Medical Mysteries: How a sore throat led to life-threatening bleeding

The Washington Post

Medical Mysteries: How a sore throat led to life-threatening bleeding

Sandra G. Boodman, The Washington Post – February 17, 2024

(Getty Images) (Dumitru Ochievschi via Getty Images)

For more than a year, Arthur L. Kimbrough had done everything he could think of to find out what was causing the stabbing sensation that radiated from his throat to his neck and down his left shoulder. He had seen anesthesiologists, an ear, nose and throat doctor, a neurologist and neurosurgeons in Florida and Maryland; undergone tests and scans; and taken a variety of drugs that failed to alleviate the intensifying pain that baffled his doctors.

It wasn’t until February 2022, after Kimbrough suffered a life-threatening hemorrhage in a hospital waiting room, that the cause was finally identified.

Two years later, Kimbrough, now 76, attributes his survival to being in the right place at the right time. He says he feels lucky to be alive and is not angry his illness wasn’t diagnosed earlier.

Doctors “missed some things clearly, [but] it wasn’t because they weren’t looking,” said Kimbrough, an executive coach who lives in the Florida Panhandle and owns funeral homes and cemeteries in Florida and Mississippi. “They were very responsive.”

“The blinders we had on was that it turned out to be the fundamentally wrong place to be looking,” he said.

Unusual sore throat

Kimbrough first noticed the pain – a tender spot under the left side of his tongue in the back of his mouth – in mid-December 2020. It didn’t seem like a conventional sore throat: Swallowing wasn’t painful. His family physician found no inflammation and recommended he see his ENT; both doctors are Kimbrough’s close friends. A heavy smoker for 25 years who quit in his early 40s, Kimbrough asked the ENT if he might have throat cancer.

The doctor was reassuring. “Throat cancer doesn’t generate this kind of pain,” Kimbrough remembers him saying. “It’s been so long since you smoked.”

The ENT suspected that a salivary gland might be infected and prescribed an antibiotic. When that failed to alleviate the pain, the doctor examined Kimbrough’s throat with a laryngoscope, an instrument used in office procedures. He told Kimbrough his throat looked healthy and suspected the soreness might reflect a jaw problem, possibly temporomandibular joint dysfunction (TMJ), or a pinched nerve in his neck. The latter hypothesis would guide Kimbrough’s 14-month quest.

After Kimbrough’s dentist ruled out TMJ, he began seeing a chiropractor who recommended spinal X-rays. They showed age-related arthritis in the C3 vertebrae near his jaw.

For the next two months, the chiropractor performed neck “adjustments.” At first, they provided some relief, but by the end of March, Kimbrough’s pain was worse. The chiropractor sent him to an anesthesiologist who specializes in pain management. He administered a nerve block, an injection consisting of a painkiller and a steroid to reduce inflammation. It didn’t help.

The anesthesiologist ordered an MRI of Kimbrough’s cervical spine, which showed spondylosis, abnormal wear on the neck cartilage and vertebrae that may be more common in very active people. He told Kimbrough he might have spinal stenosis, a common problem that increases with age and is caused by a narrowing of vertebrae that can affect nerves. But there was no sign of nerve compression that could explain his pain.

In June, six months after the throat pain started, Kimbrough consulted a friend who is a vascular surgeon to informally review his care. The surgeon told him it sounded appropriate.

Kimbrough, who pays close attention to his health, is a fitness devotee and regularly worked out with a group of former Army Rangers. At that time, in addition to his family physician, he consulted an “anti-aging” doctor every four months who ordered blood tests and prescribed supplements to enhance his health and fitness. Kimbrough took 50 pills per day.

‘Like a hot spear’

By July, the pain, which had spread to his left ear and eye socket, had worsened, disrupting his sleep. Kimbrough managed to maintain his busy work schedule and trained for a short-distance triathlon, his 20th, which he completed July 4. Exercise, he found, seemed to blunt what “felt like a hot spear stabbing me from my jawline, encasing my head like a vise and then radiating to my left shoulder blade.”

Kimbrough decided he needed to expand his search for an answer beyond north Florida. Through business contacts he obtained an August 2021 appointment with an expert in spinal neurosurgery at Johns Hopkins Hospital in Baltimore.

The neurosurgeon reviewed the results of his MRI and confirmed that it showed degenerative changes in his neck. But he told Kimbrough that the pain on the left side of his head was perplexing; according to the scan, it should have been on the right. He suggested that Kimbrough try wearing a cervical collar to immobilize his neck for 20 minutes every day to see if it helped. Neither the collar nor the acupuncture sessions Kimbrough decided on his own to try made a difference.

Over dinner one night in October 2021, Kimbrough’s ENT, noting the severity of his pain and his difficulty swallowing, suggested his spine wasn’t the problem. He thought Kimbrough might have trigeminal neuralgia (TN), chronic debilitating facial pain caused by a nerve injury.

He immediately changed Kimbrough’s medication to a drug used to treat TN. The pain “exploded,” Kimbrough said. “For the first time, I began to understand why some people commit suicide.” He called his primary care doctor who put him back on the previous drug and made a next-day appointment for Kimbrough with a neurosurgeon in Tallahassee.

The neurosurgeon couldn’t find anything and referred Kimbrough to a neurologist who was equally baffled. He sent Kimbrough to a second pain specialist who administered epidural spinal injections that didn’t help. Meanwhile the Baltimore neurosurgeon recommended he see a nerve pain specialist at Hopkins; his appointment was scheduled for late February 2022.

In December, Kimbrough underwent a CT scan of his neck and another test to determine why he was having trouble swallowing. The scan found “mild asymmetry” on his left tonsil but no visible mass. The radiologist suggested that an ENT perform a throat exam that can involve a biopsy; the procedure was never performed.

By mid-February 2022, Kimbrough was in bad shape. He had lost more than 20 pounds and was unable to swallow anything other than clear liquids. His pain varied from tolerable to “like a blowtorch” and was barely controllable despite the maximum dose of the prescription painkiller OxyContin. And none of his doctors seemed to have a clue about what might be wrong.

Kimbrough worried he had a brain tumor. “I was just wandering around the morass of doomsday scenarios,” he recalled.

A few days before his appointment with the Hopkins pain specialist, he and his wife flew to Arizona for a family celebration. The night before their flight, Kimbrough experienced a nose bleed that stopped quickly. It was a harbinger of what would happen the next day.

Drowning in blood

The Baltimore appointment began with a neurological exam. The anesthesiologist asked Kimbrough to stick out his tongue, then requested that he stick it straight out. When he said he had, she handed him a mirror. It revealed that his tongue curved markedly to the left.

The doctor told him that pressure on a nerve or a mass in his throat might be causing the deviation and asked if he could stay in Baltimore for more tests. When he said he’d stay as long as necessary, she left to schedule an urgent MRI.

Sitting in the waiting room, Kimbrough started sipping a Coke. Without warning, blood began gushing out of his mouth and nose. Someone handed him a stack of napkins; it was drenched in seconds. As he coughed and spat out some of the blood and blood clots that were cascading down his throat, Kimbrough remembers thinking, “I’m drowning in my own blood.” For years, he had taken a blood thinner to treat an irregular heartbeat; the drug can exacerbate bleeding.

Kimbrough was quickly surrounded by doctors and nurses and hustled off to the emergency department. “They were so calm I never felt any real fear,” he recalled.

“The worry was that he could die of asphyxiation” by aspirating his own blood, said otolaryngologist R. Alex Harbison, the head and neck surgeon who met him in the ER. Harbison examined Kimbrough and saw a huge six-centimeter mass – at its widest point, the height of an egg – extending from the roof of his mouth over his tonsils to the back of his tongue.

He suspected the mass was cancerous and that it was caused by the human papilloma virus (HPV). The mass, which had been growing for more than a year, had become entwined with a nerve and had irritated the left lingual artery in the throat until it ruptured, triggering the bleed. Pathologists would soon determine that Kimbrough had Stage 3 squamous cell throat cancer caused by HPV-16, the most common type.

HPV, which infects virtually everyone, is spread through sex. Most infections clear on their own, but high-risk HPV, including HPV-16, can cause several cancers later in life, including cervical and throat cancer. A vaccine approved in 2006, and usually administered in childhood before a person is sexually active, can prevent the vast majority of HPV-related cancers that account for more than 37,000 cases annually in the United States. Doctors recommend the vaccine for some adults up to age 45.

HPV oral cancer, which is growing rapidly among men, is the most common head and neck cancer in the United States. (Non-HPV oral cancer is typically caused by smoking and alcohol use.) It often responds to chemoradiation, radiation combined with concurrent chemotherapy, particularly if detected early.

Harbison told Kimbrough what doctors had found and ticked off the steps they would take to try to stop the bleeding. The doctor spoke frankly: If anything went wrong, Kimbrough was unlikely to survive. How aggressive did he want doctors to be? Harbison asked.

“I said, ‘Do whatever you’ve got to do,’” Kimbrough remembers replying.

Kimbrough was intubated, received blood transfusions and underwent an embolization, a procedure that plugged the artery with a coil to stop the hemorrhage. “After that, it’s pretty much hold your breath and wait,” Harbison said. “The level of anxiety was very high” because of the chance of another bleed.

Because Kimbrough was severely malnourished, doctors also inserted a feeding tube in his stomach. A few days later, a tracheostomy tube in his neck was inserted to protect his airway. Within a week of his emergency admission, his condition appeared to have stabilized.

The Hopkins team recommended chemoradiation. Because Kimbrough and his wife knew no one in Baltimore, they opted for treatment at Washington University in St. Louis. They had lived in the city for 20 years and one of their sons still did.

Kimbrough arrived in St. Louis on March 10 with feeding and tracheostomy tubes in place. The medical team there told Kimbrough they believed chemoradiation had a 60 percent chance of eradicating his cancer. But even if they succeeded, they warned him he might always need a feeding tube.

Playing the trombone

On that, he proved them wrong: The feeding tube was removed at the end of July, a month after he finished cancer treatment and a month before he went home to Florida. Kimbrough remains unable to swallow more than a few bites of very soft food; his diet is mostly liquid. So far, his scans have shown no sign of cancer. He has returned to work and is able to speak normally and can play his trombone.

Harbison, who is now an assistant professor of otolaryngology at Washington University (he left Hopkins to return to his native St. Louis eight months ago), noted that the characteristics and location of Kimbrough’s tumor made it harder to spot, which may have helped delay his diagnosis.

Kimbrough said his ENT recently told him that as a result of Kimbrough’s experience, he is more aggressive about performing biopsies on patients with similar symptoms and recently diagnosed another man with HPV-related cancer whose throat pain radiated to his shoulder.

“Art’s presentation is extremely rare,” said Harbison, who has treated about 200 patients with HPV-related oral cancer, which often appears as a neck lump.

But someone with “persistent throat or ear pain should be investigated by an expert,” he said. It’s possible, he added, that the cancer was missed on the 2021 MRI.

Kimbrough says he wants other men to benefit from his ordeal by learning about HPV, vaccinating their children and questioning assumptions that may turn out to be erroneous, as they were in his case.

Although he now regards it as crucial, Kimbrough said it simply didn’t occur to him to get a second ENT opinion for his sore throat, partly because the focus had been on his spine.

“Everyone was doing their best with the best of intentions,” he said. “There was a fork in the road and we didn’t go down that other path.”

Taylor Swift, Travis Kelce and a MAGA Meltdown

The fulminations surrounding the world’s biggest pop icon — and girlfriend of Chiefs tight end Travis Kelce — reached the stratosphere after Kansas City made it to the Super Bowl.

By Jonathan Weisman – January 31, 2024

Travis Kelce, left, wearing football pads with an AFC Champion T-shirt and hat that says Super Bowl, kisses Taylor Swift on the field after a game.
Taylor Swift and Travis Kelce after the Chiefs’ victory on Sunday. They are the focus of right-wing vitriol and conspiracy theories. Credit…Julio Cortez/Associated Press

For football fans eager to see a new team in the Super Bowl, the conference championship games on Sunday that sent the Kansas City Chiefs and San Francisco 49ers back to the main event of American sports culture were sorely disappointing.

But one thing is new: Taylor Swift. And she is driving the movement behind Donald Trump bonkers.

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The fulminations surrounding the world’s biggest pop icon — and girlfriend of Travis Kelce, the Chiefs’ star tight end — reached the stratosphere after Kansas City made it to the Super Bowl for the fourth time in five years, and the first time since Ms. Swift joined the team’s entourage.

The conspiracy theories coming out of the Make America Great Again contingent were already legion: that Ms. Swift is a secret agent of the Pentagon; that she is bolstering her fan base in preparation for her endorsement of President Biden’s re-election; or that she and Mr. Kelce are a contrived couple, assembled to boost the N.F.L. or Covid vaccines or Democrats or whatever.

“I wonder who’s going to win the Super Bowl next month,” Vivek Ramaswamy, the conspiratorial presidential candidate, turned Trump surrogate, pondered on social media on Monday. “And I wonder if there’s a major presidential endorsement coming from an artificially culturally propped-up couple this fall.”

The pro-Trump broadcaster Mike Crispi led off on Sunday by claiming that the National Football League is “rigged” in order to spread “Democrat propaganda”: “Calling it now: KC wins, goes to Super Bowl, Swift comes out at the halftime show and ‘endorses’ Joe Biden with Kelce at midfield.”

Other detractors of Ms. Swift among Mr. Trump’s biggest fans include one of his lawyers, Alina Habba, one of his biggest conspiracy theorists, Jack Posobiec, and other MAGA luminaries like Laura Loomer and Charlie Kirk, who leads a pro-Trump youth organization, Turning Point USA.

The right has been fuming about Ms. Swift since September, when she urged her fans on Instagram to register to vote, and the online outfit Vote.org reported a surge of 35,000 registrations in response. Ms. Swift had embarked on a world tour that helped make her a billionaire. Gavin Newsom, the California governor, praised her as “profoundly powerful.” And then Time magazine made her Person of the Year in December, kicking off another round of MAGA indignation.

The love story that linked her world with the N.F.L. has proved incendiary. Mr. Kelce’s advertisements promoting Pfizer’s Covid vaccine and Bud Light — already a target of outrage from the right over a social media promotion with a transgender influencer, Dylan Mulvaney — added fuel to that raging fire.

Taylor Swift onstage, middle, while she is projected onto two screens at left and right, in the middle of a stadium.
Ms. Swift embarked on a worldwide stadium tour last year, which included a May stop at MetLife Stadium in New Jersey. Credit…Jutharat Pinyodoonyachet for The New York Times

The N.F.L.’s fan base is huge and diverse, but it includes a profoundly conservative element that cheered on the star quarterback Aaron Rodgers’s one-man crusade against Covid vaccines and jeered Black players who knelt during the national anthem. The league has long battled charges of misogyny, from the front offices of the Washington Commanders to multiple cases of sexual and domestic assault and abuse.

The Swift-Kelce story line, for some, has delivered a bruising hit to traditional gender norms, with a rich, powerful woman elevating a successful football player to a new level of fame.

Some of the Monday morning quarterbacking has been downright silly, including speculation that Ms. Swift is after Mr. Kelce for his money. (Her net worth exceeds $1 billion, a different universe than the athlete’s merely wealthy status.)

Other accusations appear to be driven by fear and grounded in some truth, or at least in her command of her 279 million Instagram followers: that she has enormous influence, and has supported Democrats in the past. For much of her extensive music career, Ms. Swift avoided politics, but in 2018, she endorsed two Democrats in Tennessee, where she owns two homes: former Gov. Phil Bredesen, who was running for the Senate against then-Representative Marsha Blackburn, and Jim Cooper, a House member who has since retired.

“I always have and always will cast my vote based on which candidate will protect and fight for the human rights I believe we all deserve in this country,” she wrote on social media. “I believe in the fight for L.G.B.T.Q. rights, and that any form of discrimination based on sexual orientation or gender is WRONG.”

She added, “I believe that the systemic racism we still see in this country towards people of color is terrifying, sickening and prevalent.”

The alarm bells were loud enough to pull Mr. Trump into loudly backing Ms. Blackburn: “I’m sure Taylor Swift doesn’t know anything about her,” he said at the time, knowing all too well how influential Ms. Swift could be. “Let’s say that I like Taylor’s music about 25 percent less now, OK?”

He probably liked her even less in 2020 when she criticized his pandemic response, and then endorsed Mr. Biden.

While her early pop music may have mainly attracted teens and preteens, those fans have reached voting age, and her music has grown more sophisticated with the albums “Evermore” and “Folklore” to match her millennial roots and her fans’ taste.

Taylor Swift fans taking selfies outside a merchandise booth before a concert.
In September, Ms. Swift urged her fans on Instagram to register to vote, yielding a surge of 35,000 registrations on the website Vote.org. Credit…Jutharat Pinyodoonyachet for The New York Times

Much of the Swift paranoia has lurked on the MAGA fringes, with people like Ms. Loomer, the conspiracy theorist from Florida who declared in December that “2024 will be MAGA vs Swifties” and Mr. Kirk, who declared in November that Ms. Swift would “come out for the presidential election” after Democrats had another strong showing in an election that demonstrated the issue of abortion motivated voters to the polls.

“All the Swifties want is swift abortion,” he said.

Then Swift-bashing reached Fox News in mid-January. The host Jesse Watters suggested the superstar was a Defense Department asset engaging in psychological warfare. He tied Ms. Swift’s political voice with her boyfriend’s Pfizer endorsement to the remarkable success of her Eras tour, which bolstered local economies and landed her on the cover of Time.

“Have you ever wondered why or how she blew up like this?” Mr. Watters wondered on air. “Well, around four years ago, the Pentagon psychological operations unit floated turning Taylor Swift into an asset during a NATO meeting.”

Andrea Hailey, the chief executive of Vote.org, made the most of the Fox News criticism, saying the organization’s partnership with Ms. Swift “is helping all Americans make their voices heard at the ballot box,” adding that the star is “not a psy-op or a Pentagon asset.”

But her appearance on the field with Mr. Kelce in Baltimore after the Chiefs beat the Ravens on Sunday, complete with a kiss and a hug, appears to have sent conservatives into a fit of apoplexy that may only grow in the run-up to Super Bowl LVIII in Las Vegas Feb. 11.

The feelings are so strong that Fox News ran a segment on Sunday lamenting that Ms. Swift’s private “jet belches tons of CO2 emissions,” showing a sudden awareness of the leading cause of global warming.

Mr. Ramaswamy said his Super Bowl conjecture was dead serious.

“What your kind of people call ‘conspiracy theories,’ I simply call an amalgam of collective incentives hiding in plain sight,” he said.

The White House press secretary Karine Jean-Pierre stoked speculation still more by invoking the Hatch Act, which prohibits political actions by civil servants, in declining to answer whether Mr. Biden would be appearing with Ms. Swift.

“I’m just going to leave it there,” she said Monday. “I’m not going to get into the president’s schedule at all from here, as it relates to the 2024 elections.”

The Trump campaign, which had initially planned to ignore the frenzy, dispatched Karoline Leavitt, a campaign spokeswoman, to dismiss concerns about a potential Biden endorsement.

“I don’t think this endorsement will save him from the calamity” of his record, she said.

Audio produced by Parin Behrooz.

Jonathan Weisman is a politics writer, covering campaigns with an emphasis on economic and labor policy. He is based in Chicago. 

At 93, he’s as fit as a 40-year-old. His body offers lessons on aging.

The Washington Post

At 93, he’s as fit as a 40-year-old. His body offers lessons on aging.

Gretchen Reynolds – January 19, 2024

Richard Morgan competes in an indoor rowing competition in 2018. (Row2k.com)

For lessons on how to age well, we could do worse than turn to Richard Morgan.

At 93, the Irishman is a four-time world champion in indoor rowing, with the aerobic engine of a healthy 30- or 40-year-old and the body-fat percentage of a whippet. He’s also the subject of a new case study, published last month in the Journal of Applied Physiology, that looked at his training, diet and physiology.

Its results suggest that, in many ways, he’s an exemplar of fit, healthy aging – a nonagenarian with the heart, muscles and lungs of someone less than half his age. But in other ways, he’s ordinary: a onetime baker and battery maker with creaky knees who didn’t take up regular exercise until he was in his 70s and who still trains mostly in his backyard shed.

Even though his fitness routine began later in life, he has now rowed the equivalent of almost 10 times around the globe and has won four world championships. So what, the researchers wondered, did his late-life exercise do for his aging body?

Lessons on aging from active older people

“We need to look at very active older people if we want to understand aging,” said Bas Van Hooren, a doctoral researcher at Maastricht University in the Netherlands and one of the study’s authors.

Many questions remain unanswered about the biology of aging, and whether the physical slowing and declines in muscle mass that typically occur as we grow older are normal and inevitable or perhaps due, at least in part, to a lack of exercise.

If some people stay strong and fit deep into their golden years, the implication is that many of the rest of us might be able to as well, he said.

Helpfully, his colleague Lorcan Daly, an assistant lecturer in exercise science at the Technological University of the Shannon in Ireland, was quite familiar with an example of successful aging. His grandfather is Morgan, the 2022 indoor-rowing world champion in the lightweight, 90-to-94 age group.

What made Morgan especially interesting to the researchers was that he hadn’t begun sports or exercise training until he was 73. Retired and somewhat at loose ends then, he’d attended a rowing practice with one of his other grandsons, a competitive collegiate rower. The coach invited him to use one of the machines.

“He never looked back,” Daly said.

Highest heart rate on record

They invited Morgan, who was 92 at the time, to the physiology lab at the University of Limerick in Ireland to learn more, measuring his height, weight and body composition and gathering details about his diet. They also checked his metabolism and heart and lung function.

They then asked him to get on a rowing machine and race a simulated 2,000-meter time trial while they monitored his heart, lungs and muscles.

“It was one of the most inspiring days I’ve ever spent in the lab,” said Philip Jakeman, a professor of healthy aging, physical performance and nutrition at the University of Limerick and the study’s senior author.

Morgan proved to be a nonagenarian powerhouse, his sinewy 165 pounds composed of about 80 percent muscle and barely 15 percent fat, a body composition that would be considered healthy for a man decades younger.

During the time trial, his heart rate peaked at 153 beats per minute, well above the expected maximum heart rate for his age and among the highest peaks ever recorded for someone in their 90s, the researchers believe, signaling a very strong heart.

His heart rate also headed toward this peak very quickly, meaning his heart was able to rapidly supply his working muscles with oxygen and fuel. These “oxygen uptake kinetics,” a key indicator of cardiovascular health, proved comparable to those of a typical, healthy 30- or 40-year-old, Daly said.

Exercising 40 minutes a day

Perhaps most impressive, he developed this fitness with a simple, relatively abbreviated exercise routine, the researchers noted.

Consistency: Every week, he rows about 30 kilometers (about 18.5 miles), averaging around 40 minutes a day.

A mix of easy, moderate and intense training: About 70 percent of these workouts are easy, with Morgan hardly laboring. Another 20 percent are at a difficult but tolerable pace, and the final 10 at an all-out, barely sustainable intensity.

Weight training: Two or three times a week, he also weight-trains, using adjustable dumbbells to complete about three sets of lunges and curls, repeating each move until his muscles are too tired to continue.

A high-protein diet: He eats plenty of protein, his daily consumption regularly exceeding the usual dietary recommendation of about 60 grams of protein for someone of his weight.

How exercise changes how we age

“This is an interesting case study that sheds light on our understanding of exercise adaptation across the life span,” said Scott Trappe, director of the Human Performance Laboratory at Ball State University in Indiana. He has studied many older athletes but was not involved in the new study.

“We are still learning about starting a late-life exercise program,” he added, “but the evidence is pretty clear that the human body maintains the ability to adapt to exercise at any age.”

In fact, Morgan’s fitness and physical power at 93 suggest that “we don’t have to lose” large amounts of muscle and aerobic capacity as we grow older, Jakeman said. Exercise could help us build and maintain a strong, capable body, whatever our age, he said.

Of course, Morgan probably had some genetic advantages, the scientists point out. Rowing prowess seems to run in the family.

And his race performances in recent years have been slower than they were 15, 10 or even five years ago. Exercise won’t erase the effects of aging. But it may slow our bodies’ losses, Morgan’s example seems to tell us. It may flatten the decline.

It also offers other, less-corporeal rewards. “There is a certain pleasure in achieving a world championship,” Morgan told me through his grandson, with almost comic self-effacement.

“I started from nowhere,” he said, “and I suddenly realized there was a lot of pleasure in doing this.”

Should you use protein powder before or after a workout? Here’s what a sports nutritionist says

Fit & Well

Should you use protein powder before or after a workout? Here’s what a sports nutritionist says

Dan Cooper – January 18, 2024

 Person placing scoop of protein powder into a blender.
Person placing scoop of protein powder into a blender.

Everybody agrees that you need protein to build muscle, but there’s still some debate on when you should consume it.

Sports nutritionist Roo Whelan says that the timing is actually less important than making sure you eat adequate amounts. Most studies also suggest that your muscle gains aren’t affected by when you eat your protein-filled snack.

That doesn’t mean there aren’t any benefits to filling up on protein before or after your gym session. We got Whelan to explain how it affects your body.

Benefits of protein before a workout

The main benefit of eating protein before a workout is that it could improve your performance. According to Whelan, downing a shake before you exercise can stabilize blood sugar and provide sustained energy levels.

Consuming protein before you exercise will also ensure that your body has easy access to the amino acids it needs to repair and grow your muscles.

This could minimize muscle breakdown, which happens during strenuous training sessions, and also encourage your muscles to repair themselves during your workout.

Benefits of protein after a workout

According to Whelan, your body is in a heightened state of nutrient absorption after exercise. This means that it’s especially receptive to any protein you consume, using it to immediately repair damaged muscle fibers.

If your protein shake also comes with a serving of sugar and carbs, your body can use this to replenish your diminished glycogen (energy) stores.

It’s not clear how long this heightened state lasts for, but you probably have a few hours before your body returns to normal.

The other benefit of eating your protein after you exercise is that it’s easier on your digestion. Who likes doing burpees on a full stomach?

So should you eat protein before or after a workout?

Studies suggest that there’s minimal difference between consuming protein before or after a workout when it comes to muscle gains. If you want to take advantage of all of the above benefits, you could try eating protein before and after you work out.

But unless you’re a competing athlete, it’s important not to get caught up in the weeds here. If you are trying to build or maintain muscle, the main thing is just getting enough protein regardless of when you consume it.

Looking to up your protein levels without drastically increasing your carb intake? Have a read through our guide to the best protein powders for weight loss

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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Study reveals simple act could stave off 2 leading causes of death among adults: ‘Doesn’t need to be complicated’

The Cool Down

Study reveals simple act could stave off 2 leading causes of death among adults: ‘Doesn’t need to be complicated’

Erin Feiger – December 4, 2023

A quick walk a day may keep an early death away.

A study published in the British Journal of Sports Medicine found that as little as 75 minutes a week of moderately intense, non-occupational physical activity substantially lowers the risk of dying from certain types of cancer or heart disease, two of the leading causes of death among adults.

That’s just over an hour a week – and half the 150 minutes a week recommended by the CDC – of activity where your heart rate is 50% to 60% higher than when at rest.

You’ll know you’re at the right level of activity if you can speak while doing it but not sing, according to the CDC. So, while walking outside might make you feel like singing, in order to reap the health benefits of this walk, you’ll have to leave that to the birds.

This study is the largest ever done on this topic, pooling data from 196 articles and over 30 million participants from nearly 100 study groups, so the results are significant.

The Mayo Clinic agrees with its findings, stating that “physical activity doesn’t need to be complicated. Something as simple as a brisk daily walk can help you live a healthier life.”

This is good news for a large part of the population who find it difficult to carve out 30 minutes a day, five days a week, to commit to a strenuous workout.

Being able to walk in nature, or at least in a park or among trees, has added physical benefits, too.

An article by Lincoln Larson and Aaron Hipp of North Carolina State points out that “nature-based programs can even be prescribed by health care providers as part of alternative, cost-effective treatment plans.”

However, a brisk 10-minute walk among trees is likely not an option for over 80% of the population in the United States and over 50% of the world’s population who live in urban centers or urban heat islands.

Creating more green space and more walkable cities would not only allow more people to easily achieve this health benefit, but it would also reduce pollution caused by cars.

If a 10-minute walk isn’t an option for you, then find something that is, like dancing, biking, or swimming.

Walking could lower your risk of type 2 diabetes, and your speed may affect how much, study finds

CNN

Walking could lower your risk of type 2 diabetes, and your speed may affect how much, study finds

Kristen Rogers, CNN – November 28, 2023

Walking could lower your risk of type 2 diabetes, and your speed may affect how much, study finds

Sign up for CNN’s Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts.

When it comes to walking and type 2 diabetes risk, it’s not just how much you do it that helps — it’s also how fast you move, a new study has found.

Brisk walking is associated with a nearly 40% lower risk of developing type 2 diabetes later in life, according to the study published Tuesday in the British Journal of Sports Medicine.

“Previous studies have indicated that frequent walking was associated with a lower risk of developing type 2 diabetes in the general population, in a way that those with more time spent walking per day were at a lower risk,” said the study’s lead author Dr. Ahmad Jayedi, a research assistant at the Social Determinants of Health Research Center at the Semnan University of Medical Sciences in Iran.

But prior findings haven’t offered much guidance on the optimal habitual walking speed needed to lower diabetes risk, and comprehensive reviews of the evidence are lacking, the authors said.

Going a certain pace during your walk may help lower your type 2 diabetes risk, according to a new study. - LeoPatrizi/E+/Getty Images
Going a certain pace during your walk may help lower your type 2 diabetes risk, according to a new study. – LeoPatrizi/E+/Getty Images

The study authors reviewed 10 previous studies conducted between 1999 and 2022, which assessed links between walking speed — measured by objective timed tests or subjective reports from participants — and the development of type 2 diabetes among adults from the United States, the United Kingdom and Japan.

After a follow-up period of eight years on average, compared with easy or casual walking those who walked an average or normal pace had a 15% lower risk of developing type 2 diabetes, the researchers found. Walking at a “fairly brisk” pace meant a 24% lower risk than those who easily or casually walked. And “brisk/striding walking had the biggest benefit: a 39% reduction in risk.

Easy or casual walking was defined as less than 2 miles (3.2 kilometers) per hour. Average or normal pace was defined as 2 to 3 miles (3.2 to 4.8 kilometers) per hour. A “fairly brisk” pace was 3 to 4 miles (4.8 to 6.4 kilometers) per hour. And “brisk/striding walking” was more than 4 (6.4 kilometers) per hour. Each kilometer increase in walking speed above brisk was associated with a 9% lower risk of developing the disease.

That faster walking may be more beneficial isn’t surprising, but the researchers’ “ability to quantify the speed of walking and incorporate that into their analysis is interesting,” said Dr. Robert Gabbay, chief scientific and medical officer for the American Diabetes Association, via email. Gabbay wasn’t involved in the study.

The study also affirms the idea that “intensity is important for diabetes prevention,” said Dr. Carmen Cuthbertson, an assistant professor of health education and promotion at East Carolina University who wasn’t involved in the study, via email. “Engaging in any amount of physical activity can have health benefits, but it does appear that for diabetes prevention, it is important to engage in some higher intensity activities, such as a brisk walk, to gain the greatest benefit.”

Understanding the benefits of brisk walking

The study doesn’t prove cause-and-effect, Gabbay said, but “one can imagine that more vigorous exercise could result in being more physically fit, reducing body weight and therefore insulin resistance and lowering the risk of diabetes.”

Dr. Michio Shimabukuro, a professor and chairman of the department of diabetes, endocrinology and metabolism at the Fukushima Medical University School of Medicine, agreed — adding that “increased exercise intensity due to faster walking speeds can result in a greater stimulus for physiological functions and better health status.” Shimabukuro wasn’t involved in the study.

Walking speed may also simply reflect health status, meaning healthier people are likely to walk faster, said Dr. Borja del Pozo Cruz, principal investigator of health at the University of Cadiz in Spain, who wasn’t involved in the research.

“There is a high risk of reverse causality, (wherein) health deficits are more likely to explain the observed results,” del Pozo Cruz added. “We need randomized controlled trials to confirm — or otherwise — the observed results.”

Lowering your diabetes risk

The overall message “is that walking is an important way to improve your health,” Gabbay said. “It may be true that walking faster is even better. But given the fact that most Americans do not get sufficient walking in the first place, it is most important to encourage people to walk more as they’re able to.”

If you want to challenge yourself, however, using a fitness tracker — via a watch, pedometer or smartphone app — can help you objectively measure and maintain your walking pace, experts said.

If you can’t get a fitness tracker, an easy alternative for tracking exercise intensity is the US Centers for Disease Control and Prevention’s “talk test,” which relies on understanding how physical activity affects heart rate and breathing. If, while walking, you’re able to talk with a labored voice but not sing, your pace is probably brisk.

Paper: Invasive Asian Ticks Kill Cattle in Ohio

Field & Stream

Paper: Invasive Asian Ticks Kill Cattle in Ohio

Travis Hall – November 15, 2023

Ticks on a lent roller.
One of the cows reportedly suffered as many as 10,000 tick bites.

Asian longhorned ticks (ALTs) have been spreading across the Eastern and Midwestern U.S. since at least 2017, according to the Center for Disease Prevention (CDC), and the pests’ numbers are now on the rise in Ohio—a recent study from the Ohio State University reveals. According to the study’s authors, 9,287 invasive ticks were removed from a farm in eastern Ohio in the summer of 2021 after three cattle were reported dead from tick bites by the landowner.

During the study—lead-authored by Ohio State Assistant Professor of Veterinary Preventive Medicine Risa Pesapane—scientists continued to monitor the invasive tick population after most of the pests were killed off with pesticides. They found that the Asian longhorn ticks returned to the pasture and continued to spread in June 2022, despite the tick control efforts undertaken in 2021.

“You cannot spray your way out of an Asian longhorned tick infestation,” Pesapane said in a Nov. 3 news release. “They are going to spread to pretty much every part of Ohio and they are going to be a long-term management problem. There is no getting rid of them.”

Pesapane said that the cattle killed during the 2021 ALT infestation in eastern Ohio sustained thousands of tick bites. “One of those was a healthy male bull, about 5 years old,” she said in the press release. “Enormous. To have been taken down by exsanguination by ticks, you can imagine that was tens of thousands of ticks on one animal.” The term “exsanguination” refers to the action of draining a person, animal, or organ of the blood needed to sustain life.

On its website, the CDC says that ALTs, native to east Asia, have spread to 19 U.S. states since they were first reported in New Jersey in 2017. The list includes Arkansas, Connecticut, Delaware, Georgia, Indiana, Kentucky, Maryland, Massachusetts, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, and West Virginia.

According to Pesapane, the invasive tick’s rapid spread lies in its ability to reproduce asexually, without mating. “There are no other ticks in North America that do that. So they can just march on, with exponential growth, without any limitation of having to find a mate,” Pesapane said. “Where the habitat is ideal, and anecdotally it seems that un-mowed pastures are an ideal location, there’s little stopping them from generating these huge numbers.”

Read Next: Is Whitetail Deer Blood the Key to Fighting Lyme Disease in Humans?

The CDC is urging anyone who finds an Asian longhorn tick on a person, pet, or on livestock, to remove the pest as quickly as possible. “Save the tick in rubbing alcohol in a jar or a ziplock bag,” the agency advises, “then contact your health department about steps you can take to prevent tick bites and tickborne diseases.

‘Devastating toll’ of climate change now impacting ‘all regions’ of the U.S., Biden says

Yahoo! News

‘Devastating toll’ of climate change now impacting ‘all regions’ of the U.S., Biden says

The federal government’s fifth National Climate Assessment, released Tuesday, details how climate change is affecting every corner of the country.

Ben Adler, Senior Editor – November 14, 2023

Every region of the United States is now seeing rapid warming due to climate change, according to the federal government’s fifth National Climate Assessment, which was released Tuesday.

“I’ve seen firsthand what the report makes clear: the devastating toll of climate change. And its existential threat to all of us,” President Biden said from the White House Tuesday morning. “I’ve walked the streets of Louisiana, New Jersey, New York, Florida, Puerto Rico, where historic floods and hurricanes wiped out homes, hospitals, houses of worship.”

“This assessment shows us in clear scientific terms that climate change is impacting all regions, all sectors of the United States — not just some, all,” he added.

The report lays out in stark detail how climate change is already harming communities nationwide.

“Climate change is finally moving from an abstract future issue to a present, concrete, relevant issue. It’s happening right now,” the report’s lead author, Katharine Hayhoe, chief scientist at the Nature Conservancy and a professor at Texas Tech University, said in a statement.

Here are the key takeaways from the assessment.

Everyone is feeling the heat
National Park Service Rangers pose for a photo next to a sign showing a temperature of 132 degrees.
National Park Service Rangers Gia Ponce (left) and Christina Caparelli are photographed by Ranger Nicole Bernard next to a digital display of an unofficial heat reading at Furnace Creek Visitor Center in Death Valley National Park in Death Valley, Calif., on July 16. (Ronda Churchill / AFP via Getty Images) (AFP via Getty Images)

This year is on pace to be the warmest on record globally, and in the U.S., the heat is being felt nationwide, according to the report, which the federal government is required by law to produce every five years:

  • Every single region has higher average temperatures today than it did between 1951 and 1980.
  • The U.S. is warming faster than most of the world. Since 1970, the Lower 48 states have warmed by 2.5 degrees Fahrenheit, and Alaska by 4.2 degrees Fahrenheit, compared with the global average temperature rise of 1.7 degrees Fahrenheit.
  • Phoenix set a record this year with 54 days of high temperatures of 110 degrees Fahrenheit or greater, including 31 straight days over 110.
  • In Alaska, melting glaciers, thawing permafrost and disappearing sea ice are destroying the hunting and fishing-dependent economy. Some Indigenous communities may need to be relocated to flee rising sea levels.
  • Since warming is happening faster at higher latitudes, the report projects that the U.S. will warm about 40% more than the global average in the future.

Recommended reading

CBS News: 2023 ‘virtually certain’ to be warmest year recorded, climate agency says

South Florida Sun-Sentinel: Hot nights in South Florida: Nighttime low temperature set record high this weekend

‘Heavy precipitation events are increasing’
Vehicles make their way through floodwater.
Vehicles make their way through floodwater in Brooklyn, N.Y., on Sept. 29. (Ed Jones / AFP via Getty Images) (AFP via Getty Images)

Warmer air holds more moisture, so climate change is throwing the water cycle out of whack, researchers say. Since 2000, the western half of the country has endured a two-decade megadrought that has threatened freshwater supplies for millions of people.

But while annual rainfall has decreased in much of that region, the entire country has seen an increase in heavy precipitation events. As a result, this year saw a series of sometimes deadly flash floods from California to Vermont.

Hurricanes, which draw power from warm ocean waters, are also increasingly powerful, thanks in part to hotter ocean temperatures. (In July, the all-time record-high ocean temperature was set at 101.1 degrees Fahrenheit off of Florida’s Gulf Coast.)

‘More severe wildfires’
Burned trees in a forest.
Burned trees from recent wildfires stand in a forest in Fort Chipewyan, Alberta, Canada, on Sept. 3. The United States has been inundated with wildfire smoke from Canada this year. (Victor R. Caivano/AP Photo) (ASSOCIATED PRESS)

Warmer temperatures and dried-out vegetation from drought lead to more frequent and severe wildfires. Wildfires and the smoke they create have been an increasingly prevalent and severe problem in the West in recent years, but this summer the Northeast and Midwest were also at times enveloped in thick smoke from Canada’s record-setting wildfire season.

An economic toll

The report notes a sharp rise in the number of billion-dollar disasters in the U.S., with one occurring every three weeks since 2018. In the 1980s, the country experienced a billion-dollar weather disaster once every four months, according to the assessment.

“Extreme events cost the U.S. close to $150 billion each year — a conservative estimate that does not account for loss of life, health care-related costs or damages to ecosystem services,” the report stated.

Growing threats

The report also identifies frequent flooding due to sea-level rise and more powerful storms as a threat to low-lying regions across the country. Health risks, such as food and water contamination, increased air pollution from smoke, dust and pollen are also expected to worsen.

“Climate change threatens vital infrastructure that moves people and goods, powers homes and businesses, and delivers public services,” the report states.

The U.S. has begun to combat climate change
President Joe Biden delivers remarks beneath signage that reads: Historic Climate Action.
President Joe Biden delivers remarks on his administration’s actions to address the climate crisis in the South Court Auditorium of the White House on Tuesday. (Saul Loeb/AFP via Getty Images) (AFP via Getty Images)

The report also notes that U.S. greenhouse gas emissions dropped 12% between 2005 and 2019 thanks to the adoption of renewable energy sources like wind and solar energy.

The Biden administration has attempted to build on this progress through regulatory measures, like stiff new fuel efficiency standards for cars and trucks. And Congress approved $369 billion for investments in clean energy and electric vehicles in the Inflation Reduction Act. But those measures are only projected to cut emissions by 40% by 2030, not the 50% Biden has pledged to the international community.

A need to adapt, and to act

States and cities across the country have begun retrofitting infrastructure to meet the challenges of climate change, and measures such as enhanced storm drain capacity and improved forest management have increased in every region since the last assessment in 2018, according to the assessment.

But the report finds that faster, more ambitious adaptation investments are needed to minimize the still-growing costs of climate change.

Reversing your biological age could help you live longer—and reduce dementia and stroke risk. 8 habits to help flip the switch

Fortune

Reversing your biological age could help you live longer—and reduce dementia and stroke risk. 8 habits to help flip the switch

Erin Prater – November 6, 2023

Getty Images

People whose biological age is greater than their chronological age are at a “significantly increased” risk of stroke and dementia—even when smoking, drinking, BMI, and other risk factors are removed from the equation.

That’s according to a Swedish study published Sunday in the Journal of Neurology, Neurosurgery, and Psychiatry. Researchers examined the data of more than 325,000 UK residents between the ages of 40 and 70—and neurologically healthy—when the study began. They calculated the biological age of each participant via 18 biomarkers, including:

  • Blood lipids
  • Blood sugar
  • Blood pressure
  • Lung function
  • Waist circumference
  • Red blood cell count
  • Lymphocytes
  • Blood urea nitrogen
  • Creatine
  • Albumin
  • Alkaline phosphatase
  • Glycated hemoglobin
  • Uric acid
  • C-reactive protein

Nine years later, researchers checked to see if participants had developed dementia, stroke, ALS (Lou Gehrig’s disease), or Parkinson’s disease, and if there were any trends in biological age among those who had.

Having a higher biological than chronological age seemingly led to an elevated risk of dementia, especially vascular; ischemic stroke, from a blood clot in the brain; and ALS, a neurodegenerative condition, they found.

There was a weaker apparent association between elevated biological age and Alzheimer’s disease and other motor neuron diseases, which include progressive spinal muscular atrophy and primary lateral sclerosis.

Among researchers’ other findings:

  • The more air a person can expel during a forced breath, the lower the apparent risk of dementia and ischaemic stroke.
  • A higher red blood cell count seems to denote an increased risk of dementia.
  • Women below the age of 60 with an elevated biological age appear to be at the greatest risk of developing dementia.

There did not appear to be a connection between elevated biological age and the development of Parkinson’s disease.

“If a person’s biological age is five years higher than their actual age, the person has a 40% higher risk of developing vascular dementia or suffering a stroke,” Jonathan Mak—a doctoral student in the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Sweden, and one of two lead authors on the study—said in a news release about it.

While the study was an observational one and can’t prove causation, it shows that it may be possible to reduce the number of age-related diseases one develops, or to delay their onset, by improving biomarkers, the authors assert.

Biological vs. chronological age

Just what is the difference in biological and chronological age? Simply put, chronological age is how long you’ve been alive—the number of candles on your cake—while biological age is how old your cells are.

Biological age is also referred to as the epigenetic age. The epigenome “consists of chemical compounds that modify, or mark, the genome in a way that tells it what to do, where to do it, and when to do it,” according to the U.S. National Institutes of Health.

Those changes—influenced by environmental factors like stress, diet, drugs, and pollution—can be passed down from cell to cell as they divide, and from generation to generation. While chronological age can’t be reversed, biological/epigenetic age can be.

Scientists already knew that advanced chronological age is a risk factor for the development of common neurologic disorders like neuropathy, Alzheimer’s disease, and Parkinson’s disease. But because people of the same chronological age, age at different rates, it’s a “rather imprecise measure” when it comes to the prediction of disease development, Sara Hägg—an associate professor in the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet, and a lead author on the study—said in the news release.

Prior research had shown an apparent correlation between elevated biological age and increased risk of developing some cancers, depression, anxiety, and death. But little work had been done on the potential impact of biological age on the development of neurologic disorders, the authors wrote, adding that they next plan to study its impact on other diseases.

How to slow—and even reverse—biological aging

The good news: The process of biological aging can be slowed—so much so that one’s biological age can dip below their chronological age.

That’s according to new research released Monday by the American Heart Association. Scientists examined the connection between biological age and the association’s “Life’s Essential 8” checklist, which includes the goals of:

  • Eating better
  • Being more active
  • Quitting tobacco
  • Getting healthy sleep
  • Managing weight
  • Controlling cholesterol
  • Managing blood sugar
  • Managing blood pressure

After examining the records of more than 6,500 adult participants, they found that better cardiovascular health—as measured by the above factors—was associated with slower biological aging. Participants with high cardiovascular health had a biological age lower than their chronological age.

For example, the average chronological age of those with high cardiovascular health was 41, but their average biological age was 36, researchers found. Conversely, the average chronological age of those with low cardiovascular health was 53, but their average biological age was 57.

Participants who scored the highest on the aforementioned checklist—and thus were considered to have high cardiovascular health—had a biological age that was, on average, six years younger than their chronological age, researchers said.

“These findings help us understand the link between chronological age and biological age, and how following healthy lifestyle habits can help us live longer,” Dr. Donald M. Lloyd-Jones, chair of the writing group for the checklist and a past volunteer president of the American Heart Association, said in a news release on the study.

“Everyone wants to live longer—yet more importantly, we want to live healthier longer so we can really enjoy and have a good quality of life for as many years as possible.”