings and to investigate if other refined sugar alternatives, such as applesauce, honey, maple syrup or coconut sugar, may be effective alternatives.”

A limitation of the study was that not all artificial sweeteners were included. Also, diet information was reported by the participants, who may not have remembered accurately everything they ate.

Study shows that nasal spray reduces risk of coronavirus infection by two-thirds

 The trial, led by Professor Robert Bals, Director of the Department of Internal Medicine V at Saarland University Medical Center and Professor of Internal Medicine at Saarland University, divided the 450 participants into two groups. The treatment group of 227 individuals used an azelastine nasal spray three times a day over a 56-day period. During that same period, the 223 participants in the control group used a placebo spray three times a day. Robert Bals summarized the key finding as follows: ‘During the observation period, 2.2% of the participants in the azelastine group became infected with SARS-CoV-2; in the placebo group, it was 6.7%—three times as many.’ All infections were confirmed by PCR testing.

In addition to showing a marked reduction in coronavirus infections, the azelastine group also displayed fewer symptomatic SARS-CoV-2 infections, a lower overall number of confirmed respiratory infections, and, unexpectedly, a reduced incidence of rhinovirus infections, another major cause of respiratory illness. In the treatment group, 1.8% developed a rhinovirus infection, compared to 6.3% in the placebo group—a proportion similar to that seen for SARS-CoV-2.

Azelastine nasal spray has been available for decades as an over-the-counter treatment for hay fever. Previous in vitro studies on azelastine had already suggested antiviral effects against SARS-CoV-2 and other respiratory viruses. ‘This clinical trial is the first to demonstrate a protective effect in a real-world setting,’ says Professor Bals.

For Robert Bals, the results suggest practical applications: ‘Azelastine nasal spray could provide an additional easily accessible prophylactic to complement existing protective measures, especially for vulnerable groups, during periods of high infection rates, or before travelling.’ But Professor Bals also stressed the importance of further research: ‘Our results highlight the need for larger, multicentre trials to continue exploring the use of azelastine nasal sprays as an on-demand preventive treatment, and to examine its potential effectiveness against other respiratory pathogens.’