In a place with a long history of people living — and sometimes dying — under the Boardwalk, Atlantic City has launched an effort to address homelessness by preventing people from sleeping on public property and connecting them with shelter and services.

The effort comes only days after the U.S. Supreme Court ruled that municipalities can ban homeless encampments, something the city said would support its efforts to address homelessness.

It follows an April 19 fire that killed a man in a homeless encampment under the Boardwalk, months after another fire suspected of being started by homeless people burned a section of the boardwalk in front of Resorts casino. The damage has since been repaired.

“We cannot claim to be this world-class resort (if) we don’t handle the problems that the resort sometimes encounters,” said Mayor Marty Small, a Democrat.

The city is implementing plans by its Boardwalk Improvement Group, which includes using state funds to pay for workers, training and equipment to seek out homeless people and offer them help, including transportation back to where they came from.

But that offer is often rejected. Out of about 200 homeless people that city officials encountered since September, only five have accepted an offer to go back home, officials said.

Many others refuse help of any kind, said Jarrod Barnes, Atlantic City’s director of health and human services.

“When that happens, there is nothing we can do,” he said. “We can’t force them to accept help.”

A tour by city officials of places known to be where homeless people stay was only minutes old when they encountered a disoriented man sprawled across a sidewalk in the midday sun. An ambulance was called and he was taken to a nearby hospital for evaluation.

Not far away, in a vacant lot strewn with empty liquor bottles, two young women, who both described themselves as homeless, acknowledged having been assisted multiple times by city outreach teams.

Essence, who would not give her last name, said she was given a free stay at a motel by the city, but returned to the streets. At one point, she said, she lived in a homeless encampment under the Boardwalk, until police broke it up.

Tanisha, who also would not give her last name, said she had no idea where she would spend the night on Monday.

“We’re just trying to make a way, find a way,” she said.

But she acknowledged she and others living outdoors are not always ready to accept help.

“It’s really up to us to do what we got to do first,” she said. “The struggle is real.”

In the wake of the Supreme Court ruling, Atlantic City plans to introduce an ordinance in the coming weeks that would prohibit sleeping in public places. It could be adopted and put into place by September.

The outreach effort includes 10 full-time workers assigned to find and interact with people who are homeless, offering social services, a pathway into drug or alcohol rehab if needed, and a place to stay. Police assign officers to regularly patrol spots known as homeless gathering points, and police, fire department and public works officers have been trained on interacting with homeless people.

Small noted that some of the homeless encampments have shown signs of real ingenuity. Refrigerators and microwave ovens have been patched into jerry-rigged electrical connections.

And, he added, inhabitants at one encampment managed to tap into the hose of a line under the Boardwalk providing beer to a casino’s beachfront bar.

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

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

Backward walking challenges your brain

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

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

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

Backward walking benefits

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

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

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

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

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

3 easy ways to add backward walking to your routine

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

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

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

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

Backward walking challenges your brain

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

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

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

Backward walking benefits

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

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

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

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

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

3 easy ways to add backward walking to your routine

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Drug companies are racing to develop GLP-1 drugs following the blockbuster success of Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound.

Some of the experimental drugs may go beyond diabetes and weight loss, improving liver and heart function while reducing side effects such as muscle loss common to the existing medications. At the 2024 American Diabetes Association conference in Orlando, Florida, researchers are expected to present data on 27 GLP-1 drugs in development.

“We’ve heard about Ozempic and Mounjaro and so on, but now we’re seeing lots and lots of different drug candidates in the pipeline, from very early-stage preclinical all the way through late-stage clinical,” said Dr. Marlon Pragnell, ADA’s vice president of research and science. “It’s very exciting to see so much right now.”

A large portion of the data presented comes from animal studies or early-stage human trials. However, some presentations include mid-to late-stage trials, according to a list shared by the organization.

Approval by the Food and Drug Administration is likely years away for most. Some of the drugs showcased could be available for prescription in the U.S. within the next few years.

“We’ve witnessed an unprecedented acceleration in the development of GLP drugs,” said Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina. “We are now firmly entrenched in the era of the GLP.”

While the existing drugs are highly effective, new drugs that are more affordable and have fewer side effects are needed, McGowan added.

There aren’t just GLP-1 drugs in the pipeline. On Thursday, ahead of the diabetes conference, Denmark-based biotech firm Zealand Pharma released data that showed a high dose of its experimental weight loss drug petrelintide helped reduce body weight by an average of 8.6% at 16 weeks.

The weekly injectable medication is unique because it mimics the hormone amylin, which helps control blood sugar. The hope is patients will experience fewer side effects like nausea commonly associated with GLP-1 drugs such as Wegovy and Zepbound.

Can glucagon hormone help with weight loss?

GLP-1 medications work, in part, by slowing down how quickly food passes through the stomach, leading people to feel fuller longer. In several of the upcoming weight loss drugs, a different hormone called glucagon is in the spotlight. Glucagon is a key blood-sugar-regulating hormone that can mimic the effects of exercise.

One of the drugs featured at the conference on Sunday is called pemvidutide, from Maryland-based biotech firm Altimmune.

The drug contains the GLP-1 hormone, a key ingredient in Ozempic and Wegovy, in addition to glucagon.

Altimmune released data from a phase 2 trial of 391 adults with obesity or who are overweight with at least one weight-related comorbidity such as high blood pressure. Patients were randomized to either get one of three doses of pemvidutide or a placebo for 48 weeks.

Researchers found that patients who got the highest dose of the drug lost on average 15.6% of their body weight after 48 weeks, compared to the 2.2% body weight loss seen in patients who got a placebo. In similar trials, semaglutide was shown to reduce body weight by around 15% after 68 weeks.

These are not direct comparisons because the drugs weren’t compared in a head-to-head clinical trial.

Dr. Scott Harris, Altimmune’s chief medical officer, said the drug has been shown to help people lose weight, as well as provide health benefits to the liver and heart. What’s more, the drug has shown benefits in preserving lean body mass. Some studies have suggested that semaglutide, the active ingredient in Ozempic and Wegovy, can cause muscle loss.

“If people take the drugs long term, what’s going to be their long-term health? What’s going to be the long-term effects on their body composition, their muscle, their ability to function?” he said.

Harris said that people who got pemvidutide lost on average 21% of their lean body mass, which is lower than the around 25% of lean body mass people typically lose with diet and exercise.

“We’re the next wave of obesity drugs,” Altimmune President and CEO Vipin Garg said. “The first wave of mechanisms was all driven by appetite suppression. We are adding another component.”

Altimmune expects to begin a phase 3 trial soon. The company hopes the drug will be available in the U.S. sometime in 2028.

Competition could drive down costs

Expanding the number of weight loss drugs available is important for several reasons, experts say.

More options could also help alleviate the shortages seen in the U.S. with Novo Nordisk’s and Lilly’s weight loss drugs.

Increased competition could drive down the high cost of the drugs over time. A month’s supply of Wegovy or Zepbound can cost more than $1,000, often financially untenable for many patients, experts say.

Patients can also respond differently to treatments, said Dr. Fatima Cody Stanford, an associate professor of medicine and pediatrics at Harvard Medical School. In fact, some have found the existing GLP-1 options ineffective.

“Different GLP-1 drugs may have varying levels of efficacy and potency,” she said. “Some patients may respond better to one drug over another, depending on how their body metabolizes and responds to the medication.”

Since starting Ozempic in June 2022, Danielle Griffin has not seen the results her doctor predicted. “She really expected to see a huge difference in my weight, and I just never saw it,” said the 38-year-old from Elida, New Mexico. Griffin weighed about 300 pounds and has lost only about 10 pound in two years. She said her “expectations were pretty much shattered from that.”

Amid insurance battles and shortages, she has also tried Wegovy and Mounjaro, but didn’t see a difference in her weight.

“I don’t feel like there are options, especially for myself, for someone who the medications not working for.”

The prospect of new medications on the horizon excites Griffin. “I would be willing to try it,” she said, adding that “it could be life changing, honestly, and you know that alone gives me something to look forward to.”

More drugs in the pipeline

Eli Lilly, which makes Zepbound and the diabetes version Mounjaro, has two more GLP-1 drugs in development.

On Sunday, Lilly released new data about retatrutide, an injectable drug that combines GLP-1 and glucagon, plus another hormone called GIP. GIP is thought to improve how the body breaks down sugar.

In an earlier trial, retatrutide helped people lose, on average, about 24% of their body weight, the equivalent of about 58 pounds — greater weight loss than any other drug on the market.

New findings showed the weekly medication also significantly reduced blood sugar levels in people with Type 2 diabetes.

On Saturday, there were also new findings on the experimental mazdutide, which Lilly is developing in partnership with the Chinese biotech firm Innovent Biologics. The drug combines GLP-1 and glucagon.

In a phase 3 study of adults in China who were overweight or had obesity, researchers found that after 48 weeks, a 6-milligram dose of the drug led to an average body weight reduction of 14.4%.

The drug also led to a reduction in serum uric acid — a chemical that can build up in the bloodstream, causing health problems, and has been associated with obesity, according to Dr. Linong Ji, director of the Peking University Diabetes Center, who presented the findings.

That was “quite unique and never reported for other GLP-1-based therapies,” he said in an interview.

The drug could be approved in China in 2025, Ji said.

Improving metabolic conditions

An estimated 75% of people with obesity have nonalcoholic fatty liver disease and 34% have MASH, or metabolic dysfunction-associated steatohepatitis, according to researchers with the German drugmaker Boehringer Ingelheim. Fatty liver disease occurs when the body begins to store fat in the liver. It can progress to MASH, when fat buildup causes inflammation and scarring.

In a phase 2 trial of people who were overweight or had obesity, Boehringer Ingelheim’s survodutide, which uses both GLP-1 and glucagon, led to weight loss of 19% at 46 weeks. Another phase 2 study in people with MASH and fibrosis found that 83% of participants also showed improvement in MASH.

Survodutide “has significant potential to make a meaningful difference to people living with cardiovascular, renal and metabolic conditions,” said Dr. Waheed Jamal, Boehringer Ingelheim’s corporate vice president and head of cardiometabolic medicine.

On Friday, the company released two studies on the drug. One, in hamsters, found that weight loss was associated with improvements in insulin and cholesterol. The second, in people with Type 2 diabetes or people with obesity, found the drug helped improve blood sugar levels. 

The company is looking to begin a phase 3 trial.

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Some people are turning to supplements to manage those issues rather than using treatments approved by the Food and Drug Administration, such as hormone therapy. But, experts say, menopause supplements aren’t necessarily helpful. And, in some cases, they can be dangerous.

The rising popularity of menopause supplements, experts say, highlights a lack of access to evidence-based options, rampant misinformation about hormone therapy and gaps in our knowledge about menopause — even among specialists.

Current menopause treatments

“The primary treatment — and the first-line treatment — should be hormone (estrogen) therapy, especially for moderate-to-severe menopause symptoms,” Dr. Anna Barbieri, assistant clinical professor in the department of obstetrics and gynecology at Mount Sinai School of Medicine, tells TODAY.com

“There is just nothing as effective and nothing that has as wide-ranging effects and benefits as hormone therapy,” Barbieri adds.

Effectively managing hot flashes, most often through hormone therapy, may have long-term health benefits, too, Dr. Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, tells TODAY.com.

Not only do hot flashes last seven years on average (and often longer for Black women), but we also know that “hot flashes are associated with cardiovascular disease, brain fog during perimenopause, potentially declines in cognitive function down the road and multiple other medical problems,” Streicher says.

However, some people should steer clear of hormone therapy due to other health conditions. That includes a current or past hormone receptor-positive cancer (primarily breast and endometrial cancers), as well as a history of stroke, blood clots or cardiovascular disease, Barbieri explains.

If someone can’t or prefers not to take hormone therapy, that’s where non-hormonal options come in. Those include the off-label use of antidepressant medications and the recently-approved drug fezolinetant.

There are also all kinds of lifestyle and behavior techniques people may use to stay generally healthy, whether or not those techniques directly help with hot flashes, Dr. Monica Christmas, associate professor and director of the Center for Women’s Integrated Health at The University of Chicago Medicine, tells TODAY.com.

That might include avoiding certain triggers (such as alcohol), cognitive behavioral therapy, maintaining good diet and exercise habits and even hypnosis, she says.

What doctors don’t want is for you to jump into taking supplements on your own.

“I cannot tell you how many times I have identified supplements people were using that where unnecessary, potentially harmful or interacting with other medications,” Barbieri says. “Or people who were using 25 supplements where they could just use hormone therapy.” 

Should you take menopause supplements?

There are a lot of reasons someone might want to try an over-the-counter supplement to manage menopause symptoms. Of course, there’s a wealth of options available on the internet — many with little or no evidence that they actually work, and some with evidence that they can be harmful.

“Most of them just haven’t been studied,” Streicher says. “But some of them we know absolutely are not safe to use.”

In its 2023 position statement on non-hormone therapies, the Menopause Society (formerly known as the North American Menopause Society) did not recommend any dietary supplement to manage menopause symptoms. For the majority of the supplements the group looked at, their conclusions were due to flawed studies, mixed results or an overall lack of evidence.

The experts TODAY.com spoke to generally agree, but take a more nuanced position: There can be a place for supplements in managing menopause symptoms, they say. But their usefulness depends on your symptoms, what other treatments you’re comfortable with and the specific supplements you’re using.

For Streicher, it makes sense to talk about supplements when patients have only mild symptoms, or if they have more intense symptoms and already take a prescription medication but want to try something on top of that.

A typical example for Barbieri might be a patient with breast cancer and sleep issues who can’t take hormone therapy. “If someone does not use medication for sleep, and lifestyle interventions don’t work, then we may turn to something like magnesium and l-theanine or inositol,” she says, which research shows are safe for patients with a history of breast cancer who cannot take hormone therapy.

Other people “feel that menopause is natural … and they just want to use certain lifestyle interventions and only feel comfortable with supplements no matter what,” Barbieri says. “That’s OK, I just need to know that.”

More than anything, experts say, the decision whether to take menopause supplements should be based on a knowledgeable provider having a genuine conversation with a patient about what really might work for them and their preferences. (edited) 

“As providers, we do need to be able to give good information and understand that (supplements are) going to be a preference of some people,” Christmas says. “And if it doesn’t work, (we need to be) respectful that maybe shoving hormone therapy down their throat still might not be the answer.”

Common ingredients in menopause supplements

There are a ton of supplements on the market, many of which contain proprietary blends of ingredients.

Additionally, supplements are not regulated by the FDA in the same way that pharmaceutical drugs are. It’s up to the supplement manufacturer and distributors to ensure the safety and correct labeling of their products, the FDA explains.

That’s why, if you’re going to use any supplements, the experts recommend looking for a label that indicates it has been third-party verified, which means you can be more confident that it actually contains the ingredients that it advertises. Specifically, Barbieri suggests looking for USP or GMP supplement certifications on a product.

And keep the placebo effect in mind, Christmas says. When you take something new, you might feel better initially. “But the placebo effect can’t be sustained,” Streicher says.

Here are a few common ingredients you may see in menopause supplements:

Vitamins and minerals

If someone is deficient in vitamins and minerals during menopause, supplements may be a good idea, experts say.

For instance, low levels of vitamin D are correlated with poor bone health and depression, Barbieri explains. “Because these are factors that are important for all of my menopausal patients, I will actually check vitamin D and will replace that — no question,” she says.

The same goes for vitamin B12 and ferritin (a form of iron) which women may not get enough of via food, particularly those following plant-based or vegetarian diets. “These are essential nutrients that are going to result in improved health and sense of well-being if someone is deficient in them,” Barbieri says.

If you think you could benefit from a supplement to treat a deficiency, talk to your doctor about testing first.

Isoflavones, phytoestrogens and “plant-based hormones”

Phytoestrogens are plant compounds that mimic estrogen when broken down in the body. Isoflavones are a type of phytoestrogen that comes from soybean products.

This is a major category of menopause supplements, but they are not safe for people avoiding hormone therapy due to their health histories, the experts say.

“If you have a history of an estrogen-derived cancer, like a breast cancer, you shouldn’t be taking (phytoestrogen supplements) either,” Christmas says. “Those are nuances that maybe people don’t think about when they see a supplement in the health food store or local pharmacy,” she adds.

For those interested in phytoestrogen supplements who have a low-risk health history, Streicher recommends looking into S-equol. “It’s the only one that really has science (behind it),” she says, “because it’s the active metabolite of soy, which is what’s been shown to actually potentially help with hot flashes.”

Just keep in mind that people’s experiences with these kinds of supplements vary widely, Streicher says, because people metabolize them differently.

While phytoestrogen supplements are not recommended for people avoiding hormone therapy, those patients generally are OK to eat phytoestrogens occurring naturally in food, such as soy, Barbieri explains.

What about general “plant-based hormone” products? Creams are often marketed with such language, Barbieri says, adding that they may contain a version of progesterone made in a lab using a compound in yams, she says. That language is aimed at people who want to feel natural by using that, but “plants do not have human hormones,” she stresses.

Black cohosh

“Black cohosh is commonly reported to help with hot flashes and night sweats, although it hasn’t been proven to do that,” Christmas says, “and it actually can increase liver enzymes.” 

If you have an underlying liver condition, you should steer clear of black cohosh she says. Or, if you decide to take it, “you should be monitored frequently with serology to make sure your liver function isn’t worsening,” Christmas adds.

St. Johns wort

Often advertised to help with hot flashes and depression, St. Johns wort can also interact with many other medications that can have an impact on someone’s health, Christmas says.

Combinations of herbs

Some products contain a huge blend of many types of botanical ingredients and may or may not actually list the ingredients, Streicher says. For instance, you don’t know what you’re getting with products labeled simply “Chinese herbs,” she says.

Before you try menopause supplements…

It’s tempting to just buy the bottle, but the experts discouraged trying a new supplement without talking to your doctor.

First, set up a doctor’s appointment just to talk about menopause. Resist the urge to simply tack a conversation about menopause onto the end of another appointment, Christmas says.

Making an appointment specifically for menopause symptoms “automatically sets a different tone,” she explains, and “it’s probably going to get you a little bit more time in front of that health care professional.” Ideally, this should be an in-depth and individualized discussion to go through your specific symptoms, what you’ve already tried and your treatment preferences.

Unfortunately, many doctors — even OB-GYN specialists — don’t receive much (if any) training in menopause, Streicher says.

So, if your doctor isn’t well-versed in menopause treatments, find a specialist. All the experts recommend starting by using this tool from the Menopause Society to find a menopause expert near you.

If you’re in a major city, you’ll likely be able to find someone pretty easily, Streicher says. But if not, telehealth consultation services like Midi and Gennev may be your best option. (Streicher provides educational work for Midi.)

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A record-breaking number of mosquitoes in and around Las Vegas are carrying West Nile virus, sparking warnings from local health officials who say the public should take precautions to avoid getting bit. 

West Nile virus can cause fever, headaches, vomiting and diarrhea and is fatal in about 1 of 150 cases. There are no vaccines or medications to treat or prevent the mosquito-borne illness.

In recent weeks, 169 of over 24,000 pools of mosquitoes tested for West Nile virus returned positive — meaning at least one insect in the pool carried the disease — across 25 southern Nevada ZIP codes. The number of mosquitoes recorded and the tally of positive pools this early in the season break the area’s records for both metrics, set in 2019. 

“These are huge numbers of mosquitoes, and we’ve already identified a concerning number of them carrying the West Nile virus,”  said Vivek Raman, an environmental health supervisor for the Southern Nevada Health District.

Health officials have also identified six pools in the Las Vegas area that tested positive for St. Louis encephalitis virus, a mosquito-borne disease that can cause fatal inflammation of the brain.

For decades, climate scientists and public health officials have warned that climate change  could expand the reach of various infectious diseases, especially those spread by mosquitoes. Las Vegas’ exploding mosquito population and the local uptick in West Nile prevalence offers an important case study on how climate could affect human health.

Climate change increases average global temperatures and precipitation levels, fostering conditions that are ideal for mosquitoes, which breed in still, warm water. It also extends the length of warm periods, prolonging the active season for mosquitoes. These changes increase the risk of human exposure to diseases like West Nile virus, even in places that have never recorded cases before.

The first case of West Nile virus in Las Vegas was recorded in 2004 — five years after the United States’ first case was documented in 1999 in New York City. Las Vegas’ most recent West Nile outbreak occurred five years ago, resulting in 43 human cases. District health officials are concerned that this summer could be far worse.

In Nevada and much of the Southwest, springtime weather has become warmer and summertime heat waves have grown increasingly extreme over the last few decades. Las Vegas has seen average springtime temperatures rise by 6.2 F since 1970; this month, the city has already experienced a weeklong, record-breaking heat wave. 

Southern Nevada’s rising temperatures are creating favorable conditions for mosquitoes, said Nischay Mishra, an assistant professor of epidemiology at Columbia University. What’s more, ongoing drought conditions in the state, which have led to low water table levels throughout the Colorado River Basin, including in Lake Mead, may also be counterintuitively beneficial for the insects. 

“Mosquitoes typically thrive in wet and hot places,” Mishra said. “But in Nevada, as smaller bodies of water dry up, they create shallow waters that are ideal for mosquito breeding.”

Las Vegas’ mosquito surge has been giant: Last year, district health officials measured 6,000 mosquitos in traps across Clark County from April to June. This year, counts have already exceeded 24,000. 

The vast majority have been Culex mosquitoes, a primary vector for West Nile virus.  But another mosquito species that does not carry the virus, Aedes aegypti, has also become more common in Las Vegas.  Aedes was first spotted in the area in 2017, and Raman attributes its spread there to the impacts of climate change, as well.

Along with climate, human behavior plays an important role in the spread of vector-borne diseases. Aedes and Culex mosquitoes both thrive in the backyards of many Las Vegas homes — the former breed in small pools of water such as those left from sprinklers, while the latter often breed along the surface of unmaintained swimming pools.

Raman said the best way to avoid infection is to empty any open containers filled with water outside, maintain swimming pools, wear protective clothing and use bug spray to avoid getting bit.

Louise Ivers, a professor of global health and social medicine at Harvard Medical School and the director of its Global Health Institute, said situations like the one in Las Vegas will become more common as climate change continues to boost infectious disease globally. 

“We should expect to see new infectious diseases, old infectious diseases back again and a change in the patterns of exposure of existing infectious diseases like West Nile virus,” Ivers said. “Things that we used to do freely without worrying as much about protection from vectors like mosquitoes or ticks, we might not be able to do anymore.”

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Abortion rights, suddenly a potent political force in the aftermath of the U.S. Supreme Court’s decision to leave such matters to the states, have found an unlikely champion in swing state Pennsylvania.

Sen. Bob Casey, who will appear on the November ballot beneath President Joe Biden as the Democrats both seek reelection, has begun doing something he’s never done before: attacking an opponent over abortion rights.

The senator, who once called himself a “pro-life Democrat,” accuses Republican challenger David McCormick in a new TV ad of wanting to “make abortion illegal even in cases of rape and incest” — a characterization McCormick says is wrong.

Speaking to an online gathering of the progressive women’s advocacy group Red Wine & Blue earlier this month, Casey warned that electing a Republican president and a new Republican Senate majority could result in bans on the abortion pill and contraception, even in Democratic-controlled states — or purple states like Pennsylvania — where abortion remains legal.

“You could have blue-state impact whether it’s a blue-state ban that affects contraception or whether it’s a blue-state ban when it comes to abortion because of mifepristone,” Casey said.

That’s quite a reframing for Casey, who like his father and Biden comes from an Irish Catholic family in Scranton. His father, who was a two-term governor of Pennsylvania, opposed abortion rights and signed legislation restricting abortion that spawned the landmark 1992 case Planned Parenthood v. Casey.

Decision 2024 Jun 19

Former President Trump holds rally at Temple University in North Philly

Decision 2024 Apr 26

Sen. Casey, challenger McCormick ready to debate in Pa.'s 2024 US Senate race

Sen. Casey, whose race is seen as crucial to Democrats’ effort to defend their razor-thin Senate majority, says the Supreme Court’s decision to strip women’s constitutional protections for abortion changed everything in the abortion debate and prompted a “pro-life Democrat” to support access to abortion.

Casey has suggested that “pro-life” never meant a complete ban on abortion without exception, at least to him. After the court’s forthcoming decision had been leaked, Casey supported Democrats’ legislation to keep abortion legal to the Roe v. Wade standard of barring abortion only after viability, around 24 weeks.

“Everyone in the Senate had a choice to make,” Casey told The Associated Press. “You had to decide, basically, whether you’d support banning abortion or not. And that was a choice you had to make. And the choice was also a choice about legislation. … And I decided that I would support advancing that bill and thereby not being in the ban-abortion column.”

He had broken with Democrats in the past in supporting bills to ban abortions after 20 weeks and to block federal funding for abortion.

But he also had emphasized reducing abortions through services that prevent unwanted pregnancies and help pregnant women and young mothers, a reason he has given for backing federal funding for Planned Parenthood.

When the court overturned Roe v. Wade, Casey slammed it as ripping away a constitutional right and a dangerous decision that wouldn’t stop abortions but would put women’s lives at risk.

Democrats have been happy to embrace Casey’s recalibrated position.

“I don’t believe he ever wanted those (pro-life) beliefs to ever stand in the way of access to abortion, and now his position matters more than it did just two years ago,” said Brittany Crampsie, a Democratic strategist.

Mary Ziegler, a law professor at the University of California, Davis, who studies the history and politics of the abortion debate, said she thinks Casey had begun drifting from the anti-abortion movement well before the court overturned Roe v. Wade.

He was probably both pulled by a Democratic Party becoming more supportive of abortion rights and pushed by an anti-abortion movement becoming more aligned with Republicans and Christian conservatives, Ziegler said.

“If you take politics out of it, it’s possible that Casey has one of those purple positions on abortion that doesn’t tend to track with what either movement is doing,” Ziegler said.

Many Americans hold middle-of-the-road beliefs on abortion, Ziegler said, and Casey’s stance isn’t out of step with many lay Catholics. According to Pew Research Center surveys, 56% of U.S. Catholics say abortion should be legal in all or most cases.

Politically speaking, abortion rights has been a winner on the ballot since the court decision, even in red states such as Ohio, Kansas and Kentucky, where the outcomes favored keeping abortion access legal.

McCormick attacks Casey from the right. He accuses Casey of wanting to allow abortion “up until the moment of birth,” a refrain Republicans are using to attack Democrats’ legislation, which allows an exception for abortions after fetal viability in extremely rare situations when a doctor determines the life or health of the mother is at risk.

Democrats say doctors — and not the government — should be making such decisions.

Meanwhile, McCormick says he opposes abortion, with three exceptions — rape, incest and to save the life of the mother — and not just one exception, as Casey contends. McCormick also says he wouldn’t vote for a federal abortion ban.

Casey, now in his eighth statewide campaign, has never previously wielded abortion rights as a weapon. He has been on defense, however.

In the 2002 Democratic primary for governor, Casey told a radio interviewer that he favored one exception, to save the life of the mother. But, he said, if the Supreme Court were to overturn Roe v. Wade then he, if elected governor, would sign legislation with all three exceptions, including rape and incest, “and it would have the effect of reducing the number of abortions in the state.”

Casey ultimately lost to Ed Rendell, who received support from the National Abortion and Reproductive Rights Action League, which ran ads against Casey because of his opposition to abortion rights.

In Senate races, Casey’s Republican opponents have tried to poke holes in his “pro-life” bona fides by pointing out that he opposed proposals to halt federal payments to Planned Parenthood.

Casey in 2006 was first recruited by national Democrats to run when he still wore the label of “pro-life Democrat.” He hasn’t faced a serious primary challenger in his four campaigns for the Senate.

Republicans frame his evolution on the issue as pure politics. They say he changed his position to survive the party’s leftward drift and never truly opposed abortion, like his father did.

“I don’t know how you go from defending life to the ad he’s running against Dave McCormick,” said Matt Beynon, a Republican strategist who worked on Lou Barletta’s losing campaign against Casey in 2018.

Democratic strategists insist that Casey’s evolution is natural and reflects a generational shift in which abortion is discussed alongside health care and contraception.

Christine Jacobs, who founded Represent PA, an organization to help elect Democratic women to Pennsylvania’s Legislature, said Casey has spent years of thinking about it and talking about it with his staff.

Still, Democratic strategists are stumped by the question of whether Casey could have been the party’s unquestioned nominee in 2024 had he supported a ban when the party’s activists were mobilizing over abortion rights.

It’s an academic question now. But Jacobs — who, like Casey, grew up Catholic — thinks there would have been sufficient outrage.

“I think he would have had to pull out,” Jacobs said. “At least, I’d like to think that.”

The FLiRT strains — which include KP.3, KP.2, and KP.1.1 — now account for more than half of all COVID-19 infections nationwide, according to the latest data from the U.S. Centers for Disease Control and Prevention.

These new variants, which scientists dubbed “FLiRT” after the locations of their spike protein mutations, have been circulating in the U.S. since the early spring. In April, KP.2 quickly overtook JN.1, the omicron subvariant that drove a surge in COVID cases this past winter.

In a matter of weeks, the KP.3 variant overtook KP.2 to become the most prevalent strain in the U.S., per the CDC.

During a two-week period ending on June 8, KP.3 made up an estimated 25% of cases in the U.S., up from about 9% in early May. After KP.3, the next most common variant is KP.2, another FLiRT variant that gained dominance in May and now accounts for about 22% of cases. It’s followed by LB.1, a JN.1 subvariant, and another FLiRT variant, KP.1.1.

Together, the FLiRT variants make up an estimated 55% of cases in the U.S.

Although hospitalizations are down and COVID-19 numbers are relatively low, there has been a small uptick in test positivity and emergency room visits, per the latest CDC data. These trends, along with previous summer waves, have stoked fears about a surge of infections this summer.

Scientists are warning that the FLiRT variants may be better at evading the immune system due to their spike protein mutations, and that waning immunity and poor uptake of the latest COVID-19 vaccine have created a more susceptible population.

Will there be another COVID-19 wave? What are the symptoms of the FLiRT variants? Are vaccines still effective? We spoke to experts to learn more.

What is KP.3?

KP.3 is one of the FLiRT variants — along with KP.2 and KP.1.1 — which are spinoffs of JN.1.11.1, a direct descendant of JN.1. They were initially detected in wastewater samples from across the country.

KP.3 and the other new variants have additional mutations that set them apart from JN.1 and appear to give them an advantage over previous variants, Dr. Albert Ko, infectious disease physician and professor of public health, epidemiology and medicine at Yale School of Public Health, tells TODAY.com.

The nickname “FLiRT” is based on the technical names for their mutations, according to the Infectious Disease Society of America.

Just like other COVID-19 strains that have gained dominance in the U.S. over the last year — JN.1, HV.1,  EG.5 aka Eris, and XBB.1.16 or Arcturus — the FLiRT variants part of the omicron family. 

The emergence of KP.3 and other FLiRT variants is the “same old story,” Andrew Pekosz, Ph.D., virologist at Johns Hopkins University, tells TODAY.com. The SARS-CoV-2 virus mutates and gives rise to a new, highly contagious variant, which becomes the dominant strain. “The timeline that it happens in, three to six months, is much faster than we see with other viruses like influenza,” says Pekosz.

Is KP.3 more transmissible?

“It’s still early days, but the initial impression is that this variant is rather transmissible,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.

The proportion of cases caused by KP.3 is increasing, while the proportion caused by other variants is decreasing, which suggests the FLiRT variants have features that give it an advantage, the experts note.

Over 97% of people in the U.S. have natural or vaccine-induced antibodies against the the SARS-CoV-2 virus, per the CDC, but this immune protection fades over time.

Low vaccination rates and waning immunity create a vulnerable population, which may allow the FLiRT variants to take hold. Only time and more data will tell, the experts note.

Laboratory studies suggest that the FLiRT variants are mutated enough such that current vaccines and immunity from prior infection will only provide partial protection, says Schaffner. “We’ll have to see how true that is, but it appears, over time to be becoming a more prominent variant,” he adds.

“It’s still really early … but I don’t think we need to sound the alarm bells as of yet,” says Ko.

The state of COVID in the U.S.

It’s too soon to tell whether KP.3 and the FLiRT variants will cause a summer wave or surge, the experts note. However, it is clear that COVID-19 is still circulating and won’t be taking any time off.

“We’re seeing these infections year-round, at modulating levels. … We’re probably not at the stage yet where we’ll see COVID go away completely at any time of the year,” says Pekosz.

Test positivity, which is an early indicator of case levels, was 5.4% as of June 8, up 0.8% from the previous week but a sharp decline from a peak of about 12% in mid-January, per the CDC. (The CDC no longer tracks the total number of cases in the U.S.)

“We’re not seeing a lot of hospitalizations, and we’re certainly much lower than we were in the winter, so I’d say right now we’re at a low point, which is reassuring,” says Ko.

Wastewater data published by the CDC show that the viral activity level for COVID-19 is currently “low” — it was considered high or very high for most of January and February.

“It seems like transmission is pretty low right now, and that makes sense because usually the big peaks are in the winter, when people are inside and in more contact,” says Ko.

COVID-19 has caused summer waves in the past, the experts note, which are often smaller than the winter surges. “I don’t think that we’ll see any kind of massive surge in cases,” says Pekosz.

The seasonality of COVID-19 is something scientists are still trying to understand. But one thing is obvious: “This virus is now integrating itself into our population and our way of life,” says Schaffner.

Adds Ko: “I’m not expecting a large surge in the summer, but again, we have to be cautious and we have to follow the data. … We always have to be humble because SARS-CoV-2 has taught us a lot of new things.”

What are the symptoms of KP.3?

It is still too early to tell whether the symptoms of KP.3, KP.2 and other FLiRT variants are different from previous strains.

“The FLiRT variants are probably not going to create very distinctive symptoms. It looks at the moment to follow the other subvariants,” says Schaffner.

The symptoms of the FLiRT variants are similar to those caused by JN.1, which include:

• Sore throat
• Cough
• Fatigue
• Congestion
• Runny nose
• Headache
• Muscle aches
• Fever or chills
• New loss of sense of taste or smell
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

According to the CDC, the type and severity of symptoms a person experiences usually depend more on a person’s underlying health and immunity rather than the variant that caused the infection.

Similar to JN.1 and other omicron subvariants, the FLiRT variants seem to be causing milder infections, says Schaffer.

Do vaccines protect against KP.3?

Early laboratory studies indicate that the vaccines will continue to provide protection the FLiRT variants — “a little less protection, but not zero by any means,” says Schaffner.

As the virus mutates, it is becoming progressively different from the omicron strain targeted in the latest updated booster released in the fall of 2023. “We would expect that to happen, and we anticipate the plan is to have an updated vaccine in the fall available to everyone,” says Schaffner.

Advisers to the U.S. Food and Drug Administration met on Tuesday, June 5, to decide which strains to include in the updated COVID-19 vaccines for 2024–2025. The committee unanimously voted to recommend a monovalent vaccine targeting the JN.1 variant for this fall, the agency said in a press release.

Even if vaccines do not prevent infection, they can still offer some protection by preventing severe disease, hospitalization, and COVID-19 complications, TODAY.com previously reported.

“It’s still clear that the more severe cases that come into the emergency room predominate in people who either are not up to date on their vaccines or haven’t gotten a vaccine in a really long period of time,” says Pekosz.

Vaccination is especially important for the elderly, says Pekosz, which is why the CDC recently recommended adults ages 65 and older get an additional dose of the 2023-2024 updated COVID-19 vaccine.

Unfortunately, vaccination uptake is still poor, the experts note. “The vaccines are still showing signatures of effectiveness, but they’re not being utilized anywhere close to the level that they should be,” says Pekosz.

As of April 2024, only about 22% of adults and 14% of children have reported receiving the updated COVID-19 vaccine released in September 2023, according to the CDC.

All current PCR and at-home tests are recognizing KP.3 and other FLiRT variants, the experts note. (Though if you have symptoms of COVID and test negative, it’s a good idea to stay home to avoid potentially exposing other people, TODAY.com previously reported.

If you are using an at-home antigen test, always remember to check the expiration date and whether it’s been extended by the FDA.

“Antivirals (such as Paxlovid) are also working well. … There’s not any major signals of antiviral resistance in the population, which is a positive sign,” says Pekosz.

How to protect against KP.3 and FLiRT variants

While it’s too early to tell how the FLiRT variants will pan out this summer, people can always take steps to protect themselves and others against COVID-19.

The CDC recommends the following prevention strategies:

• Stay up to date with COVID-19 vaccines.
• Test for COVID-19 if you have symptoms or an exposure.
• Stay home when you are sick.
• Return to normal activities only after you have been fever-free and symptoms have been improving for at least 24 hours.
• Practice good hand hygiene.
• Improve ventilation.
• Wear a mask in crowded, indoor spaces.
• Practice social distancing.

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

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

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

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

What is the healthiest chocolate?

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

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

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

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

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

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

Is 70% dark chocolate healthy?

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

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

Dark chocolate benefits

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

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

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

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

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

Chocolate also has benefits for the mind.

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

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

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

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

Dark chocolate side effects

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

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

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

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

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

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

How much chocolate per day is OK to eat?

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

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

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

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

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

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

Both dietitians are fans of dipping fruit in melted chocolate.

Is chocolate unhealthy or healthy?

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

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

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

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

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Talkin’ baseball got Charlie Manuel talking again.

Nine months after suffering a stroke, the 80-year-old hitting guru is back to sharing his knowledge of the game with anyone who wants to learn from a World Series champion.

“When I was cooped up in the hospital, it was tough to take,” Manuel told The Associated Press. “It seemed like a long time before I really learned to walk again, and when I started doing things, I realized that when I talk about baseball, I feel more comfortable.”

The former Philadelphia Phillies and Cleveland Indians manager recently became an investor in Perfect Game, a youth and high school baseball sports platform. Manuel, who lives in Florida, has already spent a couple weekends at their local tournaments and plans to attend as many youth games as he can.

“I was interested because it’s amateur baseball and it gives me a chance to talk to kids about the game and it doesn’t interfere with the job I’m doing now,” Manuel said. “I’ve always loved watching amateurs. People don’t realize when I come to Philadelphia, I usually watch 10-15 high school games a summer. I love seeing the guys who could definitely hit.”

Manuel still works as a senior adviser for the Phillies and he’s already scouted the team’s Single-A affiliate in Clearwater. He’s heading to Double-A Reading next week and plans to visit the NL-leading Phillies at Citizens Bank Park.

Manuel got a rousing ovation when he threw out the ceremonial first pitch at the season opener on March 29. It was a long road after his stroke last September, and baseball played a major role in Manuel’s recovery.

The stroke damaged a part of Manuel’s brain that controls language expression, so he needed speech therapy to learn how to talk again. He was struggling to say his name and had a difficult time staying interested until the therapist asked him about baseball.

He perked up and the words began flowing.

“I think when I talk about baseball, I feel like I can talk better,” Manuel said. “I still am trying to improve on my speech, but at the same time, I think I can talk baseball. Plus, I love to help people.”

It took the City of Brotherly Love a while to embrace Manuel and his down-home charm when he was hired in 2005. He ended up becoming a folk hero in Philadelphia after leading the Phillies on the most successful run in franchise history, including the 2008 World Series title. He’s No. 1 on the team’s career managerial list with 780 wins, and he finished his career with a record of 1,000-826, six division titles and two pennants.

“We loved playing for the fans of Philadelphia, and Philly is my favorite place in the United States,” Manuel said.

Manuel was the ultimate player’s manager. From Jim Thome and Ryan Howard to Chase Utley and Jimmy Rollins, guys loved playing for him.

“I talk to a lot of my former players like Thome, Howard, Utley, Rollins, but also when I was in the hospital, I was surprised that a lot of the guys I had in the minor leagues, they called me,” Manuel said. “That made me feel good. I was the kind of guy, if you were one of my players, I took time to work with you, and I wanted you to be the best player in baseball.

“I still feel that way. I was honest and I think that worked for me, and I got a locker-room personality. If I could get people to relax and play the game right, that was the goal. I was very fortunate to stay in the game as long as I did and everything happened for me because I had good players. I always had good talent to work with and organizations were treating me great. That’s something I’ll never forget.”

Researchers led by the Cleveland Clinic linked the low-calorie sugar substitute xylitol to an increased risk of heart attack, stroke or cardiovascular-related deaths, according to a study published today in the European Heart Journal.

Xylitol is a sugar alcohol that is found in small amounts in fruit and vegetables, and the human body also produces it. As an additive, it looks and tastes like sugar but has 40% fewer calories. It is used, at much higher concentrations than found in nature, in sugar-free gum, candies, toothpaste and baked goods. It can also be found in products labeled “keto-friendly,” particularly in Europe.

The same research team found a similar association last year to the popular sugar substitute erythritol. The use of sugar substitutes has increased significantly over the past decade as concerns about rising obesity rates mount.

“We’re throwing this stuff into our food pyramid, and the very people who are most likely to be consuming it are the ones who are most likely to be at risk” of heart attack and stroke, such as people with diabetes, said lead author Dr. Stanely Hazen, chair of cardiovascular and metabolic sciences at Cleveland Clinic’s Lerner Research Institute.

Many heart attacks and strokes occur in people who do not have known risk factors, like diabetes, high blood pressure or elevated cholesterol levels. The research team began studying sugar alcohols found naturally in the human body to see if the compounds might predict cardiovascular risk in these people.

In the study, the investigators measured the level of naturally occurring xylitol in the blood of more than 3,000 participants after overnight fasting. They found that people whose xylitol levels put them in the top 25% of the study group had approximately double the risk for heart attack, stroke or death over the next three years compared to people in the bottom quarter.

The researchers also wanted to understand the mechanism at work, so they fed xylitol to mice, added it to blood and plasma in a lab and gave a xylitol-containing drink to 10 healthy volunteers. In all these cases, xylitol seemed to activate platelets, which are the blood component that controls clotting, said Hazen. Blood clots are the leading cause of heart attack and stroke.

 “All it takes is xylitol to interact with platelets alone for a very brief period of time, a matter of minutes, and the platelet becomes supercharged and much more prone to clot,” Hazen said.

The next question is what causes naturally-occurring xylitol to be elevated in some people and how do you lower it, said Dr. Sadiya Khan, a cardiologist at Northwestern Medicine Bluhm Cardiovascular Institute and a professor of cardiovascular epidemiology at Northwestern Feinberg School of Medicine who was not involved in the new study.

Much more research needs to be done, said Hazen. In the meantime, he is telling patients to avoid eating xylitol and other sugar alcohols, whose spelling all end in ‘itol.’ Instead, he recommends using modest amounts of sugar, honey or fruit to sweeten food, adding that toothpaste and one stick of gum are probably not a problem because so little xylitol is ingested.

The report had key limitations. 

First, the study of naturally occurring xylitol in people’s blood was observational and can show only an association between the sugar alcohol and heart risk. It does not show that xylitol caused the higher incidence of heart attack, stroke or death.

Nevertheless, given the totality of the evidence presented in the paper, “it’s probably reasonable to limit intake of artificial sweeteners,” said Khan. “Perhaps the answer isn’t replacing sugar with artificial sweeteners but thinking about more high quality dietary components, like vegetables and fruits, as natural sugars.”

Artificial sweeteners shouldn’t be difficult to avoid, said Joanne Slavin, PhD, RDN, a professor of food science and nutrition at the University of Minnesota-Twin Cities. They are listed on the ingredient list of packaged goods.

“Would I say never eat xylitol?” asked Slavin, who had no connection to the study. For some people who struggle to reduce sugar in their diet, sugar substitutes are one tool, and it comes down to personal choice, she said. 

While Slavin found the study interesting and cause for some concern, she noted that sugar alcohols are expensive and are generally used in very small amounts in gum and sugar-free candies.

Another limitation of the study is that the participants whose xylitol levels in the blood were measured were at high risk for or had documented heart disease, and so the results may not apply to healthy individuals.

Still, many people in the general public share the characteristics of the study participants, said Hazen. 

“In middle-aged or older America, it’s common to have obesity and diabetes or high cholesterol or high blood pressure,” he said.

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

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A salmonella outbreak linked to contaminated cucumbers shipped to multiple states has left more than 160 people sickened across the country, including dozens across Pennsylvania, New Jersey and Delaware, according to health officials.

The Centers for Disease Control and Prevention said Wednesday, June 5, 2024, it has received reports of 162 people who fell ill from March 11 through May 16 as a result of the salmonella strain tied to cucumbers.

Pennsylvania had the most salmonella cases reported, with 27 people falling ill, the CDC said. Three people in New Jersey and one in Delaware also reported becoming sick.

No deaths have been reported as a result of the salmonella poisonings, however at least 54 people were hospitalized, according to the CDC.

Earlier in the week, the U.S. Food and Drug Administration recalled whole cucumbers shipped to 14 states by Fresh Start Produce, a Florida-based company, from May 17-21. New Jersey and Pennsylvania were among the states where the cucumbers were sent.

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Consumers should not eat recalled cucumbers. People who bought cucumbers recently should check with the store where they purchased them to see if they’re part of the recall. Wash items and surfaces that may have been in contact with the produce using hot, soapy water or a dishwasher.

The FDA and CDC were conducting further tests on a wider sample of cucumbers to see if the same strain of salmonella is causing the wider outbreak.

“The recalled cucumbers are dark green, approximately 1.5 – 2.0 inches in diameter, and 5-9 inches long,” the FDA said.

The produce should no longer be available in stores, the CDC said. The recall did not cover English or mini cucumbers.

What are salmonella symptoms?

Those who infected with the salmonella bacteria will likely experience diarrhea, fever and stomach cramps. Symptoms will typically begin from six hours to six days after ingesting the bacteria, according to the CDC. Most people recover without any special treatment after four to seven days.

“Some people—especially children younger than 5 years, adults 65 years and older, and people with weakened immune systems—may experience more severe illnesses that require medical treatment or hospitalization,” the CDC said.

An internal review by Penn State in 2019 found evidence of “friction” between football coach James Franklin and a now-former team doctor, but it could not determine whether Franklin violated NCAA bylaws or Big Ten standards by interfering with medical decisions.

The 15-page document from Penn State’s office of ethics and compliance, dated June 3, 2019, was obtained by The Associated Press last week, the day after a Pennsylvania jury awarded $5.25 million to Dr. Scott Lynch for winning a wrongful termination lawsuit against the hospital that employs him.

The report left undetermined if Franklin or anyone else at Penn State broke any rules. It acknowledged the athletic department’s desire to make a change came after periods friction between Lynch and senior leadership in the department. The report also recommend further inquiry.

Penn State said in a statement to The Associated Press it was extremely disappointed in the jury’s ruling last week. The school said its medical decisions regarding the care of athletes and whether they can compete adhere to NCAA rules and Big Ten standards.

“The changes made in the leadership for athletic medicine were made by the Milton S. Hershey Medical Center with a singular focus: the best interests of our student-athletes,” Penn State said. “In the plaintiff’s own legal filing, which Penn State reported to the Big Ten Conference in compliance with its obligations, the plaintiff acknowledged that the medical care of our student-athletes was never influenced by coaches or anyone at the university.”

The school did not detail what internal follow-up — as suggested by the report — was done.

Coaching staffs are expected to leave medical decisions to team physicians and athletic trainers when it comes to player availability. Players are encouraged to advocate for their safety and not play through injuries, but just how much coaches influence putting a player back on the field is difficult to quantify.

Lynch told AP he believes coaches interfering with medical decisions is a problem across college sports.

“I think it’s a crisis,” Lynch said. “That nonsense has to stop.”

Lynch, a former national champion wrestler at Penn State, said he made recommendations to Penn State to better safeguard medical staff from pressure from coaches, but none were implemented.

“Protecting the health and welfare of our student-athletes is our single most important priority. Throughout James Franklin’s tenure, he has worked tirelessly to build a program focused on the well-being of student-athletes,” Penn State said.

The report, which was marked attorney/client privileged draft, was prompted by a complaint to Penn State’s athletic integrity officer made by Lynch after the doctor was removed from his position in March 2019. Lynch’s attorney tried to get the report entered as evidence in the trial, but it was denied.

The report said conflicts between Franklin and Lynch “may have been viewed as part of the natural friction between a physician and athletic interests.”

Franklin was originally named in Lynch’s lawsuit, but was dropped from the case along with Penn State athletics because of the statute of limitations. The case moved forward against Hershey Medical Center, where Lynch was based, and Dr. Kevin Black, the chairman of the department of orthopedics at the center.

Lynch’s attorneys argued the doctor was removed from his position as director of sports medicine at Penn State as retaliation for frequent conflicts with Franklin over the medical treatment of players. Lynch said the school attempted to hide Franklin’s involvement in his dismissal by saying he was replaced because he lived and practiced medicine in Hershey, which is about 100 miles southeast of the Penn State campus in State College.

Penn State officials said Lynch not living and working full-time in State College was inefficient and inconvenient for athletes and coaches. The report said Penn State’s preference for a team physician in residence full time in State College seemed to be based more on perception than conclusive evidence that it would improve coverage.

Defense attorneys in the trial said no medical treatments were ever altered under pressure from Franklin or other Penn State coaches and the internal report concluded the same.

The report also said there was “limited demonstrated evidence” that the removal of Lynch was made with a “retaliatory motive.” Lynch reported to Black in consultation with Penn State athletics, according to a contract between the school and hospital, the report said.

NCAA bylaws require schools to support “the unchallengeable autonomous authority of the primary athletics health care providers” when it comes to treatments and “return-to-play decisions.” Big Ten Conference standards bar coaches from “attempting to influence inappropriately any member of the medical or athletic training staff” regarding treatment.

Franklin has been the head coach at Penn State for 10 years, with an 88-39 record and five seasons of double-digit victories but just one Big Ten title (2015). The Nittany Lions were 10-3 last season.

Penn State gave Franklin a 10-year contract in 2021 with guarantees of more than $75 million. His buyout if he was to be fired by Penn State currently stands at more than $50 million, though a major NCAA violation could void the payment.

“My goal is not to target anybody in particular,” Lynch told AP. “My overarching goal is to try to get policies and procedures in place to stop this from happening. So what happens to him is not really my concern. My concern is way above that. Not just at Penn State. I’m hoping that this can be a catalyst so other people come forward now and we can effect change.”

Penn State investigators interviewed multiple people, including Lynch, Franklin and several Penn State athletes, who were asked about instances from 2016-19 when Lynch alleged his authority had been challenged. Six incidents involved football player injuries. Another involved a men’s soccer player. The athletes were not identified in the report.

Lynch and another doctor told investigators for the report that Franklin would say “words to the effect, ‘that I’ve been doing this for 30 years and you’ve only being doing this four years.’”

According to the report, after a football player was ruled out of a game in 2016 with an ankle injury, Lynch and another doctor were pressed by Franklin and a Penn State administrator to re-evaluate the decision. The player did not play. During the trial, former Penn State star running back Saquon Barkley, now with the Philadelphia Eagles, testified about the decision and in support of Franklin.

Franklin told investigators this was his only specific recollection of friction between him and the doctors.

That same year, another player decided to have surgery instead of rehabilitating a shoulder injury in an effort to return to play faster, the report said. Lynch had given the player the option of surgery or rehab, but he claimed the player changed his mind after Franklin became involved.

According to the report, Franklin, then-athletic director Sandy Barbour and another administrator demanded a player with a “serious mental issue” be declared a medical non-counter — meaning he would not count against the team’s scholarship limit but could still have his tuition covered — before the athlete had received treatment. This allegedly occurred before the team’s postseason banquet and in the locker room after the final game of the 2017 season.

Barbour, who retired in 2022, declined to comment, citing the legal case.

“At Penn State, student-athletes compete only upon the independent approval of the medical team and physicians, who do not report to any coach or to Intercollegiate Athletics,” Penn State said. “These measures, which protect our student-athletes, were put in place long before Coach Franklin or Dr. Lynch were in their roles and worked as intended. Neither the five-year old internal compliance report nor the information shared during the trial suggested otherwise.”

The possible exposure occurred on Friday, May 31, 2024, from 2:50 p.m. to 6 p.m. in the Federal Inspection Area at the airport’s Terminal A West, according to the health department. Officials said a person with measles was traveling through the airport and is not related to a recent measles case from Philadelphia.

“We believe there is no threat to the general public associated with this case of measles,” Dr. Landrus Burress, Director, Division of Disease Control, said. “We encourage people who were possibly exposed to take action if they are not protected against measles. Many countries, including travel destinations, are experiencing measles outbreaks, so the potential for travel-related measles cases and subsequent outbreaks in the United States has increased. We strongly encourage parents to follow the CDC’s immunization schedule and get their children fully vaccinated as soon as they are able. People planning to travel outside the United States should speak with their doctor about their travel plans and vaccinations needed.”

Measles is a highly contagious virus that can be spread to others who are not protected against it through direct contact with respiratory droplets or through droplets in the air from coughing and sneezing.

Early symptoms of measles are fever, runny nose, cough and red, puffy eyes followed by a rash. For some people, measles can be a serious infection that leads to pneumonia, brain infection and even death.

The best protection against measles is getting the Measles, Mumps, and Rubella (MMR) vaccine. The MMR vaccine is safe and highly effective in preventing the virus, according to numerous health experts. The vaccine is recommended for patients 12-15 months of age with a second dose given between the ages of 4 and 6. Infants under 12 months old are not routinely eligible for vaccine and are not protected. Health experts recommend however that infants between the ages of 6 to 11 months old should receive a dose of MMR vaccine to protect them before traveling internationally.

Families who are traveling outside the United States should also speak to their infant’s pediatrician at least two weeks before leaving.

The Philadelphia Health Department shared the following recommendations for anyone possibly exposed to the measles:

Determine if you’re protected against measles. Generally, people who are considered immune and protected are those born before 1957, or have already had measles or have received two doses of measles-containing vaccine. Check your vaccination records or ask your healthcare provider to see if you have already had two doses of the MMR vaccine.

If you are protected from measles, you don’t have to take any further action, according to health experts.

If you are not protected from measles, you should receive a dose of the MMR vaccine and talk to your healthcare provider to learn how you can get it.

Those who are under 12 months of age, pregnant and not immune or have a weakened immune system should consult with their healthcare provider as soon as possible.

Measles is contagious for four days before to four days after a rash starts. If you are not immune and may have been exposed, you could give measles to someone at high risk before developing a rash. Those who are not immune and possibly exposed should wear a mask in indoor public spaces and around anyone who is unvaccinated until three weeks after the exposure.

If you are not immune, may have been exposed and develop any symptoms through June 21, 2024, that appear like measles, contact your doctor immediately. Early symptoms of measles include fever, runny nose, cough and puffy, red eyes followed by a rash. You should also notify the Philadelphia Health Department at 215-685-6740 or state health department at 877-724-3258.

Learn more about measles here.

“It was basically like a hand sanitizer solution,” Whitehead shared with NBC News, who lives in Torrance, California. “Smelled like hand sanitizer, looked like hand sanitizer.”

The gel wasn’t hand sanitizer, though. It was a hormonal solution meant to block Whitehead’s sperm production. The gel was male birth control.

Until this past winter when his participation concluded, Whitehead was a volunteer in a phase 2 trial for the gel. The product — which contains testosterone and a synthetic hormone called Nestorone that reduces sperm production — is the most advanced among a crop of novel birth control options for men.

If the Food and Drug Administration approves the gel, Whitehead said he would definitely keep using it, especially after watching his partner struggle with available female birth control options.

“The gel was such an easy process,” he said. “It was basically like taking the pill for the day.”

Whitehead said he didn’t notice side effects using the gel beyond some upper back acne and possibly a bit of weight gain, although that could have been linked to a new sedentary job.

Hormonal gel trial shows promise

On Sunday, at the Endocrine Society’s conference in Boston, researchers with the National Institutes of Health’s Contraceptive Development Program presented encouraging phase 2 trial results on the hormonal gel.

The trial involved 222 men, ages 18 to 50, who applied 5 milliliters of the gel (about a teaspoon) to each of their shoulder blades once per day.

The second part of the two-part trial is still underway. Initial findings showed that the contraceptive worked faster than expected, according to Diana Blithe, chief of NIH’s Contraceptive Development Program.

After 12 weeks of applying the gel every day, 86% of trial participants achieved sperm suppression, meaning they had only up to 1 million sperm per milliliter of semen, the amount the researchers deemed effective for contraception. On average, the timing for effective contraception was eight weeks.

In comparison, normal sperm counts without contraception can range from 15 million to 200 million per milliliter.

The faster-than-expected timing to suppress sperm is an encouraging sign, especially since past attempts have taken longer to reach these sperm levels, Blithe said in a news release about the new data.

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Prior efforts using testosterone alone have required higher doses of the hormone, which can cause side effects. Because the gel includes both testosterone and Nestorone, it acts more quickly and requires less testosterone, she said.

Nestorone is a type of synthetic hormone called a progestin that’s already used in the vaginal ring contraceptive. Combining Nestorone and testosterone in the new gel is meant to keep men from producing sperm without affecting their sex drive or causing other side effects.

So far, the men in the gel clinical trial have shown low enough blood levels of testosterone to maintain their normal sexual function.

Researchers are now tracking how well the gel works to prevent pregnancy. Because of pregnancy risk, male participants are required to be in committed, monogamous relationships, and need consent from their female partners too. The couple must agree to use the gel as their only birth control and to have sex at least once a month for a year. Throughout the study, men have their sperm counts tested periodically, which is a good predictor of fertility. If the sperm counts remain low, the chances of pregnancy are slim.

After decades of early-stage attempts and failures, there are no federally approved male birth control drugs. Only a handful have even advanced into human trials.

It’s not because the approaches haven’t shown potential, researchers say, but because there hasn’t been enough funding or financial investment to complete expensive advanced human trials.

“We’ve been pushing for hormonal male contraceptives for 50 years, but there isn’t enough money available to really drive something through a very large phase 3 trial,” said Daniel Johnston, chief of the National Institute of Child Health and Human Development’s Contraception Research Branch.

If one male birth control drug gains approval from the FDA, pharmaceutical companies and industry investors would put more resources into other medications or products, Johnston believes.

“We’ve been chasing this for a long time,” Johnston said. “I hope we’re entering new territory.”

Nonhormonal options in development

Also at the Boston conference on Sunday, YourChoice Therapeutics said a very small trial in the U.K. — just 16 men — showed that its nonhormonal pill, YCT-529, was safe and free of side effects. The San Francisco company’s nonhormonal pill works by blocking the vitamin A receptor important for male fertility.

YourChoice is planning a larger trial, according to CEO Akash Bakshi.

“We’re excited to see what happens next,” Bakshi said.

Separately, a Charlottesville, Virginia, medical device company, Contraline, is developing a nonhormonal male birth control method that involves injecting a gel into the vas deferens, the tubes that transport sperm from the testicles.

Injecting the gel, called ADAM, involves a single, 15-minute procedure, said Kevin Eisenfrats, Contraline’s CEO and co-founder. Then, the gel is meant to stay in place for years. Contraline compares the long-acting reversible contraceptive to an intrauterine device (IUD) for women.

Contraline has been testing ADAM in an early clinical trial in Australia. In January, the company reported that among 25 clinical trial participants, the approach resulted in a 99.8% to 100% reduction in the number of motile sperm within 30 days of the procedure, Eisenfrats said.

“It’s honestly very similar to the experience patients have after a vasectomy,” he said. “Some of these patients had light bruising and swelling, which go away on their own.”

Contraline hopes to start testing ADAM in the U.S. in 2025.

Because Contraline is developing ADAM as a medical device and not a drug, it may be able to go through a speedier clinical trial and regulatory process than contraceptive drugs like the hormonal gel, experts suggest.

If it goes according to plan — which can be rare for novel products with no precedent — Eisenfrats said he’s aiming for an FDA approval in 2027.

Another company called Next Life Sciences is developing a similar method. Next Life’s approach, called Plan A, or Vasalgel, also involves blocking the vas deferens with a gel-like injection. Next Life is based in Flagstaff, Arizona. Next Life hasn’t started testing Plan A in people yet, although the company did test its method of injecting the gel in Canadian volunteers this past year.

Demand for new contraception is growing

U.S. and global surveys have found that men are willing to use contraception, said gynecologist Dr. Brian Nguyen, one of the investigators on the gel clinical trials.

“By and large, they always say they’d be interested,” said Nguyen, an associate professor of obstetrics and gynecology at the University of Southern California.

According to one 2023 survey published in the journal Contraception, three-quarters of 2,066 male respondents said they’d be willing to use new contraceptives.

In 2019, the nonprofit Male Contraceptive Initiative estimated more than 17 million men in the U.S. want more birth control options.

Heather Vahdat, the Male Contraceptive Initiative’s executive director, said interest in male birth control has been on the rise since the Supreme Court overturned Roe v. Wade in 2022.

Recent research from the University of Pittsburgh School of Public Health found that the number of young women and men choosing permanent birth control such as vasectomy and tubal ligation increased sharply after the court’s decision and has continued to rise.

A separate study conducted in part by the Male Contraceptive Initiative, showed that before the abortion ruling, 78% of men in the U.S. said they were interested in trying new birth control methods. Afterward, it climbed to 82%.

“The demand has always been there, but there’s a greater intensity now,” Vahdat said. “We get emails daily from people asking where they can sign up for clinical trials.”

Unlike a vasectomy, each of the new contraceptive approaches is meant to be reversible, so men can stop using them and regain their ability to have children.

“Vasectomies are a great solution for men who are done having kids,” Eisenfrats said. But reversing the procedure — which involves reattaching the vas deferens in a three-hour microsurgery — can be extremely challenging and doesn’t always work, he said.

While condoms can be highly effective against pregnancy or sexually transmitted infections when used perfectly, perfect use is hard to achieve. And condoms generally aren’t the preferred contraceptive in long-term relationships, YourChoice’s Bakshi said. 

Why is male birth control taking so long?

The new trial results are encouraging to Vahdat. But she knows that it’s not enough to show a birth control method is safe and effective. The product needs substantial buy-in from investors, too.

“We have this classic line, ‘Male contraceptives have been 10 years away for 50 years,’” Vahdat said.

The reason, she believes, boils down to lack of funding.

After NIH research grants, the Male Contraceptive Initiative is the second-biggest funder of male contraceptive research in the world, according to Vahdat.

“That’s super exciting, except when you consider we only grant about $1.5 million a year,” she said.

On average, the Congressional Budget Office ballparks $1 billion to $2 billion as the amount needed to take a drug through clinical trials and onto the market.

Right now, there’s just not enough money to take any of these male birth control approaches through the FDA review process, USC’s Nguyen said.

The hormonal gel is the most advanced in clinical trials, but it still hasn’t gone through a much larger, lengthy phase 3 trial. As of now — in part due to funding uncertainties — plans to test the gel further are still up in the air.

Most academic researchers or small biotech companies developing new drugs rely on drugmakers with deep pockets to fund advanced trials. In exchange, these bigger companies usually expect a cut of profit once the drugs make it to market.

The studies so far have been funded by NIH and the independent nonprofit Lundquist Institute in Torrance, California.

As of now, Nguyen said, there’s no major pharmaceutical company stepping in to fund the male contraceptive gel’s next-stage trials.

“There has to be an industry partner,” he said.

Nguyen thinks the challenge is that despite evidence that men want options, many couples still depend on female birth control.

“But that doesn’t mean they are satisfied with them and wouldn’t appreciate a male method.” Nguyen said.

“People always ask, ‘How long will it be until we see this product on the market?’” Nguyen said. “Most people will say five to 10 years, but I disagree.”

However, the chance of any of these male contraceptives — the gel, the physical blockers, the pills and whichever new methods crop up next — making it to market depends on whether investors with deep pockets recognize the demand is really there, Vahdat said.

To reach this point, she believes, the conversation has to shift away from viewing male contraception and female contraception as mutually exclusive landscapes with two separate populations demanding them.

“I think of male contraception as women’s health,” she said. “You’re still preventing unintended pregnancy.”

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The Food and Drug Administration posted its initial review of the drug Friday, ahead of a meeting of outside advisers who could help decide whether MDMA — currently illegal under federal law — becomes the first drug of its kind to win U.S. approval as a medication.

In their assessment, FDA scientists said that patients who received MDMA and talk therapy showed “rapid, clinically meaningful, durable improvements in their PTSD symptoms.” But they also called the research “challenging to interpret,” and questioned how long the benefits might last.

They said it’s difficult to know how much of the improvement came from MDMA versus simply undergoing intensive therapy, and also raised several safety concerns, including MDMA’s heart risks and potential for abuse.

The outside experts will take a nonbinding vote on the drug’s overall benefits and risks during Tuesday’s meeting. The FDA will make the final decision, likely in August.

Antidepressants are now the only FDA-approved drugs for post-traumatic stress disorder, which is closely linked to depression, anxiety and suicidal thinking and is more prevalent among women and veterans.

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If approved, MDMA would be reclassified as a prescription medicine and made available to specially certified doctors and therapists. Currently, the drug is in the same ultra-restrictive category as heroin and other substances the federal government deems prone to abuse and devoid of any medical use.

MDMA, also known as ecstasy or molly, is the first in a series of psychedelics that are expected to be reviewed by the FDA in coming years. It’s part of a resurgence of research into the potential of psychedelics for hard-to-treat conditions like depression, addiction and anxiety. MDMA’s main effect is triggering feelings of intimacy, connection and euphoria.

Companies are studying MDMA, psilocybin, LSD and other mind-expanding drugs for numerous mental health problems.

Until recently, psychedelic research was mainly funded by a handful of nonprofit advocacy groups, including Multidisciplinary Association for Psychedelic Studies, or MAPS. The company seeking approval for MDMA, Lykos Therapeutics, is essentially a corporate spinoff of MAPS, which conducted all the studies submitted for FDA review.

In two studies, patients received MDMA as part of an intensive, four-month course of talk therapy lasting more than a dozen sessions, only three of which involved taking the drug. The drug is thought to help patients come to terms with their trauma and let go of disturbing thoughts and memories.

The approach was studied in nearly 195 adults with moderate-to-severe PTSD who were randomly assigned to undergo the therapy with MDMA or with a dummy pill. Following treatment, patients who received MDMA had significantly lower PTSD scores and were more likely to be in remission.

But FDA reviewers noted that the vast majority of patients correctly guessed whether they had received MDMA or a dummy pill, making it “nearly impossible” to maintain the so-called “blinded” objectivity considered essential for high-quality drug research. The agency also questioned how long the drug’s benefits might last. The studies tracked some patients for up to two years, but reviewers noted that about a quarter of patients quickly dropped out of the follow-up study, limiting the usefulness of the results.

The most common side effects of MDMA included headache, nausea, muscle tightness and decreased appetite. More serious issues included heart palpitations and elevated blood pressure, which FDA reviewers said had the “potential to trigger” life-threatening heart problems.

They also raised concerns about the potential for patients to abuse MDMA, which functions similarly to amphetamines and other stimulants.

While MDMA would be a first-of-a-kind approval, U.S. doctors and the FDA itself have already laid some of the groundwork for working with drugs that can cause intense, psychological experiences.

Hundreds of clinics across the U.S. already offer ketamine — the powerful anesthetic sometimes used as a party drug — to treat a host of ailments, including depression, anxiety, chronic pain and PTSD. The FDA has only formally approved the drug for use during surgery, but its availability allows doctors to prescribe it “off-label” for various mental and physical ailments.

In 2019, the FDA approved Johnson & Johnson’s proprietary form of the drug, Spravato, a nasal spray that treats severe depression. Similar to ketamine, the drug is offered at doctor’s offices and clinics where patients usually spend several hours reclining in a chair.

___

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

Gyms across Philadelphia are teaming up this weekend to raise money for the Mazzoni Center. The Center provides resources to LGBTQIA+ individuals in the region, including health care, gender-affirming care, mental health services, access to food and more.

One of the center’s board members, Dylan Van Duyne, had the idea to merge two of his passions, to raise money for the cause.

“Pride is an exciting time of the year,” said Van Duyne. “It’s one of my favorite times of the year. I also think Pride, at it’s core to me, is about removing barriers and increasing access.”

Van Duyne is a fitness instructor. He, along with his co-workers, organized the Philly Fitness Pride Kickoff. In total, 11 local gyms are participating in this weekend’s fundraiser:

Saturday, June 1

• Solidcore – Center City – 7 a.m.
• Unite – 8 a.m.
• F45 – South St – 11 a.m.
• Revel Ride – 11 a.m.
• Arena – 11:30 a.m.
• Cyclebar – 12:30 p.m.
• Barry’s – 12:50 p.m.

Sunday, June 2

• Soul Cycle – 8:30 a.m.
• Solidcore – Rittenhouse – 9 a.m.
• Solidcore – Nolibs – 1:30 p.m.
• Solidcore – Bryn Mawr – 4 p.m.

One of the gyms participating is Unite Fitness in Rittenhouse. Master Coach, Parker Lloyd, is teaching the class. They’ll take you through a mixture of cardio and strength training, while blasting a fire playlist.

“I want them to feel excited,” Lloyd said. “I want them to feel like they’re about to go to a concert.”

As a nonbinary coach, Lloyd says they’re passionate about making sure everyone in their class feels confident and welcome.

“I think a lot of people undersell themselves,” said Lloyd. “I always love to see the surprise when people come out of a class being like, ‘oh my God I was so much stronger than I originally thought!’ I just love supporting people in that way and making them discover their strength.”

U.S. Rep. Dwight Evans of Philadelphia said Thursday that he is in a rehabilitation facility recovering from a minor stroke, and plans to return to voting in Washington in about six weeks.

“I wanted to let my constituents know that I am recovering from a minor stroke, and I want to emphasize the word minor,” the fourth-term Democrat wrote on social media. “I’m recovering at an inpatient rehabilitation facility.”

Evans — who represents the 3rd Congressional District that includes Northwest and West Philadelphia and parts of North, South, Southwest and Center City Philadelphia — said he is having difficulty with one of his legs that will impact his walking for some time and expects to leave the rehabilitation facility in about a week.

Evans, 70, said he received the diagnosis this week for a stroke that was so minor that he didn’t realize what had happened for a few days. He said the stroke won’t affect his long-term ability to serve in Congress.

He said he took some time to rest and decide how to go public with the diagnosis.

“In the coming months, I want to help educate people and remove the stigma that sometimes accompanies strokes — many people can recover and continue on with their life and their work,” Evans said.

Evans served for 36 years in the state House of Representatives, rising to become Appropriations Committee chairman, before winning the seat of the convicted former U.S. Rep. Chaka Fattah.

The report, conducted on behalf of NBC News, found that spironolactone made up 47% of all oral medications prescribed to women for acne in 2023, up from 27% in 2017. Prescriptions for oral antibiotics — previously the go-to pill for acne — decreased from 41% to 27% in the same time period.

The shift is likely driven in part by the American Academy of Dermatology’s call to limit the use of antibiotics when possible, according to Dr. John Barbieri, a dermatologist and epidemiologist at Brigham and Women’s Hospital in Boston. Those prescribing guidelines, which Barbieri helped write, have encouraged dermatologists since at least 2016 to limit prescribing antibiotics in an attempt to combat drug resistance.

“There’s been more interest in antibiotic stewardship over the past few decades than prior to that, so I think those trends have helped to spur these shifts,” Barbieri said.

Antibiotics including doxycycline have long been prescribed for acne. They work by targeting acne-causing bacteria and decreasing inflammation, though they can come with side effects including increased sensitivity to the sun and gastrointestinal issues.

Barbieri said that “the growing evidence supporting the safety and effectiveness of spironolactone,” which is used off-label, has also likely contributed to the rising prescribing rates.

While the drug was approved as a high blood pressure medication in 1960, it was in the 1980s that some doctors began prescribing it to women for acne. 

Dr. Jessica Krant, a dermatologist at Laser and Skin Surgery Center of New York, said that she prescribes spironolactone more now than she used to. 

“The more years we go on with it out in the market, and everybody being generally OK with it, the more comfortable I get prescribing it,” Krant said. 

Dr. Patricia Oyetakin, a dermatologist at Medical Dermatology Specialists in Atlanta, is among a younger generation of doctors who learned about spironolactone in medical school. 

“If it’s hormonal acne, I will always have the conversation about spironolactone,” she said. That patient, Oyetakin said, is typically “still having her menstrual cycles, late 20s and onwards in age and having the hormonal pattern acne.”

Hormonal acne appears on the lower face, chin, jawline and neck, she said. 

“You know you’re dealing with the testosterone or androgen receptors in the skin and in the glands, the active ingredient has to be something that addresses specifically that hormone,” she added.  

Spironolactone works by blocking these hormones, which can clog pores and cause acne by increasing oil production in the skin.

Birth control pills can also be an effective treatment for this type of acne, and indeed, can be prescribed by dermatologists for this reason. However, prescriptions of birth control for acne also fell from 2017 to 2023, Epic Research found. 

That change may be the result of women choosing other means of contraception. Oyetakin, Barbieri and Krant all said they have patients who have switched to intrauterine devices, or IUDs, which means that even if they’d previously been taking a birth control pill for acne, they’d have to stop.

“We do know that over time, IUD rates have gone up over the last two decades,” said Dr. Deborah Bartz, who is an obstetrician-gynecologist at Brigham and Women’s Hospital.

That change could be another reason spironolactone use has gone up. 

When patients make the switch from oral contraceptives to another form, they may develop acne, especially on areas of the body they hadn’t before, Krant said. “Some of them do definitely break out more with those hormonal IUDs,” she added.

“There are a lot of people who just taking a birth control pill for contraception were treating their acne, and now if they’re using other forms of contraception, they might be more likely to develop acne or have acne that’s harder to control,” Barbieri said. Those patients may then need an additional medication, like spironolactone, to treat that acne, he added.

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

• Louisiana legislature approves bill classifying abortion pills as controlled dangerous substances
• Norfolk Southern will pay modest $15 million fine as part of federal settlement over Ohio train derailment
• Second human case of bird flu linked to dairy cows found in Michigan

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

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

Backward walking challenges your brain

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

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

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

Backward walking benefits

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

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

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

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

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

3 easy ways to add backward walking to your routine

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

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

• Michael J. Fox plays guitar with Coldplay at Glastonbury: ‘Thank you to the main reason why we’re in a band’
• It took Lainey Wilson more than 10 years to get noticed in music. What kept her going
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The New Jersey Democrat said he was revealing his wife’s health crisis at her request after repeated inquiries from the media.

“We are, of course, concerned about the seriousness and advanced stage of the disease,” the senator said in a statement.

He added: “She will require follow up surgery and possibly radiation treatment. We hope and pray for the best results.”

Previously, lawyers for Nadine Menendez had requested her trial on charges in the case be delayed after she was diagnosed with what was only previously described publicly as a serious health issue.

Judge Sidney H. Stein had postponed her trial until at least July. Nadine Menendez, who married the senator two years after she began dating him in 2018, has pleaded not guilty.

One of her lawyers declined comment in response to Bob Menendez’s disclosure Thursday.

The senator, on trial with two of three businessmen who allegedly paid him bribes, has pleaded not guilty to charges of bribery, fraud, extortion, obstruction of justice and acting as a foreign agent of Egypt. A third businessman has pleaded guilty in the case and will testify against the others.

Menendez’s statement about his wife was released just after opening statements were completed and the presentation of evidence began at his trial in Manhattan federal court.

The trial’s first witness was an FBI agent, Aristotelis Kougemitros, who described leading a June 2022 raid on the couple’s Englewood Cliffs, New Jersey, home.

He testified that two 1-kilogram (2.2-pound) gold bars, 11 1-ounce gold bars and $486,461 in cash were among valuables found in the home, along with cellphones and jewelry. In all, 52 items were seized.

At first, Kougemitros said, the FBI had directed agents to photograph any cash that was found, but not necessarily to seize it.

But he said that based on his experience and training, along with the “totality of the circumstances,” that he decided the amount of cash was so voluminous that it would be seized.

“I believed there was evidence potentially of a crime,” he said, drawing an objection from Menendez’s lawyer that was sustained by the judge.

Through dozens of photographs and the agent’s testimony, jurors were taken on a tour of the home as Kougemitros described where cash and the gold bars were discovered by a team of eight agents that was later supplemented by two Manhattan agents who brought cash-counting machines.

The gold bars were found in a safe and on the floor nearby inside locked closets in a bedroom, he said. Much of the cash was found stuffed in jacket pockets, in two pairs of boots and on a shelf in the home’s basement, he said.

One pair of Timberland boots contained $14,500 in cash nearly evenly divided while another set of boots also had cash stuffed in each boot, he said.

A black jacket, which was among four jackets found to contain cash, had $21,000 in envelopes in its pockets, Kougemitros said. The other jackets, he added, had $4,300, $6,000 and $8,000.

On a shelf nearby, he said, a plastic bag contained $100,000, while another bag held $95,000.

Earlier in the day, lawyers for New Jersey real estate developer Fred Daibes and businessman Wael Hana delivered their opening remarks to jurors a day after a prosecutor and Menendez’s lawyer gave opening statements.

Attorney Lawrence Lustberg, representing Hana, said prosecutors had built their case against his client on “innocent acts.”

He said Hana was longtime friends since 2009 with Nadine Menendez and that Hana and Nadine Menendez had exchanged expensive gifts over the years. He said there was never a time when Hana either directly to Bob Menendez or indirectly through Nadine Menendez gave a bribe in exchange for official acts by the senator.

Attorney Cesar De Castro, representing Daibes, told jurors the case was about relationships and prosecutors were trying to exploit facts about a three-decade friendship between the senator and Daibes to claim crimes occurred. He said they will conclude his client was not guilty.

On Wednesday, attorney Avi Weitzman, representing Bob Menendez, told jurors his client was unaware that his spouse had accepted gifts from the three businessmen and did not know about cash and gold bars hidden in a closet at their home.

The statement came after an opening statement by Assistant U.S. Attorney Lara Pomerantz in which the prosecutor repeatedly highlighted the gold bars and cash found in the home.

Menendez has held public office continuously since 1986, serving as a state legislator before 14 years as a U.S. congressman. In 2006, then-Gov. Jon Corzine appointed Menendez to the Senate seat he vacated when he became governor.

The trial, which began Monday, is projected to last up to two months.

___

Catalini reported from Trenton, New Jersey.

The oldest living person of Japanese descent in the United States, according to the Gerontology Research Group, Miwa prefers to focus on the times when she was happiest. She’s lived through the Spanish flu, prohibition, Black Tuesday, World War II, and the losses of her parents, siblings and friends, and still the supercentenarian’s go-to piece of longevity advice is: Don’t dwell.

Miwa is part of the nisei — the second-generation Japanese Americans sent to internment camps during World War II — who often say “gaman,” which translates to “enduring the seemingly unbearable with patience and dignity,” Alan Miwa, her son, tells TODAY.com. It’s often loosely translated to “perseverance,” “patience,” or “tolerance.”

These feelings, Alan Miwa suspects, are born from the resilience of many from his mother’s generation — who had much to endure. Shikata ga nai (仕方がない), a Japanese phrase meaning, “It cannot be helped,” or, “Nothing can be done about it,” is a common saying among them, too, he adds.

Yoshiko Miwa was born Yoshiko Tanaka on Feb. 28, 1914, in Guadalupe, California, to Japanese immigrants. She was the fifth of seven children. When her mother and infant brother died in 1919, her father struggled to care for his family and tend to the farm he owned. So Yoshiko Miwa and her siblings were sent to live at the children’s home founded by their parish, Guadalupe Buddhist Church.

She went on to graduate from Santa Maria High School in 1932, and she studied business at the University of California, Berkeley, graduating in 1936. She married Henry Miwa in 1939.

During the Second World War, the pair and their families were sent to Poston Internment Camp in Arizona before relocating to Hawthorne, California, after the war. When they, along with many other Japanese people, had difficulty finding work upon their release in 1945, her husband founded a plant nursery business, and in 1963, Yoshiko Miwa got her nursing license.

Yoshiko Miwa has three sons, 10 grandchildren, 20 great-grand children and one great-great-grandchild.

These days, Alan Miwa says she’s in good health and lives in a care facility, where she gets her hair done weekly and attends church services on Sundays.

In addition to a positive spirit, keeping your mind and body active is the key to a long life, Yoshiko Miwa has said in the past. Ahead she shares a few other aspects of her life that she believes have led to her longevity.

She keeps an ever-expanding roster of hobbies

When Yoshiko Miwa retired, she’d walk 4 miles each morning. In 1990, at 76, she walked a 20K as part of the March of Dimes Walkathon. She’s an avid reader, she practices ikebana (flower arranging), sumi-e (Japanese ink art), sashiko (Japanese stitching), sewing, furniture refinishing and reupholstery.

These days, though, her favorite activity is sleeping, she tells TODAY.com via email.

She wrote an autobiography

After taking a writing course, Yoshiko Miwa penned an autobiography. In it, she recalls her travels to Rome, Japan, Paris and Niagara Falls. She describes life in the children’s home and the long walks to school, her siblings and her childhood with her parents.

“We had a big pasture for the horses and cows to graze on,” she wrote of her family’s farm her in autobiography. “Some days, my sister and I would wander around the pasture to pick wild violets that grew there.”

She loves to eat noodles

Yoshiko Miwa’s a fan of any kind of noodles, eating them every day. “When I was in the children’s home, the cook used to make noodles and I used to love them,” she says. “Today, I like spaghetti, udon, ramen, soba and any other kind of noodles.”

Her faith energizes her

Yoshiko Miwa is grateful to Rev. and Mrs. Issei Matsuura of the Guadalupe Buddhist Church, who took her in when her mother died of the Spanish flu.

Yoshiko Miwa was 4 years old when her father turned to the church for help. “The church then started a children’s home and taught us Buddhism, Japanese language, Japanese culture and responsibility,” she recalls. “I’ve always been indebted to Rev. and Mrs. Matsuura.”  

… And her family does, too

The Miwa family travels together and hosts reunions. “I’ve been fortunate that my sons, my grandchildren, my great grandchildren and relatives have always been there for me,” says Yoshiko Miwa.

“Because my mother died so young, I have never enjoyed the warmth and love of a family unit,” she wrote in her autobiography. “Later, when I had my children, I keenly felt the wholesomeness of a complete family.”

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

• Hilary Duff welcomes baby No. 4: ‘Pure moments of magic’
• What’s the healthiest Starbucks drink? Dietitians share their top 5 picks
• This celeb traveled to the Met Gala under a head-to-toe beige umbrella

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

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

Backward walking challenges your brain

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

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

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

Backward walking benefits

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

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

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

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

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

3 easy ways to add backward walking to your routine

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

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

• Michael J. Fox plays guitar with Coldplay at Glastonbury: ‘Thank you to the main reason why we’re in a band’
• It took Lainey Wilson more than 10 years to get noticed in music. What kept her going
• ‘Inside Out 2’ hits major box office milestone last achieved by ‘Barbie’

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

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

Backward walking challenges your brain

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

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

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

Backward walking benefits

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

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

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

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

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

3 easy ways to add backward walking to your routine

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

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

• Michael J. Fox plays guitar with Coldplay at Glastonbury: ‘Thank you to the main reason why we’re in a band’
• It took Lainey Wilson more than 10 years to get noticed in music. What kept her going
• ‘Inside Out 2’ hits major box office milestone last achieved by ‘Barbie’

Editor’s Note (May 16, 2024, 6:12 a.m.): Gov. Josh Shapiro signed the “tranq” bill on May 15.

Pennsylvania Gov. Josh Shapiro will sign legislation to criminalize the misuse of a powerful animal tranquilizer called xylazine that is showing up in supplies of illicit drugs and contributing to a growing number of human overdose deaths, the first-term Democrat’s office said Wednesday.

Xylazine, which is being mixed into fentanyl and other illicit opioids, will remain legal for its intended use by veterinarians.

The bill received approval from the state House of Representatives and the Senate in the past week.

Under the bill, xylazine (a.k.a. tranq) will be listed as a “schedule III” drug under Pennsylvania’s controlled substance law, formalizing an order that Shapiro issued last year when Pennsylvania joined a growing list of states that were moving to restrict access to xylazine.

Xylazine is a prescription sedative used by veterinarians to safely handle and treat farm animals, wildlife, zoo animals and household pets such as cats and dogs.

Officials say the pain-relieving, muscle-relaxing drug, sometimes referred to as “tranq,” is often abused by being added to fentanyl and heroin. It was detected in 3,000 U.S. drug deaths in 2021, according to the federal Drug Enforcement Administration.

The illicit use of schedule III drugs carries a penalty of imprisonment of up to five years. The law would require that the drug be stored safely when used professionally, to prevent theft or improper access.

Federal officials last year declared xylazine-laced fentanyl an “emerging threat” and introduced a plan to scale up testing, treatment and efforts to intercept illegal shipments of xylazine.

Xylazine can cause breathing and heart rates to fall to dangerous levels when used in humans. When injected it can cause large open sores and infections, sometimes leading to amputation.

That’s because the U.S. Food and Drug Administration recently said it’s OK for producers of yogurt to make that claim — even though the agency acknowledged that it’s based on limited evidence.

Why did FDA allow yogurt makers to claim it can lower diabetes risk?

Danone North America, the U.S. branch of the French firm that makes several popular yogurt brands, asked the FDA in 2018 for clearance to make what is known as a “qualified health claim.” FDA gave Danone the nod in March.

The way FDA sees it, there’s some support — but not significant scientific agreement — that eating at least 2 cups of yogurt per week may reduce the risk of developing the disease that affects about 36 million Americans.

What is a ‘qualified health claim’?

Those are claims that lack full scientific support but are permitted as long as the product labels include disclaimers to keep from misleading the public.

They have been allowed for dietary supplements since 2000 and for foods since 2002, ever since the FDA faced lawsuits challenging the standard of requiring scientific agreement for product claims. Back then, lawyers successfully argued that such standards violated free speech rights guaranteed in the U.S. Constitution.

Rather than fight proposed label changes in court, the FDA created a new category, separate from authorized health claims, in which products must prove significant scientific agreement among qualified experts that they reduce the risk of a disease or a health-related condition.

Examples of qualified health claims include reports that consuming some types of cocoa may reduce heart disease and that cranberry juice might cut the risk of recurrent urinary tract infections in women.

what do experts say about yogurt and type 2 diabetes?

Danone submitted information from studies that observed participants over time and found a link between eating yogurt and lower markers of diabetes. The FDA agreed that there is “some credible evidence” of benefit of eating yogurt as a whole food, but not because of any particular nutrient in it.

In other words, there is no direct evidence that yogurt can prevent diabetes — only weak evidence that eating yogurt may be associated with reducing certain biomarkers that are related to increase risk of the disease.

Critics questioned approval of the claim, saying it’s not based on gold-standard randomized controlled trials that could have proven whether yogurt actually reduces Type 2 diabetes risk.

No single food can reduce the risk of a disease tied to overall diet, the advocacy group Center for Science in the Public Interest said. In fact, the label change might raise the risk of diabetes by encouraging consumption of yogurt types that include added sugars and mix-ins such as cookies and pretzels.

Marion Nestle, a food policy expert, said qualified health claims based on limited evidence are “ridiculous on their face.”

___

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

After being diagnosed with stage 4 cancer, the high school football coach and counselor started chemotherapy in 2023, but he had to stop abruptly when the drug he received, cisplatin, became harder to find as part of a nationwide shortage of chemotherapy drugs.

“I just keep wondering, ‘What if we had gotten the cisplatin? Could it have slowed his cancer down? she tells TODAY.com. “Would he have been able to coach even more? Would he have been stronger? Would he have felt better? … It’s always a second guess.” 

In 2022, Jeff Bolle, of Milwaukee, learned he had bile duct cancer, which has a dismal long-term survival rate. At the time, doctors hoped that surgery and chemotherapy could prolong his life. He was in good health prior to his diagnosis, which made everyone feel optimistic.

He underwent surgery and four rounds of chemotherapy before the chemotherapy shortage stopped his treatment in May 2023 — two rounds short.

As the months passed and his cancer progressed unchecked, Jeff Bolle became sicker. In late September 2023, doctors realized “there was really nothing else they could do, which was hard to hear,” Connie Bolle recalls. There was no immunotherapy. There was no other chemotherapy.”

Jeff Bolle died on Dec. 29, 2023, seven months after losing access to his chemo drugs.

Last summer, Jeff Bolle shared his story with TODAY.com to raise awareness of the chemotherapy shortage. He also shared his desire to coach at least one more football season. He achieved that — and it was even sweeter than he could have imagined.

“The Marquette University High School ended up winning the division one state championship football title, and they were not predicted to be the one (to win),” Connie Bolle says. “Jeff made it to every single one of the games.”

Stage 4 cancer diagnosis

When Jeff Bolle felt the twinge of back pain in October 2022, he thought he pulled a muscle while exercising. But later that year, he was diagnosed with stage 4 bile duct cancer.

He underwent surgery, where doctors removed most of the tumor, and then started immunotherapy and chemotherapy, even though he knew he would likely never be cured.

“My doctor said it was the type of cancerous growth you’ll never really get into remission,” Jeff Bolle told TODAY in 2023. “Their thoughts were that they could get most of the tumor out and they could use chemo … to hold it off.”

The Bolles understood this. Still, it felt devastating when Jeff Bolle stopped treatment because of the chemotherapy shortage.

“He was never able to get on cisplatin (again),” Connie Bolle says. “His cancer was just continuing to grow, and his bile ducts were getting compromised because the cancer was pushing on them even more. He was really getting so very sick. It was horrible.”

Although he felt too weak to work as a counselor, Jeff Bolle continued coaching football. Prior to becoming sick, he’d ride to practice on his motorcycle, wearing sleeveless shirts to show off his biceps. He often hit the weight room with the players and challenge them to bench presses. Even when sick, Jeff Bolle continued to show up for his players at least several times a week and at games.

Eventually, he needed a wheelchair to attend the games and sat on the sidelines, but he coached the defensive backs for as long as he could. No matter what, he always rated the game film after. In fact, Connie Bolls recalls that during one stay in the intensive care unit, he brought his laptop to grade a football game.

Connie Bolle says she believes he lived to finish this season.  

“He knew how important it was for these high school kids,” she says. “Some of the seniors had journeyed with Jeff for four years.”  

The team kept winning, ending up at the state championship in November.

“I don’t know how Jeff did it because he could barely stand honestly. At that point, he was probably down to about 140 pounds,” Connie Bolle says. “The cold was just intense, and he went up and down the sideline with his walker.”  

Chemotherapy shortage

Last year, cancer patients, like Jeff Bolle, and oncologists faced some grim news: Many chemotherapy drugs and agents used in oncological imaging had become increasingly difficult to find.

The most impactful shortages were of chemotherapeutic agents carboplatin and cisplatin, often used in cancers that can’t be cured, Dr. William Dahut, chief scientific officer of the American Cancer Society, told TODAY.com in 2023.

But shortages of cancer therapeutics are not new.

“What we’re experiencing right now is really the latest of multiple waves of shortages that have really gone back a decade,” Mark Fleury, Ph.D., who works in policy development and emerging science at the American Cancer Society Cancer Action Network, tells TODAY.com.

“We have many drugs that have never really left shortage and some that cycle in and cycle back out (of shortages).”

Last summer, NBC News reported that 14 drugs used in cancer treatment were hard to come by. In April 2024, the U.S. Food and Drug Administration website indicates that 15 oncology agents are currently in shortage.

Asked about the status of the chemo shortage, FDA spokesperson Chanapa Tantibanchachai shared an email statement with TODAY.com that says:

“The FDA recognizes the potential impact that lack of availability of certain products may have on health care providers and patients. While the agency does not manufacture drugs, and cannot require a pharmaceutical company to make a drug, make more of a drug, or mandate who a pharmaceutical company chooses to sell its product to (among lawful purchasers), the public should rest assured the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or reduced availability of certain products.”

FDA Commissioner Dr. Robert Califf told NBC News in May 2023 that the main reason for the chemo shortage is there’s not enough profit in producing these drugs, many of which are generic and do not have a patent. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology,” Califf said.

While carboplatin and cisplatin are “still listed in shortage,” Fleury says last year the FDA allowed imports of cisplatin that helped assuage that shortfall, and the drugs are now being produced more widely in the U.S.

“We’re not seeing the type of shortage that we did,” Fleury says. “We qualify it as in shortage, but … patients are getting their drugs.”

How chemo drug shortages affect cancer patients

Cancer patients felt the shortages. A survey by the American Cancer Society Cancer Action Network published in December found that 10% of all cancer patients were impacted, but the “shortages were not felt equally,” Fleury says.

For example, people on Medicaid experienced a tougher time, with 22% reporting a cancer drug shortfall affected their treatment. Some reported struggling to find pain medications or other therapies not directly used to treat their cancer but still important, he notes.

“Folks just had no idea whether they were going to get their next treatment or not, whether the dose was going to be cut in half,” Fleury says. “These are drugs … have really formed the backbone (of cancer care) and in some case have pretty high efficacy. And if they’re not available, you’re entering uncharted territory.”

While patients grappled with a high “mental toll,” they also faced “logistical tolls,” too, with some patients driving around to find treatment, he says.

“There are patients today who need help,” Fleury adds. “We need to figure out how to better manage the crisis that we’re in, but we also need to address some of the underlying causes, which keep us in this constant state of crisis.”

Lawmakers have taken some steps to address this issue. While many bills often provide short-term solutions, the Senate Finance Committee has been “doing a deeper dive” to address constant shortages, Fleury explains.

“The government has an important role to solve this,” Fleury says. “(But) that’s not to say that the private sector can’t.”

A lasting impact

By Dec. 14, 2023, Jeff Bolle was in hospice at home. Connie Bolle knew he was nearing the end on Dec. 28, when he agreed to stay in a hospital bed on the first floor because he was too weak to get to their bedroom on the second floor. He died the next day.

“He only spent one night in it,” she says. “That was the sign of defeat.”

At his funeral, his players shared what Jeff Bolle meant to them.

“They said such amazing things about the strength and determination and perseverance (they learned) from Jeff and kindness and love and compassion,” she says.

Connie Bolle believes that her husband would be humbled hearing about the impact he had on his students. She also believes he would be proud that his story raised awareness of the shortage of cancer therapeutics.

“He really cared about other people not getting these chemotherapy drugs,” she says. “He would still be sad today that people are still dealing with this.”

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A large staffing firm that performed COVID-19 contact tracing for Pennsylvania and exposed the private medical information of about 72,000 residents will pay $2.7 million in a settlement with the Justice Department and a company whistleblower, federal prosecutors announced Wednesday.

The Pennsylvania Department of Health paid Atlanta-based Insight Global tens of millions of dollars to administer the state’s contact tracing program during the height of the pandemic. The company was responsible for identifying and contacting people who had been exposed to the coronavirus so they could quarantine.

Employees used unauthorized Google accounts — readily viewable online — to store names, phone numbers, email addresses, COVID-19 exposure status, sexual orientations and other information about residents who had been reached for contact tracing, even though the company’s contract with the state required it to safeguard such data.

State health officials fired Insight Global in 2021 after the data breach came to light. A subsequent federal whistleblower lawsuit alleged that Insight Global secured its lucrative contract with Pennsylvania knowing that it lacked secure computer systems and adequate cybersecurity.

The whistleblower — a former Insight Global contractor — complained to company management that residents’ health information was potentially accessible to the public, according to the lawsuit. The company initially ignored her, then, when pressed, told the whistleblower “it was not willing to pay for the necessary computer security systems and instead preferred to use its contract funds to hire large numbers of workers,” the lawsuit said.

It took Insight Global five months to start securing residents’ protected medical information, according to the U.S. Justice Department.

“Contractors for the government who do not follow procedures to safeguard individuals’ personal health information will be held accountable,” Maureen R. Dixon, who heads up the inspector general’s office at the U.S. Department of Health and Human Services, said Wednesday in a statement on the settlement, of which the whistleblower is set to receive nearly $500,000.

Insight Global, which has about 70 offices in the U.S., Canada and the U.K., has previously acknowledged it mishandled sensitive information and apologized. The company said at the time it only belatedly became aware that employees had set up the unauthorized Google accounts for sharing information.

A message was sent to the company Wednesday seeking comment on the settlement.

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“It gives you a better outlook on life. It really does,” Assal, who is 81 years old, said. “I just love to run.”

His love for running has fueled the now octogenarian through countless races. One of his favorites to run in is the Independence Blue Cross Broad Street Run.

“Ask anybody, everyone says that is their favorite race. It is the fast one and it is just so nice,” Assal said. ” When you see that Navy Yard coming up you really get psyched up. And the crowds! The crowd is just fantastic.”

The crowd cheered Assal on in 2023 as he took first place in the 80 & over category by more than 30 minutes.

“There was, I think, 15 other people 80 and over. It was just nice to do that. It felt good,” Assal said.

Assal has competed in the Broad Street Run on and off for decades. He said his age may have slowed him down a bit over the years, but it certainly will not keep him from lacing up.

“If I stop running, I’ll get old really quick,” he said.

Not even a major running injury in 2021 kept Assal from the starting line on Broad Street. After a year of rehab and recovery, Assal made his big return to the race in 2023.

“Last year’s Broad Street Run was so rainy. I mean, it was really bad. Everybody was totally soaked. Yet it was fun,” Assal said.

For Assal, that is what it is all about. Fun. It is why you will also find him on Lansdale Catholic High School‘s track most week nights, coaching the next generation of runners.

“He is such an inspiration to them. It shows that age is really just a number,” Meghan Callen, the high school’s president, said. “We are his biggest fans. We absolutely adore him. Go Jim. Go coach. We love you.”

Assal said he feels most himself when he is running and coaching.

At this year’s Broad Street Run, Assal is aiming for 10 minute miles. But, he said it is all relative.

“If you finish the race and you are still standing, that is an accomplishment, right?” Assal said.

The even bigger accomplishment for Assal is inspiring others to run after what they enjoy, no matter what.

“Keep on running or keep on doing whatever you do. Tennis, golf, whatever. Keep on doing it,” Assal said. “Don’t just sit home and watch TV. Well, maybe channel 10! What channel 10.”

Kids and people nostalgic for their childhood days can take one last stroll this weekend through the Franklin Institute’s Giant Heart before the beloved attraction closes for six months.

The massive replica heart with a distinctive smell that lets children of all ages act like blood pumping through the organ has stood in the Franklin Institute’s Center City Philadelphia location for more than 50 years.

“Hear the sounds of an actual human heartbeat as you go through the chambers,” the Franklin Institute says on its website.

(This writer loves running with his kids through the “Oxygen Exchange” section.)

Luckily, the heart isn’t going away, it’s just taking a break for a procedure.

People will only have through this weekend to dash or stroll the Giant Heart in its current iteration before it closes for renovations on May 6, 2024.

The closure is part of the museum’s bicentennial transformation, dubbed “200 Years of Science: TFI is Transforming.”

“This gallery reopens in November, featuring the Giant Heart as the centerpiece of an all-new exhibit on the human body,” the Franklin Institute said.

Another current exhibit — the neighboring Electricity — will also close Monday, but unlike the Giant Heart won’t return. “This space will completely transform and be part of the expansive new human body exhibit,” the museum said.

Philadelphia Jan 10

Art of the Brick: Get a look inside world's largest display of Lego art at Philly's Franklin Institute

Philadelphia Nov 29, 2023

Franklin Institute's IMAX theater will not reopen

Philly live Nov 16, 2023

Immerse yourself at Franklin Institute's ‘Wondrous Space' exhibit

So, what will the beloved science museum look like after all these renovations are done?

“Six all-new exhibits and a two-story collections gallery will transform the museum, elevating immersion, imagination, and impact. It began with the award-winning Wondrous Space exhibit in 2023 and continues in 2024 with the opening of an expansive new exhibit on the human body and the unveiling of the Hamilton Collections Gallery,” the museum wrote.

“These six innovative exhibits will be the core of the new Franklin Institute experience, further enriched by our planetarium, observatory, daily live science shows, and new collections gallery. They will provide our guests with unparalleled opportunities to engage with cutting-edge scientific discoveries across various topic areas, including space, the human body, computer science, the built environment, advanced machines and robotics, and earth systems.”

In the meantime, get your blood pumping with this walkthrough of the Giant Heart (beating heart sound included) the Franklin Institute posted in 2020.

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On TikTok, there are hundreds of videos from people claiming the practice can do even more: whiten teeth, reverse tooth decay, fight gum disease, and treat a number of oral health conditions.

The practice has evolved from taking a spoonful of coconut or sesame oil to using pricey single-use oil pulling packets that come in a variety of fancy flavors.

How does oil pulling work and is there any validity to these claims about its benefits?

How does oil pulling work?

“Oil polling has been around for thousands of years as a way to better oral hygiene,” Dr. Matt Messina, clinic director of Ohio State Upper Arlington Dentistry, tells TODAY.com.

The traditional remedy is rooted in the Ayurvedic medicine system and has been practiced widely in India and Southern Asia.

“It’s a tradition that’s now being adopted because it’s trendy … I think it’s become popular over the last couple of years with the idea of, how do I find something ‘natural’ to make my mouth healthier,” Dr. Suhail Mohiuddin, Chicago-based dentist and founder of Dentologie, tells TODAY.com.

Oil pulling starts with taking a tablespoon of an edible oil and placing it in the mouth. Coconut oil is commonly used for oil pulling, Dr. Mark Wolff, dean of Penn Dental Medicine, tells TODAY.com. Sesame oil, olive oil, and sunflower oil may also be used — as long as the oil is edible, the experts note.

Next, the oil is vigorously swished around in the mouth similar to mouthwash, the experts note. “The idea is you sort of chew the oil around and ‘pull,’ by creating your own suction to tug it between the teeth and the gums,” says Messina.

After swishing the oil around for some time — oil pulling techniques vary but the practice can last anywhere from two to 20 minutes — you spit the oil out, says Messina.

Oil pulling is thought to help clean the teeth and reduce bacteria in the mouth, which can lead to the buildup of plaque and tooth decay. “Gingivitis or gum disease is basically inflammation of your gums caused by plaque, which is a biofilm,” Mohiuddin adds.

Oil pulling benefits

Although people have been practicing oil pulling for centuries to boost oral health, the research is limited and mixed, at best, the experts note.

“It’s (going) around on social media as an alleged method for reducing tooth decay, bad breath, gum disease (gingivitis), and a whole litany of of untested health items,” says Wolff. Some influencers tout oil pulling for its systematic benefits, including improving skin health and “detoxing” the body.

Overall, there aren’t enough robust, large-scale clinical studies clinical trials demonstrating these benefits, says Wolff.

“There are no reliable scientific studies to show that oil pulling reduces cavities, whitens teeth or improves oral health and well-being,” according to the American Dental Association.

One way cavities form is when the pH of the mouth is too acidic (below 5.5), which can cause the demineralization or erosion of enamel, says Mohiuddin. “There is no data that suggests that oil pulling can change the pH of the mouth,” he adds.

A 2022 meta-analysis investigating the effects of oil pulling on oral health found that oil pulling may have potential benefit in reducing salivary bacteria colony counts, but had no significant effects on reducing plaque or gingivitis.

As for removing toxins from the body, there’s no evidence oil pulling can do this, and the body detoxes itself on its own just fine with help from the liver, kidneys, lungs, and digestive system, TODAY.com previously reported.

“The real hard science on it is not very strong,” says Woolf.

While many of the supposed benefits of oil pulling are “somewhat questionable,” says Messina, the practice may still have a place in dental hygiene.

“The oil pulling method can have some effectiveness in removing loose debris from around the gum tissues and the teeth,” says Messina. “Anything that we do to remove food debris, plaque, or bacteria from the teeth is certainly beneficial,” Messina adds.

However, other methods like toothbrushes and flossing will do a much better job, the experts note. Our oral hygiene tools and capabilities have changed drastically in just the last 100 years, Messina points out. Compared to newer methods, oil pulling has a minimal effect on reducing debris and bacteria in the mouth.

Once a biofilm or plaque forms, oil pulling will “have no impact, or no greater impact than rinsing with water,” says Mohiuddin. “The only way to properly remove plaque is with a mechanical interruption, such as brushing or flossing,” Mohiuddin adds.

“Now we even have water flossers and irrigators to power-pull or power-rinse to get between the teeth and below the gum line — it’s simply a case of we’ve gotten better,” Messina notes.

“Oil pulling is a historic method that has been supplanted by some better ways to clean our teeth,” says Messina. That’s why it’s important to use oil pulling as a supplementary dental hygiene practice in addition to brushing and flossing, not as a replacement for these methods.

Oil pulling side effects

“Oil pulling is not in any way dangerous. There’s nothing wrong with it, there’s nothing bad about it — there’s no scientific evidence to indicate benefit or harm,” says Messina.

Compared to other trendy oral hygiene hacks on social media, such as brushing the teeth with charcoal (which is abrasive and harmful to enamel, says Messina), oil pulling is “pretty benign,” he adds.

Edible oils are used for oil pulling, which are safe to put in the mouth and swallow, even though the oil is meant to be spit out at the end, the experts note. “We’re not talking about engine oil (or) any petroleum-based oils. That would not be safe,” says Wolff.

Swallowing too much of these edible oils may cause stomach upset or diarrhea, says Wolff. Otherwise, oil pulling is generally pretty safe.

“The only time I would argue that oil pulling could be considered dangerous is if someone it has, say an infection or periodontal disease, and you’re using oil pulling instead of a known beneficial treatment,” says Messina.

Should you brush your teeth after oil pulling?

It’s typically recommended to brush your teeth after oil pulling, the experts note.

“Depending on what oil you’re using, if your mouth tastes like a salad, you might brush a little longer with some more toothpaste,” says Messina.

How often to oil pull

Most of the recommendations around oil pulling suggest doing the practice one to two times per day, the experts note. “If oil pulling is being done as as an additional treatment, there’s nothing wrong with that,” says Messina.

Avoid swallowing the oil, and spit it into the trash can instead of the sink when you’re done, as the oil can clog pipes, TODAY.com previously reported.

Do dentists recommend oil pulling? 

Due to the lack of scientific evidence, the American Dental Association does not recommend oil pulling as a dental hygiene practice.

“I would personally not recommend it as I can’t find the science to support it,” says Wolff.

Adds Messina: “Dentists aren’t going to recommend it because there’s no scientific basis to say that it’s beneficial, but we’re certainly not going to discourage it unless people are going to do this instead of something that is beneficial.”

Mohiuddin agrees that while most dentists won’t recommend oil pulling, “as long as you’re also brushing with a fluoride toothpaste, flossing or using a water-flosser, I don’t think they’re going to care,”

What the ADA and dentists do recommend is brushing twice a day with a fluoride-containing toothpaste for at least two minutes and flossing once a day. It’s also important to avoid tobacco, visit your dentist for yearly examinations and get routine cleanings.

As with any claim about any remedy on social media, try to look for trusted sources and talk to your dentist if you have any questions or want to change your dental hygiene routine.

“Everybody’s oral health needs are different. … Your dentist can give recommendations for your individual situation,” says Messina.

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A certain type of fee is popping up on more and more bills, and experts say it can range anywhere from a couple bucks to $1,000.

“That’s the facility fee. They bill the insurance company $212, but they knock it down to $60.21,” said Paul Paoli, who said he was surprised to see an unexpected $60.21 charge for his last doctor’s appointment.

It wasn’t for his cancer treatment, but rather for a “facility fee” for his hospital visit. The explanation of benefits does not detail what the facility fee covers.  

“It’s not transparent, you know, because most of us are used to a copay and you pay it and you’re down the road, and then now this has come up,” said Paoli.

Facility fees are becoming more common across the country.

Abe Scarr with the Public Interest Research Group of Illinois explained why.

“More and more we’re seeing these mega health systems, hospital systems, and as they grow and have more market power, that’s when we start to see things like this, these arbitrary fees that they’re only able to get away with because consumers don’t really have much choice,” said Scarr.

Scarr said knowing how much the fees may cost can be hard to predict.

“They don’t work in any predictable way. So we’ve seen them as small as $4 and up to $1,000. And they’re often not disclosed until after the fact. So it’s not necessarily a percentage of your bill, or anything tied to any other part of your bill. It’s a tacked-on fee,” said Scarr.

As Paoli learned, asking for the cost of the facility fee at the time you schedule your appointment may not lead to a clear answer.

“I said, ‘What’s the facility fee?’ And he goes, ‘Well, there’s going to be a fee, but I can’t tell you what it is.’ I go, ‘What do you mean?’ ‘Well it depends on how long or this or that,'” said Paoli.

According to a new report from PIRG, 15 states across the country passed laws about facility fees. Illinois and Wisconsin are not included in the list, but last year, Indiana passed a law requiring more transparency about facility fees.

Connecticut, Colorado, Maryland, New York, Ohio, Texas and Washington state all passed laws either restricting or banning facility fees on patient’s medical bills.

Scarr said if you’re billed this fee, you can try disputing it.

“Bring it up with your insurer, contest it with the hospital or provider, and file a complaint with the Consumer Financial Protection Bureau or here in Illinois with the Attorney General’s Office. I can’t say that that’s going to be successful, any of those disputes, but it’s always worth trying,” said Scarr.

After he spoke up, Paoli got his insurance company to cover the entire cost of his facility fee.

“I can afford it, but not everybody can afford it,” said Paoli.

Previously, the task force had said women could choose to start breast cancer screening as young as 40, with a stronger recommendation that they get the exams every two years from age 50 through 74.

The announcement Tuesday from the U.S. Preventive Services Task Force makes official a draft recommendation announced last year. The recommendations were published in the Journal of the American Medical Association.

“It’s a win that they are now recognizing the benefits of screening women in their 40s,” said Dr. Therese Bevers of MD Anderson Cancer Center in Houston. She was not involved in the guidance.

Other medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — instead of every other year — starting at age 40 or 45, which may cause confusion, Bevers said, but “now the starting age will align with what many other organizations are saying.”

Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second-most common cause of cancer death for U.S. women. About 240,000 cases are diagnosed annually and nearly 43,000 women die from breast cancer.

The nudge toward earlier screening is meant to address two vexing issues: the increasing incidence of breast cancer among women in their 40s — it’s risen 2% annually since 2015 — and the higher breast cancer death rate among Black women compared to white women, said task force vice chair Dr. John Wong of Tufts Medical Center in Boston.

“Sadly, we know all too well that Black women are 40% more likely to die from breast cancer than white women,” Wong said. Modeling studies predict that earlier screening may help all women, and have “even more benefit for women who are Black,” he said.

Here are more details on what’s changed, why it’s important and who should pay attention.

When should I get my first mammogram?

Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk. They should have the X-ray exam every other year, according to the new guidance. Other groups recommend annual mammograms, starting at 40 or 45.

The advice does not apply to women who’ve had breast cancer or those at very high risk of breast cancer because of genetic markers. It also does not apply to women who had high-dose radiation therapy to the chest when they were young, or to women who’ve had a lesion on previous biopsies.

What about women 75 and older?

It’s not clear whether older women should continue getting regular mammograms. Studies rarely include women 75 and older, so the task force is calling for more research.

Bevers suggests that older women talk with their doctors about the benefits of screening, as well as harms like false alarms and unnecessary biopsies.

What about women with dense breasts?

Mammograms don’t work as well for women with dense breasts, but they should still get the exams.

The task force would like to see more evidence about additional tests such as ultrasounds or MRIs for women with dense breasts. It’s not yet clear whether those types of tests would help detect cancer at an earlier, more treatable stage, Wong said.

Does this affect insurance coverage?

Congress already passed legislation requiring insurers to pay for mammograms for women 40 and older without copays or deductibles. In addition, the Affordable Care Act requires insurers to cover task force recommendations with an “A” or “B” letter grade. The mammography recommendation has a “B” grade, meaning it has moderate net benefit.

The chiefs association, prosecutor’s office, and the emergency response department are partnering to launch the first Gloucester County Special Needs Registry and Blue Envelope Program.

Residents can voluntarily register themselves or their family members with special needs. The information will be accessible to first responders only during emergencies. People can add notes in the registry that might be helpful for first responders to know.

“For example, it will provide information on whether or not there are triggering aspects such as lights or sirens. Whether or not there is something we can do to improve level of communication,” explained Christine Hoffman, Gloucester County prosecutor. “Whether or not someone is verbal, nonverbal. Whether or not there is someone we can call for assistance so we can improve our interaction right from the very, very beginning.”

The county hopes the registry will also serve as a tool for resource allocation and community engagement.

The Blue Envelope Program aims to help with interactions during traffic stops. The blue envelope is designed to hold important papers including a driver’s license, registration, and insurance card. If there is an interaction with police, the driver can hand the officer the envelope. The back of the envelope has a special needs awareness guide for police. The other side of the envelope has information on what a driver can expect during a traffic stop.

Drivers can pick up a blue envelope at any police department in Gloucester County.

“The Special Needs Registry and Blue Envelope Program will allow our officers, along with other emergency response personnel, to provide enhanced assistance to those folks who have mental or physical impairments that may cause difficulty in communicating during emergencies and other interactions with first responders,” Harrison Township Police Chief Ronald Cundey said.

The county is hosting a resource fair Saturday, April 27, 2024, to launch the registry and blue envelope program. Community members are invited to attend. The resource fair is being held at RiverWinds Community Center in West Deptford from 11 a.m. to 1 p.m.  

To learn more about signing up for the registry, click here.

A London-based dentist has sparked an online debate after advising against three situations that many regard as good times to brush your teeth.

The video, posted by Dr. Shaadi Manouchehri, clinical director at Smart Dental and Aesthetics Clinic in the U.K., has garnered more than 12 million views on TikTok, leaving many incredulous that they were brushing wrong all this time.

She recommends not brushing your teeth directly after vomiting and eating breakfast or sweets.

“I’ve ALWAYS brushed after vomiting,” one shocked TikTok user exclaimed.

“So then why have we ALWAYS been taught to brush out teeth after meals?” one quipped.

“Ah, yes, the three times I want to brush my teeth more than any other time,” another lamented.

So, do other dentists agree with Manouchehri’s assessment? TODAY.com spoke with a few experts to find out.

Acid and brushing your teeth

The argument against not brushing your teeth in certain scenarios is “all about the acid,” Dr. Tien Jiang, assistant professor of oral health policy and epidemiology at Harvard School of Dental Medicine, tells TODAY.com via email.

Many people think cavities come from sugar, but it’s not the direct cause, she says. It’s acid, which can remove the minerals, a process called demineralization, from the tooth’s outer layer, also known as enamel.

“Acid can come from many places — vomit … carbonated drinks, sucking on lemons, etc.,” Jiang explains.

The bacteria that break down the food you eat also release acid. As a result, “it’s natural for the pH of our mouths to drop when we eat, while the bacteria get to work to break down our food.”

Brushing while there’s too much acid in the mouth can damage your teeth.

“People should never brush when your mouth has a very low pH because you don’t want to then scrub that acid into your teeth,” Dr. Beth Caunitz, a dentist in New York City, New York, tells TODAY.com.

Should you brush directly after vomiting?

Many of the experts TODAY.com interviewed recommend waiting to brush your teeth after vomiting.

“Vomit contains stomach acids, which can soften and dissolve the outer layer of your teeth,” says Dr. Diana Nguyen, chief of clinical general dentistry at UCSF School of Dentistry.

“If you brush after vomiting, you’d actually be spreading the acid around to more of your enamel and risk stripping layers of enamel off your teeth with your toothbrush, which can cause the teeth to appear more yellow over time.”

One easy hack that she recommends is a simple homemade rinse.

Add a teaspoon of baking soda to a cup of water, swish it around in the mouth and then spit it out, she says. “This can help buffer the acids and protect your teeth.”

Rinsing after vomiting also reduces how long your teeth will be exposed to acid. A fluoride mouthwash in particular can help re-mineralize the enamel, and then you can brush your teeth sooner, adds Dr. Carlos González-Cabezas, professor and associate dean for academic affairs at the University of Michigan School of Dentistry.

Should you brush after you eat breakfast?

“When we eat, the mouth becomes acidic, as the bacteria in our mouth also feed on the food we eat and metabolize this to an acid, therefore dropping the pH of the mouth,” Manouchehri tells TODAY.com.

“If we brush straight away, we are rubbing this acid onto the teeth, which … can be damaged,” she says.

Our saliva naturally buffers this acidic state over approximately 30 to 60 minutes, so she recommends waiting at least that long to brush.

Jiang agrees: “Waiting 30 (minutes) after eating anything (not just breakfast or sweets) to brush is a normal instruction.”

“In these conditions, tooth enamel is softened, so you could actually damage your teeth by brushing them right after eating,” she explains. “In the meantime, you can drink water and rinse with mouthwash to help clear food particles away from your teeth and gums.”

However, Gonzalez-Cabezas says the impact on the enamel of brushing right after eating is likely minimal. The most important thing is that you brush your teeth at some point every morning.

Should you brush immediately after eating sweets?

Some experts recommend waiting at least an hour after eating sweets to brush your teeth to give your mouth time to wash away the acid, according Mayo Clinic.

Anything with sugar can increase the amount of acid in your mouth, but examples include soft drinks, sports drinks, sour candies, and citrus juices and fruits.

People should also avoid brushing right after having carbonated beverages, as they’re acidic, Caunitz warns.

Instead of brushing your teeth after eating sweets, Caunitz recommends drinking a glass of water because the water will rinse off all the unwanted acid.

However, Gonzalez-Cabezas says that brushing your teeth after eating sweets helps remove potentially harmful sugars that can damage the enamel sooner. Thanks to the toothpaste, brushing right after will also provide fluoride to your teeth, which promotes remineralization.

For those who enjoy sweets or snacking on sugary foods, Nguyen recommends the following:

• Drinking plenty of water
• Using a toothpaste that contains a remineralizing agent like fluoride
• Visiting your dentist regularly to monitor for tooth decay and other dental conditions

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Lisa Pisano’s combination of heart and kidney failure left her too sick to qualify for a traditional transplant, and out of options. Then doctors at NYU Langone Health devised a novel one-two punch: Implant a mechanical pump to keep her heart beating and days later transplant a kidney from a genetically modified pig.

Pisano is recovering well, the NYU team announced Wednesday. She’s only the second patient ever to receive a pig kidney — following a landmark transplant last month at Massachusetts General Hospital – and the latest in a string of attempts to make animal-to-human transplantation a reality.

This week, the 54-year-old grasped a walker and took her first few steps.

“I was at the end of my rope,” Pisano told The Associated Press. “I just took a chance. And you know, worst case scenario, if it didn’t work for me, it might have worked for someone else and it could have helped the next person.”

Dr. Robert Montgomery, director of NYU Langone Transplant Institute, recounted cheers in the operating room as the organ immediately started making urine.

“It’s been transformative,” Montgomery said of the experiment’s early results.

But “we’re not off the hook yet,” cautioned Dr. Nader Moazami, the NYU cardiac surgeon who implanted the heart pump.

“With this surgery I get to see my wife smile again,” Pisano’s husband Todd said Wednesday.

Other transplant experts are closely watching how the patient fares.

“I have to congratulate them,” said Dr. Tatsuo Kawai of Mass General, who noted that his own pig kidney patient was healthier overall going into his operation than NYU’s patient. “When the heart function is bad, it’s really difficult to do a kidney transplant.”

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THE PIG ORGAN QUEST

More than 100,000 people are on the U.S. transplant waiting list, most who need a kidney, and thousands die waiting. In hopes of filling the shortage of donated organs, several biotech companies are genetically modifying pigs so their organs are more humanlike, less likely to be destroyed by people’s immune system.

NYU and other research teams have temporarily transplanted pig kidneys and hearts into brain-dead bodies, with promising results. Then the University of Maryland transplanted pig hearts into two men who were out of other options, and both died within months.

Mass General’s pig kidney transplant last month raised new hopes. Kawai said Richard “Rick” Slayman experienced an early rejection scare but bounced back enough to go home earlier this month and still is faring well five weeks post-transplant. A recent biopsy showed no further problems.

A COMPLEX CASE AT NYU

Pisano is the first woman to receive a pig organ — and unlike with prior xenotransplant experiments, both her heart and kidneys had failed. She went into cardiac arrest and had to be resuscitated before the experimental surgeries. She’d gotten too weak to even play with her grandchildren. “I was miserable,” the Cookstown, New Jersey, woman said.

A failed heart made her ineligible for a traditional kidney transplant. But while on dialysis, she didn’t qualify for a heart pump, called a left ventricular assist device or LVAD, either.

“It’s like being in a maze and you can’t find a way out,” Montgomery explained — until the surgeons decided to pair a heart pump with a pig kidney.

TWO SURGERIES IN EIGHT DAYS

With emergency permission from the Food and Drug Administration, Montgomery chose an organ from a pig genetically engineered by United Therapeutics Corp. so its cells don’t produce a particular sugar that’s foreign to the human body and triggers immediate organ rejection.

Plus a tweak: The donor pig’s thymus gland, which trains the immune system, was attached to the donated kidney in hopes that it would help Pisano’s body tolerate the new organ.

Surgeons implanted the LVAD to power Pisano’s heart on April 4, and transplanted the pig kidney on April 12. There’s no way to predict her long-term outcome but she’s shown no sign of organ rejection so far, Montgomery said. And in adjusting the LVAD to work with her new kidney, Moazami said doctors already have learned lessons that could help future care of heart-and-kidney patients.

Special “compassionate use” experiments teach doctors a lot but it will take rigorous studies to prove if xenotransplants really work. What happens with Pisano and Mass General’s kidney recipient will undoubtedly influence FDA’s decision to allow such trials. United Therapeutics said it hopes to begin one next year.

The case marks the first time the Supreme Court has considered the implications of a state ban since the nationwide right to abortion was overturned. It comes from Idaho, which is among 14 states that now ban abortion at all stages of pregnancy with very limited exceptions.

While members of the high court’s conservative majority expressed concern about pregnant patients’ ability to get emergency care in the state, it was unclear whether any were swayed by the Biden administration’s argument.

The Justice Department says abortion care must be allowed in emergencies that seriously threaten a woman’s health under a federal health care law that requires hospitals accepting Medicare to provide emergency care regardless of patients’ ability to pay.

“How can you impose restrictions on what Idaho can criminalize, simply because hospitals in Idaho have chosen to participate in Medicare?” said Justice Samuel Alito, who wrote the decision overturning Roe v. Wade.

Justices on the high court’s liberal minority, meanwhile, raised sharp questions about whether Idaho’s law was putting women’s health at risk.

“Within these rare cases, there’s a significant number where the woman’s life is not in peril, but she’s going to lose her reproductive organs. She’s going to lose the ability to have children in the future unless an abortion takes place,” said Justice Elena Kagan.

The Biden administration argues that even in states where abortion is banned, federal health care law says hospitals must be allowed to terminate pregnancies in rare emergencies where a patient’s life or health is at serious risk.

Idaho contends its ban has exceptions for life-saving abortions but allowing it in more medical emergencies would turn hospitals into “abortion enclaves.” The state argues the administration is misusing a health care law that is meant to ensure patients aren’t turned away based on their ability to pay.

The Supreme Court has allowed the Idaho law to go into effect, even during emergencies, as the case played out. It makes performing an abortion a felony punishable by up to five years in prison.

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Dueling protests were taking shape outside the court before the start of arguments on Wednesday. “Abortion saves lives,” read signs displayed by abortion rights supporters. Opponents displayed a sign that read, “Emergency rooms are not abortion clinics.”

Doctors have said Idaho’s abortion ban has already affected emergency care. More women whose conditions are typically treated with abortions must now be flown out of state for care, since doctors must wait until they are close to death to provide abortions within the bounds of state law.

Meanwhile, complaints of pregnant women being turned away from U.S. emergency rooms spiked after the Supreme Court overturned Roe v. Wade, according to federal documents obtained by The Associated Press.

Anti-abortion groups blame doctors for mishandling maternal emergency cases. Idaho argues the Biden administration overstates health care woes to undermine state abortion laws.

The justices also heard another abortion case this term seeking to restrict access to abortion medication. It remains pending, though the justices overall seemed skeptical of the push.

The Justice Department originally brought the case against Idaho, arguing the state’s abortion law conflicts with the 1986 Emergency Medical Treatment and Active Labor Act, known as EMTALA. It requires hospitals that accept Medicare to provide emergency care to any patient regardless of their ability to pay. Nearly all hospitals accept Medicare.

A federal judge initially sided with the administration and ruled that abortions were legal in medical emergencies. After the state appealed, the Supreme Court allowed the law to go fully into effect in January.

The Supreme Court is expected to rule by the end of June.

The settlement stemmed from Philly’s 2021 suit against the pharmacy chain.

“The City began litigation efforts in 2017 to hold manufacturers, distributors, and pharmacy dispensaries of prescription opioids accountable for fueling the opioid epidemic,” a news release from Philadelphia said. “The Opioid Settlement Fund spending plan was announced in 2023, with plans to utilize and distribute settlement funds from several related lawsuits.”

While agreeing to pay $22 million a year over the next five years, Walgreen’s denies any wrongdoing in the settlement.

“Through this settlement, the City of Philadelphia has successfully held Walgreens accountable for oversupplying powerful drugs to people in our communities — with little consideration for the risk of addiction or harm posed by opioids,” a “proud” Mayor Cherelle Parker said. “The $110 million in funds from this settlement will support our Kensington Community Revitalization Plan and other efforts across Philadelphia to reinforce public health and safety in neighborhoods that have been hit the hardest by the opioid crisis.”

The first payment is expected in September, the City said.

In January, the EPA asked the city of Trenton to collect and analyze soil samples from the Sony Vereen Playground, Breunig Avenue Park and the Grant Avenue Playground. 

Results from the samples showed elevated levels of lead in the soil of all three parks. 

To warn park visitors of the ongoing issue, the EPA placed “lead awareness” signs at each park, urging visitors to pay attention to fenced-off areas to avoid lead exposure. 

“If they don’t want kids there, they should put a fence, close it up. You know? Kids—they’re still going to get in there,” Trenton resident Carlos Baez told NBC10.

The EPA has four tips to limit exposure when visiting the three parks:

• Avoid digging or disturbing the soil.
• Wash hands thoroughly after visiting the parks, especially before eating.
• Remove shoes before entering homes and buildings to avoid tracking in contaminated soil.
• Supervise children closely and prevent them from putting dirt in their mouths.

The EPA is currently working with the city to come up with a solid plan to protect the community from any kind of health risks associated with this lead contamination. 

“It’s a chronic exposure. So just because you walk through the park once, does not mean you’re going to have a health effect. It’s the frequency and how you’re being exposed,” EPA on-scene coordinator Jon Byk said.

As a part of the plan to keep people safe and limit lead exposure, the city says some areas of the parks will be completely closed while other parts of the parks will stay open as the EPA works to cover the contaminated soil and grass. 

According to the World Health Organization, excessive lead exposure can be dangerous to anyone, but especially to children. 

For kids, the WHO says lead exposure can lead to permanent adverse health effects, typically on brain and nervous system development. 

Adults are also at risk of facing some long-term health effects such as an increased risk of high blood pressure, heart problems and kidney damage. 

In addition, on top of potentially getting sick themselves, pregnant women also face the risk of their baby developing serious effects such as brain and nervous system problems. 

While the agency is unsure what exactly caused this instance of excessive lead contamination, back in 2020, the EPA started to investigate the pottery industry for its potential relation to the lead contamination in soil. 

“You would use clay, you’d form it into a shape like a plate, but then they would put a glaze on it for coloration and that glaze had lead in it and that piece of pottery was basically put in a furnace, high temperatures and smoke carried the lead up and out the smoke stack and that was deposited throughout the neighborhood,” Byk explained.

Following testing of the pottery industry in 2023 through 2024 the EPA tested several homes, public schools, and then of course, the parks. 

As of now, the EPA has sampled a total of 130 residential properties, many of these had high concentrations of lead found in the soil. 

Over the next several months, the EPA will install protective measures at residential homes impacted by elevated levels of lead to limit exposure.

These will help reduce exposure and harm to individuals in vulnerable populations like children and pregnant women. 

The EPA is going to offer free soil testing for residential homes throughout the spring and summer of 2024 at the East Trenton Study Area. 

Gov. Josh Shapiro and his top human services official said Wednesday that the administration has a plan to end a waiting list of thousands of families who are considered to be in dire need of help for an adult relative with intellectual disabilities.

Shapiro and Human Services Secretary Val Arkoosh said it is vitally important to the plan for lawmakers to approve a funding increase for state-subsidized services, such as in private homes or group homes.

Shapiro’s administration considers the funding increase a first step that is intended to boost the salaries of employees who, through nonprofit service agencies, work with the intellectually disabled.

“Over the next several years, if this budget passes, there will be a plan in place to finally end that waiting list,” Arkoosh told a discussion group at BARC Developmental Services in Warminster. “It’s a big deal.”

Pennsylvania has maintained a growing waiting list of people seeking such services for decades, as have the vast majority of states.

Roughly 500,000 people with developmental or intellectual disabilities are waiting for services in 38 states, according to a 2023 survey by KFF, a health policy research group. Most people on those lists live in states that don’t screen for eligibility before adding them to a list.

Federal law doesn’t require states to provide home and community-based services, and what states cover varies. In Pennsylvania, the state uses its own dollars, plus federal matching dollars, to cover home and community-based services for intellectually disabled adults.

However, the state’s money hasn’t met the demand, and in Pennsylvania, roughly 4,500 families with an intellectually disabled adult relative are on what’s called an emergency waiting list for help, the state Department of Human Services said.

“These are the critical of the critical,” said Sherri Landis, executive director of The Arc of Pennsylvania, which advocates for people with intellectual and developmental disabilities.

In many cases, parents on the emergency waiting list have grown old waiting for help for their adult child whom they are increasingly struggling to look after.

One major problem is the difficulty in finding and hiring people to take jobs as care workers. That problem has grown significantly as the COVID-19 pandemic increased stress across the spectrum of workers in health care and direct care disciplines.

Shapiro’s budget proposal includes an extra $216 million in state aid, or 12% more, to boost worker salaries and help agencies fill open positions. Federal matching dollars brings the total to about $480 million.

The funding request is part of a $48.3 billion budget that Shapiro is proposing to lawmakers for the 2024-25 fiscal year beginning July 1.

BARC’s executive director, Mary Sautter, told Shapiro that her agency has a worker vacancy rate of 48%, forcing current employees to work overtime or extra shifts.

“There is a way to fix that and we’ve known that there’s been a way to fix that for a long time, which is to pay people more and be able to hire more people and be able to fill more slots with people who need support and assistance,” Shapiro told the discussion group at BARC.

Shapiro’s administration envisions several years of increased funding that will eventually lead to expanding the number of people who can be served and eliminate the emergency waiting list.

Shapiro’s 2024-25 proposal is about half the amount that advocates say is needed to fix a system beset by staffing shortages and low pay. But they also say this year’s funding proposal, plus a multiyear commitment to eliminate the waiting list, would be an unprecedented injection of money into the system.

“This is the entire boat coming to rescue a system that is really struggling,” Landis said. “And people deserve services.”

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“He was telling me, ‘Oh my neck is really hurting me,’” wife Lauren Barchanowicz, 38, of Finleyville, Pennsylvania, tells TODAY.com. “I’m like, ‘I think you should probably get it checked out.’”

The couple visited the emergency room where doctors found an orange-sized mass in his chest. Len Barchanowicz had a thymoma, a type of cancer of the thymus.  

“I thought I was a dead guy, honestly. Even how she presented it to me because she said she couldn’t tell if it was attached to my aorta,” Len Barchanowicz tells TODAY.com. “I thought honestly I was going in for an emergency surgery.”

Neck pain reveals underlying problem

As a mailman in the Pittsburgh area, Len Barchanowicz spends a lot of his time walking. When he began experienced stinging pain in his neck he wondered if he somehow pinched a nerve. Then on a humid August day, he felt like he couldn’t breathe easily.   

“I started having almost like chest pains, but not heart related but above where your heart would be,” Len Barchanowicz says.

At first, he attributed that to the weather, but Lauren Barchanowicz, a nurse, worried something more serious was occurring. She examined him and didn’t think he was having a heart attack. Still, it felt concerning.

“He’s like, ‘Oh it’s getting better,’” Lauren Barchanowicz says. “I’m like, ‘I don’t know. I think you should probably get checked out.’”

At the emergency room, it soon became clear something serious was occurring as doctors ran a slew of tests on him.

“I thought maybe they found like a clog or something was going on heart related,” he says.

While an X-ray didn’t show anything, a doctor had a hunch that something else was occurring and ordered a CT scan with contrast. That test revealed an orange-sized mass nestled in his chest above the heart.

“It was a shock,” Lauren Barchanowicz says.

At first, the oncologists thought he had Hodgkin’s Lymphoma, a type of cancer that begins in the lymphatic system which works to protect the body from infection.

“(When) you read the report on the CT, it is very unclear,” Lauren Barchanowicz says. “The only thing that they could say is there is a big mass.”

The surgical team mentioned something called a thymoma, too, but the diagnosis remained mysterious. His blood test had markers for Hodgkin’s Lymphoma and he no other symptoms consistent with cancer.

“They give you the cancer checklist,” Len Barchanowicz says. “Like, is there is a sudden weight loss? Do you have night sweats? Do you feel nauseated? I wouldn’t be able to check any of them.”

Len Barchanowicz eventually underwent a PET scan, which can determine where cancer is in the body.

“The only thing that lit up with him was literally the little circle right around … the mass,” Lauren Barchanowicz. “We were like, ‘Oh thank God. It’s localized. It’s not spread throughout his body.’”

Soon after, he underwent a video-assisted thoracoscopic surgery (VATS) for doctors to obtain a sample of the tumor to better understand what he had. It was still unclear but doctors had a better idea.

“They said probable thymoma,” Lauren Barchanowicz says.

Thymoma

Cancer of the thymus gland remains “very rare,” Dr. Ranjita Pallavi, a medical oncologist and Len Barchanowicz’s doctor at Allegheny Health Network in Pittsburgh, tells TODAY.com.

“He turned out to have something called a thymoma, which is a tumor that arises from the front of the chest,” says Pallavi. “When we see a mass in that area we’re thinking of something arising from the thymus gland.”

Everyone has a thymus gland, which is part of the immune system, but it works the most during infancy and childhood before becoming dormant, according to past TODAY.com reporting.

Pallavi says these types of tumors tend to be encapsulated, meaning they do not easily spread, and don’t have many symptoms associated with them. Doctors tend to find them incidentally when someone come in with an other unrelated problem. And in some rare cases, there can be symptoms, Pallavi says.

“There’s a proportion of patients where the mass can really get big in size when it starts compressing on the surrounding organs,” she explains. “That’s the time when people actually present with chest pains or shortness of breath.”

In Len Barchanowicz’s case, his tumor remained mostly encapsulated but did spread a little bit, deeming it a stage 2 cancer.

“It was also invading into the surrounding fat,” Pallavi says.

A surgeon removed the 8.7 centimeter mass and 14 lymph nodes leaving clean margins on October 3, 2023.

“He was not given any radiation after surgery,” she says. “For the same reason, because of the very low risk of these tumors coming back, he did not get chemotherapy.”

Len Barchanowicz will need to undergo a chest CT scan every six months for the first two years then yearly for up to eight more years.

“Sometimes the tumors can come back seven, eight years down the line,” Pallavi says. “The surveillance does extend up to 10 years.”

Recovery

Recovering from surgery, which required doctors to crack open his sternum, felt difficult. Len Barchanowicz experienced intense pain.  

“It was a nightmare,” he says. “I was hitting that (pain medicine) button pretty regularly on the hour.”

After two days in the hospital, Len Barchanowicz went home.

“Having good lung capacity and having a good heart, I think that probably helped in my recovery early, too,” he says.

Good news came shortly after, he says. His tumor had not become attached to his aorta or his phrenic nerve, where the cancer sometimes grows, Lauren Barchanowicz notes.

“There was no involvement with the major arteries and he did not have any major bleeding because that was a big concern as well,” she says. “The (surgeon) said … ‘The tumor came out easily and beautifully.”

Len Barchanowicz is struck by how quickly neck pain turned into a serious diagnosis that he luckily overcame. 

“It’s so weird that one day everything’s going great and then you get hit with this,” he says. “I almost have survivor’s guilt.”

By January 2024, Len Barchanowicz was able to return to work and feels grateful for the great care he received from his doctors at Allegheny Health Network and the support of loved ones.

“When something like that happens it hits you like a ton of bricks,” he says. “I was always very blessed with my kids and my wife and I really do live this great life.”

The Barchanowicz family wanted to share his story to help others who might also experience a thymoma because they often felt alone in the experience.

“We just can’t believe that this happened and I don’t want anyone else to feel this way,” Lauren Barchanowicz says.

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The department said symptoms include a runny nose, sudden, uncontrollable bursts or spells of coughing, and a persistent cough that sometimes causes vomiting.

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If your child has symptoms, they should stay home from school and activities, according to health officials.

Officials also recommended making sure your family’s pertussis vaccinations are up to date.

Nine of the 19 patients were hospitalized, the CDC said. Four “were treated with botulism antitoxin because of concerns that the botulinum toxin could have spread beyond the injection site.”

Botox uses a purified form of a neurotoxin called botulinum toxin that prevents muscles from moving for a period of time. The product is often used to prevent or ease facial wrinkles. When the toxin is found in food, it can lead to widespread paralysis and even death.

But when it is injected carefully, botulinum toxin is generally considered safe. Too much in the wrong places can be damaging, according to the CDC.

Cases have been detected in Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee and Washington. No deaths have been reported.

It is unclear whether the reactions were the result of fake products, contamination or poor hygiene practices. The CDC’s investigation is ongoing, the agency said.

The Food and Drug Administration said in a statement Friday that it was involved with the investigation.

Warnings about medical procedures at unregulated med spas are rising. Colorado health officials told NBC News that they’re investigating a case of botulism-like illness after an unlicensed provider injected a patient with what was allegedly botulinum toxin. The Illinois patients received injections from a nurse “who was performing work outside her authority,” according to the state’s Public Health Department.

Problematic reactions to botulinum toxin injections include:

• blurry or double vision
• drooping eyelids
• difficulty swallowing or breathing
• dry mouth
• slurred speech
• fatigue and weakness

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Nutrition advice is ever changing, which can leave consumers uncertain about which foods are actually healthy. NBC News asked nine health experts about the foods they think have been wrongly villainized. Here are some of the items they listed and the benefits people may miss out on if they forgo them entirely.

Eggs are packed with protein

Eggs have been demonized for being high in dietary cholesterol, which health experts once believed could contribute to heart disease, said Dr. Maya Vadiveloo, an associate professor of nutrition at the University of Rhode Island.

But updated science has debunked that notion, showing that dietary cholesterol and blood cholesterol affect heart health differently.

Eating foods high in saturated fat, such as red meat, fried foods and fatty dairy can increase the type of blood cholesterol that raises one’s risk of heart problems, according to the Centers for Disease Control and Prevention. But consuming things with cholesterol, like eggs and shellfish, has little correlation to high cholesterol in the blood or a risk of heart disease.

Despite this shift, many people still view eggs poorly. Vadiveloo said that could also be because of other breakfast foods they’re often paired with.

“When people think of eggs, they also think of bacon and home fries,” she said — items that are high in salt and saturated fat. But on their own, eggs are nutritious, she added.

The American Heart Association says people can enjoy one or two eggs every day as a high-quality source of protein; each egg contains about 6 grams.

Eggs are also a source of vitamin D and choline, a nutrient that plays a role in metabolism, memory and muscle control.

Eggs even have a stamp of approval from the WeightWatchers program, which uses a point system to assign values to each type of food and drink based on its nutritional profile. Fruits, vegetables and lean meats are worth zero points, meaning followers of the diet don’t need to measure their portions. Eggs have been on the “ZeroPoint” list since 2017.

Just don’t fry your potatoes

It’s no secret that how you cook and season food influences how healthy it is. Caroline Susie, a registered nutritionist and spokesperson for the Academy of Nutrition and Dietetics, said potatoes have been demonized because of the unhealthy ways they’re prepared.

“Potatoes are just fantastic. What happens is, unfortunately, we tend to screw them up by not eating the skin or frying or mixing them with everything under the sun, like sour cream and butter and bacon,” Susie said. Such toppings add saturated fat, which should be limited to 13 grams or less per day, according to the American Heart Association.

A 2021 study found that consuming higher quantities of french fries was associated with an increased risk for chronic diseases such as Type 2 diabetes and high blood pressure. But boiled, baked and mashed potatoes weren’t linked to a higher risk of hypertension in that study and were only slightly associated with an increased risk of Type 2 diabetes.

Potato skins are high in fiber, which aids digestion. Potatoes also contain vitamin C and potassium, Susie added.

She advised roasting, baking, mashing or boiling potatoes and seasoning with olive oil, salt, pepper and herbs.

Frozen doesn’t always mean less healthy

Seven nutrition experts bemoaned the common perception that frozen fruits and vegetables are less healthy than their fresh counterparts.

“Frozen vegetables and frozen foods are picked at their pinnacle of nutrient density and then flash-frozen. So in many cases, they retain higher nutrient content than their fresh counterparts,” Vadiveloo said, “particularly when you live in a place that has more seasonal variation and availability.”

Susie said that in addition to retaining their nutrients, frozen vegetables are sometimes cheaper than fresh ones and can help people prevent food waste.

“Sometimes when I buy fresh produce, it essentially just goes to, I joke, the veggie bin graveyard. It just goes there to die,” she said. “But canned and frozen lasts longer.”

A few cups of coffee are not cause for concern

Coffee’s poor reputation comes from its caffeine, which is addictive and can cause jitters or anxiety for some people when overconsumed.

However, the Food and Drug Administration says people can drink up to four or five cups per day. Research shows coffee can contribute to a decreased risk of cancer, heart failure, Type 2 diabetes and even death.

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Vadiveloo said she drinks three to five cups of coffee with milk every day. Studies suggest it can improve cognitive function, she said, so she believes coffee’s benefits outweigh the potential drawbacks of caffeine consumption.

“That’s a myth that I regularly debunk. Because a lot of people will say, ‘Oh, I’m trying to reduce coffee or caffeine.’ And the research just doesn’t support that coffee, particularly if you’re not adding a ton of added sugar or creamer and things like that, has any health risks within a reasonable consumption amount,” Vadiveloo said.

Alicia Henson, the education specialist for the Master of Nutritional Sciences and Dietetics program at the University of California, Berkeley, said the health value of coffee — much like potatoes — depends on what’s added.

“If you’re going to Starbucks and you’re drinking frappuccinos or you’re drinking coffee that has a ton of added sugar and cream to it, then that’s not necessarily a healthy addition,” Henson said.

The type of carbohydrate makes all the difference

Experts said carbohydrates as a whole are often assumed to be unhealthy, in part because of the popularity of low-carb and ketogenic diets. But it’s incorrect to think that all carbs are the same.

“It has to do with the quality of the carbohydrates — so refined versus whole grains,” said Dr. Linda Shiue, an internist and the director of culinary and lifestyle medication at Kaiser Permanente.

Refined grains, such as those used to make processed food like white bread, crackers and pastries, lack the fiber and nutrients that make whole grains healthy, Shiue said. That includes iron and B vitamins. But quinoa, farro and brown rice, for instance, offer protein, magnesium, iron and fiber, which keeps you feeling full.

Dr. Melina Jampolis, a physician nutrition specialist with a private practice in Los Angeles, said she often recommends one particular whole grain to patients as a snack, much to their surprise: popcorn.

Many people associate popcorn with the movie theater version, which is full of salt, butter and sometimes sugar — and often sold alongside a large soda. But when you prepare popcorn at home with just olive oil and spices, Jampolis said, the snack is fibrous and can be part of a balanced diet. Research also shows popcorn contains phenolic acids, a type of antioxidant.

Jampolis added that people shouldn’t fixate on avoiding any one food; instead, it’s best to cultivate a healthy eating pattern that prioritizes whole foods over ultraprocessed items with added sugar.

“That’s what the real experts do,” she said. “We don’t look at single foods necessarily in isolation.”

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“Our water has been cloudy and bubbly and looks milky,” said Barrett, who blames fluoride, a mineral that communities across the nation have for decades added to the water supply to help prevent cavities and improve dental health.

“I don’t want fluoride in my nothing!” said Barrett, echoing a growing number of people who not only doubt the mineral’s effectiveness but also believe it may be harmful despite decades of data pointing to public health and economic benefits.

In February, the Board of County Commissioners in Union County, whose seat is Monroe, voted 3-2 to stop adding fluoride to drinking water at the Yadkin River Water Treatment Plant, the only water source wholly owned and operated by the county. But the decision came after heated discussions among residents and county officials.

“My children had the blessing of growing up with fluoride in their water and … they have very little dental issues,” said Commissioner Richard Helms ahead of the vote. A fellow commissioner saw it differently: “Let’s stop putting something in the water that’s meant to treat us, and give people the freedom to choose,” said David Williams.

Barrett’s water comes from the city of Monroe, not the Yadkin facility. So, for now, she will continue to drink water enhanced with fluoride. “I’m suspicious as to why they add that to our water,” she told KFF Health News.

It is a scenario playing out nationwide. From Oregon to Pennsylvania, hundreds of communities have in recent years either stopped adding fluoride to their water supplies or voted to prevent its addition. Supporters of such bans argue that people should be given the freedom of choice. The broad availability of over-the-counter dental products containing the mineral makes it no longer necessary to add to public water supplies, they say. The Centers for Disease Control and Prevention says that while store-bought products reduce tooth decay, the greatest protection comes when they are used in combination with water fluoridation.

The outcome of an ongoing federal case in California could force the Environmental Protection Agency to create a rule regulating or banning the use of fluoride in drinking water nationwide. In the meantime, the trend is raising alarm bells for public health researchers who worry that, much like vaccines, fluoride may have become a victim of its own success.

The CDC maintains that community water fluoridation is not only safe and effective but also yields significant cost savings in dental treatment. Public health officials say removing fluoride could be particularly harmful to low-income families — for whom drinking water may be the only source of preventive dental care.

“If you have to go out and get care on your own, it’s a whole different ballgame,” said Myron Allukian Jr., a dentist and past president of the American Public Health Association. Millions of people have lived with fluoridated water for years, “and we’ve had no major health problems,” he said. “It’s much easier to prevent a disease than to treat it.”

According to the anti-fluoride group Fluoride Action Network, since 2010, over 240 communities around the world have removed fluoride from their drinking water or decided not to add it.

One needs only to look to Union County to see just how intense discussions can be. Usually when the commissioners meet on the first floor of the Government Center in downtown Monroe, there are more vacant seats than attendees. But sessions about the prohibition of fluoride in public water supplies were packed, and residents who signed up to speak were divided.

One person who came to the microphone on Feb. 5 compared water fluoridation to a seat belt. It does not “prevent the car crash, but it limits the harm done,” he said. Another argued that there is no proof fluoride is safe or effective. “It’s a significant potential milestone to reverse 60-plus years of poisoning the public,” he said, using an unproven claim often made by opponents of fluoridation.

Fluoride opponents claim the mineral is responsible for everything from acne to high blood pressure and thyroid dysfunction to bone cancer.

The National Institutes of Health acknowledges that, when ingested in extremely large amounts, fluoride from dental products or dietary supplements can cause nausea, vomiting, abdominal pain, diarrhea, bone pain, and even death in extremely rare cases.

Infants and children who receive too much fluoride can develop discoloration or small dents in their teeth. In adults, consumption of excessive fluoride for extended periods can lead to skeletal fluorosis, a very rare condition that causes joint pain and stiffness, weak bones, muscle loss, and nerve problems.

However, the recommended dosage in drinking water has always been small. In 2015, the Department of Health and Human Services lowered the optimal fluoride concentration from 1.2 milligrams per liter to 0.7 mg/L.

Juneau, Alaska, voted to remove fluoride from its drinking water in 2007. A study published in the journal BMC Oral Health in 2018 compared the dental records of children and adolescents who received dental care for decaying teeth four years before and five years after the city stopped adding fluoride to the water. Cavity-related procedures and treatment costs were significantly higher in the latter group, the study found.

Portland, Oregon, is the largest city in the nation that has consistently refused to fluoridate its drinking water. Voters have repeatedly rejected measures to add it, first in 1956 and the latest time in 2013.

Despite the strong recommendation of local doctors and dentists, voters in Wichita, Kansas, have rejected adding fluoride to the water several times, most recently in 2012.

The Brushy Creek Municipal Utility District in Williamson County, Texas, had been adding fluoride to its water system since 2007 but ended the practice in December.

In 2016, Collier County, Florida, commissioners opted not to remove fluoride from the water system. But they unanimously reversed that decision following a 2023 Health Freedom Bill of Rights county ordinance in response to covid-19 “to safeguard the healthcare rights and freedoms of Collier County residents.”

The State College Borough Water Authority in Pennsylvania stopped adding fluoride to the water of its 75,000 customers in March 2023. Officials used claims often cited by fluoride opponents, such as potential environmental contamination, concerns about medical freedom, and possible adverse health effects, like the potential for the appearance of faint white lines on the teeth and lowered IQ for babies.

A study published in JAMA Pediatrics in 2019, conducted in six Canadian cities, associated fluoride exposure during pregnancy with lower IQ scores in children. But the study was based on self-reporting and has been criticized for its perceived methodological shortcomings.

In 2016, several consumer advocacy groups, including the Fluoride Action Network, Food & Water Watch, and Moms Against Fluoridation, petitioned the EPA to end water fluoridation under the Toxic Substances Control Act, alleging that significant research showed fluoride was neurotoxic at the doses now used. The same group filed a federal lawsuit against the EPA the following year, after the agency denied their citizen petition.

During a 10-day bench trial in San Francisco that concluded in mid-February, the two sides debated the risks and areas of uncertainty. If Senior U.S. District Judge Edward Chen determines water fluoridation presents an “unreasonable risk” to human health, the EPA will be forced to create a rule regulating or banning water fluoridation in the U.S. A decision is expected soon.

For the time being, decisions about whether to fluoridate community water systems are still made primarily at the local level, which Barrett hopes will change.

“Of all things, they want our teeth healthy when basic needs of housing and food are lacking.”

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

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

Backward walking challenges your brain

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

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

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

Backward walking benefits

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

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

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

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

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

3 easy ways to add backward walking to your routine

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

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Dr. Bernstein will use the funding to study the RAD51C gene and how mutations of the gene can help to develop targeted therapies for breast cancer patients, specifically women facing triple-negative breast cancer.

Triple-negative breast cancer is an aggressive form of the disease and disproportionately affects Black and Latina women under 40.

Women do not begin routine breast cancer screenings, like mammograms, until the age of 40. Younger women are not offered screenings or may be denied screenings unless they have a genetic reason, a mutation, or discover a mass or other breast changes.

Rates of the disease are higher in Black and Latina women due to factors like higher breast density which makes it less likely to be screen-detected. Obesity and other health disparities that prevent access to adequate or affordable care also contribute to late-stage diagnoses.

Black women are more likely to die from breast cancer than any other group, are twice as likely to be diagnosed with triple-negative breast cancer, are diagnosed with later stage disease and have the lowest survival rates in each stage of diagnosis, according to breastcancer.org. Black women are also less likely to receive treatment that follows nationally recommended guidelines.

“Thinking about my personal relationship with cancer, I know how important this type of research would’ve been for my family and if I could do that for other families, to help them so they don’t have to suffer these tremendous losses, the work is really important,” Dr. Bernstein told NBC10’s Yukare Nakayama.

The American Cancer Society states triple-negative breast cancer tends to grow quickly, is more likely to have spread at the time it’s found, and is more likely to come back after treatment than other types of breast cancer. Because of this, the mortality rates for triple-negative breast cancer are higher than they are for other types of breast cancer.

Triple-negative breast cancer makes up 10-15% of all breast cancers.

In all, five women who lived in different parts of southwest Michigan suddenly sought help for serious eye problems within weeks of each other.

The medical mystery led to a startling diagnosis: All of the patients had ocular syphilis, a complication of the sexually transmitted disease.

The cluster of cases shared a common link. It turned out the five women had sex with the same man who had syphilis, according to a case report published by the Centers for Disease Control and Prevention in November 2023. His illness was mostly asymptomatic and never affected his eyes.

Few people know syphilis can endanger vision, doctors say.

“Patients are very surprised, and most of the lay public doesn’t think of syphilis involving the eye,” Dr. Rahul Khurana, a spokesperson for the American Academy of Ophthalmology, tells TODAY.com.

“Untreated syphilis in the eye is devastating because it can lead to blindness.”

‘Syphilis crisis’

It’s especially concerning as syphilis cases surge in the U.S.

More than 207,000 Americans were diagnosed with the disease in 2022, an 80% increase since 2018 and the highest levels since the 1950s, the CDC reported in January 2024.

Cases were up in most every region and demographic group, including older people.

The U.S. Department of Health and Human Services called it a “syphilis crisis” and an “epidemic.”

Possible reasons why it’s happening include a rise in substance use, with alcohol and marijuana linked to more risky sexual behavior, Dr. Akshay Syal, a medical fellow with the NBC News Health and Medical Unit, told NBC News Now.

There’s also been a decrease in condom use and less funding for clinics where people can get tested for STDs, he added.

As the crisis unfolds, doctors are seeing more people in the U.S. hospitalized for syphilitic uveitis, or inflammation inside the eye and the most common ocular manifestation of syphilis, according to an investigation published in JAMA Ophthalmology in November 2023.

What causes ocular syphilis?

Syphilis is a sexually transmitted disease caused by a bacterium that invades blood vessels and could involve the central nervous system — when that happens, it can go into the brain and the eye, Khurana says.

The illness can lie hidden in the body only to cause symptoms later in time, so it’s often not caught early and people don’t realize that they have it, he adds. Some of his patients had no idea they were infected until they sought help for eye problems.

“We often call syphilis the great imitator because it looks like many other things,” says Khurana, who is ophthalmologist at Northern California Retina Vitreous Associates.

“Because it’s non-specific, it’s often missed by many ophthalmologists, and many people don’t even think about it.”

Besides causing blindness, untreated syphilis can seriously damage the heart and brain, and cause deafness and paralysis, the CDC warns.

What are the symptoms of ocular syphilis?

When syphilis affects the eyes, it usually causes inflammation inside them known as uveitis, Khurana says.

Eyes may be red, light sensitive or painful, he notes.

“Whenever I have a patient with uveitis, I always rule out everybody for syphilis just because it can present in so many different ways that you don’t want to miss it,” Khurana notes.

Syphilis accounts for 1% to 5% of cases of eye inflammation, according to the American Academy of Ophthalmology notes.

Other possible symptoms of ocular syphilis include floaters, blurry vision or even blindness, the CDC warns.

A blood test can confirm if a patient has syphilis.

What is the treatment?

If there’s a positive test, it’s important for the patient to see an infectious disease doctor because when syphilis involves the eyes, it’s also potentially involved in the brain, Khurana says.

Patients are treated with an intravenous antibiotic for 10 to 14 days and usually respond well, he notes. They may also get anti-inflammatory medicine to take care of the eye inflammation.

“If these things are caught early and treated early, patients could do very well,” Khurana says. “The challenge with syphilis is that often (doctors) don’t think about it, and so the diagnosis is often delayed.”

He urges eye doctors to have a “high index of suspicion” and rule out syphilis when patients show up with eye inflammation.

Treatment may not undo any damage caused by the infection, the CDC warns.

Using condoms every time you have sex can reduce the risk of getting syphilis, the agency notes.

Always get checked for any vision problems to rule out eye syphilis or other sexually transmitted diseases. STDs such as herpes and gonorrhea can also harm the eyes, according to the American Academy of Ophthalmology.

“With the incidence of STDs and syphilis on the rise in the community, I think everyone should be aware of it,” Khurana says.

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Gutke, of Joliet, Illinois, has polycystic ovary syndrome, or PCOS, and the medications and supplements help the 45-year-old cope with migraines, high blood pressure, diabetes, high cholesterol, anxiety and depression that come with the complex hormonal condition. 

Not one of  Gutke’s medications are technically “PCOS drugs.” 

The Food and Drug Administration has not approved a medication specifically for PCOS, which is often linked to infertility, irregular or missed periods, weight problems, and other debilitating symptoms. Gutke’s array of medications is typical of how many of the estimated 5 million women in the U.S. diagnosed with PCOS deal with it.

“It’s such a vast syndrome that affects everything from your head to your toes,” she said. She was diagnosed with endometrial cancer — another risk linked to PCOS — at age 37. 

After nearly a century of disagreements over what, exactly, defines the condition, as well as a lack of research, PCOS is still poorly understood. The symptoms vary so widely that any single drug would be unlikely to help all patients, said Dr. Heather Huddleston, a reproductive endocrinologist at the University of California, San Francisco and director of UCSF’s PCOS Clinic. 

Women with PCOS and the doctors who care for them say they want better options — treatments for the condition’s root causes rather than bandages for individual symptoms. Even as calls for better treatments grow, the lack of investment in PCOS research has limited doctors’ ability to help their patients. 

“It gets very messy to try to identify one treatment that’s going to work for everybody,” Huddleston said. 

Many women with the condition end up taking off-label prescriptions — meaning drugs technically approved for other conditions, like diabetes or obesity — to help PCOS-related symptoms. Navigating insurance coverage for off-label prescriptions can be challenging.

“There’s no magic pill,” said Tallene Hacatoryan, 31, a registered dietician from Orange County, California. “There are too many components for there to be a one-size-fits-all treatment.”

Hacatoryan was diagnosed with PCOS at age 18 and now works as a diet and lifestyle coach for women with PCOS.  

Although research is murky when it comes to the best diet for women with PCOS, the most up-to-date international guidelines recommend exercise and a healthy diet. There’s no evidence that any particular diet improves symptoms, although some women have found lifestyle coaching helpful.

Insufficient funding for research

Among the reported 315 medical conditions that receive federal support from the National Institutes of Health, PCOS ranks near the bottom, with an estimated $10 million earmarked for research in 2024. Until 2022, PCOS was so underfunded that it wasn’t included as a line item in the NIH list.  And the condition is not explicitly included in the $100 million the Department of Health and Human Services announced recently to research neglected areas of women’s health. Neither is PCOS mentioned in President Joe Biden’s recent executive order to advance women’s health, which includes $200 million for NIH research grants, or the White House’s calls for Congress to allocate $12 billion to fund women’s health research.

A spokesperson at the NIH said that it’s too early to know which women’s health conditions will receive funding under the new initiative. 

“Given how common PCOS is, the amount of funding it’s gotten is proportionately extremely small,” Huddleston said. 

Government funding is just one part of the total research budget for a given disease. While it’s tough to pin down a dollar figure for private industry spending, experts say the lack of FDA-approved PCOS treatments reflects a lack of investment from drugmakers, too. 

Developing PCOS treatments requires a better understanding of the condition. This, in turn, requires far more research tracking thousands of women over many years, which can be extremely expensive, experts say. 

However, there are some promising signs.

Although research is early and only in a few dozen women, there are a handful of small drug companies studying possible PCOS treatments. A Menlo Park, California-based company called May Health, for instance, is developing a one-time surgical procedure it thinks could help with PCOS. Spruce Bio, a San Francisco biotech firm, is running a small clinical trial with a drug called tildacerfont for PCOS. It is not clear yet if the oral drug works. President and CFO Samir Gharib said larger clinical trials will depend on the company’s ability to “secure additional financing” or partner with another drug company. 

The FDA recently attended a meeting with advocacy group PCOS Challenge where women shared their experiences with the agency’s scientists and drug companies. No PCOS drug trials were announced after the meeting, but the FDA’s interest shows a growing push for improved treatment, said William Patterson, a spokesperson for PCOS Challenge.

No known cure for PCOS

Doctors recommend hormonal contraceptives — most commonly the birth control pill — to regulate heavy, irregular periods;, acne;, and unwanted hair growth. Others say taking the pill just masks, rather than treats, their PCOS symptoms and the symptoms return as soon as they stop taking it. 

“PCOS is unfortunately not curable, so treatment is about managing its symptoms,” said Dr. Jessica Chan, a reproductive endocrinologist at Cedars-Sinai. Chan said birth control can be a good option for some, but not all, of her PCOS patients. 

For women with PCOS whose main concerns are insulin resistance or stubborn weight gain, Chan often prescribes off-label diabetes medications like metformin. 

Some doctors who treat PCOS, including OB-GYNs or endocrinologists, have also begun prescribing GLP-1 agonists like Ozempic and Wegovy, which have shown promise for some women with PCOS,  although studies have been small and early -stage.

Novo Nordisk, the company that makes Ozempic and Wegovy, said it has no plans as of now to seek FDA approval for PCOS. Still, the company mentions PCOS on its Truth About Weight website, part of its marketing campaign for Wegovy

Causes and symptoms of PCOS

“We don’t know the initial spark leading to PCOS or where it arises from,” Chan said.

PCOS affects an estimated 6% to 12% of reproductive-age women in the U.S. The real prevalence is likely higher since an estimated 70% of cases go undetected. 

Experts generally agree that PCOS, at its core, is a hormone-related condition. Women with PCOS have higher levels of androgen hormones, which can cause a range of symptoms, including:

•  Missing, irregular, or heavy periods
• Acne
• Excess hair growth on the face or body
• Thinning or balding scalp hair

According to endocrinologist Dr. Andrea Dunaif, some doctors have been pushing to separate PCOS into two different diagnoses: one having more to do with the reproductive cycle and fertility issues and another having more to do with metabolism, high body weight, and diabetes. 

“PCOS looks to be at least two or three different conditions we’re lumping together, but they’re genetically distinct,” said Dunaif, the chief of the endocrinology, diabetes and bone disease division of Mount Sinai Health System and the Icahn School of Medicine.

The confusion surrounding PCOS diagnosis is partly why it’s been hard to get large pharmaceutical companies to invest in PCOS treatment, she said.

In Dunaif’s view, it’s not accurate to call the condition “PCOS” at all, because it has more to do with excess hormones than it does with actual cysts on the ovaries. PCOS got its name from the bumps on the ovaries appearing like cysts on an ultrasound image. These are not cysts, but instead egg follicles that are, as Dunaif described them, “arrested in development.” 

As it is, many doctors diagnose the condition based on two of three factors:

• Irregular periods
• High androgen levels
• Multiple follicles on the patient’s ovaries

But these three factors don’t account for some of the most challenging symptoms of PCOS: insulin resistance and stubborn weight gain. Excess androgen hormones can spike insulin levels, which interferes with how the body processes sugar. Doctors aren’t sure whether the hormonal dysregulation causes insulin resistance, or whether insulin resistance causes excess androgen hormones. 

Either way, women with PCOS have a higher risk of diabetes, excess weight gain, high cholesterol, and high blood pressure. Yet these metabolic conditions aren’t included in the criteria many doctors use to diagnose PCOS. The result? A missed diagnosis. 

This was initially the case for Candice Bolden, 35, who started noticing acne and excess facial and body hair several years before she was diagnosed with PCOS in 2021. Bolden, a lifelong dancer, also had unusually low energy.  

“The final straw was excess weight gain that I could not take off no matter what I did,” said Bolden, who lives in Los Angeles. “All the other things I had kind of just stuffed under the rug. I’d just chalked it up to being a hairy, Haitian woman.”

After gaining 35 pounds, the 5-foot-2-inch Bolden, who exercised twice a day and followed strict diets, saw multiple doctors who she said ignored her symptoms. 

“Doctors kept telling me I was fine, and to go home, work out, and eat clean,” she said. “It was the most frustrating thing ever.”

‘We don’t have to live underneath this dark cloud’

Women living with PCOS say the rise of online communities, including on social media apps like TikTok and Instagram, has given them a place to speak out, share the treatment approaches working for them, and meet other women with PCOS. 

When Bolden finally got a diagnosis, she wasn’t sure what to do next. Gutke and Hacatoryan had similar experiences. 

“I was like, ‘Wait, I have so many questions,’ and the doctor just told me, ‘It is what it is,’” Hacatoryan said. 

Hacatoryan calls women in her online community her “cysters.”

Bolden said she’s noticed more women turning to social media to learn how others manage their PCOS and share their own stories.

On her own social media accounts, she’s been trying to change the narrative about PCOS being primarily a fertility problem, which she sees as an outdated perception.

“When I was diagnosed, my doctor mentioned PCOS being the No. 1 reason for infertility, and that shattered me,” said Bolden, who was newly engaged at the time and eager to start a family. “I was happy I was diagnosed, because it showed me something was actually happening and I wasn’t just crazy. But I was heartbroken.”

Things changed after Bolden moved; found a new doctor; and worked closely with her husband and the  online PCOS community to find a system that worked to manage her PCOS symptoms.  

Bolden is now pregnant and expecting a baby girl. 

“I want people diagnosed with PCOS to know there’s hope, and we don’t have to live underneath this dark cloud all the time,” she said.

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