The dieting approach that could work better than intermittent fasting
The comprehensive review analysed data from 99 studies involving over 6,500 participants, many of whom had pre-existing health conditions.
Researchers found that both intermittent fasting strategies and continuous energy restriction diets led to overall body weight reduction.
Specifically, alternate-day fasting resulted in an average of 1.29kg more weight loss than continuous energy restriction.
While the weight reduction was considered 'trivial' when compared to time-restricted eating and whole-day fasting, alternate-day fasting was the only intermittent fasting strategy to show a distinct benefit over continuous energy restriction.
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Daily Mail
17 minutes ago
- Daily Mail
Harvard doctor reveals what happens to your FACE if you cut out sugar for just two weeks
A leading doctor has revealed on TikTok what happens to your body just two weeks after cutting out sugar—and the video has quickly struck a chord with viewers. Dr Saurabh Sethi, a Harvard-trained gastroenterologist who posts gut health advice to more than 500,000 followers under the handle @doctorsethimd, told his audience that giving up sugar can have surprisingly rapid effects. 'Your face will likely shift from looking rounder to a more natural shape,' he claimed in the clip, which has already racked up more than 10,000 views. 'Any puffiness or fluid retention around your eyes will also reduce. You will also see a reduction in belly fat as the fat in your liver begins to decrease.' He went on to explain that eliminating sugar can restore a healthier gut microbiome—the trillions of microorganisms that live in the digestive tract and play a key role in breaking down food and absorbing nutrients. 'Lastly, if you have acne or red spots, your skin should improve and look clearer,' he added. The advice echoes recent research. A 2019 study of more than 8,000 students in China found that high-sugar soft drinks 'significantly' increased the risk of acne. Other research has linked excess sugar to liver fat accumulation and inflammation. Dietitians have long highlighted how cutting out sugar—which can trigger drug-like cravings—can boost health, fitness and even performance at work. Dr Samantha Coogan, a lecturer at the University of Nevada, has previously described the effects of quitting the sweet stuff. Withdrawal symptoms such as headaches, stomach aches and bowel changes may last for days or even weeks, but once the body adjusts, she said people often see sharper brain function, fewer sick days and more energy for exercise. According to Dr Coogan, hair, skin and nails also improve, sleep becomes more restful and weight loss is 'inevitable' when high-calorie snacks are eliminated. Cutting sugar further reduces the risk of serious diseases, with excess intake widely linked to type 2 diabetes, heart disease and cancer. 'Sugar is an addictive substance for some people, so it really is necessary to approach it in a similar manner to drug or alcohol detoxification,' she wrote in a recent article. Experts warn that the type most people overconsume are so-called 'free sugars,' found in sweets, chocolate, fizzy drinks and many processed foods. But some naturally occurring sugars also count as 'free sugars' like those in honey, syrups, nectars, unsweetened fruit juices and smoothies. How much 'free sugars' should you consume each day? The NHS says anyone aged 11 or older shouldn't consume more than 30g of added sugar a day. But they warn children and infants should have less. They recommend the following limits per day: Children aged seven to 10 should have no more than 24g of 'free sugars'. Children aged four to six should have no more than 19g of 'free sugars'. Children aged two to three should have no more than 14g of 'free sugars'. Children aged one should have no more than 10g of 'free sugars'. While there is no guideline limit for babies under the age of one, sugars shouldn't be added to foods or drinks given to babies. Meanwhile, sugar that occurs naturally in milk, fruit and vegetables is not counted as 'free sugar,' according to the NHS. To cut down, the health service recommends simple swaps such as replacing fizzy drinks or sugary squash with water. It also warns that even unsweetened fruit juices and smoothies contain high levels of sugar, advising people to limit intake to no more than 150ml a day. For those who take sugar in hot drinks like tea or coffee, the NHS suggests gradually reducing the amount or switching to a sweetener. The advice comes amid a sharp rise in type 2 diabetes cases in the UK, a condition that places immense pressure on the NHS. Earlier this year, government figures estimated that 3.6 million people in England are now living with type 2 diabetes, based on an analysis of diagnosed and undiagnosed cases in each local authority. Helen Kirrane, head of policy and campaigns at the charity Diabetes UK, previously said: 'Without the right treatment, it can lead to dangerously high blood sugar levels and this can cause life-altering diabetes-related complications.'
The Independent
19 minutes ago
- The Independent
FDA's new expert panels are rife with financial conflicts and fringe views
When the Food and Drug Administration needs outside guidance, it normally turns to a trusted source: a large roster of expert advisers who are carefully vetted for their independence, credentials and judgment. But increasingly, the agency isn't calling them. Instead, FDA Commissioner Marty Makary has launched a series of ad hoc 'expert panels' to discuss antidepressants, menopause drugs and other topics with physicians and researchers who often have contrarian views and financial interests in the subjects. Former agency officials worry the meetings are skirting federal rules on conflicts of interests and transparency, while promoting fringe viewpoints that align with those of Health Secretary Robert F. Kennedy Jr. 'These meetings are a chance to advance RFK's pet peeves — talc, antidepressants, fluoride — with people who have been handpicked,' said Dr. Peter Lurie, a former FDA official who is now president of the Center for Science in the Public Interest. 'Nobody would put forward these panels as representing the general scientific opinion on these topics.' A spokesperson for Kennedy did not answer specific questions about the panels, but said they represent an effort to 'apply rigorous, evidence-based standards to ingredient safety and modernize regulatory oversight.' The panels kicked off in May with a meeting on talc, the soft mineral sometimes added to makeup, baby powder and other consumer goods. The meeting echoed thousands of lawsuits alleging talc has contributed to ovarian cancer and other illnesses, and included two experts who testified in those cases. Under FDA regulations, the ingredient is still considered safe when carefully tested for the presence of asbestos. And federally funded studies haven't shown a link to cancer. A July meeting on the safety of antidepressants during pregnancy also featured doctors who have testified in class action lawsuits, alongside other experts who allege the drugs cause autism, birth defects and other conditions — links that are not supported by science. The meeting concluded with all but one of the experts calling for a new boxed warning — the most serious type — about antidepressant risks for mothers and developing babies. A meeting on estrogen-based drugs for menopause took the opposite approach: Experts urged the removal of a long-standing warning. Most of the physicians at that meeting prescribe the hormones or are involved with a pharmaceutical industry campaign opposing the warning label. Nearly 80 researchers sent a letter to the FDA this month objecting to the 'two-hour meeting of hormone proponents' and calling for an official advisory committee meeting. Advisory panels operate under strict rules The FDA has more than 30 panels composed of experts specializing in various drugs, vaccines, food ingredients and other products. Their meetings are subject to strict government transparency rules in terms of scheduling, panel composition and disclosure of any financial conflicts. A comment period open to the public is also required. Additionally, FDA scientists usually publish a detailed memo explaining their position on the topic. The latest FDA meetings haven't included those elements. Former FDA lawyers say the agency could expose itself to legal challenges if it tries to use Makary's informal panels as the basis for regulatory decisions. But that may not be the aim of the meetings. 'They seem more designed as a forum to put a stamp of approval on predetermined opinions,' said Genevieve Kanter, a health policy specialist at the University of Southern California. 'The information in these panels could be used in litigation and presented as coming from experts or representing some intellectual consensus that doesn't exist.' Antidepressants meeting aired unfounded claims Antidepressants have long been a target of Kennedy, an attorney and outspoken critic of pharmaceutical companies. During his confirmation hearings he suggested, without evidence, that the drugs contribute to school shootings. The FDA's recent session cataloged many unsubstantiated theories about the drugs, often based on animal studies, including that they contribute to autism, birth defects and miscarriages. Several participants had served as expert witnesses against drugmakers, including in lawsuits alleging that they cause homicidal behavior. All but one of the other panelists have criticized the drugs in books, articles, interviews or other forums. 'It's never been possible to identify a group of people who do particularly well on antidepressants,' said Dr. Joanna Moncrieff, a British psychiatrist, author and co-founder a group critical of mainstream psychiatric medicine. The American College of Obstetricians and Gynecologists called the panel 'alarmingly unbalanced' and full of 'outlandish and unfounded claims.' Antidepressants carry pregnancy warnings about risks of excess bleeding and lower birth weight for newborns. But psychiatric experts say those risks are far outweighed by the well-documented harms of untreated depression in mothers, which can lead to pregnancy complications, substance abuse and suicide. 'I tell people I'm working with that the best thing they can do for themselves and their baby is to get the treatment that they need,' said Dr. Nancy Byatt of University of Massachusetts ' Chan Medical School. Financial conflicts at menopause meeting FDA has not disclosed how panelists were selected for the meetings. Last month's session on hormone therapies for menopause included doctors who consult for drugmakers or promote the medications in their practices. The views they expressed largely echoed those of Makary, who has argued that current warning labels overstate hormone therapy risks and don't reflect possible benefits for some women, such as reducing heart disease and cognitive decline. 'Hormone replacement therapy for women is basically a modern-day miracle,' Makary told a podcast host last year. But guidance from the FDA and other top federal authorities specifically advises against using the drugs to prevent chronic conditions due to a lack of clear benefit. The drugs are only FDA-approved for specific menopause symptoms, including hot flashes. Discussions around hormone therapy reflect ongoing debate about a landmark study of two different hormone regimens in more than 26,000 postmenopausal women. The research was halted more than 20 years ago because scientists discovered that the risk of serious health problems outweighed the benefits. All estrogen drugs still carry boxed warnings about the higher rates of stroke, blood clots and cognitive problems among women taking the medications. But some doctors — including those at FDA's meeting — say the warnings are exaggerated and should be removed from at least some products, such as low-dose creams typically used for vaginal dryness. Makary raised the possibility of also removing the warning from higher-dose pills, patches and sprays. It's unclear whether the FDA will move ahead with those changes or heed calls for an official advisory meeting — a step that Kennedy's critics say would be in keeping with his pledge for 'radical transparency.' 'If you really wanted to be transparent about these issues you'd put together a balanced panel of experts, who have been carefully screened for conflicts and you'd invite the public in,' Lurie said. 'But that's the antithesis of what's going on in these cases.' ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
The Guardian
20 minutes ago
- The Guardian
US private prison healthcare industry grows despite alleged medical neglect
Early one morning this spring, staff at a Santa Barbara county jail heard screams coming from one of the cells. A 57-year-old inmate was moaning and hyperventilating. She said her 'guts are all twisted up'. Rather than sending her to the ER, medical staff chalked her pain up to opioid withdrawal, since they had taken a prescription opioid away upon her arrival days before, a grand jury investigation later found. They placed the inmate – referred to as CF in the grand jury's report – on mental health observation and gave her Tylenol. Even as the cell floor became covered in vomit, staff ignored her requests to go to the hospital. The documentation that should have been filled out to explain why her request was not honored was never completed. The grand jury determined that CF's stomach had perforated days before her excruciating death in March. Medical staff had taken her inability to walk from her cell to the exam room as 'a refusal of treatment', according to the investigation. Twenty minutes later, CF was discovered 'unresponsive in her cell, slumped over, with lips that had become blue in color'. An autopsy report and investigation concluded that CF would have had a 90% chance of survival if she had received immediate treatment. Instead, medical staff had attempted to revive her with Narcan, which only revives people who are experiencing overdose. Wellpath, one of the nation's leading health providers to prisons and jails, was the contractor responsible for healthcare at Santa Barbara county's Northern Branch Jail, where CF died. The grand jury's report is the latest in over a decade of government investigations into two behemoths in the prison health industry – Wellpath and Corizon – which are both backed by private equity investors. Since 2014, in eight cases involving these two private equity-backed healthcare companies examined by the Guardian, investigators from the Department of Justice, New York City department of investigation, and other local investigators, have found their negligence so severe that it violated inmates' eighth amendment rights protecting them from substantial risk of harm, including preventable death. Staff shortages are often a contributing factor – a 2023-24 Santa Barbara county grand jury investigation into Wellpath-managed jails found that staffing shortages led to delays in care. Despite these issues, the private prison healthcare industry has only continued to grow – it was estimated to be a $9.3bn business in 2022. Both Corizon and Wellpath continued to contract with jails, prisons, immigration and juvenile detention centers around the country until they faced so much liability – both from lawsuits and other complex business issues – that both landed in bankruptcy court over the last two years. The Guardian approached Wellpath and Corizon's new iteration, YesCare, for comment about alleged medical neglect. Wellpath said in a statement that it provides 'safe and effective care' to patients. YesCare did not provide a comment. Both companies were still operating in some form while restructuring in Chapter 11 bankruptcy proceedings, and had reorganization plans confirmed in bankruptcy court this year that allowed them to settle many of their debts and continue their prison contracts. Colleen Grogan, a professor at University of Chicago's school of social work, said the reason for Wellpath and Corizon's continued existence, despite facing scrutiny, is simple: 'These private equity firms have a ton of political power, and prisoners are the most vulnerable. The political power dynamics are about the worst they can be.' Corizon formed in 2011 from a merger between two existing prison healthcare companies. By 2016, Corizon had been sued 660 times for malpractice, including many wrongful death and personal injury suits. During that time, a US Department of Justice investigation into conditions at New York City's Rikers Island found that adolescent inmates at the facility had their constitutional rights violated due to the high risk of violence from Rikers staff and other inmates. Corizon medical staff sometimes failed to report injuries from prison staff use of force, and would avoid calming inmates being forcibly removed from their cells, even though it was part of their job. The investigation also raised concerns about poor quality of mental healthcare Corizon provided at Rikers, which may have violated the federal Americans with Disabilities Act. In 2015, a New York City department of investigation report on the same facility found 'significant breakdowns' by Corizon Health. 'Corizon staff improperly removed inmates from suicide watch or otherwise failed to supervise inmates with serious mental illnesses,' the report said. 'Two of those inmates died while unsupervised.' Corizon lost its contract with Rikers Island in 2015, but it still remained a market leader. Corizon's then CEO claimed at the time that Corizon provided oversight rather than directly employing medical staff. The remarks contradicted the New York City department of investigation's findings. In 2016, an independent medical expert investigated Corizon's performance with the Alabama department of corrections and found that in some cases medical providers employed by the company attempted to manage care 'for which they have no experience', which could result in harm to patients. In a media report at the time, Corizon said that it provided quality care to its patients. In one case, a patient was briefly hospitalized for a groin infection, but returned to the prison quickly. Over the next six months, the expert's report said, the infection spread to his entire right leg, and began to ooze and become discolored. When he returned to the hospital, his doctor recommended a surgical consultation, but Corizon's regional medical director called to have him returned to prison instead, the report said. He died of septic shock. As lawsuits against Corizon piled up, a new market leader emerged when the private equity firm HIG merged together multiple companies to form Wellpath in 2018. During this time, the market was growing, but the number of competitors was shrinking. Erin Fuse Brown, a professor of health services at Brown University, said private equity is known for buying up competitors. Private equity firms, she said, were able to grow their market shares in prison health because they have deep pockets that allow them to handle the risk that comes with an industry so prone to legal liability – and to provide a variety of services all at once so prisons and jails do not need to look for additional contracts. 'They basically are saying, 'we can provide this whole thing, soup to nuts',' Fuse Brown said, adding that once they land those contracts, private equity firms will aggressively cut costs to further edge out competitors and maximize profits. Those cost cutting measures tie directly to alleged civil rights violations, according to Caroline Cohn, a staff attorney at the National Consumer Law Center. Multiple contracts from Wellpath and Corizon, as well as Wellpath's own promotional materials, show both companies charged facilities per inmate per day. 'When private healthcare companies receive a fixed fee per person, their financial incentive is to spend less on the care they're providing to incarcerated patients,' Cohn explained. 'The impact on quality of care is predictable, and there are hundreds of lawsuits, complaints, and news stories documenting just how horrific this care often is.' As Wellpath became the dominant player, accusations of constitutional violations stacked up against them as well. Department of Justice investigations into the Massachusetts department of corrections in 2020 and the San Luis Obispo county jail in 2021 both found that Wellpath staff violated inmates' rights by failing to adequately monitor inmates facing mental health crises – including those who were self harming – and by in some case placing them in solitary confinement for prolonged periods rather than offering treatment. In 2019, according to the federal investigation, one Massachusetts inmate died by suicide after hanging himself in an isolation cell. It was his seventh attempt in the prison. After one attempt, 'he made statements about sacrificing himself to prove how bad the system is.' Before he died, the investigation found, mental health staff employed by Wellpath 'took his word that he would not harm himself and granted his request to leave mental health watch without addressing his risk factors'. In 2023 an order from San Jose, California's district court required that records pertaining to Wellpath's performance in Monterey county jails be unsealed – these reports show multiple preventable deaths, and at least one lost limb. 'Prison health is the perfect market for private equity because they are serving a literally captive audience,' said Brendan Ballou, former special counsel to the Department of Justice's anti-trust division and author of the book, Plunder: Private Equity's Plan to Pillage America. He said 'tough-on-crime' legislation 'had made it harder for prisoners to have their rights vindicated'. For example, the 1996 Prison Litigation Reform Act requires incarcerated people pay filing fees if they want to initiate a lawsuit, and to 'exhaust all remedies' available to them in prison before seeking justice in civil court, even if those remedies are difficult to access. Supreme court rulings in 2006 and 2020 added additional hurdles for inmates seeking justice. And private equity firms have another layer of protection from liability, according to Ballou. Past court rulings make it difficult to hold private contractors liable for wrongdoing in prisons, and 'corporate veil piercing law', which protects private equity firms from being held responsible for the actions of their investments, makes it very difficult for victims to go after the firms behind the prison health companies that allegedly hurt them. So private equity firms know that even if their prison health investments face a lot of liability, they can remain relatively untouched. When federal investigations implicated Wellpath in constitutional violations, they would center their regulatory firepower on Wellpath's government clients and not Wellpath itself. Even then, the sanctions were not severe, mostly coming in the form of recommendations for improvements, including better training for mental health staff. Department of Justice settlements with the Massachusetts department of correction and San Luis Obispo county did not include any fines or punishment for Wellpath, although the company did eventually lose its contract with the Massachusetts department of correction. Inmates and their loved ones who suffered from Wellpath's alleged negligence did not receive any compensation under these settlements. Both the Massachusetts department of correction and San Luis Obispo county denied any wrongdoing. A Wellpath spokesperson said in a statement that 'Wellpath is committed to our patients and the communities we serve. Our company and our thousands of frontline caregivers are dedicated to providing safe and effective care to our patients.' The controversies may have started to affect the companies' bottom line – both filed for bankruptcy in the last two years. Corizon's 2023 bankruptcy was controversial – they attempted a maneuver known as a 'Texas two-step', in which a company splits the company in two, putting its assets into one company and its liabilities in another, which files for bankruptcy. A group of senators, led by Elizabeth Warren wrote a letter accusing the company of using the bankruptcy court to 'evade liability'. In a response defending the bankruptcy, company leadership claimed Corizon was so loaded with liability in 2020 that investors sold it to Flacks Group, a private equity firm that specializes in distressed assets, for around $10m – the same amount the company paid out in a wrongful death suit the previous year, and a pittance for a company that had recently reported $800m in revenue. Both Wellpath and YesCare, the surviving half of Corizon's split, had Chapter 11 reorganization plans approved in bankruptcy courts this year. Both companies still have contracts in prisons and jails across the country. As for CF, the inmate who died in a Santa Barbara county jail – the grand jury's investigation did not do much in the way of justice for her. Despite the horrific death the report describes, the only consequence for Wellpath is that the county will conduct a thorough assessment of its services in the jail. Even if Wellpath does lose its contract, there won't be a lot of other options to choose from. YesCare's press office did not respond to the Guardian's request for comment.
