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• Ryan Reynolds is speaking out about his father’s life with Parkinson’s disease nine years after his death.
• Reynolds says he hopes to raise awareness of some of the early signs and symptoms of the disease, including less common psychological and cognitive problems.
• Reynolds’ father experienced hallucinations and delusions, which are part of a spectrum of symptoms due to psychosis.

Actor Ryan Reynolds is opening up about his father’s journey with Parkinson’s disease and the painful effects it had on his family in hopes of raising awareness about some of the lesser-known symptoms of the disease.

In an intimate interview with People, Reynolds described the cognitive symptoms, including hallucinations and delusions that his father experienced while living with Parkinson’s.

He also addressed how the diagnosis affected him and his family and the persistent stigma that exists around Parkinson’s even to this day.

Reynolds has recently partnered with the educational campaign More to Parkinson’s to raise awareness and offer families and caretakers additional resources.

“It’s a moving story, and it’s a story that many families experience because the onset of Parkinson’s is so insidious,”  David Charles, MD, a Professor and Vice-Chair of Neurology at Vanderbilt Medical Center, told Healthline. 

“The symptoms that precede the motor symptoms and the things that we see in a person with Parkinson’s when we examine them have sometimes been present for years beforehand, but we’re not really able to conclude that they are related to a future diagnosis of Parkinson’s,” said Charles. 

The differences between hallucinations and delusions

It has been nine years since Reynold’s father, James Chester Reynolds, died at the age of seventy-four after living with Parkinson’s disease for almost two decades. He’s now ready to talk about the challenges and complex inter-family dynamics wrought by the disease.

Parkinson’s disease is a progressive neurological disorder that affects both movement and cognition. While some are likely familiar with the motor-related symptoms of Parkinson’s, like tremors and slow movement, the cognitive symptoms are, perhaps, not as widely known. And that’s precisely what Reynolds addresses in his interview.

“At the time, I just thought, ‘My dad’s losing his mind.’ My father was really slipping down a rabbit hole where he was struggling to differentiate between reality and fiction,” Reynolds’ told People. He describes both hallucinations and delusions that his father experienced. Collectively, these symptoms, which exist on a spectrum of severity, are known as Parkinson’s psychosis.

Between 20% and 40% of people with Parkinson’s experience some form of psychosis during the early stages of the disease. As the disease progresses into later stages, up to 70% experience psychosis.

“These symptoms fall under the non-movement symptom category. They are common and can be more troublesome and disabling at times than the movement symptoms,” Emile Moukheiber, MD, an Assistant Professor of neurology at Johns Hopkins University School of Medicine, told Healthline.

Hallucinations and delusions are not synonymous and have unique characteristics.  

• Hallucinations are when an individual sees, hears, or even smells something that is not actually there. Hallucinations may not be alarming to the person experiencing them.
• Delusions are signs of an alternative or irrational view of reality. Delusions may generally include paranoia or more specific delusions such as Capgras delusions, in which an individual believes that a friend or family member has been replaced by an impostor.

Moukheiber explains that psychosis can manifest in different forms, from shadowy figures to fully formed individuals able to converse.

However, cognitive issues may not be extreme either. The person with Parkinson’s may just seem “off” or different in an abstract way.

“Some people feel just like that person has changed, whether it’s a change in personality or a consequence of some behavioral issue,” said Charles.

How to identify early Parkinson’s disease symptoms

There are several “classic” signs and symptoms of Parkinson’s disease. However, there is no simple test to identify it, which means that a doctor can only diagnose based on a multitude of factors, including physical symptoms, medical history, and a neurological assessment.

Early symptoms of Parkinson’s disease include:

• Decreased or loss of sense of smell (anosmia)
• Constipation
• Small, cramped handwriting
• Voice changes
• Stooped posture

“These symptoms can sometimes precede the movement symptoms classic of Parkinson’s by a decade or more. Others include increased anxiety and depressive symptoms that had not been present in younger years,” said Moukheiber.

As the disease progresses, movement-related symptoms will begin to appear, which are more obvious to observers. These include:

• Tremors
• Slow movement
• Stiffness in the arms, legs, and trunk
• Balance and stability problems that lead to falls

The stigma of Parkinson’s

In his conversation with People, Reynolds describes the secrecy around his father’s diagnosis:

“He said the word ‘Parkinson’s’ maybe three times as far as I knew — and one of them wasn’t to me. There was a ton of denial, a ton of hiding,” Reynold’s said.

His experience is not a unique one, but instead an all-too-common thread between families, friends, and even co-workers of people with Parkinson’s.

“I’ve had patients who did everything they could to hide their symptoms from others,” said Charles. “One person comes to mind who only told his spouse. Did not tell his children. Did not tell his coworkers. With each visit, one after the other, it was more and more apparent that he was literally carrying the weight of the world on his shoulders, trying to hide.”

Michael S. Okun, MD,  a board certified neurologist and co-founder and co-director of Norman Fixel Institute for Neurological Diseases, told Healthline that there’s more work to do with both healthcare providers and families alike to address the issue of stigma.

“We need to be teaching clinicians and healthcare teams to have deeper and more meaningful discussions to uncover stigma and to help folks live well with the disease.  When we hear stories like Ryan’s father, it emphasizes how real the ‘hidden’ phenomenon is,” he said.

The bottom line

Ryan Reynolds has spoken out about his late father’s Parkinson’s disease journey and the effects it had on him and his family.

While the disease is most commonly associated with motor problems, including tremors and slow movement, there are also psychological and cognitive symptoms. Reynolds’ father experienced hallucinations and delusions, known as psychosis.

Early symptoms of Parkinson’s include constipation, loss of smell, and stooped posture.

Stigma still persists around Parkinson’s disease, with many individuals hiding their symptoms and diagnosis from those around them.

• Real Housewives of Dubai star Caroline Stanbury revealed that she “projectile vomited” at a bar while she was on Ozempic.
• Nausea, vomiting, diarrhea, and upset stomach are side effects associated with Ozempic and can become worse when the medication is combined with alcohol.
• However, research shows that Ozempic might also have applications in treating alcohol use disorder.
• Research suggests the drug may help suppress people’s cravings for alcohol.

Speaking on Page Six’s Virtual Reali-Tea podcast, Real Housewives of Dubai star Caroline Stanbury revealed that she had once “projectile vomited” at West Hollywood bar The Abbey due to her Ozempic use.

Her confession was in response to host Evan Real’s admission that he had stopped drinking a couple of months before due to the way alcohol use worsened the side effects of the weight loss drug.

Stanbury’s episode of vomiting occurred after having only a small amount of alcohol, she told the host.

“You drink half a glass, and you’re like, literally — There’s no way to run to the bathroom,” she laughed.

“If you haven’t projectile vomited on Ozempic, you haven’t lived yet,” she added.

Why people using Ozempic have can have negative reactions to alcohol

Paul Daidone, MD, FASAM, Medical Director at True Self Recovery, said that the reaction between Ozempic and alcohol experienced by Stanbury and Real occurs because of how this GLP-1 drug works.

Ozempic mimics glucagon-like peptide-1 (GLP-1), a hormone that regulates blood sugar by triggering insulin secretion. It also slows down stomach emptying and reduces hunger, which is the effect that helps people lose weight.

Slower stomach emptying means that food and drinks remain in the stomach for longer, which can either make people feel fuller longer or, in some cases, feel nauseated, said Daidone.

Another factor that can lead to vomiting in those who are using Ozempic to treat diabetes is the fact that alcohol can cause “dramatic shifts” in blood sugar.

“Hypoglycemia or low blood sugar might occur due to a combination of Ozempic’s effect on reducing glucose as well as alcohol’s impact on the same compound,” Daidone explained, “and its symptoms may include nausea and vomiting.”

How Ozempic might help reduce alcohol consumption

There is research indicating that Ozempic could have positive effects on those living with alcohol use disorder (AUD), a medical condition that occurs when people are unable to control their alcohol use despite experiencing negative consequences.

For example, a case series published on November 27, 2023, in The Journal of Clinical Psychiatry, found that 100% of six weight loss patients who were using the generic version of Ozempic, semaglutide, also had a significant reduction in their AUD symptoms.

Explaining why Ozempic might have this effect, Michael Villarreal, CADC, CEO of Tres Vistas Recovery, noted that studies have shown that GLP-1 receptor agonists like Ozempic impact reward pathways in the brain that could be involved in addictive behaviors.

“By modifying these neural circuits, Ozempic could attenuate alcohol’s pleasurable effects, thereby reducing its attractiveness and possibly promoting abstinence,” he said.

Villarreal further discussed Ozempic’s ability to induce feelings of satiety while suppressing cravings.

“[I]t can help one not feel like drinking when they are out with friends or trying to cope with stressors,” he said.

“This unique characteristic of having a dual effect on both physical and mental facets of addiction makes Ozempic a viable choice for those who want to quit or cut down on their drinking while managing conditions like diabetes or obesity,” he concluded.

Takeaway

Real Housewives of Dubai star Caroline Stanbury discussed on a recent episode of Page Six’s Virtual Reali-Tea podcast how she had experienced a negative reaction to alcohol after only drinking a small amount, blaming it on Ozempic use.

Experts say side effects associated with Ozempic, such as nausea and vomiting, can become worse with alcohol use.

For people living with diabetes who are taking Ozempic, alcohol use can cause blood sugar to drop even more, also worsening the side effects associated with GLP-1 drugs.

However, Ozempic does offer promise for those who are dealing with alcohol use disorder. It may impact the reward pathway in the brain, making alcohol less desirable. It could also work to suppress cravings.

• Medicare announced negotiated prices for 10 prescription drugs, ranging from 38% to 79% discounts on the drug list prices.
• Price negotiation resulted from a provision of the Inflation Reduction Act, signed into law in 2022.
• While Medicare enrollees should see lower out-of-pocket costs for these 10 drugs starting in 2026, other factors may lessen the impact.

Medicare enrollees are expected to save money on 10 prescription drugs starting in 2026, after the federal government successfully negotiated with pharmaceutical companies to lower list prices for these medications.

The discounts on the list prices range from 38% for the blood cancer drug Imbruvica to 79% for the diabetes drug Januvia.

About nine million Medicare enrollees use at least one of the drugs selected for price negotiation, the U.S. Department of Health and Human Services said August 15 in a news release.

The department estimates that in 2026, enrollees will save a combined $1.5 billion on out-of-pocket costs such as copays at the pharmacy. How much individuals save personally depends on their Medicare Part D coverage.

Taxpayers spent more than $56 billion on the 10 drugs in 2023, HHS said. Had the negotiated prices been in effect last year, Medicare would have saved an estimated $6 billion.

The 10 medications were selected last year for the initial round of price negotiations based on conditions laid out in the Inflation Reduction Act, which was signed into law by Biden in 2022.

Previously, individual Medicare plans were able to negotiate prescription drug prices, but Medicare was banned from using its leverage to negotiate prices for the program as a whole.

All Democrats in Congress voted for the IRA, while all Republicans voted against the bill.

Which drugs are impacted?

Here are the 10 medications selected for this initial round of price negotiations, with the discount off the 2023 list price, according to HHS:

• Januvia (diabetes): 79%
• Fiasp/NovoLog (diabetes): 76%
• Farxiga (diabetes, heart failure, chronic kidney disease): 68%
• Enbrel (rheumatoid arthritis, psoriasis): 67%
• Jardiance (diabetes, heart failure, chronic kidney disease): 66%
• Stelara (psoriasis, Crohn’s disease, ulcerative colitis): 66%
• Xarelto (prevention and treatment of blood clots, coronary or peripheral artery disease): 62%
• Eliquis (prevention and treatment of blood clots): 56%
• Entresto (heart failure): 53%
• Imbruvica (blood cancers): 38%

These drugs represent a range of conditions rather than just one or two.

“What Medicare did with these first 10 drugs is focus on medical conditions that affect the Medicare population more than the general population,” said Robert Slavkin, JD, chair of Akerman LLP’s Healthcare Practice Group.

The negotiated prices will go into effect in January 2026.

Early next year, the U.S. Centers for Medicare & Medicaid Services (CMS) will select up to 15 additional drugs for price negotiation, with lower prices to take effect in 2027. This will be followed by lower prices for up to 20 more Part B or Part D drugs for each year after that.

The pharmaceutical industry has filed several lawsuits to keep the negotiated prices from going into effect. So far, none have succeeded.

The industry has claimed that price negotiation will hamper drug innovation. However, the non-partisan Congressional Budget Office estimates that the IRA will prevent 13 new drugs from coming to market over the next 30 years — out of an estimated 1,300 new drugs.

What could Medicare enrollees save?

Many enrollees will see out-of-pocket savings on the medications that are subject to price negotiations, but it will depend on their Medicare Part D coverage.

HHS gave a hypothetical example of a Medicare enrollee taking Stelara who pays a 25% coinsurance on the drug. Today this would amount to about $3,400 for a 30-day supply. After the negotiated price takes effect, they would pay $1,100 per month.

“If you’re taking one of those 10 negotiated drugs, the odds are, the government will benefit, and you, the patient, will benefit,” said Mark Fendrick, MD, director of the University of Michigan Center for Value-Based Insurance Design.

However, he pointed out that it’s not clear yet what Medicare Part D and Medicare Advantage prescription drug (MAPD) plans will do with these drugs, in terms of formulary placement.

“I believe these first 10 drugs will be placed in really good positions [on the formulary], with lower out-of-pocket costs for patients,” he told Healthline.

“But as the great [baseball player] Yogi Berra said, ‘It’s tough to make predictions, especially about the future,’” Fendrick added.

Slavkin agrees that ultimately the price negotiations will have a positive impact for Medicare and Medicare enrollees.

“The question is, ‘How?’ And I don’t think we know the full answer to that yet,” he said, pointing to the many aspects of the healthcare system that could affect how much enrollees end up paying out of pocket.

This includes pharmaceutical manufacturers, insurers, and pharmacy benefit managers (PBMs), as well as drug rebates, out-of-pocket caps and the Medicare donut hole coverage gap.

In addition, “pharmaceutical companies have programs to help patients pay for their drugs,” Slavkin told Healthline, “which may affect whether price negotiation is going to ultimately have a positive impact on Medicare beneficiaries.”

Unintended consequences of negotiation

The price negotiations could also have unintended consequences that might reduce out-of-pocket savings for Medicare enrollees, said Fendrick. He expanded on these in a recent Health Affairs commentary.

While CMS price negotiation sets a “maximum fair price” for a drug, there are no regulations for how Part D insurers make the drug available. 

For example, insurers could require enrollees to pay a larger percentage of out-of-pocket costs for a negotiated drug. Since patient cost-sharing requirements are often based on a drug’s “list price,” this could help plans recoup their lost revenue.

Plans could also restrict access to drugs with negotiated prices by adding in additional administrative hurdles, such as requiring that physicians obtain prior authorization before prescribing a medication, or asking patients to try other medications first.

“CMS has acknowledged that [these kinds of things] might happen,” said Fendrick, “so it’s really important that we continue to watch to make sure it doesn’t.”

“Because the whole goal of negotiating prices for these drugs is to lower the cost not only for the government but also for the patient,” he said.

Other ways to save on prescriptions

While Medicare price negotiation is one of the most highly publicized healthcare parts of the IRA, Fendrick pointed out three other provisions that will help Medicare enrollees save on their medications even sooner than 2026.

First, the $35 monthly cap on out-of-pocket costs for insulin prescriptions, which went into place last year.

Second, is the removal of cost-sharing for vaccines covered under Part D plans, such as shingles and pneumococcal vaccines. “This is hardly ever talked about, but it’s really impactful,” said Fendrick.

Third, the $2,000 out-of-pocket cap on Medicare enrollees’ prescription drug spending. This takes effect next year.

Connected with the out-of-pocket cap is the Medicare Prescription Payment Plan (MPPP), an optional program that allows people on Medicare to pay for their medicines in predictable monthly installments.

“A lot of older adults on a fixed income can’t pay $2,000, particularly at one time,” said Fendrick, “which can happen if you are taking something like a cancer drug or a drug for an autoimmune condition.”

He suggests people consider signing up for MPPP when Medicare Open Enrollment happens in the fall.

Takeaway

Medicare announced negotiated prices on 10 prescription drugs, with the lower list prices set to take effect in January 2026. The impact on Medicare enrollees will depend on their Part D plan.

The discounted list prices range from 38% for the blood cancer drug Imbruvica to 79% for the diabetes drug Januvia. About 9 million Medicare enrollees use at least one of these drugs.

While price negotiation will likely lower patients’ out-of-pocket costs, insurers could increase cost-sharing for these drugs or restrict access to them through increased administrative hurdles.

• The CDC issued an alert over rising human parvovirus B19 cases, also known as “fifth disease” and “slapped-cheek disease.”
• Most cases are generally mild and occur in children, leading to a fever and trademark bumpy red rash on the face or elsewhere on the body.
• Pregnant people and immunocompromised individuals face the highest risk of parvovirus-related complications.
• Currently, there is no vaccine against this infectious disease.

A highly transmissible virus you may have never heard of is circulating as summer draws to a close.

The Centers for Disease Control and Prevention (CDC) recently received reports of human parvovirus B19 activity among people of all ages in the United States, notably children.

Clusters of parvovirus-related complications among pregnant people and people with sickle cell disease were also identified.

“In the first quarter of 2024, public health authorities in 14 European countries observed unusually high numbers of cases of parvovirus B19,” a CDC health adivsory reported on August 13. “In the United States, there is no routine surveillance for parvovirus B19, and it is not a notifiable condition.” 

The CDC’s alert advises healthcare professionals to screen high risk patients presenting associated symptoms, which include fever and unexplained anemia, and the trademark rash that gave this disease its “slapped cheek” nickname. 

Children who contract parvovirus are more likely to develop a bumpy red rash on their cheeks, whereas adults may develop a rash elsewhere on the body.

Most healthy adults and children are considered low risk for serious illness from this respiratory disease, which is often asymptomatic, and will not require treatment.

“Because Parvovirus B-19 is mostly contagious before symptoms present or in the early stages, the only recommendation is to stay home if [you have a fever],” Jennifer Walsh, assistant professor at George Washington University School of Nursing, told Healthline. “Once the typical childhood rash presents, the individual is no longer considered contagious.”

Other groups, such as immunocompromised adults and pregnant people, face higher risks of parvovirus-related complications. Here’s what you need to know to protect yourself.

How common is parvovirus?

Cases of human parvovirus B19 are increasing among people of all ages, from less than 3% in 2022–2024 to 10% in June 2024. 

According to the CDC, the largest increase occurred in children ages 5–9 years, from 15% in 2022–2024 to 40% in June 2024.

Parvovirus was also detected in plasma donors 19.9% of plasma donors in June, up from 1.5% in 2023. 

While the Food and Drug Administration (FDA) is required to screen donated plasma for parvovirus B19, transmission through plasma transfusions is rare in the U.S., the CDC notes.

Why is it called the ‘slapped cheek’ disease?

Parvovirus (Erythema infectiosum) is transmitted through respiratory droplets and may cause a distinct, red, splotchy rash on the cheeks or other parts of the body.

Also known as “fifth disease,” parvovirus was once listed as fifth among the six common rash-related illnesses in children: measles, rubella, chicken pox, roseola, and Duke’s disease.

According to the CDC, about half of parvovirus infections occur from household exposure, with 20–50% of infections occurring at school or child care settings. 

Parvovirus is considered a seasonal disease, but unlike other seasonal respiratory viruses, such as the flu, it does not occur regularly or yearly. 

Because parvovirus transmission is so common among children, around half of adults have antibodies from prior infection by their 20s, with over 70% having antibodies by the time they reach 40 years of age, the CDC notes.

In many cases, people with parvovirus infection are asymptomatic. Symptoms are generally mild and should resolve within a week. These include:

• rash
• fever
• anemia
• muscle or joint pain
• swelling
• diarrhea
• malaise 

Still, immunocompromised people and adults with certain health conditions may face higher risks of more severe illness.

Pregnant people at high risk for complications

Pregnant people are considered at high risk for serious complications from parvovirus. 

The virus can cross the placenta and infect a developing fetus, which may cause complications such as fetal anemia, abnormal fluid buildup, or fetal loss.

“The major unfortunate aspect of this virus is, if it infects susceptible persons who are pregnant, it can have an adverse effect on them and the fetus that they’re carrying — it can lead to miscarriage,” said William Schaffner, MD, professor of preventive medicine and infectious diseases in the Department of Health Policy at Vanderbilt University Medical Center in Nashville.

“If the fetus survives, the virus can get through the placenta into the baby and cause anemia and liver disease. As you can imagine, that causes a great deal of concern on the part of the parents,” Schaffner told Healthline.

Schaffner said because there is no vaccine against parvovirus, it’s important for healthcare professionals like OB-GYNs to be aware of the current surge in cases.

According to the CDC, most cases of fetal parvovirus infection resolve without adverse outcomes. Still, there’s a 5–10% risk of an adverse fetal outcome. This risk is highest when infection occurs during weeks 9–20 of pregnancy.

For instance, a pregnant woman almost lost her baby at 18 weeks from parvovirus-related anemia, NBC recently reported.

“If people become ill, we can provide them supportive care and reassurance and insights into what is likely to happen,” Schaffner said.

Walsh noted that higher-risk populations “should contact their provider if they believe they have been exposed or suspect they have Parvovirus B-19 to discuss potential testing and management.”

Immunocompromised people are also at risk

In people who are severely immunocompromised, the CDC warns that parvovirus B19 can cause chronic or transient aplastic anemia, which can be life threatening.

Health conditions or statuses that put people most at risk for serious complications from parvovirus include:

• leukemia or other cancers
• chemotherapy
• organ transplant
• HIV 
• chronic hemolytic disorders (i.e., sickle cell disease, thalassemia, hereditary spherocytosis)

Aplastic anemia is usually treated with red blood cell transfusions and intravenous immunoglobulin.

Why isn’t there a vaccine for parvovirus?

Vaccines against other common respiratory illnesses like the flu or COVID-19 do not offer immunity against parvovirus B19.

With parvovirus outbreaks being as unpredictable as they are, why haven’t researchers developed a vaccine?

According to Schaffner, it is likely because parvovirus is not considered a deadly disease. 

He explained that some preliminary research has been done into developing a parvovirus vaccine, but further development may have slowed due to a lack of public awareness about the virus and ongoing vaccine hesitancy. 

“We are in the midst of a great period of vaccine reluctance, hesitancy, and skepticism, and so introducing a vaccine against some weird virus that nobody’s ever heard of probably wouldn’t go over very well,” Schaffner said. 

Increased awareness, further evaluation, and general acceptance of a parvovirus vaccine could lead to additional studies and clinical trials that could reduce the frequency and impact of parvovirus outbreaks, he noted.

Takeaway

The human parvovirus B19, also known as “fifth disease” or “slapped-cheek disease,” is circulating in the U.S.

The CDC received reports of a surge in parvovirus cases, most notably in children, which usually presents as a red rash on the face or other parts of the body.

Most cases of parvovirus are mild, but pregnant people and immunocompromised people face higher risks of serious complications.

• Cottage cheese is gaining traction on social media, with users touting its protein content and abilities to help people feel fuller longer and lose weight.
• Registered dietitians say cottage cheese can be a regular part of a nutritious diet, but some health claims need nuance.
• They also shared some suggestions for healthy ways to dig into cottage cheese.

Some TikTok trends — like luxury handbags, color analysis, and makeup products needed to achieve a bronzed “latte makeup” look — come with a side of sticker shock even with a discount (courtesy of an influencer affiliate).

However, the platform has a favorite snack that’s accessible — as in, under $10 and available at most big-box grocery stores: cottage cheese.

Numerous videos involving this dairy food have hundreds of thousands and even millions of views.

However, TikTok doesn’t exactly have the best track record for providing trustworthy diet and nutrition information.

Yet, some of the claims about cottage cheese trending on the platform start with at least a kernel—or curd—of truth.

Healthline asked dietitians to help separate fact from fiction, and they shared the following seven ways TikTok’s favorite dairy food can boost your health.

Cottage cheese improves gut health

The probiotic content of Greek yogurt has made it a favored food for gut health. However, what about cottage cheese? Experts say it depends on the type you choose.

“Some cottage cheese is cultured — meaning it contains the beneficial bug known as probiotics — not all brands or varieties of cottage cheese are,” says Cara Harbstreet, MS RD LD of Street Smart Nutrition. “Compared to other fermented forms of dairy, such as Greek yogurt or kefir, it’s much less likely to contribute a significant number of CFUs, or colony forming units, that’s typically needed for clinical significance. In everyday terms, you could get some probiotics from cottage cheese, but probably not enough.”

Maddie Pasquariello, MS, RDN, a registered dietitian, agrees and added that some cultures found in cottage cheese that may contribute to a person’s gut health include: 

• Lactococcus Lactis
• Lactobacillus Acidophilus 
• Bifidus cultures

Further digging into the comparison between Greek yogurt and cottage cheese, Pasquariello says that low fat cottage cheeses often contain more calories and protein than their low fat Greek yogurt counterparts. However, the differences are typically negligible.

“Enjoy whichever you prefer best,” Pasquariello says. “If dairy is part of your diet — this isn’t a difference that will make a huge impact on your health either way.”

Pasquariello says the sodium content in cottage cheese is less negligible, but it is often significantly higher than that of Greek yogurt. She recommends being mindful of sodium intake if you consume cottage cheese multiple times daily or weekly.

She also says some people may not tolerate some of the additives, like certain gums, in cottage cheese.

Finally, Pasquariello and Harbstreet added another caveat (that is also true of Greek yogurt): Not everyone tolerates dairy products. For some, consuming cottage cheese can irritate the stomach and digestive system.

“Cottage cheese is not a lactose-free food unless specifically stated on the label, so if you struggle with symptoms of lactose malabsorption, proceed with caution to avoid uncomfortable GI symptoms,” Harbstreet says.

Cottage cheese improves immune health

Cottage cheese may not be high in Vitamin C (a vitamin often touted for its immune system benefits), but some TikTok users claim it has components that could contribute to immune health.

Harbstreet says this claim is “potentially” true.

“It probably comes down to the protein — you’ll notice a pattern here,” Harbstreet says. 

A 2022 review of nutrition’s effect on the immune system pointed to data indicating that protein intake could assist with immune health.

“The immune system relies on many important proteins to function well, and these proteins are synthesized — or built — from individual amino acids that we source from foods in our diet,” Harbstreet says. “Cottage cheese can supply this, as well as other nutrients to support your immune system.” 

Harbstreet says these other nutrients include:

• Vitamin B12
• Vitamin B6
• Small amounts of zinc and choline.

One way to increase the vitamin density of a cottage cheese snack? Add some ingredients.

“When using cottage cheese for a snack with some fruits or vegetables, you provide your body with even more nutrients and antioxidants that promote healthy immune systems,” says Razan Hallak, MS, RDN, LD, of The Ohio State University Wexner Medical Center.

Still, Pasquariello says this claim needs nuance, too.

“If you’re really focusing on immunity, one of the best things you can do is consume more plant-based foods in the form of prebiotics,” she says. ”Prebiotics feed your beneficial gut bacteria and encourage them to thrive so they can, in turn, get rid of the bad stuff.”

Prebiotic sources include:

• Grains
• Vegetables like asparagus and cabbage
• Beans
• Fruits, such as grapefruit, peaches, and bananas

Cottage cheese builds muscle

Hallak explains that protein — which cottage cheese has — plays a critical role in building and maintaining muscle. The 2020-2025 Dietary Guidelines for Americans suggest that most healthy adults consume 10-35% of their daily calories from protein. Others may require more, and cottage cheese can help.

“Athletes and active adults can benefit from eating above the current [recommended daily amount] for protein, which is 0.8 grams per kilogram of body weight,” Harbstreet says. “A half-cup serving of cottage cheese provides 11-plus grams of protein, which can make it easier to hit your intake goals each day. However, don’t bank on it being the answer if you’re not also training and resting.”

However, one caveat Harbstreet says to consider is that protein content varies by the brand, with some reporting 12-14 grams of protein per half-cup serving. So, it’s important to check the nutrition label. 

The American Heart Association also suggests adding moderate to high intensity muscle-strengthening activity, such as resistance or weight training, to your routine each week to improve muscle strength.

Cottage cheese helps with weight loss

It can, but it’s not a miracle food (no food is).

“The thing that ultimately determines weight loss is being in a calorie deficit, so cottage cheese on its own can’t achieve that,” Pasquariello says. “Someone could be eating above their ‘maintenance’ calories and exceed what they’re burning each day, and whether or not cottage cheese is a part of their diet won’t matter.”

However, once again, protein could make this reported benefit accurate for some people.

“Eating a diet that’s higher in protein can help some people improve satiation levels and prevent over-eating, which can then help them better manage their caloric intake and thus their weight,” Pasquariello says. “So, in a sort of roundabout way, consuming more cottage cheese could be beneficial for those hoping to lose weight, as long as they’re not simply tacking it onto their existing diet for the sake of doing so.”

Research from 2020 suggested that high protein diets could assist with weight loss and prevent obesity and obesity-related diseases, but the authors said studies lasting more than 12 months are needed. 

Importantly, Pasquariello says getting protein from other sources is possible if cottage cheese isn’t a food you enjoy. If you do like cottage cheese, the type you choose also matters, as well as what you eat with it.

For example, TikTok’s viral “cottage cheese and mustard diet,” which involves consuming mustard, cottage cheese, raw veggies, and sausage, was previously panned by dietitians for its high sodium content and potential to promote disordered eating.

“Many dairy products, especially those that are full-fat, can hinder someone hoping to lose weight by adding unnecessary calories,” Pasquariello says.

Cottage cheese can help you feel fuller for longer

“The sensation of fullness is subjective, but it stands to reason that the high protein content of cottage cheese could contribute to feeling fuller, longer, compared to meals or snacks that don’t include adequate protein,” Harbstreet says.

Using cottage cheese as a piece — or base — for a balanced meal and snack can further increase feelings of satiety.

“Adding cottage cheese to a breakfast rich in carbs and fiber is a good way to balance out your plate and keep you full longer than if you just had carbs on their own,” Pasquariello says. “If you consider something like a piece of toast and an apple versus a piece of toast, an apple, and a bowl of cottage cheese, you’re likely to stay full for longer with the latter meal.”

Cottage cheese lowers the risk of Type 2 diabetes

Experts say there’s some truth to this claim, but the type of cottage cheese matters.

“Plain cottage cheese helps in managing blood sugar since it is high in protein and low in carbohydrates,” Hallak says. “The high protein content allows blood sugar to stabilize, preventing spikes or drops. However, flavored cottage cheese with added fruits will have extra carbohydrates that may affect blood sugar negatively. Therefore, choosing a plain option and adding your fresh fruits on it would be ideal for your health.”

Also, dairy products have carbohydrates, something people who are at risk for or living with type 2 diabetes are generally advised to consume in moderation.

A 2019 systematic review indicated a link between total dairy product consumption and lower type 2 diabetes odds, particularly for yogurt and low fat dairy consumption. 

However, some TikTok-favored recipes, like cottage cheese cookie dough, may not live up to the health hype.

Harbtreet says influencers often frame the recipes as a higher protein, lower-sugar cookie dough recipe that can satisfy your sweet tooth. 

“Do your due diligence because many of these recipes still feature maple syrup, honey, or other forms of sweeteners — natural or artificial,” Harbstreet says.

One more important note: “Check in with yourself to see if you genuinely enjoy the sensory differences between cottage cheese cookie dough and the real thing,” Harbstreet says. “It’s perfectly fine to skip this and source your dietary protein from more savory foods instead.”

Cottage cheese improves bone health

The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that calcium can play an important role in bone health, and cottage cheese has it. 

“In general, the consensus seems to be that consuming dairy products, including cottage cheese, could potentially improve bone health and/or prevent fractures in aging populations,” Harbstreet says.

However, it won’t fulfill your daily needs, which depend on age and sex.

“A half-cup serving of cottage cheese provides less than 10% of daily calcium needs, but that can still be an improvement for people concerned about bone health,’ Harbstreet says. 

However,  calcium isn’t the be-all, end-all nutrient for bone health. Harbstreet says cottage cheese also has other essential nutrients for the bones, including:

• Vitamin D
• Potassium
• Phosphorus

If cottage cheese — or dairy in general — isn’t for you, Pasquariello says other calcium-fortified, non-dairy choices include:

• Firm tofu
• Spinach
• Black-eyed peas
• Squash
• Shellfish

Simple ways to enjoy more cottage cheese in your diet

Health experts say there are many simple ways you can enjoy cottage cheese as a healthy snack besides simply eating it plain.

Hallak suggests the following tips to dress up a serving of cottage cheese in a healthy way: 

• With pineapple and chia seeds 
• Egg bites (Mix cottage cheese with eggs and veggies)
• On toast with some veggies (cucumber, tomatoes)
• Added to lasagna with ricotta cheese

And Pasquariello adds that she recommends cottage cheese:

• On sourdough with a drizzle of honey and banana or fresh berries, pumpkin seeds, and cinnamon
• In a dip. For instance, use feta to make a whipped feta and cottage cheese spread. (Bonus: “Add some fresh herbs, lemon zest, and fresh black pepper while blending, and top with pine nuts and a drizzle of olive oil,” Pasquariello says.)
• Swapped for Greek yogurt in the morning (or do half cottage cheese, half Greek yogurt)
• Dolloped in tomato sauce as a swap for full-fat ricotta  

Takeaway

Cottage cheese is easily accessible at grocery stores, and it’s having a moment on social media, where users are touting its high protein content, weight loss benefits, and ability to support gut and immune health.

Dietitians say that cottage cheese can serve up these benefits, but that nuance is required.

The type of cottage cheese and how it’s consumed as part of an overall diet matters. For instance, look for cultured cottage cheese if you’re interested in gut health, and opt for low or no-fat versions without sugar added if you’re working with a doctor to lose weight or reduce your type 2 diabetes risk.

Cottage cheese is versatile and can be added to dips or soups, mixed with fruits and veggies, or enjoyed on its own. 

This blog post has essential tips and advice if you’re thinking of dipping your feet into the cool water of Britain’s beaches, lakes and rivers. Read our tips on reducing your risk of becoming ill after open water swimming.

• A new study found that light to moderate drinking is associated with increased cancer- and disease-related mortality in older adults.
• The findings corroborate mounting evidence showing the harmful effects of alcohol consumption, even for moderate drinkers.
• Public perception around alcohol is shifting, especially for young people, as more people choose to limit their consumption or avoid it altogether to preserve their health.

Everything in moderation — but with caveats. 

As more research confirms the negative health effects of alcohol consumption, even in moderate amounts, long-held beliefs about the purported health benefits of the occasional drink or two are shifting.

A large new study published August 12 in JAMA Network Open found that moderate-level alcohol consumption had no benefit for older adults but raised disease-related mortality risk instead.

The findings are based on health records of more than 135,000 adults ages 60 and older in the United Kingdom with health-related or socioeconomic risk factors.

During initial interviews, participants were asked detailed questions about their alcohol use between 2006 and 2010. Using data from the UK Biobank, researchers found increases in cancer-related and all-cause mortality in low-, moderate-, and high-risk drinkers. 

No associations for moderate drinkers without socioeconomic or health-related risk factors were found. However, low risk drinking was still associated with a higher risk of cancer mortality in this group, while moderate drinking continued to show greater chances of death from cancer and other causes. 

Meanwhile, a new Gallup poll shows young people in the United States increasingly view alcohol as unhealthy.

“There is a pervasive myth that low or moderate alcohol consumption improves health outcomes,” David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told Healthline. Cutler was not involved in the study.

“Nothing could be farther from the truth. The fact is that population-wide studies demonstrate that any alcohol consumption can have a negative health impact. So, it is difficult to argue with the general conclusion that alcohol consumption may be dangerous to your health,” Cutler said.

Moderate drinking raises disease-related death risk

This new research highlights what many health experts have long suspected about moderate drinking, despite other studies that may have shown the inverse. 

An older study published in 2000 suggests “significant” reductions in cardiovascular mortality risk from drinking red wine. More recently, a 2020 research review highlighted the health benefits of light and moderate alcohol consumption, including reduced cardiovascular disease and type 2 diabetes. 

Current guidelines for moderate drinking continue to suggest up to 14 grams or 1 drink per day for females and up to 28 grams or 2 drinks per day for males on days when alcohol is consumed. 

In the JAMA study, researchers defined moderate drinking as 20–40 grams of alcohol per day for males and 10–20 grams of alcohol per day for females. This range extends beyond the threshold for current moderate drinking guidelines.

The researchers reported the lowest alcohol-related mortality risks among individuals who consumed no more than 10 grams of alcohol daily (less than 1 standard drink), which became more evident in those with higher socioeconomic status.

“The big picture of the health risks of alcohol should not be ignored,” Cutler said. “Cancer mortality was increased in even the lowest risk drinkers. And if health-related and socioeconomic factors were also present these risks were even greater. So, while some people may find excuses in light alcohol consumption because they lack risk factors for poor outcomes, moderate and heavy drinkers have no such safe haven.”

Daniel Landau, MD, board certified oncologist, medical director of virtual hematology at the Medical University of South Carolina, and contributor for the Mesothelioma Center, told Healthline that alcohol may have been exceptionally harmful to the older adults included in the study because they already had other health issues.

“People who are over the age of 60 often have other comorbidities such as diabetes or heart disease and are already at higher risks of developing cancers,” said Landau, who was not involved in the study. “Adding alcohol on top of these risks seemed to exacerbate these other medical conditions and possibly promote the risk of cancer development.”

Socioeconomic status linked to higher death risk from alcohol

Socioeconomic status was also an important factor researchers used to calculate alcohol-related disease risk. 

Participants in this study were also mostly white, which means the findings do not account for alcohol’s effects on other racial demographics.

Of those who were classified as having light alcohol consumption, preferred wine, and drank only with meals, no negative health outcomes were reported. 

“The theory is that many of these patients were typically of a higher socioeconomic status [and] had more access to care and less comorbidities,” Landau said. “With potentially having a lower rate of diabetes or other medical conditions, the alcohol may not have had the full detrimental effect it did on the rest of the population.”

More young people are avoiding alcohol

A new Gallup poll published on August 13 revealed nearly half (45%) of Americans believe that moderate alcohol consumption may be harmful to health. 

This is a 6 percentage point increase from last year and a 17 percentage point increase from 2018, marking an all-time high for this survey over the past 20 years.

The shifting opinion about alcohol becomes more pronounced among young people.

Around 65% of adults ages 18 to 34 say alcohol negatively affects health. Indeed, there is a growing “sober curious” movement among Gen Zers.

Still, 37% of respondents ages 35 to 54 and 39% of those 55 and older agree that alcohol may cause harm.

Only 8% of people believe that alcohol may have a positive effect, which Gallup notes is the lowest on record.

“The history of alcohol consumption in our society has always been ambivalent about whether this substance is a tonic or a toxin,” Cutler said. “The evidence shows that alcohol, in any amount, can be harmful. Prudent people should give serious thought to whether any alcohol consumption is in the best interest of their overall health.”

Why is alcohol unhealthy?

Exposure to ethanol and formaldehyde is harmful to human health. Alcohol beverages contain these components in varying amounts.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), when alcohol is metabolized by the body, most of the ethanol consumed is broken down by the liver and transformed into a toxic compound called acetaldehyde, a known carcinogen that may lead to DNA damage.

While this acetaldehyde reaction is usually short-lived before it’s broken down into acetate, it may still lead to significant damage, particularly in the liver, where the majority of alcohol metabolism occurs.

Other studies have examined the harmful effects of formaldehyde in many alcoholic beverages, Landau noted.

A 2011 study, for instance, detected toxic formaldehyde in 132 of 508 alcohol beverage samples, which included beer, wine, spirits, and other sources of alcohol.

“The conversion of alcohol to formaldehyde is one of the prevailing theories as to why alcohol is detrimental to our organs, especially our liver,” Landau said. “It is very toxic, and excessive amounts of it are incredibly dangerous.”

Should you stop drinking alcohol?

The shift in public perception about alcohol and mounting evidence showing its potential harm has left many people wondering whether to limit their alcohol intake or avoid it entirely.

In 2023, the World Health Organization (WHO) declared that no amount of alcohol is safe.

The U.S. Dietary Guidelines for Americans, 2020-2025 acknowledges the emerging evidence showing that drinking within the current recommendations may raise the risk of death from all causes, including cancer and heart disease, and advises caution. 

However, a silver lining in the JAMA study suggests that having a drink only with meals could help lower the associated mortality risks.

“I remain a believer in ‘everything in moderation,’” Landau said. “However, people have their own theories on what moderation looks like. I generally advise my patients that having a drink with dinner on a weekend is acceptable, but once we start incorporating daily drinking, that starts to become more excessive.”

Takeaway

Public perception about alcohol is shifting as growing evidence shows the potential harm it may cause to human health. 

A new study found that even moderate alcohol consumption had negative health outcomes for older adults of lower socioeconomic status. 

While that risk was smaller for people of high socioeconomic status or those who only drank during meals, moderate drinking should still be approached with caution.

• The majority of prescriptions in the United States for GLP-1 drug semaglutide were paid with commercial insurance.
• Semaglutide is the active ingredient in anti-diabetes drugs Ozempic and Rybelsus, and the weight loss drug Wegovy.
• Smaller numbers of people paid for GLP-1 prescriptions with Medicaid and Medicare, and even fewer by cash.

A new study shows that commercial health insurance paid for the majority of prescriptions in the United States for the anti-diabetes drugs Ozempic and Rybelsus and the anti-obesity drug Wegovy. This trend was especially true for Wegovy.

In contrast, much smaller numbers of prescriptions for these drugs were filled using Medicare Part D or Medicaid, with a tiny fraction of people paying with cash.

“Despite the disproportionate burden of obesity in Medicaid and Medicare Part D populations and recent increases in public spending on weight-loss medications, most Wegovy fills were for the commercially insured,” wrote study author Dima M. Qato, PharmD, MPH, PhD, director for the Program on Medicines and Public Health at the USC School of Pharmacy, and her colleagues.

The study was published August 2 in JAMA Health Forum.

Commercial insurance is most commonly used to cover GLP-1 prescriptions

In the study, researchers examined data from IQVIA’s National Prescription Audit PayerTrak. This system covers 92% of prescriptions filled and dispensed at retail pharmacies in the United States.

They looked specifically at prescriptions for semaglutide. This drug is the active ingredient in anti-diabetes medications Ozempic and Rybelsus, and anti-obesity drug Wegovy.

They also examined the type of payment used for the prescriptions — commercial health insurance, Medicaid, Medicare Part D, or cash.

Researchers found that between January 2021 and December 2023, the number of prescriptions filled for semaglutide increased by over 442% (from 471 ,876 to 2, 555 ,308). Of these, over 70% were for Ozempic.

During this period, semaglutide prescriptions increased for all types of payment. However, most of the prescriptions were filled using commercial insurance, particularly for Wegovy.

In 2023, commercial insurance accounted for 61.4% of prescriptions filled for Ozempic, 89.5% of Wegovy prescriptions, and 58.1% of Rybelsus prescriptions.

In contrast, Medicare Part D accounted for only 28.5% of prescriptions filled for Ozempic, 32.9% of Rybelsus prescriptions, and 1.2% of Wegovy prescriptions.

Medicaid accounted for less than 10% of prescriptions filled for all three drug brands in 2023.

A small number of people paid cash for Ozempic and Rybelsus, less than 1% of all prescriptions each.

A larger percentage paid cash for Wegovy — 12.7% of prescriptions in 2021, 2.6% in 2022 and 1.2% in 2023.

This trend may represent increased insurance coverage of this medication over time.

What the new study reveals about GLP-1 medication coverage trends

Robert Klitzman, MD, professor of psychiatry and director of the Master of Science in Bioethics program at Columbia University, said that the results of the new study are important, but they don’t give us the whole picture. Specifically, why these prescription trends are happening. 

For example, are people with Medicare and Medicaid less comfortable asking their doctor to prescribe one of these drugs for weight loss? And how many people stop taking the drug after a few months, and does it vary by the type of insurance?

“There’s room for more research here to find out why there are differences in the number of people on Medicare, Medicaid, and private insurance taking these medications,” said Klitzman.

However, he pointed out that in 2022, 54.5% of Americans had commercial insurance, 18.8% had Medicaid and 18.7% had Medicare, according to the US Census.

“So the distribution of prescriptions found in the JAMA Health Forum article is not as alarming as one might initially think,” Klitzman, author of Doctor, Will You Pray for Me?: Medicine, Chaplains, and Healing the Whole Person, told Healthline.

Also, he said the fact that patients on Medicare are more likely than others to be on Ozempic or Rybelsus is not surprising “since these people are older and hence more likely to have heart disease or stroke, which would make them eligible for these medications.”

A glimpse into how the U.S. is tackling the obesity epidemic

Overall, Klitzman thinks this study only provides a glimpse into how well the United States is handling the obesity epidemic.

More than two in five American adults are living with obesity, according to the Centers for Disease Control and Prevention. Rates are higher among Black adults and adults with lower levels of education.

Newer GLP-1 drugs have been shown to be very effective at helping people lose weight and keep the weight off — as long as they keep taking the medication — but Klitzman thinks this is only part of the solution.

“You certainly want to have a good treatment [such as GLP-1s] available to everyone,” he said, “but I wouldn’t want people to think, ‘all we need is for everyone to take a medication and we’ll all be treated.’”

Eating healthy, staying physically active and learning to  deal with stress can also help people lose weight, while offering other benefits.

“Exercise helps you not just lose weight, but it helps with your cognitive thinking and it helps with your heart,” said Klitzman.

However, Lydia C. Alexander, MD, president of the Obesity Medicine Association and chief medical officer of Enara Health, cautions against thinking that people should skip the GLP-1 drugs and only try to lose weight with diet and exercise, something that fuels the stigma surrounding obesity.

People with obesity sometimes get judged for “not taking good care of themselves” or “not trying as hard as they can to maintain a healthy weight,” she told Healthline.

“This thinking is very common, even among primary care physicians,” she added.

While nutrition, physical activity and lifestyle changes are essential to treating obesity, “obesity is a disease,” Alexander said, “and just like any other disease, a medication may also be needed.”

“Because obesity is a metabolic dysfunction, where the body is no longer getting the correct signals to maintain a healthy weight,” she said.

GLP-1 coverage varies across healthcare plans

One limitation of the new study is researchers did not have information on why people were prescribed semaglutide, which may have affected prescription rates.

Ozempic was initially approved for the treatment of type 2 diabetes, and later to reduce the risk of serious heart problems in adults with cardiovascular disease who living with overweight or obesity.

This drug is also sometimes prescribed off-label to help people lose weight, something that was especially common before Wegovy was approved in June 2021 by the Food and Drug Administration as an anti-obesity drug.

The extent of coverage for semaglutide and other GLP-1 medications depends upon the type of health insurance — and the condition it is prescribed to treat.

“Medicare Part D will cover GLP-1 medications when they are used to treat type 2 diabetes or people with pre-existing cardiovascular disease who need to lose weight,” said Alexander.

But “there’s an actual clause that prohibits treating obesity [alone] as part of Medicare,” she said. As a result, the Medicare population does not have GLP-1s readily available to them for all uses.

With Medicaid, GLP-1 coverage varies from state to state since these are state-run programs.

“For example, in Arizona, it’s relatively more difficult to have Medicaid cover anti-obesity medications,” said Alexander, “but in California, these drugs are included as part of Medicaid coverage, and many times without prior authorization needed.”

Among commercial insurance plans, coverage also varies. 

However, a recent survey found that one-third of employer health plans said they are covering GLP-1 drugs for both diabetes and weight loss. This is an increase from around one-quarter in 2023.

In addition, over half of employer health plans cover GLP-1 drugs only as a treatment for type 2 diabetes, the report from the International Foundation of Employee Benefit Plans found.

However, of employers with GLP-1 coverage only for diabetes, almost one-fifth said they are considering offering the drugs for weight loss.

How to find out if your insurance covers GLP-1 drugs like Ozempic

To find out if your health insurance plan covers GLP-1s for weight loss, check the plan’s formulary and summary of benefits and coverage (SBC). This information should be available on your insurance company’s website.

Ro, a direct-to-patient healthcare company, also recently launched the GLP-1 Insurance Coverage Checker, a free tool to help people find out if their insurance covers treatment with GLP-1 medications.

The company said in a news release that nearly half of its patients have coverage for GLP-1s for weight loss, and most have coverage for more than one medication.

In addition, about two-thirds of patients with coverage paid less than $100 per month, the company said. However, most companies require people to get prior authorization before accessing the drugs.

The list price for Wegovy is almost $1,350 for a month’s supply. This is the amount people without insurance coverage would pay before any discounts or rebates. Drugmaker Novo Nordisk also offers a savings card that allows people to pay cash for a one-month supply for $650.

Takeaway

Researchers found that between 2021 and 2023, the majority of prescriptions in the United States for anti-diabetes drugs Ozempic and Rybelsus, as well as the anti-obesity drug Wegovy, were paid with commercial health insurance. The trend was especially strong for Wegovy.

Smaller numbers of people paid for prescriptions with Medicare or Medicaid, which may reflect fewer Americans having these health plans. However, Medicare does not offer coverage for Wegovy, and Medicaid coverage of GLP-1 drugs varies across states.

The study provides a glimpse into how well the country is tackling the obesity epidemic, but experts say more information is needed. For example, why are there differences in prescription rates across insurance, and how many people are prescribed these drugs solely for weight loss?

• A recent study found a connection between the artificial sweetener erythritol and an increased risk of blood clots. 
• After consuming erythritol, participants showed a sharp spike in platelet activity, indicating a greater chance of blood clot formation.
• While the findings align with previous research, further studies are needed to fully understand the potential health risks of erythritol.
• As a precaution, experts advise avoiding erythritol and opting for small amounts of natural sweeteners like 100% stevia or pure maple syrup.

A new study from Cleveland Clinic researchers suggests that consuming a 30-gram serving of erythritol, a popular artificial sweetener, could rapidly raise the risk of blood clots.

The findings were published August 8 in Arteriosclerosis, Thrombosis and Vascular Biology. 

Erythritol is commonly found in diet, low-calorie, and sugar-free food and drink products, particularly those marketed for keto diets. It is often blended with stevia and monk fruit sweeteners to enhance their bulk.

In the study, researchers examined the effects of erythritol or regular sugar on blood platelets, which play a crucial role in blood clotting. They found that typical amounts of erythritol appear to significantly increase platelet activity, raising potential concerns about an elevated risk of blood clots. Sugar did not have this effect on platelets.

Blood clots form within a blood vessel and may travel to the heart, causing a heart attack, or to the brain, potentially resulting in a stroke. A blood clot can also travel to the lungs, leading to a pulmonary embolism.

The findings from this new study echo the research team’s 2023 findings linking erythritol with a higher risk of heart attack and stroke. This concerning data suggests it may be time to reevaluate erythritol’s safety as a food additive.

Popular sweeteners like Truvia and certain Splenda products contain erythritol as a key ingredient.

Healthline reached out to both companies, but Splenda (Heartland Food Products Group) declined to comment on these new findings.

On behalf of Truvia, the Calorie Control Council (CCC), which represents the low- and reduced-calorie food and beverage industry, told Healthline the findings were “misleading.”

“For more than 30 years, global authorities have repeatedly confirmed the safety and efficacy of erythritol and other low and no-calorie sweeteners,” the CCC representative said.

Erythritol linked to blood clots

The new study looked at healthy people with normal kidney function. It involved 20 volunteers, averaging about 30 years old, including both males and females.

After fasting overnight, 10 participants drank water mixed with 30 grams of sugar (glucose), while the other 10 had water with 30 grams of erythritol. Blood samples were taken before they drank and again 30 minutes later.

In those who consumed erythritol, blood levels of erythritol rose dramatically — over 1000 times higher than initial levels. These participants also showed a significant increase in platelet aggregation (clumping) when exposed to certain triggers and an increase in specific markers released from platelets.

There were no changes in platelet reactions after glucose consumption, emphasizing erythritol’s unique effect on platelet function.

Although the study was small and examined the effects of only one dose shortly after consumption, it raises concerns about erythritol’s potential to increase the risk of blood clot formation when consumed in typical daily amounts.

These results follow another recent study by the same researchers, which found that xylitol, another artificial sweetener, may similarly increase blood clotting risk in healthy adults.

This highlights the need for further research into the long-term health effects and cardiovascular safety of sugar alcohols like erythritol and xylitol, especially for those at higher risk of blood clots.

Is erythritol safe?

Erythritol is commonly marketed as a natural and healthy alternative to traditional sugar because it is calorie-free and naturally occurs in small amounts in some fruits and vegetables.

However, erythritol is also commercially manufactured through a fermentation process and used in larger amounts as a food additive than would naturally occur in foods. 

While many sweetener products contain erythritol as a primary ingredient, it is also found in many other processed foods and drinks, including:

• sugar-free gum
• energy bars
• some diet sodas
• protein shakes

The amount of erythritol used in the present study (30 grams) reflects the typical daily amount that people consume from food and drinks based on data from the 2013 to 2014 National Health and Nutrition Examination Survey and FDA calculations from 2001. 

However, given the steady rise in artificial sweetener use, daily intakes of erythritol may have increased since these estimations were made.

Once consumed, erythritol is not digested. It enters the bloodstream through the intestine and is primarily excreted through urine, remaining unchanged.

The body naturally produces small quantities of erythritol, but any extra intake from the diet can build up in the blood, as seen in the current study.

Even though there is growing evidence questioning its safety, the FDA still considers erythritol as “generally recognized as safe (GRAS).” This means that erythritol is deemed safe for the general population to consume in typical daily amounts from food and drink products. 

Should you avoid erythritol?

Erythritol has previously been recommended as a sugar alternative for people with chronic conditions like obesity, diabetes, and heart disease.

While erythritol is widely used and remains classified as GRAS, experts are now urging caution and advising against its use.

“The GRAS designation relies on the assumption that a substance is safe based on existing research and historical use, but this approach may not always account for long-term or cumulative risks,” Thomas M. Holland, MD, a physician-scientist and assistant professor at the RUSH Institute for Healthy Aging, RUSH University, College of Health Sciences, not involved in the study, told Healthline. 

“While the FDA requires safety parameters to be established and data to be publicly accessible, this does not eliminate the need for consumers to stay informed and cautious,” he warned.

Holland suggested that people should “err on the side of caution” regarding artificial sweeteners like erythritol, especially for individuals at risk of cardiovascular issues or with conditions related to an increased risk of blood clots.

Kiran Campbell, a registered dietitian nutritionist at Dietitian Insights, echoed this sentiment, urging the FDA to reconsider erythritol’s safety.

She told Healthline that consumers should avoid erythritol as a precaution until we know more, especially because nearly half the adult population “has some form of heart disease, including stroke, and may be taking antiplatelet medications.”

Campbell also highlighted the World Health Organization’s (WHO) updated 2023 guidelines, which advise against using non-nutritive (zero-calorie) sweeteners for weight loss or chronic disease prevention.

What is a good substitute for erythritol?

Holland emphasized the importance of being cautious with food additives and prioritizing natural, whole foods, as these don’t contain harmful additives and instead offer recognized health benefits.

Both Holland and Campbell also advised that, in small amounts, minimally refined natural sugars and sweeteners could be safer alternatives to artificial sweeteners like erythritol. These include:

• pure grade A honey
• pure maple syrup
• dates
• coconut sugar 
• 100% stevia extract (calorie-free)
• 100% monk fruit extract (calorie-free)

“While a diet low in added sugars is ideal, occasional consumption of natural sugars is likely safer than relying on artificial alternatives, given the current evidence,” Holland said. 

“However, even natural sugars should be consumed sparingly to prevent long-term negative effects, such as metabolic disorders,” he cautioned. 

Takeaway

A new Cleveland Clinic study shows that a 30-gram serving of erythritol, a common artificial sweetener, might significantly raise the risk of blood clots.

The research highlights that even substances considered safe by regulatory bodies could pose potential risks, especially for individuals with existing health issues.

As evidence mounts against erythritol and other artificial sweeteners, experts advise consumers to avoid these products as a precaution and consider choosing natural sugar and sweetener alternatives in moderation.

• Actor Daisy Ridley spoke in an interview about her Graves’ disease diagnosis.
• Graves’ disease is an autoimmune condition that causes excess thyroid hormone.
• Symptoms can include rapid heartbeat, weight loss, and protruding eyes.
• It might be caused by a genetic predisposition combined with environmental triggers.
• Treatment can involve medications, surgery, and lifestyle changes.

“Star Wars” star Daisy Ridley revealed in the August 6, 2024, issue of Women’s Health that she was diagnosed with Graves’ disease in September of 2023.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Graves’ disease is an autoimmune disorder affecting the thyroid, a small gland in the front of the neck often described as being shaped like a butterfly.

Graves’ disease occurs when the immune system begins to attack the thyroid as if it is an outside invader, causing the gland to become overactive. NIDDK explains that this can cause the body’s functions to speed up.

Ridley told the magazine that she first realized that something was not right when she began to experience hot flashes and fatigue after the completion of her movie Magpie, in which she plays a woman involved in a troubled relationship.

“I thought, Well, I’ve just played a really stressful role; presumably that’s why I feel poorly,” she told Women’s Health.

Upon learning of her symptoms — which also included hand tremors, a racing heart, and weight loss — her primary care doctor referred her to an endocrinologist, who diagnosed her as having the autoimmune condition.

Ridley additionally described to the publication how it felt to finally understand why she had felt so bad: “It was funny, I was like, ‘Oh, I just thought I was annoyed at the world,’ but turns out everything is functioning so quickly, you can’t chill out.”

Ridley has also previously spoken about her diagnoses of endometriosis and polycystic ovarian syndrome (PCOS), which research suggests are linked with a higher risk for Graves’ disease.

What are the symptoms of Graves’ disease?

Micheal O. McKinney, MD, a physician with Healthy Outlook, said that Graves’ disease results in the excessive production of thyroid hormone, a condition known as “hyperthyroidism.”

When this occurs, it can have various metabolic and systemic complications, he explained.

Some of the symptoms you might experience, per McKinney, include:

• Unusual or very fast heartbeats
• Weight loss, even if you eat more than you need
• Anxiety and being easily annoyed
• Trembling hands or fingers
• Inability to tolerate heat accompanied by perspiration for no reason
• Protruding eyes (Graves’ ophthalmopathy)
• Fatigue and muscle weakness
• Enlarged thyroid gland, also known as “goiter”

“It’s worth mentioning that these symptoms develop gradually over time, so they may resemble other illnesses,” he added, “thus demanding specific testing for accurate diagnosis.”

How to reduce your risk of Graves’ disease

John Lowe, MD, a physician at Restore Care, explained that the exact causes of Graves’ disease are unknown.

However, certain factors such as genetic predisposition and environmental triggers may contribute to its occurrence, he said.

To minimize your risk, Lowe said, “Relax through practicing yoga, meditation, and physical exercises effectively.”

“Avoid smoking since it increases the risk and severity of Graves’ ophthalmopathy,” he added. Graves’ ophthalmology is a condition in which swelling around the eyes makes them bulge out.

Additionally, you’ll want to be consistent about getting medical checkups of your thyroid health, especially if you have a family history of thyroid conditions, said Lowe.

Treatments for Graves’ disease

Lowe described several medical treatments for Graves’ disease. Among these are:

• Antithyroid Medications. “These drugs reduce the production of thyroid hormones and may then bring their levels back to normal,” he said.
• Radioactive Iodine Therapy. This treatment involves taking radioactive iodine by mouth in order to destroy the overactive cells, per Lowe.
• Beta-Blockers. “Such medications are useful in managing symptoms like fast heartbeats and tremors,” he said, “but they do not address the underlying cause of hyperthyroidism which is associated with them.”
• Surgery. Lowe said that sometimes, if other treatments haven’t worked or are not appropriate for the patient, it may be necessary to perform a thyroidectomy to remove all or part of the gland.
• Lifestyle Adjustments: “Eating healthy foods, regular exercise, and stress management techniques can help to promote overall well-being as well as alleviate some of the symptoms,” he said.

Lowe concluded by noting that Graves’ disease is treatable through both medical intervention and lifestyle changes.

“It is important to diagnose and treat it early enough since any delay may lead to complications as well as affect one’s quality of life significantly,” he said.

Takeaway

“Star Wars” actress Daisy Ridley revealed in a Women’s Health interview that she had been diagnosed with Graves’ disease, an autoimmune thyroid condition that causes an overproduction of thyroid hormone.

It can lead to symptoms of thyroid hormone excess, such as weight loss, rapid heartbeat, and protruding eyes.

The causes of Graves’ disease are unknown, although it may be due to a combination of genetic predisposition and environmental triggers.

However, it can be treated with medications, surgery, and lifestyle adjustments.