• Researchers people with body mass index measurements that fluctuate between high and low have higher risks of serious cardiovascular issues.
• Experts say the variations in body mass index can put additional strain on the heart and other organs.
• They add that regaining weight also tends to produce abdominal fat.
• They say that regular exercise and a healthy diet are two ways to maintain body weight at a healthy level.

Having a high body mass index (BMI) may be linked to a wide range of health issues, which can ultimately result in serious cardiovascular conditions.

According to a new study, highly variable BMI was associated with adverse cardiovascular events. Highly variable BMI is repeated fluctuations in weight.

The findings were published in JAMA Network Open: Cardiology.

Researchers analyzed data gathered from the Million Veteran Program between 2011 and 2018 and participants in the UK Biobank enrolled between 2006 and 2010. The follow-up was an average of nearly 4 years.

Researchers reported that increased BMI fluctuation was associated with adverse cardiovascular events regardless of common cardiovascular disease risk factors and genetic risk.

They said the findings indicate that highly variable BMI could be linked to a high-risk phenotype for cardiovascular disease.

How BMI affects your overall health

BMI is associated with increased levels of adipose (fat) in your body and, in turn, can lead to numerous chronic health conditions.

“We know that central obesity and, in turn, waist circumference are independent risk factors for the development of atherosclerotic cardiovascular disease (i.e. stroke, heart attack, coronary artery disease, and peripheral vascular disease), diabetes, and kidney disease,” Dr. Hosam Hmoud, a cardiology fellow at Northwell Lenox Hill Hospital in New York who was not involved in the study, told Healthline.

Elevated levels of adipose tissue release pro-inflammatory chemical messengers in the body that accelerates the development of high cholesterol and inflammation leading to plaque buildup in your arteries (atherosclerosis), insulin resistance which causes diabetes, and high blood pressure (hypertension), Hmoud explained.

Having a BMI in the normal range is an important marker for overall health for a number of reasons, experts say.

“Excess weight puts additional burden on the heart, the circulatory system, and the joints in the body,” said Brooke Aggarwal, an assistant professor of medical sciences and behavioral cardiology expert at Columbia University Vagelos College of Physicians and Surgeons in New York who was not involved in the study. 

“Excess adipose tissue also leads to increased blood pressure, elevated triglycerides and cholesterol, and poor blood sugar control, which contributes to increased risk for developing cardiovascular disease, the leading cause of death globally,” Aggarwal told Healthline.

The health risks of high BMI and low BMI

BMI as it relates to overall health is a U-shaped relationship.

“Very low or high BMI associated with increased morbidity and mortality,” John Higgins, a sports cardiologist with UTHealth Houston who was not involved in the study, told Healthline.

Here is a general guideline:

• Optimal for adults is BMI between 18.5 and 25
• BMI less than 18.5 – A person is considered underweight
• BMI between 25 and 30 is considered overweight
• BMI over 30 is considered obese.

Fluctuating BMI and heart health

Highly variable BMI may be associated with cardiovascular events in several different ways.

“It’s possible that every time the weight is regained, cardiovascular risk factors such as blood pressure, cholesterol, and glucose inch higher, above the baseline level, and this is known as the ‘repeated overshoot theory‘,” Aggarwal said.

In addition, weight that is lost is usually a mix of fat and some lean muscle tissue, whereas weight that is regained is typically all adipose tissue, he explained.

This fat may be preferentially deposited in the abdomen and abdominal fat has been strongly associated with risk for cardiovascular disease.

Ways to manage your BMI

To improve your BMI, Hmoud recommends 30 minutes of adequate exercise at moderate intensity for at least 5 days per week.

He also suggests modifying your diet to include more Mediterranean-based foods (i.e. olive oil, fish, vegetables), and seeing your primary doctor on a regular basis to monitor your weight.

“BMI reduction decreases the rate of major adverse cardiovascular events, including stroke and heart attack, by decreasing basal levels of inflammation, lowering blood pressure and blood sugar, and improving your gut health, which also decreases inflammation,” said Hmoud. “Supplementation of a healthy lifestyle with weight loss drugs such as GLP-1 RA (semaglutide) may also be helpful in the setting of refractory weight loss efforts.”

When thinking about BMI, experts say it’s important to consider the bigger picture in terms of lifestyle and developing healthy long-term habits.

“I think the study highlights the importance of trying to achieve a healthy body weight in a sustainable way and one that can become a lifestyle rather than a short-term fix. Conventional diets that focus on eliminating entire food groups and severe calorie restriction often fail to yield sustained weight reduction and health benefits,” Aggarwal said.

Strict short-term diets can lead to a pattern of restricting and bingeing over the long-term. Intuitive and/or mindful eating is a more achievable approach to weight management that may lead to gentle weight loss long-term and improvement of other physiological parameters, such as inflammation, Aggarwal explained.  

“We and others have also shown that eating a large percentage of one’s total daily calories in the evening meal is associated with greater risk of elevated BMI and blood pressure, so eating the majority of your calories earlier in the day may be a good strategy for managing weight, without severe restriction,” he added.

“You can calculate your own BMI by dividing your weight in pounds by your height in inches squared, and then multiplying by 703,” said Aggarwal.

To learn more specific information about own BMI, try this adult BMI calculator.

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• In a recent interview, Elon Musk revealed that he has a prescription for ketamine to treat depression.
• Ketamine is a powerful anesthetic that research indicates can help treat depression, but it is not currently FDA-approved for that or any other psychiatric indication.
• Experts told Healthline that Musk’s interview will raise the profile of the drug, which could lead to more seeking treatment, but also more misuse.

Elon Musk revealed that he takes ketamine for depression in a recent interview with former CNN host Don Lemon.

The tech mogul told Lemon that he hoped by speaking out about the drug that it might “help other people.”

While remaining generally tight-lipped about the specifics, Musk did have this to say about his ketamine usage in the interview:

“There are times when I have a sort of negative chemical state in my brain, like depression, I guess — depression that’s not linked to any negative news. Ketamine is helpful for getting one out of a negative frame of mind.”

Experts contacted by Healthline agreed that Musk’s revelation would certainly help to raise the profile of the drug and its reputation as a treatment for depression.

However, they also noted reservations that it might lead to misuse outside appropriate medical and psychiatric settings.

What is ketamine?

Ketamine hydrochloride is an FDA-approved anesthetic that was developed some fifty years ago and is still used today.

It is a Schedule III non-narcotic substance, according to the Drug Enforcement Agency, and has currently accepted medical uses.

But Ketamine also has a reputation as an illicit party drug that is known to cause hallucinations and a relaxed, disconnected feeling. 

In the past twenty years, researchers have increasingly investigated ketamine for its potential use in a wide variety of mental health conditions, including:

• depression (especially treatment-resistant depression)
• substance use disorder
• post-traumatic stress disorder (PTSD)
• anxiety

Ketamine infusion therapy or intravenous ketamine is the most widely studied form of ketamine therapy for psychiatric disorders. Typically, a patient will receive a dose of the drug while under observation at a clinic and will then receive several maintenance doses over the following months.

There is no set dosage or infusion schedule; protocols may vary from clinic to clinic and patient to patient.

Simultaneously, researchers also began looking at similar drug formulations. In 2019, the Food and Drug Administration approved Spravato (esketamine) for treatment-resistant depression. However, esketamine is not ketamine and is administered via a nasal spray rather than intravenously.

Among these conditions, research indicates that the strongest evidence for ketamine therapy is for treatment-resistant depression, according to an expert review in The AmericanJournal of Psychiatry from 2021.

Despite mounting evidence, ketamine is currently not FDA-approved for any psychiatric disorders, but it can be prescribed by a licensed doctor.

“Ketamine infusion therapy or IV ketamine is not approved by the FDA. It’s really only been within the last couple decades that there’s been increased attention by the public and also by, psychiatry researchers and clinicians in using this in a clinical setting,” Dr. Jeffrey Zabinski, MD, an Assistant Professor of Psychiatry at the Columbia University Medical Center told Healthline. 

The Columbia University Medical Center does offer ketamine infusion therapy as part of their psychiatric services.

What health experts think of Musk’s use of Ketamine to treat depression

Referring to Musk’s interview, Zabinski said, “There’s a positive opportunity for education when something like this comes up. The flip side of it is that ketamine is absolutely not appropriate for everyone. So you have to make sure to work with a psychiatrist or other mental healthcare professional to make sure that if there are other options that are safer, that those are explored before going to ketamine.”

Asked by Lemon if he ever abuses the drug, Musk responded, “I don’t think so. If you use too much ketamine, you can’t really get work done, and I have a lot of work.”

He went on to explain his ketamine usage and said that he only uses “a small amount once every other week.”

Dr. Boris Heifets, MD, PhD, an Assistant Professor in the Department of Anesthesiology & Perioperative Medicine at Stanford Medicine, also told Healthline that Musk’s interview is likely to help destigmatize mental health. However, he was more blunt about the downsides:

“Someone could listen to that interview and say, ‘Hey, I’m depressed, and it sounds like this guy, who is very high functioning, says it’s okay, then maybe it’s going to be good for me. Maybe I don’t need to have a doctor tell me what’s what because I don’t trust the medical establishment. I’m just going to get some ketamine.’ And that is a problem. I feel very comfortable saying that worries me a lot.”

Is ketamine safe?

Ketamine has a strong safety profile and has been used professionally in medical settings for decades. However, there are serious concerns about the dangers posed when the drug is used recreationally.

There are also questions about the long-term safety of ketamine infusion therapy for depression.

“Ketamine is exceptionally safe when given once. We have fifty years of experience with ketamine being given to millions of people in operating rooms around the world. But we also know ketamine is a drug abuse,” said Heifets.

Even for those prescribed ketamine, more research is needed about safety.

“There’s a lot we don’t know about its risk profile that we should attend before making determinations,” he said.

As a potential drug for misuse, ketamine is complicated. While there is some misuse potential, research has also found that ketamine may play a role in the treatment of substance disorders.

“Ketamine has been abused historically in the past few decades. So, it’s something that we have to pay extra attention to when patients have a history of substance use disorders. The complicated thing is, there are some studies that show that sometimes doses of ketamine can be helpful for substance use disorders.”

Health Risks of Ketamine

Ketamine has the potential for both short and long-term health risks. Immediately after taking the drug, individuals may experience:

• Hallucinations
• Feeling drunk
• Sedation
• Disorientation
• Nausea

Overdosing on ketamine can result in unconsciousness and dangerously slowed breathing.

In the long-term, ketamine use can lead to:

• Urinary and bladder problems
• Abuse and misuse
• Increased blood pressure
• Psychiatric events

The bottom line

Elon Musk recently discussed his prescription for ketamine to treat depression.

Ketamine is a powerful, FDA-approved anesthetic that research indicates is also an effective therapy for treatment-resistant depression.

However, the drug is not FDA-approved for any psychiatric disorders.

Experts say that while Musk speaking out may be helpful to destigmatize mental health, it may also lead to increased interest in the drug, which has the potential for misuse.

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• Actor Jake Gyllenhaal says he contracted a staph infection while filming a fight scene for Road House.
• Staph infections occur when staphylococci bacteria enter the body via a cut or abrasion.
• Staph infections can be mild, but they can also be serious and life-threatening.
• You should see a physician immediately if you experience rapid heart rate, neck stiffness, chest pain, fever, severe headache, or trouble breathing. 

Jake Gyllenhaal has revealed he contracted a staph infection while shooting his latest movie. 

Chatting on Dax Shephard’s Armchair Expert podcast alongside his co-star Conor McGregor, Gyllenhaal shared that while filming a fight scene for Road House, he cut his hand, and it resulted in a staph infection. 

Recalling the scene, he said: “We’re fighting on the floor, fighting around tables, we’re fighting around glass.” 

During the scene, the actor sustained an injury when he placed his hand on glass. “I felt the glass going in my hand. I remember the feeling [and] went, ‘That’s a lot of glass,” he shared. 

Gyllenhaal hurt himself while filming another portion of the film. “I thought [the infection] came from, remember that scene where you come with a piece of wood?” he asked McGregor. 

“I grabbed your arm, and I thought, ‘Oh, maybe I’m injured.’ But my whole arm swelled up. It ended up being staph.”

Staph infections are common, and in some cases, they can be serious. However, there are steps you can take to reduce your risk of infection following an injury.

What are staph infections? 

“All of us have staphylococci bacteria and other bacteria on our skin. This is normal and healthy and part of our microbiome,” explains Daniel D. Rhoads, vice chair of the College of American Pathologists Microbiology Committee. 

“What can become a problem is when the skin’s integrity is compromised, and the bacteria that are normally on the surface of our skin can now contaminate deeper tissue where bacteria do not belong.” 

Sometimes this compromise in the skin can be imperceivable, like a minor cut or small abrasion that you do not even notice. Other times, the compromise is more obvious, as it was for Gyllenhaal. 

Either way, Rhoads says, when we have a cut or abrasion, there is always a risk that bacteria from our skin (in this case, Staphylococcus aureus, also known as S. aureus) or from the environment could not only contaminate the exposed tissue but could also start growing. 

This is a staph infection, and it triggers the body’s immune response, resulting in calor, dolor, rubor, and tumor. 

“Mr. Gyllenhaal described his arm swelling up. That swelling is “tumor.” I would bet that his arm was also red (rubor), hot (calor), and painful (dolor),” Rhoads explains. 

How dangerous are staph infections? 

Staph infections can range in severity. When a bacterial infection like this starts spreading from the local site of the tissue damage toward the middle of the body, Rhoads says it’s “bad news” because it means the immune system is having a hard time curtailing the infection. 

Dr. Linda Yancey, infectious disease specialist at Memorial Hermann Health System in Houston has a helpful analogy in understanding the varying degrees of infection. 

“To say “Staph infection” is like saying “traffic accident.” They range from fender benders to sixteen-car pileups and everything in between,” she explains. 

“Most Staph infections are minor and resolve on their own, but the more severe ones require medical care.” 

Staph infections on the mild end of the spectrum will usually present with a little pain and swelling. Often, the immune system is able to fend off the infection, and it will go away without medical or surgical intervention. 

However, that’s not always the case. “Staph infections are most concerning when they are spreading quickly, and symptoms transition from local tissue inflammation to systemic symptoms, for example, chills and increased rate of breathing,” Rhoads warns. 

In the most extreme cases, which were much more common before we had antibiotics, Rhoads says severe local infections can spread to cause a systemic infection and then death.

How to reduce your staph infection risk 

It can be challenging to prevent staph infections, given that the bacteria that causes them is already present on the skin. However, Yancey says good hygiene is the cornerstone of good health. 

It’s important to regularly – and thoroughly – wash your hands. You should also shower after physical activity. These steps can keep cuts clean and reduce the risk of infection.

Rhoads says, “It’s good to wash cuts and abrasions with soap and water to try to remove bacteria and debris that could be contaminating a new wound.” 

You should also keep any open wounds covered to stop bacteria from entering the skin. 

Meanwhile, sharing towels, razors, and other pieces of personal equipment, such as makeup brushes, is a big no-no. 

“People who share sports equipment, for example football teams, should ensure that equipment is cleaned and sanitized between uses,” Yancey adds. The same rings true if you exercise in a public place, like a gym. 

When to seek medical care 

If you are concerned about a staph infection, Yancey says your first step should be your primary care provider. 

“However, if the infection you are concerned about is a boil or abscess, urgent care or an emergency room is a better choice as they will have the equipment to drain it if needed.” 

It’s essential you seek medical assistance if you notice the infection is getting worse and is spreading quickly or if it’s accompanied by fever, headache, neck stiffness, and/or chest pain, rapid heart, and trouble breathing. 

Oftentimes, staph infections can be treated with antibiotics, though sometimes surgery may be required. 

Takeaway 

Staph infections happen when bacteria enter the body via a cut or abrasion. They can be mild and clear up on their own.

However, staph infections can also be serious and life threatening. If you’re concerned, you should consult a medical professional straight away.

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• Kate Middleton, the Princess of Wales, revealed she has cancer and is undergoing chemotherapy.
• The March 22 announcement follows Catherine’s two-month absence from the public eye to recover from major abdominal surgery for a condition that was previously believed to be noncancerous.
• Catherine, who is married to William, the Prince of Wales and heir to the British throne, has asked for privacy during her recovery.
• Catherine is the latest British royal to reveal she has cancer. King Charles III and former royal family member Sarah Ferguson, Duchess of York, have recently shared their cancer diagnoses.

Catherine, Princess of Wales, shared on March 22 that she’d been diagnosed with cancer and is currently in the early stages of treatment, undergoing preventive chemotherapy. The type of cancer was not specified.

The announcement was shared in a video message two months after Catherine had stepped away from official public appearances to recover from major abdominal surgery, which Kensington Palace said at the time had been noncancerous.

A message from Catherine, The Princess of Wales pic.twitter.com/5LQT1qGarK

— The Prince and Princess of Wales (@KensingtonRoyal) March 22, 2024

Catherine spent 13 days in a London hospital following the procedure and paused public duties during her recovery.

However, Catherine explained that tests performed after the January 16 surgery revealed a cancer diagnosis.

“This of course came as a huge shock, and William and I have been doing everything we can to process and manage this privately for the sake of our young family,” said Catherine, 42, who is married to William, the Prince of Wales and the heir to the British crown.

“As you can imagine, this has taken time. It has taken me time to recover from major surgery in order to start my treatment. It has been an incredibly tough couple of months for our entire family, but I’ve had a fantastic medical team who have taken great care of me, for which I am so grateful,” Catherine continued.

World leaders react to Kate Middleton’s cancer diagnosis

Shortly after Catherine’s announcement, the White House said the administration was “incredibly sad to hear of the news.” 

“Our thoughts are with the Duchess of Cambridge and her family members and friends during this incredibly difficult time, and certainly we wish her a full recovery,” said White House press secretary Karine Jean-Pierre.

British Prime Minister Rishi Sunak said Catherine has “the love and support of the whole country” and has shown “tremendous bravery with her statement.”

Both U.K. and U.S. leaders have urged the public to respect the privacy of the British royal family during this time.

Catherine’s recent absence from the public spotlight drew widespread speculation about what had been a mysterious health condition. As conspiracy theories mounted, Catherine also recently came under fire for sharing a family portrait that had been altered, which was redacted by media outlets around the world.

Privacy for British royals, it seems, has historically never been easy to come by.

Other British royal family members diagnosed with cancer

Catherine’s cancer diagnosis is the latest in a series of recent royal family cancer announcements.

King Charles III is currently undergoing treatment for an unspecified cancer that was discovered during a procedure for a benign prostate enlargement.

Former royal family member Sarah Ferguson, Duchess of York, is recovering from skin cancer. Ferguson’s melanoma was detected early during reconstructive surgery from a mastectomy following a breast cancer diagnosis.

“At this time, I am also thinking of all those whose lives have been affected by cancer. For everyone facing this disease, in whatever form, please do not lose faith or hope,” Catherine concluded in the video.

Takeaway

Catherine, Princess of Wales, also known as Kate Middleton, shared in a video message that she has cancer.

While the type of cancer was not specified, Catherine revealed it was detected during testing following a recent major abdominal surgery.

Catherine’s cancer diagnosis follows recent cancer announcements made by King Charles and the Duchess of York.

The royal family, as well as world leaders, urge the public to respect the privacy of Catherine and her family during this time.

Family concerns will be front and centre for the Princess of Wales…

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• In a new study, researchers found that by targeting a type of protein, they were able to suppress replication of HIV in certain cells.
• This is a potential step toward complete elimination of the virus.
• Experts caution that more study is needed.

A new study published this week in Cell Chemical Biology suggests a path forward for eliminating the so-called viral reservoir cells in people with HIV.

By targeting a type of protein called the Nef protein, researchers at the University of Pittsburgh School of Medicine were able to suppress the replication of HIV in target cells, a potential step toward complete elimination of the virus.

The Nef protein helps HIV-infected cells avoid detection by a person’s immune system.

Why scientists targeted this protein

The Nef protein was long considered “undruggable” because it provides few ways for any antiviral drugs to bind.

Previous Nef inhibitors, which only bind to those proteins, can block some of its functions but were unable to disrupt others that are essential for HIV infection. If a person has stopped taking antiretroviral drugs but reservoir cells remain because the Nef protein is helping them hide, the reservoir cells can eventually reactivate and start producing new virus again.

Dr. Lori Emert-Sedlak, Ph.D., a research associate professor in the Department of Microbiology and Molecular Genetics at the University of Pittsburgh School of Medicine and one of the study’s authors, told Healthline that their approach to targeting Nef proteins was based on a type of drug called PROTAC drugs that have been successful in attacking cancer cells.

“PROTAC stands for proteolysis targeting chimeras, which are ‘two-headed’ small molecules; one end binds selectively to the drug target (HIV Nef in our case) and the other end binds to a cellular machine…that marks the target protein for degradation. The PROTAC, therefore, acts as a bridge between the target protein and this cellular machine,” Emert-Sedlak said.

The research for this latest discovery has been in the works for a long time, she added.

“Discovery and development of small molecules that bind selectively to Nef took us about 10 years, and extending the work to the targeted degrader approach required another 3 years,” Emert-Sedlak said.

Researchers “synthesized more than 500 unique compounds for this project, all of which had to be screened for activity in a battery of biophysical, biochemical, and virological tests,” Emert-Sedlak said. “PROTACs are not trivial compounds for chemists to make and no clear ‘rules’ exist to predict which ones will work in advance. So, each analog must be tested individually, which takes time.”

Does this mean we are close to a cure for HIV?

Experts caution that there will need to be more testing and that the implementation of PROTACs for the treatment of HIV is still a long way off.

The next step would be testing the approach using animal models before any human trials can begin. Dr. Tom Smithgall, Ph.D., a professor at the Department of Microbiology and Molecular Genetics at the University of Pittsburgh School of Medicine and another author of the study, told Healthline that the data behind their research are promising, but there’s still a lot more testing to be done.

“Our results suggest that treatment of an HIV-positive individual with a Nef PROTAC would not only suppress viral growth like existing antiretroviral drugs but also keep the infected cells ‘visible’ to the immune system for elimination,” Smithgall said. “This effect may prevent seeding of a reservoir early in the infection, and therefore might help to eliminate the virus entirely.”

Smithgall said more testing will be needed to verify this is a safe and effective treatment. But if this ends up being a way to treat HIV, it could help eliminate the need for lifelong antiretroviral therapy.

Dr. Monica Gandhi, MPH, a professor of medicine at the University of California San Francisco’s Division of HIV, Infectious Diseases, and Global Medicine, told Healthline that achieving a widespread application of PROTAC drugs could be a huge leap forward in the search for a cure for HIV.

“The maintenance of the viral reservoir is our key barrier to achieving HIV cure among individuals living with HIV infection and we have not been able to find strategies yet that could eliminate the reservoir. This new Nef-destroying strategy represents a major advance and could be the ‘holy grail’ we have been looking for in terms of HIV cure,” Gandhi said. “However, there is still a lot of work to be done prior to testing in humans, including testing this strategy in animal models of HIV infection.”

Are there other viruses that PROTACs could be effective against?

One additional potential benefit to developing Nef PROTAC drugs would be applying the mechanics to other viruses — including COVID-19, which also utilizes some of its proteins to avoid detection by the immune system. Smithgall said the template they identified with HIV could be a deterrent for new viruses, but cautioned that it’s not an easy goal to achieve.

“In theory, PROTACs against such proteins may work in combination with existing antivirals and vaccines to help the immune system control the virus, thereby limiting the severity of infection,” Smithgall said.

Smithgall also points out that first, researchers have to find the right molecule to target, which can take a long time. “However, this ‘warhead’ molecule needs only to bind selectively to its target, not inhibit it directly, to construct a PROTAC. In theory, the PROTAC approach can render any protein ‘druggable’ even if it lacks an active site like many targets for current drugs.”

Takeaway

A new study by scientists at the University of Pittsburgh School of Medicine shows promise for PROTAC drugs that can disrupt HIV “reservoirs” — groups of HIV-infected cells that can hide the virus from the body’s immune system.

Over a 10-year period, researchers developed a way to target a type of protein which aid HIV in hiding and can prompt a return of the virus if a person stops taking antiretroviral drugs.

There is still a significant amount of testing and research to be done before PROTACs can be implemented in humans.

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