Category: Food & Wine

PCOS symptoms are still difficult for doctors to diagnose and treat. Here’s why

NBC News

PCOS symptoms are still difficult for doctors to diagnose and treat. Here’s why

Caroline Hopkins – March 31, 2024

Every morning, Jeni Gutke swallows 12 pills. In the evening, she takes 15 more, then another before bed. She also takes an injectable medication once weekly, and two other medications as needed.

Gutke, of Joliet, Illinois, has polycystic ovary syndrome, or PCOS, and the medications and supplements help the 45-year-old cope with migraines, high blood pressure, diabetes, high cholesterol, anxiety and depression that come with the complex hormonal condition.

Not one of  Gutke’s medications are technically “PCOS drugs.”

portrait (Courtesy Jeni Gutke)
portrait (Courtesy Jeni Gutke)

The Food and Drug Administration has not approved a medication specifically for PCOS, which is often linked to infertility, irregular or missed periods, weight problems, and other debilitating symptoms. Gutke’s array of medications is typical of how many of the estimated 5 million women in the U.S. diagnosed with PCOS deal with it.

“It’s such a vast syndrome that affects everything from your head to your toes,” she said. She was diagnosed with endometrial cancer — another risk linked to PCOS — at age 37.

After nearly a century of disagreements over what, exactly, defines the condition, as well as a lack of research, PCOS is still poorly understood. The symptoms vary so widely that any single drug would be unlikely to help all patients, said Dr. Heather Huddleston, a reproductive endocrinologist at the University of California, San Francisco and director of UCSF’s PCOS Clinic.

Women with PCOS and the doctors who care for them say they want better options — treatments for the condition’s root causes rather than bandages for individual symptoms. Even as calls for better treatments grow, the lack of investment in PCOS research has limited doctors’ ability to help their patients.

“It gets very messy to try to identify one treatment that’s going to work for everybody,” Huddleston said.

Many women with the condition end up taking off-label prescriptions — meaning drugs technically approved for other conditions, like diabetes or obesity — to help PCOS-related symptoms. Navigating insurance coverage for off-label prescriptions can be challenging.

“There’s no magic pill,” said Tallene Hacatoryan, 31, a registered dietician from Orange County, California. “There are too many components for there to be a one-size-fits-all treatment.”

portrait weights exercise happy smile (Courtesy Tallene Hacatoryan)
portrait weights exercise happy smile (Courtesy Tallene Hacatoryan)

Hacatoryan was diagnosed with PCOS at age 18 and now works as a diet and lifestyle coach for women with PCOS.

Although research is murky when it comes to the best diet for women with PCOS, the most up-to-date international guidelines recommend exercise and a healthy diet. There’s no evidence that any particular diet improves symptoms, although some women have found lifestyle coaching helpful.

Insufficient funding for research

Among the reported 315 medical conditions that receive federal support from the National Institutes of Health, PCOS ranks near the bottom, with an estimated $10 million earmarked for research in 2024. Until 2022, PCOS was so underfunded that it wasn’t included as a line item in the NIH list.  And the condition is not explicitly included in the $100 million the Department of Health and Human Services announced recently to research neglected areas of women’s health. Neither is PCOS mentioned in President Joe Biden’s recent executive order to advance women’s health, which includes $200 million for NIH research grants, or the White House’s calls for Congress to allocate $12 billion to fund women’s health research.

A spokesperson at the NIH said that it’s too early to know which women’s health conditions will receive funding under the new initiative.

“Given how common PCOS is, the amount of funding it’s gotten is proportionately extremely small,” Huddleston said.

Government funding is just one part of the total research budget for a given disease. While it’s tough to pin down a dollar figure for private industry spending, experts say the lack of FDA-approved PCOS treatments reflects a lack of investment from drugmakers, too.

Developing PCOS treatments requires a better understanding of the condition. This, in turn, requires far more research tracking thousands of women over many years, which can be extremely expensive, experts say.

However, there are some promising signs.

Although research is early and only in a few dozen women, there are a handful of small drug companies studying possible PCOS treatments. A Menlo Park, California-based company called May Health, for instance, is developing a one-time surgical procedure it thinks could help with PCOS. Spruce Bio, a San Francisco biotech firm, is running a small clinical trial with a drug called tildacerfont for PCOS. It is not clear yet if the oral drug works. President and CFO Samir Gharib said larger clinical trials will depend on the company’s ability to “secure additional financing” or partner with another drug company.

The FDA recently attended a meeting with advocacy group PCOS Challenge where women shared their experiences with the agency’s scientists and drug companies. No PCOS drug trials were announced after the meeting, but the FDA’s interest shows a growing push for improved treatment, said William Patterson, a spokesperson for PCOS Challenge.

No known cure for PCOS

Doctors recommend hormonal contraceptives — most commonly the birth control pill — to regulate heavy, irregular periods;, acne;, and unwanted hair growth. Others say taking the pill just masks, rather than treats, their PCOS symptoms and the symptoms return as soon as they stop taking it.

“PCOS is unfortunately not curable, so treatment is about managing its symptoms,” said Dr. Jessica Chan, a reproductive endocrinologist at Cedars-Sinai. Chan said birth control can be a good option for some, but not all, of her PCOS patients.

For women with PCOS whose main concerns are insulin resistance or stubborn weight gain, Chan often prescribes off-label diabetes medications like metformin.

Some doctors who treat PCOS, including OB-GYNs or endocrinologists, have also begun prescribing GLP-1 agonists like Ozempic and Wegovy, which have shown promise for some women with PCOS,  although studies have been small and early -stage.

Novo Nordisk, the company that makes Ozempic and Wegovy, said it has no plans as of now to seek FDA approval for PCOS. Still, the company mentions PCOS on its Truth About Weight website, part of its marketing campaign for Wegovy

Causes and symptoms of PCOS

“We don’t know the initial spark leading to PCOS or where it arises from,” Chan said.

PCOS affects an estimated 6% to 12% of reproductive-age women in the U.S. The real prevalence is likely higher since an estimated 70% of cases go undetected.

Experts generally agree that PCOS, at its core, is a hormone-related condition. Women with PCOS have higher levels of androgen hormones, which can cause a range of symptoms, including:

  • Missing, irregular, or heavy periods
  • Acne
  • Excess hair growth on the face or body
  • Thinning or balding scalp hair

According to endocrinologist Dr. Andrea Dunaif, some doctors have been pushing to separate PCOS into two different diagnoses: one having more to do with the reproductive cycle and fertility issues and another having more to do with metabolism, high body weight, and diabetes.

“PCOS looks to be at least two or three different conditions we’re lumping together, but they’re genetically distinct,” said Dunaif, the chief of the endocrinology, diabetes and bone disease division of Mount Sinai Health System and the Icahn School of Medicine.

The confusion surrounding PCOS diagnosis is partly why it’s been hard to get large pharmaceutical companies to invest in PCOS treatment, she said.

In Dunaif’s view, it’s not accurate to call the condition “PCOS” at all, because it has more to do with excess hormones than it does with actual cysts on the ovaries. PCOS got its name from the bumps on the ovaries appearing like cysts on an ultrasound image. These are not cysts, but instead egg follicles that are, as Dunaif described them, “arrested in development.”

As it is, many doctors diagnose the condition based on two of three factors:

  • Irregular periods
  • High androgen levels
  • Multiple follicles on the patient’s ovaries

But these three factors don’t account for some of the most challenging symptoms of PCOS: insulin resistance and stubborn weight gain. Excess androgen hormones can spike insulin levels, which interferes with how the body processes sugar. Doctors aren’t sure whether the hormonal dysregulation causes insulin resistance, or whether insulin resistance causes excess androgen hormones.

Either way, women with PCOS have a higher risk of diabetes, excess weight gain, high cholesterol, and high blood pressure. Yet these metabolic conditions aren’t included in the criteria many doctors use to diagnose PCOS. The result? A missed diagnosis.

This was initially the case for Candice Bolden, 35, who started noticing acne and excess facial and body hair several years before she was diagnosed with PCOS in 2021. Bolden, a lifelong dancer, also had unusually low energy.

portrait (Courtesy Candice Bolden)
portrait (Courtesy Candice Bolden)

“The final straw was excess weight gain that I could not take off no matter what I did,” said Bolden, who lives in Los Angeles. “All the other things I had kind of just stuffed under the rug. I’d just chalked it up to being a hairy, Haitian woman.”

After gaining 35 pounds, the 5-foot-2-inch Bolden, who exercised twice a day and followed strict diets, saw multiple doctors who she said ignored her symptoms.

“Doctors kept telling me I was fine, and to go home, work out, and eat clean,” she said. “It was the most frustrating thing ever.”

‘We don’t have to live underneath this dark cloud’

Women living with PCOS say the rise of online communities, including on social media apps like TikTok and Instagram, has given them a place to speak out, share the treatment approaches working for them, and meet other women with PCOS.

When Bolden finally got a diagnosis, she wasn’t sure what to do next. Gutke and Hacatoryan had similar experiences.

“I was like, ‘Wait, I have so many questions,’ and the doctor just told me, ‘It is what it is,’” Hacatoryan said.

Hacatoryan calls women in her online community her “cysters.”

Bolden said she’s noticed more women turning to social media to learn how others manage their PCOS and share their own stories.

On her own social media accounts, she’s been trying to change the narrative about PCOS being primarily a fertility problem, which she sees as an outdated perception.

“When I was diagnosed, my doctor mentioned PCOS being the No. 1 reason for infertility, and that shattered me,” said Bolden, who was newly engaged at the time and eager to start a family. “I was happy I was diagnosed, because it showed me something was actually happening and I wasn’t just crazy. But I was heartbroken.”

Things changed after Bolden moved; found a new doctor; and worked closely with her husband and the  online PCOS community to find a system that worked to manage her PCOS symptoms.

Bolden is now pregnant and expecting a baby girl.

“I want people diagnosed with PCOS to know there’s hope, and we don’t have to live underneath this dark cloud all the time,” she said.

‘After Years Of Failed Fad Diets And Workouts, I Started Lifting Heavy Weights At 43′

Women’s Health

‘After Years Of Failed Fad Diets And Workouts, I Started Lifting Heavy Weights At 43′

Jenna Seguin, as told to Andi Breitowich – March 30, 2024

jenna seguin strength transformation
‘I Tried Every Diet, But This Changed Everything’Courtesy of Jenna Seguin


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I’ve always tried to eat well and exercise, but I lacked consistency. Whether it was the Whole30 diet, 75 Hard challenge, or a month-long bootcamp, everything always had a clear start and end date. I was quick to move on and, consequently, never saw lasting results.

In April 2021, I finally had enough. I realized doing the same thing over and over without results is scarier than trying something new, so I set up a meeting with a personal trainer at my local gym. I experimented with lifting weights in my early 20s here and there, but I was never consistent and didn’t follow a program. But I’m a lifelong learner who enjoys getting out of my comfort zone. My goals were simple, yet ambitious: I wanted to master the big lifts—bench press, squat, and deadlift—and I wanted to understand how to increase weight progressively to reach my full potential.

My first session was tough. Everything was hard, my form was all over the place, and the moves felt awkward. I was also nervous that people thought I didn’t belong in the gym. But instead of saying, “This is hard I can’t do it,” I said, “How can I improve?” Approaching this new challenge with curiosity, rather than fear, empowered me. I was determined to get stronger, and I was ready to put in the work.

I committed to training four times a week: two days with my trainer and two days on my own. I wanted to stay consistent, improve my form, and build muscle. I was excited for the challenge and motivated to get better.

After consistently working with my trainer for a year, I was craving more.

On Instagram, I came across a video of Michelle MacDonald bench pressing and was in awe of her form and heavy weight. I wanted to level up, so I applied to Michelle’s personal training community, The Wonder Women.

In August 2022, I started virtual training with The Wonder Women five days a week: three lower body days and two upper body days. I prioritized form and focused on progressive overload, but I also got curious about bodybuilding.

I decided to start training for my first bodybuilding competition in June 2023, but 12 weeks into prep, my competition was canceled. The Wonder Women didn’t have spots available to transfer into the current bodybuilding training group, so I switched teams and joined Dynasty Training.

Now, I train four days a week—two for lower body and two for upper body.

I’m preparing for my first show at the end of 2024, so I recently started my “build phase,” which consists of four days of weight training: two lower body days and two upper body days. My goal is to build muscle, but instead of only focusing on how much weight I can lift, I also prioritize tempo and increasing my reps and sets.

For lower-body workouts: I do a glutes and quads day and a posterior chain day. My workouts are typically an hour and a half, and I do seven to 10 moves per session. The number of reps and sets varies, but most of my current lower-body lifts are based on a ladder model: 12 reps, 10 reps, eight reps, and six reps of each move, increasing weight as the number of reps decreases.

For upper-body workouts: I do a shoulders and back day and a chest and arms day. These workouts are typically an hour, and I do seven to 10 moves per session, including bench press, pullups, man makers, lat pulldowns, and pushups.

I also do 35 minutes of cardio six days a week and have one day designated to core and high intensity intervals, and one day of stretching. Sunday is my day off.

Lower body is my favorite to train and I especially love deadlifts, Bulgarian split squats, and hip thrusts. Now, I can deadlift 195 pounds and thrust 300 pounds. I’m currently working on adding a pause at the top of each hip thrust and let me tell you… it adds a whole other level of intensity.

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I learned to count macros and let go of the belief that I needed to restrict food.

I’ve tried every diet in the book, but nothing was ever sustainable or satisfying. Then, I learned to count macros and realized I could still eat my favorite foods when I paid attention to portion size and nutrition labels.

I eat four to five meals a day and focus on my protein, carb, and fat intake. I always prioritize protein, and chicken, turkey, and fish are my go-to sources. It’s also fun to try new macro-friendly recipes, and meal prepping on Sunday sets me up for success during the week.

That said, it took me a long time to get over the idea of restriction. I was so used to eliminating foods and eating as little as possible, but once I learned nothing is off limits and macros are about balance and variety, I felt better than ever. Instead of a month-long, restrictive, fad diet, I realized the most sustainable plan is listening to my body and eating the foods I love.

These three things were key to my strength transformation success.

1. I let go of the notion that my strength journey needs to be perfect.

When I started strength training in 2021, it wasn’t necessarily the “perfect time” to embark on a new journey. But I decided to stop waiting and took control of my situation. Is every workout perfect? Nope! But that’s okay. I realized if I keep trying and continue to show up it’s going to pay off in the long run.

2. I became more self-aware and understood the value of the mind-body connection.

It’s so easy to operate on autopilot, but I’ve learned to evaluate my *entire* lifestyle when something feels off. If my energy levels are low, I look at my diet and sleeping habits. When I’m stressed, I reflect on why instead of letting anxiety rule my day.

As a result, I’ve learned the importance of the mind-body connection. How I’m feeling physically and mentally can have a direct impact on each other and the overall sense of self-awareness has gotten me closer to my goals.

3. I gave myself the opportunity to be good at something and realized consistency is key.

Most of my life, I participated in diets and fitness programs that had a clear start and end date. Once I understood that people become good at things by being consistent, a light bulb went off. I realized I had never given myself a chance (or the time) to get good. I always expected quick results and a long-term program seemed daunting, but when I challenged myself to start weight lifting without an end date in mind, my whole mindset changed.

Not only do I love that consistency brings me closer to my goals, but I found value and motivation in the process. Whether it’s perfecting my form or mastering a recipe, the sense of accomplishment after nailing a new skill keeps me determined to get better and stronger. It’s fun to show up for yourself and consistency in the gym has given me the opportunity to believe in myself.

Do turmeric supplements really treat pain, boost mood, and improve allergies? Experts say they work best for 2 conditions

Fortune

Do turmeric supplements really treat pain, boost mood, and improve allergies? Experts say they work best for 2 conditions

Stephanie Watson – March 30, 2024

Getty Images

Americans spend around $50 billion a year on vitamins and supplements. One of the most popular is turmeric, a bright orange root that has its roots in both traditional Eastern medicine and cuisine. Proponents are willing to pay $20 or more for a bottle, hoping to relieve arthritis pain and inflammation, lower cholesterol and blood sugar levels, and treat whatever else happens to ail them. But is it worth the money?

While a lot of research has highlighted turmeric’s antioxidant and anti-inflammatory properties, the wide range of supplement potencies and doses used in studies has made it hard to confirm any health claims.

Dr. Keith Singletary, professor emeritus of nutrition at the University of Illinois Urbana-Champaign, has reviewed the evidence on turmeric. His take? “I think it’s promising,” he says, but he stresses that it isn’t “the cure-all that marketing would make it appear.”

Health benefits of turmeric

The health properties attributed to turmeric come from natural compounds called curcuminoids. “Curcumin, which is the major one, is believed to be largely responsible for the health benefits of turmeric,” says Singletary.

What might curcumin do? The best evidence centers on two conditions: arthritis and metabolic syndrome.

Arthritis

Considering turmeric’s anti-inflammatory properties, it’s not surprising that researchers have investigated its use for arthritis. The supplement does appear to reduce pain and stiffness from osteoarthritis, the most common form of this achy joint disease.

“It’s not a miracle drug, but it probably works as well as ibuprofen or acetaminophen,” says Dr. Janet L. Funk, professor of medicine and vice chair of research for the Department of Medicine at the University of Arizona College of Medicine-Tucson. Her lab studies plant-derived dietary supplements for inflammatory diseases.

Metabolic syndrome

This isn’t a disease, but rather a cluster of conditions like obesity, high blood pressure, high blood sugar, and high triglycerides that collectively increase the risk for diabetes, heart disease, and stroke. About 1 in 3 American adults have metabolic syndrome, according to the National Heart, Lung, and Blood Institute (NHLBI).

Studies have looked at the effects of turmeric on blood sugar, triglycerides, and insulin levels, as well as on inflammation (which also plays a role in metabolic syndrome). “In general, there was a strong preponderance of evidence that it might help reduce all those things. So it might have some benefit in people who are overweight and concerned about inflammation and diabetes,” Funk says.

But—there’s a very big caveat. “There’s a lot of inconsistency between studies,” Singletary says. And therein lies the problem in evaluating turmeric.

An imperfect science

Though plenty of research is being done on turmeric, the studies aren’t consistent. Researchers have tested different amounts of the supplement in different groups of people for different amounts of time. Some studies added a compound like piperine, found in black pepper, to make turmeric more active in the body (researchers call this increased “bioavailability”).

For example, one study on knee osteoarthritis had participants take 180 milligrams (mg) of curcumin for eight weeks. Another one used doses of 500 mg plus 5 mg of BioPerine (black pepper) extract three times a day for six weeks.

Because most of the studies have lasted four months or less, researchers don’t know what might happen with long-term use. “The bottom line is, there’s no definitive, well-designed studies at this point,” Funk says. She’s skeptical that there ever will be, given that the nutraceutical industry and the National Institutes of Health aren’t funding them.

The risks of turmeric

Turmeric is probably safe if you get it from the spice or you take only the recommended amount in supplements, says the National Center for Complementary and Integrative Health. In larger quantities, it could cause GI side effects like nausea or diarrhea.

Piperine poses its own set of issues, because it increases the bioavailability of curcumin by inactivating an enzyme in the liver that would otherwise break it down. “That enzyme is really important for [breaking down] most drugs people take,” says Funk. Theoretically, piperine might cause a buildup of medications in the body, thus increasing the risk for side effects. “Generally speaking, if you’re taking other medications, I would shy away from any product that has piperine in it, just in case it could interfere with the metabolism of your other drugs,” she adds.

An even bigger concern is a rare but serious risk of liver damage from turmeric supplements, as well as high levels of lead in these products. Several studies, including one that Funk co-authored, found excessive amounts of lead in some turmeric supplements—especially those that contained turmeric root. Exposure to lead in large quantities can have toxic effects on the body, including heart and kidney problems.

Should you take turmeric?

Is it worth taking turmeric? “That’s the million- dollar question,” says Singletary. Given the lack of clear evidence on its benefits and the potential risks, he says you’re safest getting turmeric through your diet. You can add the spice to soups, stews, sauces, and smoothies. Top them with a pinch of black pepper or cook turmeric in oil to enhance its bioavailability.

If you do use turmeric supplements, it can be difficult to know which form is best, or how much to take. The best advice is to ask your health care provider, says Singletary. Start out with a low dose to see how your body responds to it. And don’t expect turmeric to be a “cure-all for all your ailments, which is unlikely to be the case,” he adds.

Read more on supplements:

New report finds striking parallels between tobacco, gas stove campaigns: ‘This is intentional; it’s by design’

The Cool Down

New report finds striking parallels between tobacco, gas stove campaigns: ‘This is intentional; it’s by design’

Ben Stern – March 22, 2024

For decades, tobacco companies misled the public about the dangers of their products, engaging in multipronged PR campaigns and spreading disinformation.

Today, nicotine and smoking are widely acknowledged to be addictive, and cigarettes are known to cause cancer. But it took years to expose these truths, all while massive tobacco corporations profited from the harm they caused.

In a striking new report titled “Cooking with Smoke: How the Gas Industry Used Tobacco Tactics to Cover up Harms from Gas Stoves,” the Public Health Law Center has revealed how Big Tobacco’s playbook of deception was also used to convince the public that gas stoves are safe.

The beginning of the gas stove fight

While news coverage on the potential dangers of gas stove pollution has recently picked up, researchers have been trying to sound the alarm since at least the 1970s.

Early studies conducted by the Environmental Protection Agency were primarily focused on investigating the health impacts of nitrogen dioxide (NO2) pollution from gas stoves.

After it was determined that such NO2 exposure could cause or worsen asthma and other respiratory problems, the American Gas Association (AGA), fearing public outcry, began to fund its own research claiming that gas stoves weren’t associated with respiratory issues.

Yet the current scientific consensus is that gas stoves are burdening the public with health issues, specifically our children. One peer-reviewed study from the nonprofit think tank RMI found that more than one in eight cases of childhood asthma in America is associated with a gas stove in the home.

The full health impacts of exposure to gas stove pollution are unfortunately not yet known. Pediatrician Dr. Lisa Patel, the Executive Director of the Medical Society Consortium on Climate and Health, believes it’s critical to learn more about gas stoves’ potential dangers sooner rather than later.

“Because the oil and gas industry has been so successful in pulling the wool over our eyes, suppressing the research, we’re still figuring out which of the pollutants [from stoves] is the ‘worst’ in terms of risk,” Dr. Patel told The Cool Down.

Cooking with smoke

The Public Health Law Center’s new report lays out how eerily similar the disinformation campaigns of the gas and tobacco industries are.

“Cooking with Smoke” describes seven of the deceptive tactics used by both the tobacco and gas industries to mislead the American public.

One such tactic is hiring the same scientists and research labs to provide biased or partial information pointing to desired results — namely, downplaying the health impacts of tobacco products and gas stoves. The AGA has hired the exact same laboratory as the Council for Tobacco Research, a tobacco industry trade group, for its sponsored research.

Last year, a New York Times exposé revealed that not only did the AGA hire a toxicologist to obscure the relationship between gas stoves and health impacts, but that same toxicologist was hired by the cigarette company Philip Morris to provide testimony claiming that Marlboro Lights were “safer for smokers.”

Another strategy utilized by both industries is the marketing of deceptive media to children. As outlined in the report, gas companies have used social media influencers to promote gas stoves to young people. Within the past two years, the gas industry has also sent coloring books to schools, telling children that “natural gas [is] your invisible friend,” as the report noted.

We deserve better

Due to decades of industry disinformation, the health harms caused by gas stoves have largely gone unnoticed or misunderstood by the American public. But just as Big Tobacco couldn’t hide the truth about cigarettes, the gas industry won’t be able to successfully hide the dangers of its stoves from the public forever.

“The gas industry wants us to accept health harms that we don’t have to. This is intentional; it’s by design,” Joelle Lester, Executive Director of the Public Health Law Center, told The Cool Down. “That’s where the gas industry is similar to Big Tobacco. They will continue to resist regulation and restriction to protect their profits.”

Change is coming

Both Lester and Dr. Patel believe that more information about the true health risks of gas stoves will inevitably emerge. When it does, change will follow.

“Jurisdictions will make changes [to transition away from gas stoves],” Lester told The Cool Down, “and once the sky doesn’t fall, and the health benefits can be measured, it will be so powerful.”

And according to Dr. Patel, “in the end, science and wanting to take care of each other will always win out.”

Actions you can take now

For those worried about the impacts of gas stoves, waiting on policy fixes isn’t necessary. The best way for an individual to eliminate the health risks of a gas stove is to replace it with an induction or electric range.

Induction cooktops have already proven to be the superior option in many ways, cooking food more quickly, evenly, efficiently, and safely than gas stoves.

While replacing your gas stove may seem daunting, the federal government, through the Inflation Reduction Act, will offer up to $840 to those who make the switch.

Even renters will be able to take advantage of this point-of-sale rebate by purchasing plug-in induction cooktops.

Some landlords may also be amenable to electrification projects, like installing induction stoves, once they find out how much more energy-efficient the devices are. The nonprofit Rewiring America has an in-depth guide for talking to your landlord about upgrading.

Of course, even with an $840 upfront discount, not every family will be able to make the switch. For those families, many options still exist to protect their respiratory health. Dr. Patel told The Cool Down: “If they can’t get that gas cooktop out, using electric appliances, opening windows, [or] using an overhead vent helps.”

Fast-food companies seeing low-income diners pare orders

Reuters

Fast-food companies seeing low-income diners pare orders

Waylon Cunningham – March 27, 2024

FILE PHOTO: McDonald's Corp. reports fourth quarter earnings
McDonald’s Corp. reports fourth quarter earnings
FILE PHOTO: A Wendy's sign and logo are shown at one of the company's restaurant in Encinitas, California
A Wendy’s sign and logo are shown at one of the company’s restaurant in Encinitas, California

SAN ANTONIO, Texas (Reuters) – Runaway prices at U.S. fast-food joints and restaurants have made people skittish down the income ladder and executives at chains including McDonald’s and Wendy’s recently said they worry about losing business from those on the tightest budgets.

Roughly a quarter of low-income consumers, defined as those making less than $50,000 a year, said they were eating less fast food and about half said they were making fewer trips to fast-casual and full-service dining establishments, according to polling in February by Revenue Management Solutions, a consulting firm.

The rising price of food is contributing to budget-conscious diners cutting back.

Whether consumed at home or in a restaurant, food prices rose 20% from Jan. 2021 to Jan. 2024, the fastest jump on record. A recent census Household Pulse Survey showed half of people earning less than $35,000 a year had difficulty paying everyday expenses, and nearly 80% were moderately or “very” stressed by recent price increases.

Lauren Oxford, a musician who works part time at a bed-and-breakfast in Tennessee, said she used to stop by McDonald’s after running errands, treating herself to two double hamburgers, fries and a drink, for less than $5. As prices rose, she switched to smaller hamburgers and stopped getting the drink.

But after a year in which McDonald’s franchisees drove prices up about 10% according to the company’s executives, she’s going to McDonald’s less in general. “Now I don’t know if I can justify that.”

In the Fed’s most recent Beige Book compendium of anecdotal reports gathered from business and community contacts around the country, 7 of 12 regional Fed districts reported low-income consumers were changing spending habits in search of bargains, seeking more help from community groups, or struggling to access credit.

About one-third of Black American households, and 21% of white American households, earned less than $35,000 in 2022, according to the latest available U.S. census data.

For fast-food companies that often promote an image of affordability, low-income consumers are a significant portion of the customer base and a bellwether for longer-term trends. But they are typically the first to cut back spending and the last to come back.

But now, chains may be less likely to chase customers as hard as they have in the past because even with a drop in traffic, sales have remained consistent supported by increased prices.

Fast food companies aren’t “in a hurry to take traffic over profit the way they were a decade ago,” said Mike Lukianoff, CEO of SignalFlare.ai and a veteran consultant in the fast food industry.

For example back in 2008, Subway introduced its nationwide $5 footlong, which became the poster sandwich for the Great Recession. That spurred rivals to introduce extreme value deals for budget-conscious customers, such as “$5 Fill-Up Boxes” at Yum! Brands KFC.

In 2016, McDonald’s, after a prolonged slump in sales, introduced a bundle deal it called “McPick 2”, allowing customers to choose 2 items, like a McDouble, for $2. Within months, Wendy’s offered a four for $4 deal. Burger King offered five for $4. Pizza Hut had a $5 “flavor menu.”

APP-DRIVEN DISCOUNTS

Now, instead of across-the-board menu slashes and broad discounts, industry analysts say chains are being more selective, aiming them at specific demographics or limiting them to specific meal times or channels, such as its app or only through delivery.

McDonald’s executives told investors in February that it would rely on its existing “value menu” to appeal to low-income consumers who might be tempted to eat packaged food at home instead. CFO Ian Borden said affordability is core to the brand, and the company would continue “evolving” its value offerings.

“The battleground is certainly with that low-income consumer,” McDonald’s CEO Chris Kempczinski told investors, referring to people making less than $45,000.

Wendy’s recently introduced a limited-time $1 burger — available only through its app. Its CFO Gunther Plosch told investors in February that among lower-income customers, their traffic is down but their share with the general market is unchanged.

For major fast-food companies, loyalty apps are the go-to strategy among major brands to increase retention and the average amount of money spent. The upside for chains, David Henkes, senior principal with Technomic said, is that they capture more transaction data and demographic data for the consumer, “which is a trade-off many are happy to do.”

For example, McDonald’s frequently offers in-app discounts, such as 20% off an order or free delivery with a large enough order.

Domino’s halved the minimum purchase price to get points in its loyalty program, to $5 from $10, its CEO told investors at a conference in January. It also reduced the number of purchases needed to get a free pizza to as few as two from six. “And so essentially, for this lower-income consumer, we’ve made the brand more accessible,” CEO Russell Weiner said.

To be sure, not every chain is seeing weakness among low-income customers. At Taco Bell, which sells a single taco for $1.40 at many of its stores in San Antonio, locations in low-income markets did better than other locations, Yum! CEO David Gibbs told investors in February.

McDonald’s still holds its appeal for Andreas Garay, a retail worker eating at a McDonald’s in westside San Antonio. He said he plans to keep his coffee-and-Big-Mac habit– even if prices continue going up.

(Reporting by Waylon Cunningham in San Antonio and Howard Schneider in Washington, D.C.; Editing by Anna Driver)

I Was Diagnosed With Colon Cancer at 32. Here Are the First Symptoms I Had

Self

I Was Diagnosed With Colon Cancer at 32. Here Are the First Symptoms I Had

Julia Ries – January 18, 2024

Raquel A./powerofforever/Getty Images

Raquel A., 33, never guessed she had cancer, even though she had symptoms that worried her. A few years ago, her bowel movements became increasingly frequent and abnormal, which she figured was due to undiagnosed irritable bowel syndrome (IBS) or a food intolerance. She didn’t have health insurance, so she put off going to the doctor and tried to ease her discomfort with fiber supplements and dietary changes. After getting a job that offered medical coverage, she saw a primary care physician, who told her she likely just had anxiety. Her symptoms worsened, and in 2023, she was diagnosed with stage four colon cancer. Raquel has been sharing her experience with the condition—as well as what she wants others to know about seeking help as early as possible—on TikTok. Here’s her story, as told to health writer Julia Ries.

I first started having noticeable gastrointestinal issues in 2019, right before the pandemic. I was living with a roommate, and one day we started talking about how I was going to the bathroom all the time. I could go number two 8 to 10 times a day and never feel like I had a complete bowel movement. I told my roommate I suspected I wasn’t getting enough fiber, or perhaps I simply wasn’t eating “healthy enough.” Maybe I had irritable bowel syndrome (IBS), or a gluten or dairy sensitivity. It never occurred to me that I might have cancer.

I didn’t have health insurance. As a result, going to the doctor—unless I had an absolute emergency—wasn’t something I did in my 20s. Instead of checking in with a primary care doctor, I started intermittently taking Metamucil, a fiber supplement, to help regulate my bowel movements and treat random bouts of diarrhea. This helped, at least for a little while.

In 2021, I moved to the greater Seattle area, where I landed a job in the tech industry and, with it, good health insurance. My symptoms remained quiet until they came back in 2022. I was going to the bathroom a lot again, and my bowel movements became uncomfortable. My stools were pencil-thin, sometimes orangish-red in color, and occasionally there’d be a little blood. I got abnormally full after eating. I was bloated, no matter what I ate—I tried being dairy-free, then gluten-free. Looking back, these were major warning signs that something was wrong, and I wouldn’t find out until later that they were classic signs of colorectal cancer.

I scheduled a physical—my first in over a decade—in May of 2023. I told my doctor about the digestive issues I’d been experiencing since 2019: the frequent—and sometimes painful—bowel movements, the bloody stools, the early satiety. I shared that it felt like my symptoms were getting worse, and she said I likely had anxiety—and maybe gas—and scheduled a psychiatric appointment for me.

I believed her. I thought, “Maybe she’s right: I’m worrying too much about these symptoms and should just let it go.” In retrospect, she was incredibly dismissive, which I think was a result of my being so young at the time—I was 32, a woman, and a minority. Statistically speaking, people who fall into any of those categories, let alone all three of them, tend to have their health issues dismissed by doctors.

Three weeks after that exam, I developed severe abdominal pain. It wasn’t just localized to my lower stomach or my side—the pain radiated throughout my entire abdomen and toward my lower back. It was unbearable. I nearly fainted in my apartment. I’m not somebody who’s quick to take medication or go to the doctor, but I knew something was wrong, so I went to the emergency room. Again, I doubted myself and thought that perhaps I was making a big deal out of nothing. Fortunately, my ER physician took my pain seriously—she ordered a CT scan, scheduled an abdominal ultrasound, and ran a full panel of blood work. When the results came in, she sat down and told me they found cancer on my ovaries and liver. I was diagnosed with ovarian cancer.

I met with an oncologist and had a liver biopsy. That’s when they discovered that the cancer, adenocarcinoma, had originated in my colon and metastasized, or spread, to other organs. I was diagnosed with stage four colorectal cancer. I had an endoscopy and a colonoscopy so the doctors could get a better look—my colorectal cancer was so large and so advanced that they had trouble getting the scope through my colon.

I learned that colorectal cancer is very slow-growing. I could have had cancer for 8 to 10 years, potentially all of my 20s, without knowing it. With colon cancer, you usually don’t start having noticeable (or even severe) symptoms until it’s progressed to stage three or four. Plus, the symptoms, like nausea, constipation, diarrhea, or difficulty going to the bathroom, can be due to so many other conditions—some serious, like ovarian cancer, but others more benign, such as IBS.

After my diagnosis, I started chemotherapy. The cancer had caused a buildup of fluids in my stomach, the source of the bloating, that I had to have drained. I met with a GI specialist who advised me to tweak my diet—for example, I had to limit how much meat I was eating, cut out raw fruits and vegetables, and stick to soft foods, like pudding and mashed potatoes—which immediately improved my bowel movements. I’ve done various blood tests that assess how my cancer is progressing—including a CEA (a marker for colorectal cancer), CA125 (a marker for ovarian cancer), and CA19 (another cancer marker) tests—and have undergone genetic testing to better understand how my genes may have contributed to the cancer.

I continue to get chemotherapy biweekly, though I’ve switched to another chemotherapy drug because I experienced unpleasant side effects with the first type, and the cancer on my liver and lungs wasn’t responding to that treatment. My doctors informed me that eventually the chemo will stop working because my condition is terminal. I don’t qualify for surgery, since my cancer has spread so deeply, but I’m continuing to look into surgical options along with new treatments and clinical trials I can participate in. My chances of reaching survival two years after the diagnosis was 20%. At five years, that drops to 5%, but I’m determined to beat the odds.

Throughout this entire experience, I’ve learned how to advocate for myself. After I received my diagnosis, doctors took my condition very seriously and quickly scheduled multiple procedures and appointments for me—but that wasn’t always the case. I’d been dismissed for years, and even after I started chemotherapy, I felt as though my doctor wasn’t listening to my concerns, so I found a new oncologist who has been very responsive and attentive. I’ve learned how important it is to get a second opinion—all you need is that one doctor who is going to listen and fight for you. You might not find that person right away, but keep pressing: Getting screened could be a matter of life or death.

If I hadn’t followed my intuition—if I skipped going to the ER that day in 2023, or stuck with doctors who said nothing was wrong—there’s a chance I wouldn’t be alive. It’s so easy to doubt yourself, especially if medical professionals are downplaying your symptoms, but if you feel like something is wrong, go with your gut. It’s usually right.

Related:

What Costco Doesn’t Want Customers To Know

Daily Meal

What Costco Doesn’t Want Customers To Know

Jacob Smith – January 14, 2024

Costco rotisserie chickens being prepared
Costco rotisserie chickens being prepared – Bloomberg/Getty Images

Costco boasts nearly 130 million members worldwide. The vast majority of these are found in the United States, but regardless of whether they’re shopping in the U.S. or abroad, customers turn to Costco for the same reason: the store’s shockingly low prices.

Bargains form the basis of Costco’s brand, and discounted products can be found everywhere in the store. Furthermore, some of the store’s most iconic products — such as the $4.99 rotisserie chicken or $1.50 hot dog and soda combo — have not experienced price increases for years. But while the prices of these products are widely and frequently celebrated, few customers are aware of the outsized social, environmental, and ethical costs associated with them.

In an effort to drive down prices and maximize profit, Costco has been linked with some rather unsavory business practices including rearing animals in horrible conditions, the use of illegal labor, and questionable product labeling. Although prices remain low, it appears that Costco’s well-loved bargains do not come cheap.

Costco’s Chickens Were Reared Inhumanely
Chickens at Costco farm
Chickens at Costco farm – mercyforanimals/YouTube

Costco’s $4.99 rotisserie chicken is the store’s most celebrated product. In fact, the cheap chicken is so integral to the brand that Costco has spent $1 billion building an industry-leading chicken processing plant in Nebraska with the sole goal of streamlining its rotisserie chicken supply chain. That being said, a $4.99 chicken is never going to be far from controversy, and Costco’s rotisserie chicken has received its fair share of criticism in recent years.

The majority of these complaints stem from a 2021 investigation of a Costco-controlled poultry farm. Videos taken by nonprofit organization Mercy For Animals showed birds living in cramped, filthy conditions. Some were even suffering from open wounds. When confronted with the evidence, Costco claimed to the New York Times that much of the footage was unremarkable and also stated that the company adhered to standards laid out by trade associations (via CNN). Despite pressure, Costco has not followed the lead of many other food businesses and signed on to the Better Chicken Commitment, a welfare policy designed to improve the lives of industrially reared broiler chickens.

Following the Mercy For Animals investigation, two shareholders, represented by the litigation nonprofit Legal Impact for Chickens, launched a lawsuit against Costco. The lawsuit alleged that decisions made by Costco executives caused the company to neglect its livestock, meaning the fast-growing chickens were often unable to access food and water. The case was dismissed, but during the summer of 2023, Costco announced it was reviewing and investigating the issue. No actions have been reported.

Several Costco Products Have Been Linked With Child Labor
A Darigold plant
A Darigold plant – Ian Dewar Photography/Shutterstock

An article published by The New York Times at the end of 2023 alleged that numerous migrant children were and are working for the producers of various Costco products. According to the article, the vast majority of these children use forged documents to gain and keep employment. Lax checks and the huge workforces associated with many plants and factories mean that child workers are often missed by private auditors, while senior employees often turn a blind eye. What’s more, auditors rarely visit businesses during the night shift when child labor is most prevalent.

As part of its article, NYT interviewed Miguel Sanchez, a child migrant who works at Darigold, a milk supplier for Costco. In his interview, Sanchez detailed dangerous working conditions that resulted in him suffering from an injury. Other workers noted that minors were a common part of the workforce.

This is not the only instance of child labor linked with Costco. Underage workers have also been found to work in sanitation teams, cleaning slaughterhouses which supply Costco with meat. Packers Sanitation Services, the company that employed these minors, had over 100 underage workers on its payroll and was fined $1.5 million. In all these instances, Costco has said it was not aware of any child labor practices in its supply chain.

Customers’ Private Health Data Was Shared With Meta
Costco Pharmacy sign
Costco Pharmacy sign – Bloomberg/Getty Images

Costco boasts a pharmacy as part of its business. As with any pharmacy, Costco’s pharmacy frequently requires and receives customers’ private healthcare information, including their prescriptions and prior illnesses or conditions. This information is both private and sensitive, meaning it should be treated with the utmost care. Unfortunately, Costco has not always managed to do this.

According to The Seattle Times, a lawsuit raised against Costco in 2023 alleged that the company had shared millions of Americans’ medical information with Meta without customer consent. This was due to Costco’s improper use of Meta Pixel, a tracking code that is designed for use as a business tool. By having Meta Pixel active on the health care section of Costco’s website, any sensitive information that customers entered was automatically shared with Meta. Health-specific targeted ads were reported as a result of the illicit information sharing.

Meta itself has said that using Meta Pixel in this way is against company policy and claims that steps are taken to educate businesses on how to use Meta products properly. Costco has refused to comment on the issue, and the lawsuit is currently ongoing.

Terrible Conditions Were Reported At Costco’s Egg Suppliers
An egg-laying hen at a Costco farm
An egg-laying hen at a Costco farm – Direct Action Everywhere – DxE/YouTube

It’s not just Costco’s rotisserie chickens that have been victims of inhumane farming practices but the company’s egg-laying hens, too. Initially, calls to improve the chicken’s lifestyles centered upon the removal of battery cages from the company’s supply chain. These cages were shown to cause the birds immense suffering due to the chickens’ inability to move properly in such a small space. Celebrities such as Bill Maher and Brad Pitt called for the company to remove them in 2015, and Costco listened; 97% of Costco eggs were cage free by September 2022.

Unfortunately, the near complete removal of battery cages from Costco’s supply chain does not mean hens are reared in humane conditions. Videos recorded by a network of animal rights activists, Direct Action Everywhere, at a chicken farm that supplied eggs for Costco’s Kirkland brand showed appalling conditions. The barn the animals were kept in was filthy, and dead and rotting birds littered the floor. Many living chickens also bore injuries associated with the increased aggression the animals display in cage-free systems.

In a response to the video, reported by The Seattle Times, Costco said: “We have reinspected the barn and other operations of this supplier, and based on these inspections and prior audits, we are comfortable with the animal-welfare aspects of the operation.”

Costco Is Clamping Down On Membership Card Sharing
Costco member card being checked
Costco member card being checked – View Press/Getty Images

Costco runs a membership model wherein customers must pay an annual fee to shop at its stores. In order to ensure that non-members do not slip into the shop — and benefit from its low prices — all members are given a card they must display when prompted by cashiers or other staff members. These cards usually feature a photograph of the member, ensuring one card cannot be used by numerous people. However, savvy shoppers have frequently used the self-checkout lanes to get away with using another person’s membership card.

Costco committed to closing this loophole during the summer of 2023 by requiring all customers to show their membership cards when using the self-service checkouts. While an unpopular policy for those who have benefited from this loophole, many members think it is only fair that such a policy gets put in place. After all, they pay for access to discounted goods, so why shouldn’t others?

Some Costco members are not in favor of the crackdown. Many of these individuals are tired of being forced to prove they are members time and again. As one Redditor put it, “I think people are getting more annoyed when they’re getting accused of card sharing and have to jump through hoops to prove that it’s them. It doesn’t help that the picture quality on Costco’s cards is cra***.”

The Company’s Advertising Practices Have Been Challenged
Costco canned tuna in boxes
Costco canned tuna in boxes – The Image Party/Shutterstock

In 2023, it was announced that Costco was being taken to court over false and deceptive advertising and labeling practices. The product at the center of the lawsuit was Kirkland Signature White Albacore Tuna in Water. This product carried the “Dolphin Safe” label on its packaging. The plaintiff in the case, Melinda Wright, claimed that this label was directly misleading as the method in which tuna was caught is not dolphin safe.

The Dolphin Protection Consumer Information Act lays out specific criteria tuna products need to achieve to be labeled as dolphin safe. Due to Costco supplier’s use of potentially harmful longline fishing techniques to catch tuna, the Kirkland Signature White Albacore Tuna cannot be defined as dolphin safe according to the Dolphin Protection Consumer Information Act. This suggests that Wright, and other customers like her, were deliberately misled by Costco, which sought to play up the product’s environmental credentials.

This is not the first time Costco has been accused of mislabeling seafood. Also in 2023, the grocery store brand was forced to pay $33,000 AUD after it sold imported Canadian lobsters in its Australian stores, per 9News. In this instance, it was not how the lobsters were caught that was misrepresented but where. Although hailing from Canada, the crustaceans were erroneously labeled as being from Australian waters.

Costco Accepted Illegal Kickbacks From Drug Companies
Tony Gagliese talking
Tony Gagliese talking – The Fifth Estate/YouTube

Kickbacks, often known as rebates, are payments drug companies make to pharmacy chains. These payments are made to ensure the pharmacy will stock the company’s drugs. Kickbacks are legal in some parts of Canada but not in Ontario, which outlawed the practice during 2013 in an effort to lower drug prices. Despite the law, two senior pharmacy executives at Costco in Ontario — Joseph Hanna and Lawrence Varga — demanded kickbacks from drug salesmen several years after 2013.

Tony Gagliese, a salesman for drug company Ranbaxy, secretly recorded Costco pharmacy executives asking for kickbacks in 2018. The Ontario government subsequently launched an investigation into the brand’s illegal kickback practices. It found Costco had accepted over $7.2 million in illegal kickbacks. In an email to CBC, Hanna said: “I genuinely believed at the time Ranbaxy made the payments in question that they were permissible. Neither I, nor Costco, would ever knowingly accept a payment that was prohibited.”

Costco was fined the amount it illegally earnt in kickbacks, around $7.25 million according to CBC. Hanna and Varga were ordered to pay $50,000 each in fines and costs. Neither pharmacy executive was fired.

Costco Underwent An Eight-Year Lawsuit With Tiffany
People by Costco jewlery case
People by Costco jewlery case – Bloomberg/Getty Images

Unlike many other grocery store brands, Costco often stocks an impressive range of jewelry. However, this aspect of the store took a hit when famous jewelry brand Tiffany and Co. launched a lawsuit against Costco on Valentine’s Day 2013. Once again, the lawsuit revolved around Costco’s advertising and labeling choices. In this instance, Costco used the name “Tiffany” to describe a range of diamond rings.

Costco defended this choice by stating that “Tiffany” was being used to describe the ring’s pronged setting and did not indicate any connection with the well-known jewelry brand. Tiffany and Co. begged to differ, alleging that Costco was deliberately misleading customers into believing the rings were made by or in association with the brand. Over 3,000 of the rings were sold.

In 2017, four years after the lawsuit was brought against Costco, a judge ruled that Costco had to pay Tiffany and Co. nearly $20 million in damages and punitive damages, per Reuters. Costco appealed the judgment and won. The two companies settled out of court in 2021, according to CNBC. No details regarding the settlement were released.

Multiple Employees Have Accused Costco Of Discrimination
Rae Ellis smiling
Rae Ellis smiling – Bloomberg/Getty Images

Costco has a reputation for being a good place to work. Employee pay and benefits are among the highest in the sector, and the company’s employee turnover is very low. That being said, Costco has also been accused of taking various discriminatory actions against employees. The most infamous of these resulted in over 700 women launching a class-action lawsuit against Costco.

The lawsuit, led by plaintiff Rae Ellis, alleged that Costco discriminated against women when it came to filling managerial positions. The lawsuit was initiated in 2004. At this time women made up half of Costco’s entire workforce, yet only 13% of Costco store managers were female. The lawsuit was settled in 2013, according to Public Justice. As part of the deal, Costco committed to changing its promotion procedures. These changes are working; at the end of the 2022 fiscal year 37.5% of Costco managers were female.

Other lawsuits have accused Costco of disability discrimination. One such lawsuit was leveled against the company by Marisa Martinez. Martinez was the Mexico Buyer for Costco and was on a work trip to the country when she witnessed a car being held at gunpoint. Martinez developed anxiety after this event and did not feel able to travel to Mexico. In retaliation, Costco banned her from performing any other work-related travel and threatened to remove her from management if she did not travel to Mexico. In the ensuing court case, Costco was forced to pay Martinez $1.85 million in damages, per McGillivary Steele Elkin LLP.

Costco Was Found To Have Lax Pharmacy Controls
Employee working in Costco pharmacy
Employee working in Costco pharmacy – Bloomberg/Getty Images

In January 2017, it was announced that Costco would pay $11.75 million as a result of a number of its pharmacies improperly filling prescriptions. Lax controls were reported in multiple Costco pharmacies in locations including Washington, Michigan, and California. Among the alleged actions were the filling of incomplete prescriptions and the filling of prescriptions without valid Drug Enforcement Administration registration numbers.

After the settlement was reached, U.S. Attorney Eileen M. Decker released a statement. In it she said: “These are not just administrative or paperwork violations — Costco’s failure to have proper controls in place in its pharmacies likely played a role in prescription drugs reaching the black market.”

In an effort to ensure such violations do not occur again, Costco invested in a new pharmacy management system. The chain also adopted an auditing system that involved the use of external auditors.

Many Of Costco’s Steaks Are Mechanically Tenderized
Costco meat
Costco meat – ARTYOORAN/Shutterstock

The process of mechanically tenderizing meat involves tiny holes being punctured into the meat by needle-like blades before packaging and selling. This process helps break down some of the meat’s fibers, making the meat feel more tender when it is eaten.

While there is no disputing that mechanically tenderizing steaks works, the process has drawn some criticism as it increases the risk of foodborne illnesses being transferred by the meat. The United States Department of Agriculture highlights that mechanical tenderizing increases the risk of foodborne illnesses, as any pathogens or bacteria that happen to be located on the meat’s surface will be driven into the center of the meat during the puncturing process. This makes the pathogens harder to kill during cooking, increasing the chances that a contaminated piece of meat makes a customer ill.

One way to mitigate this risk is to cook the steaks more thoroughly, raising their internal temperature to 145 degrees Fahrenheit and holding it there for three minutes, or making sure the internal temperature reaches 160 degrees as Costco recommends. Thankfully, Costco indicates on a steak’s label whether it has been mechanically tenderized, giving customers the knowledge they need to prepare and consume their steaks safely.

Costco’s Gold Ingots Are Not A Great Investment
Gold bought from Costco
Gold bought from Costco – goldeagleprice/X, formerly known as Twitter

Costco made headlines throughout 2023 due to the popularity of an unlikely grocery store product: 1-ounce gold bars. Costco repeatedly sold out of the product, with CFO Richard Galanti indicating in a company earnings call that after restocking, the product sold out in a few hours. The ingots do not come cheap; Costco has been selling them at around $2,000, and some customers have likely seen them as a worthwhile investment.

Although gold is known to hold its value in times of uncertainty, those looking to make some money are probably better off looking elsewhere. George Milling-Stanley, chief gold strategist at State Street Global Advisors, explained the reason for this in an interview with Investopedia: “There’s a premium of up to 5% when you go to buy it, and there’s often a discount of up to 5% when you want to sell it […] gold’s really got to go up 10% before you actually break even.”

Despite being known as a discount wholesaler, Costco has not waived the costs associated with gold. The price of the company’s gold ingots has hovered between 5% and 7% above the market value. This ensures that it’s Costco, and not the buyers, that are benefiting from this transaction the most.

Health Benefits of Kiwi

Health

Health Benefits of Kiwi

Chelsea Rae Bourgeois, RDN, LD – December 11, 2023

<p>Cathy Scola / Getty Images</p>
Cathy Scola / Getty Images

Medically reviewed by Simone Harounian, MS

Kiwi, once called the Chinese gooseberry, is a small fruit with significant nutritional benefits. Native to the hillsides of Southwest China, kiwi is now a popular fruit grown in many areas of the world. It earned its name from New Zealand fruit exporters, who named it after the flightless kiwi bird based on similarities in appearance.

There are several kiwi species, but the two most commonly consumed are known under the scientific names Actinidia deliciosa and Actinidia chinensis. The Actinidia deliciosa species is the typical green kiwi often seen in stores. However, no matter the type, kiwis offer many evidence-based health benefits. They are rich in vitamin C and can support digestive, heart, and eye health, among other health benefits.

Supports Digestive Health

Kiwis contain soluble and insoluble fiber, supporting health on many levels, starting in the digestive system. Soluble fiber supports a healthy gut microbiome, while insoluble fiber helps maintain regular bowel movements. Research has shown that the fiber found in kiwis can influence stool consistency and transit time through its water-retaining capabilities, more than fiber in other fruits.

These digestive benefits can help those experiencing constipation find relief by adding bulk to stool and decreasing the time it spends in the digestive tract. Furthermore, a healthy gut microbiome can support many health goals. Research continues to point to its profound implications in health concerns, such as diabetes, irritable bowel syndrome (IBS), cardiovascular disease, and depression.

Excellent Source of Vitamin C

Kiwi is an excellent source of vitamin C, a powerful antioxidant essential to a healthy immune system. Vitamin C helps protect the body from oxidative damage caused by free radicals, which are molecules or fragments of molecules with at least one set of unpaired electrons. The oxidative stress triggered by free radicals damages healthy cells and is thought to play a role in a variety of diseases. Just one kiwi provides 64 milligrams (mg) of vitamin C, which is 71% of the recommended intake for men and 85% for women.

Research has shown that eating two kiwis daily for as little as four weeks can improve immune cell function in those with low serum vitamin C. These immune cells, called neutrophils, are white blood cells that help protect the body against infection.

May Benefit Heart Health

A diet rich in fruits and vegetables can help support heart health through several mechanisms, and the kiwi can be a contributing benefactor. For example, a study that examined kiwi intake and blood pressure found that participants who ate three kiwis daily experienced lower blood pressure than those who ate other fruits. Besides regular exercise, adding kiwi to a well-balanced diet can help maintain healthy blood pressure levels.

Kiwi may also positively affect cholesterol. Research has shown a link between daily kiwi consumption and reduced total cholesterol and triglycerides. The study even connected kiwis with improved HDL cholesterol, the healthy cholesterol.

Supports Weight Management

Kiwis can be a nutritious addition to a well-balanced diet, especially for those aiming to lose weight. They’re deliciously sweet but low in calories, meaning they can satisfy cravings without adding excessive energy intake.

Kiwis also contain dietary fiber, which adds bulk to the diet without skewing calorie intake. Plus, fiber contributes to feelings of fullness, which can help prevent overeating. For reference, one kiwi provides around 42 calories and 2 g of fiber.

Still, it’s important to remember that sustainable weight management relies on a well-balanced diet of fruits, vegetables, lean proteins, whole grains, and healthy fats. Kiwis should be consumed mindfully with individualized nutrition needs in mind.

May Improve Eye Health

Interestingly, kiwis may also benefit eye health. Their impressive nutrient profile can help maintain optimal vision and reduce the risk of age-related eye concerns, such as macular degeneration and cataracts. The lutein and zeaxanthin carotenoids found in kiwis can help reduce oxidation in the eye, which can ultimately lead to cataracts. Compared to other sources of carotenoids, kiwis offered a high bioavailability.

The vitamin C found in kiwis also plays a role in eye health and eye structure. As an antioxidant, it may help reduce inflammation and the resulting risk of common eye problems like macular degeneration. However, further research is needed better to understand the relationship between vitamin C and eye health.

While there is a need for a deeper understanding of kiwi and its role in the eyes, regular kiwi consumption may benefit those who want to be proactive with their eye health.

Low-Glycemic Index

Carbohydrates are essential to a healthy diet, but not all carbs are created equal. Some provide more nutritional value, while others cause significant blood sugar spikes. The glycemic index ranks carbohydrate-containing foods based on their effects on blood sugar levels. Foods are ranked on a scale from 0 to 100 based on how quickly they raise your blood glucose. The faster their effects, the higher their rank.

Kiwis have a high water content and are considered a low-glycemic index food. The green kiwi varieties have a glycemic index of around 39, and the golden types around 48. Because of its limited effects on blood sugar levels compared to other fruits, the kiwi may be a good choice for those with diabetes.

Nutrition of Kiwi

One kiwi with a 2-inch diameter, or approximately 69 g of the flesh of a raw green kiwi, provides:

  • Calories: 42.1
  • Fat: 0.36 g
  • Sodium: 2.07 milligrams (mg)
  • Carbohydrates: 10.1 g
  • Fiber: 2.07 g
  • Added sugars: 0 g
  • Protein: 0.79 g
  • Vitamin C: 64 mg
  • Vitamin K: 27.8 micrograms (mcg)
  • Copper: 0.09 mg

The kiwi is a powerhouse fruit, rich in many essential vitamins and minerals. One kiwi provides 10 g of carbs, supplying a boost of energy without causing a rollercoaster of blood sugar levels.

Kiwis are also rich in vitamin C, a potent nutrient for the immune system, and vitamin K, essential for blood clotting and bone health. Lastly, kiwis contain approximately 10% of the recommended daily intake of copper. The body uses copper to carry out many vital functions, including making energy, blood vessels, and connective tissue.

Risks of Kiwi

Kiwis are considered generally safe for the average healthy individual. However, they pose a significant risk for those who have a kiwifruit allergy. Kiwis contain many allergens, including actinidin, a major allergen.

Signs of a kiwi allergy include:

  • Abdominal pain
  • Vomiting
  • Wheezing
  • Difficulty swallowing
  • Generalized hives
  • Itchy throat and mouth
  • Facial swelling
Tips for Consuming Kiwi

The kiwi is a nutritious fruit that offers many health benefits in addition to its delicious flavor. Consider these tips for consuming kiwi:

  • To quickly peel a kiwi, cut it in half and scoop the flesh out with a spoon.
  • The peel can be eaten for an additional boost of fiber.
  • Once ripe, a kiwi should be refrigerated until eaten.
  • Kiwi can be found with green or golden flesh.
  • Combine kiwi chunks with mango, peppers, and cilantro to make a zesty salsa.
  • Layer kiwi slices with Greek yogurt and low-fat granola to make a nutrient-dense breakfast parfait.
  • Add kiwi slices to various smoothie recipes to add vitamin C and copper to a nutritious snack.
A Quick Review

Kiwi is a powerhouse fruit, rich in flavor and nutrients. Despite its small size, it provides a significant amount of the recommended daily intake of many vitamins and minerals. Kiwis are rich in vitamin C, copper, and vitamin K and contain smaller portions of many other important nutrients. Their impressive nutrition profile supports many avenues of health, including digestion, weight management, and blood sugar control. They also support heart and eye health and a healthy immune system.

Kiwis are generally considered safe, except for those with a known allergy to the fruit or any of its components. A registered dietitian nutritionist can help you incorporate kiwi and other nutritious fruits into a well-balanced diet to help meet your health and wellness goals.

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This number will shape Earth’s future as the climate changes. You’ll be hearing about it.

USA Today

This number will shape Earth’s future as the climate changes. You’ll be hearing about it.

Elizabeth Weise, USA TODAY – November 30, 2023

Consider that 3 degrees Fahrenheit is the difference between a raging fever and a healthy toddler. Between a hockey rink and a swimming pool. Between food going bad or staying at a safe temperature.

Now consider that Earth is about 2 degrees Fahrenheit hotter on average than it was in the 1800s. It’s little wonder that has already led to measurable shifts in the climate: The last eight years have been the hottest in recorded history and 2023 is expected to be the hottest yet.

But there’s a looming threshold that will dictate the future of planet Earth. It could have cascading effects on how hot the planet gets, how much seas rise and how significantly normal daily life as we now know it will change.

The number is 2.7 degrees Fahrenheit.

World leaders at an annual gathering beginning Thursday will be spending considerable energy pondering that number, although they will use the Celsius version: 1.5 degrees.

“We can still make a big difference and every single tenth of a degree is enormously important,” said Anthony Leiserowitz, director of the Yale Program on Climate Change Communication.

Representatives and negotiators from 197 nations are gathering at an event called COP (Conference of the Parties) in the United Arab Emirates, a 13-day meeting that comes at what scientists say is a critical moment in the fight to keep the already dangerous effects of climate change from tipping over into the catastrophic.

Research published last month estimated humanity has only six or so more years before so much carbon dioxide has been pumped into the atmosphere that there’s only a 50% chance of staying below the threshold.

Why 2.7 degrees Fahrenheit is so important

In 2016, the United States and 195 other parties signed the Paris Agreement, a legally binding international treaty on climate change aimed at lowering the amount of greenhouse gases in the atmosphere to keep global warming at bay.

All the nations that signed the Agreement pledged to try as hard as possible to keep the global average temperature increase below 2.7 degrees, and to definitely keep it below a 3.6 degrees Fahrenheit rise. (Only the Agreement said it in Celsius, which comes out to the smoother-sounding 2.0 degrees Celsius and 1.5 degrees Celsius.)

The numbers sound pretty small – but they aren’t.

A few degrees is a big deal

The difference between 65 degrees and 67.7 degrees (that critical 2.7-degree difference) isn’t even worth carrying a sweater. So why does it worry climate scientists?

It’s because they’re thinking about global temperature averages, and when the global average goes up, the extremes go way up.

The Earth is already 1.1 degrees Celsius warmer than it was in the 1800s, about 2 degrees Fahrenheit. And it’s warming fast.

Ocean surface temperatures were the highest ever recorded this year, causing fish die-offs and increasing red tides.

People across America are already noticing the effects. Storms are more extreme, drenching areas with more water that’s causing an increasing number of devastating flash floods. Dozens of people in Vermont, Tennessee and Pennsylvania are only the most recent victims.

These aren’t just normal storms, these are deluges where four months of rain falls in one day.

We’re also experiencing more devastating droughts catastrophic wildfires and wetter hurricanes.

Swedish climate activist Greta Thunberg takes part in a press conference at the UNFCCC SB58 Bonn Climate Change Conference on June 13 in Bonn, Germany. The conference lays the groundwork for the adoption of decisions at the upcoming COP28 climate conference in Dubai in December.
Swedish climate activist Greta Thunberg takes part in a press conference at the UNFCCC SB58 Bonn Climate Change Conference on June 13 in Bonn, Germany. The conference lays the groundwork for the adoption of decisions at the upcoming COP28 climate conference in Dubai in December.
Why is it important to not let the Earth warm an extra degree?

The difference between an aspiration of no more than 2.7 degrees warming and a serious commitment to no more than 3.6 degrees might not seem large.

But multiply the extremes and their effects, and each results in a vastly different world. One is difficult, resulting in a less reliable and more chaotic climate than the one we live with today. The other verges on a movie cataclysm.

At their heart, the 13 days of COP28 negotiations are the place global governments sit down to hammer out just how much each will lower its carbon emissions, though many other climate change topics are on the table as well.

Using published research and reports from the U.N.’s Intergovernmental Panel on Climate Change, Carbon Brief laid out the likely measurable difference between a world that is 2.7 degrees warmer and one that is 3.6 degrees warmer:

◾ Sea level rise by 2100 of 18 inches vs. 22 inches

◾ Ice-free Arctic summer chance of 10% vs. 80%

◾ Central U.S. warm spells last 10 days vs. 21 days

◾ Percentage of people facing at least one severe heat wave in five years is 14% vs. 37%

Why is this all about fossil fuels?

Before the Industrial Revolution, the carbon dioxide in the atmosphere – which is what’s causing global warming – was 280 parts per million.

The current measurement is 421.47 parts per million.

NASA graph showing the rise of carbon dioxide levels in the Earth's atmosphere from 800,000 years ago to today.
NASA graph showing the rise of carbon dioxide levels in the Earth’s atmosphere from 800,000 years ago to today.

The change has been underway for decades, but the extent of the shift is only now becoming clearly evident. In the 1980s, the country experienced on average a $1 billion, adjusted for inflation, disaster every four months. It now experiences one every three weeks. This year, the country has set a new record with 25 billion-dollar disasters.

The Earth crossed a key warming threshold in 2023, with one-third of the days so far having an average temperature at least 1.5 degrees Celsius higher than preindustrial levels. On Nov. 17, it reached 2.07 degrees above. This year is expected to be the warmest in recorded history, warmer than any other in 125,000 years.

What is COP28?

COP28 is the annual United Nations meeting of the 197 parties that have agreed to the U.N. Framework Convention on Climate Change, originally adopted in 1992. The meeting is the decision-making body of the countries that signed onto the U.N. framework. It is held to assess how well nations are dealing with climate change and set agendas and goals.

How important is this COP?

In a major report, the UN’s climate change body said earlier this month that global greenhouse gas emissions need to fall by 45% by the end of this decade compared to 2010 levels to meet the goal of limiting global temperature rise to 1.5 degrees Celsius.

Things are not going in the right direction. Instead, emissions are set to rise by 9%.

COP28 is where changes can be made.

Scientists say humanity has about a decade to dramatically reduce heat-trapping gas emissions before thresholds are passed that may make recovery from climate collapse impossible.

To do so will require cutting nearly two-thirds of carbon pollution by 2035, the Intergovernmental Panel on Climate Change said. That means ending new fossil fuel exploration and weaning wealthy nations away from coal, oil and gas by 2040.

“Humanity is on thin ice – and that ice is melting fast,” United Nations Secretary-General Antonio Guterres said in the spring. “Our world needs climate action on all fronts – everything, everywhere, all at once.”

The #1 Whole Grain to Eat to Help Decrease Inflammation, According to a Dietitian

Eating Well

The #1 Whole Grain to Eat to Help Decrease Inflammation, According to a Dietitian

Deborah Murphy, M.S., RDN – November 25, 2023

It’s nutty, chewy and tasty for breakfast, lunch or dinner.

<p>PHOTOGRAPHER: GREG DUPREE, FOOD STYLIST: MARTGARET DICKEY PROP STYLIST: KAY CLARKE</p>
PHOTOGRAPHER: GREG DUPREE, FOOD STYLIST: MARTGARET DICKEY PROP STYLIST: KAY CLARKE

Reviewed by Dietitian Emily Lachtrupp, M.S., RD

Inflammation has long been Enemy No. 1 when it comes to your health. It’s not all bad, though. After all, inflammation promotes healing during injury or infection. After a few hours to several days, it subsides when you’re all better. However, an inflammatory response that lingers and becomes chronic can put you at increased risk for heart disease, type 2 diabetes and cancer, among other conditions.

Related: The Best Foods to Eat to Fight Inflammation

Luckily, lifestyle changes and healthy eating habits can often keep chronic inflammation in check. Adopting an anti-inflammatory diet can help. This style of eating is similar to the popular Mediterranean diet, since both emphasize anti-inflammatory foods like fruits, vegetables and whole grains.

And speaking of whole grains, these foods are top inflammation fighters. They’re all good to have on your plate, but one earns our top pick for a top anti-inflammatory grain.

How Whole Grains Help Fight Inflammation

Whole grains have a reputation as a healthy food—and for good reason. “Whole grains are part of a balanced diet and are known for their role in reducing the risk of chronic diseases like heart disease, diabetes and even some forms of cancer,” says Seattle-based registered dietitian nutritionist, Ginger Hultin, M.S., RDN, owner of Ginger Hultin Nutrition and author of Anti-Inflammatory Diet Meal Prep. “A lot of people don’t realize that whole grains can help lower chronic inflammation levels in the body,” she adds.

A 2022 study published in JAMA Network Open, analyzed data collected from over 4,000 adults and compared whether the source of dietary fiber (cereals, fruits, vegetables) made a difference on markers of inflammation. Cereal fiber from whole grains was linked to significantly lower markers of inflammation than fiber from either fruits or vegetables.

“The reason [whole grains] play a role in managing systemic inflammation is because they are rich in fiber, which aids both in detoxification and maintaining a healthy gut microbiome, a critical component for a robust immune system and controlling inflammation,” Hultin explains. When beneficial bacteria in the gut ferment whole-grain fiber, they produce compounds, such as short-chain fatty acids, that may help reduce inflammation, per a 2020 review in Nutrition Reviews.

The No. 1 Whole Grain for Decreasing Inflammation

Picking just one whole grain for decreasing inflammation was difficult since they all have so much to offer. In the end, farro (aka emmer) was our top whole-grain pick. Here’s why.

Packed with Fiber

As previously mentioned, the fiber in whole grains is part of the reason they have so many anti-inflammatory benefits. When choosing a whole grain to boost your fiber intake, farro is an excellent choice. Just 1/4 cup uncooked farro (about ½ cup cooked) provides 5 grams of fiber, according to the USDA. It’s recommended you aim for 28 to 34 grams of fiber per day, making farro a good source of the nutrient.

Rich in Antioxidants

Farro contains a variety of antioxidants. These are beneficial compounds in foods that can prevent damage caused by free radicals. Although free radicals are produced naturally in the body, if left unchecked they can contribute to chronic inflammation. Farro contains antioxidants like carotenoids, as well as tocotrienols. Carotenoids are yellow, orange and red pigments typically found in veggies like carrots and bell peppers, notes the Linus Pauling Institute at Oregon State University. Tocotrienols are compounds in the vitamin E family with antioxidant and anti-inflammatory properties, per a 2021 review from the Institute of Human Nutrition Sciences.

Contains Inflammation-Battling Betaine

Our body naturally produces the compound betaine when it metabolizes the nutrient choline, but betaine can also be found in certain foods like beets, spinach and whole grains, according to a 2023 study in BMC Endocrine Disorders. And, you guessed it—farro contains the compound betaine, according to a 2018 article in the Journal of Cereal Science. As noted in a 2023 article in Molecules, there is new interest in betaine as a possible ingredient with anti-inflammatory benefits.

A Versatile Grain

Unlike oats, which are generally reserved for breakfast, farro can be used in a variety of dishes from porridge to soups and salads. If oatmeal is your go-to breakfast, try this Slow-Cooker Overnight Farro Porridge. Add tons of fiber to soup by incorporating farro like we did in this Slow-Cooker Italian Vegetable & Farro Soup. Use farro as a stand-in for rice in risotto in this Farro Risotto with Mushrooms & Greens.

Bottom Line

Even though inflammation is a normal and important part of our body’s natural defense system, chronic inflammation puts you at risk for a bevy of health conditions. Luckily, incorporating anti-inflammatory foods like fruits, vegetables and whole grains into your diet can help tame chronic inflammation. Our top whole-grain pick for inflammation is farro, since it’s packed with fiber and antioxidants while also being a versatile pantry staple.