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People who frequently drink beverages made with sugar or artificial sweeteners could carry a higher risk of a potentially dangerous heart condition, new research shows.

The findings come from a study, published March 5 in the American Heart Associations journal Circulation: Arrhythmia and Electrophysiology, which found a link between these sweetened beverages and atrial fibrillation (A-Fib), an irregular heart rhythm that can increase a persons risk of stroke and heart failure.

People who frequently drank artificially sweetened drinks, like those containing sucralose or aspartame, had a 20% higher risk of A-Fib compared to those who didnt consume any such beverages. Those who drank beverages made with sugar had a 10% higher risk.

Meanwhile, people who said they occasionally drank pure fruit juiceless than one liter a weekhad an 8% lower risk of A-Fib.

Our studys findings cannot definitively conclude that one beverage poses more health risk than another due to the complexity of our diets and because some people may drink more than one type of beverage, lead study author Ningjian Wang, MD, PhD, a researcher at the Shanghai Ninth Peoples Hospital and Shanghai Jiao Tong University School of Medicine in Shanghai, China, said in a press release.

However, based on these findings, we recommend that people reduce or even avoid artificially sweetened and sugar-sweetened beverages whenever possible, Wang added. Do not take it for granted that drinking low-sugar and low-calorie artificially sweetened beverages is healthy, it may pose potential health risks.

Heres what you need to know about the new research, and how it might influence your beverage choices.

seksan Mongkhonkhamsao / Getty Images

For the study, Wang and his Shanghai-based team of researchers reviewed answers from dietary questionnaires and genetic data from more than 200,000 adults enrolled in the U.K. Biobank, a large biomedical database and research resource.

At the time participants enrolled in the research, between 2006 and 2010, they were free from A-Fib. But over the course of a 10-year follow-up period, 9,362 cases of A-Fib were diagnosed.

After analyzing and comparing sweetened beverage choices among participants, researchers found that both sugar- and artificially sweetened drinks were associated with an increased risk of A-Fib.

People who drank at least two liters of artificially sweetened beverages each weekcomparable to about six 12-ounce canshad a 20% higher risk of A-Fib, compared to people who didnt consume any sweetened drinks. For people who drank the same amount of sugar-sweetened beverages each week, their A-Fib risk was 10% higher.

Researchers looked at fruit juice intake too, but participants who drank one liter or less of pure fruit juice each week had an 8% lower risk of A-Fib.

Other factors were also considered in A-Fib risk: Researchers found that drinking more than 2 liters of artificially sweetened drinks per week resulted in a high A-Fib risk regardless of genetic susceptibility to the condition, However, when smoking was paired with sugar-sweetened beverage consumption, participants saw a 31% higher risk of A-Fib.

These novel findings on the relationships among atrial fibrillation risk and sugar- and artificially sweetened beverages and pure juice may prompt the development of new prevention strategies by considering decreasing sweetened drinks to help improve heart health, Wang said.

Although there is robust evidence linking sugar-sweetened beverages to cardiovascular disease risk, less is known about the heart effects of artificial sweeteners, American Heart Association committee member Penny M. Kris-Etherton, PhD, RD, said in the press release.

This is the first study to report an association between no- and low-calorie sweeteners and also sugar-sweetened beverages and increased risk of atrial fibrillation, said Kris-Etherton, who is also an emeritus professor of nutritional sciences at Penn State University.

Because this study only shows an association between sweetened beverages and A-Fib, the true heart risks of drinking these beverages are still unclear. However, there are several possible explanations, including insulin resistance and the bodys response to different sweeteners, Wang said.

According to Henri Roukoz, MD, cardiologist and chief of electrophysiology at the University of Minnesota medical school, people who drink sugar-sweetened beverages tend to have a higher risk of obesity, type 2 diabetes, heart disease, kidney disease, and other health concerns. Among others, obesity and diabetes are also known risk factors for A-Fib.

Regarding artificially sweetened drinks, Roukoz said the diets of those consumers may be putting them at an increased risk of A-Fibnot the drinks themselves. Patients who tend to consume more beverages that are artificially sweetened, in general, tend to also eat more. They eat also less quality food, said Roukoz. That predisposes you to all these other factors that increase your cardiovascular risk.

The diet theory may also matter for fruit juice drinkers. Patients who actually are careful enough to avoid artificial sweeteners, said Roukoz, and careful enough to consume small amounts of [fruit juice], are probably also watching their diet.

Every person could benefit from cutting back on sugar- and artificially sweetened beverages. But while the studys results are intriguing and may pave the way for additional research on A-Fib risk and sweetened beverages, it still had its share of limitations.

The study was observational and relied on participants recalling their own diets, which can lead to less accurate results. The caffeine content of the drinks is also unknown, as were the specific types of artificial sweeteners used in the beverages consumed.

Use of data from the U.K. Biobankwhile robustis also not a perfect match for a more diverse U.S. population, meaning that the same study conducted here could yield different results, said Roukoz. In the U.S., for example, A-Fib is more common in white Americansbut African American and Mexican American adults are more likely to drink sugar-sweetened beverages.

Its important too that these findings dont overshadow more concrete A-Fib risk factors, like having sleep apnea or diabetes, or not following a nutritious diet, said Roukoz.

Still, water is the best choice, and, based on this study, no- and low-calorie sweetened beverages should be limited or avoided. Kris-Etherton said.

Roukoz agrees: It is prudent to consume [sweetened] products in moderation. Below two liters per weekit wouldnt hurt to do that.

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Study: Diet, Sugary Drinks Linked to Atrial Fibrillation Risk - Health.com

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Summary

Jake Gyllenhaal put immense effort into getting his body in shape for Road House, and his personal trainer praises him for his efforts. The new movie is a remake of the 1989 Patrick Swayze film and stars Gyllenhaal as a former UFC fighter who is recruited to work as a bouncer. With Conor McGregor's Knox posing an existential threat, Gyllenhaal's Dalton has to be in perfect shape to stop his rampaging enemy.

Since there were multiple shirtless scenes and several real-world UFC fighters in the Road House cast, Gyllenhaal needed to get in shape to match everyone else. Men's Health spoke to Gyllenhaal and his personal trainer, Jason Walsh, about what it took to help him look like a UFC fighter.

While Gyllenhaal praised the entire team, Walsh wanted nothing more than to commend Gyllenhaal for his work effort. He emphasized that the actor was willing to engage in a variety of drills, including sled work, chain push-ups, and climber sprints, and he did so without faltering. Check out Walsh's quote below:

"The way he looked throughout the movie, there [are] peaks, right? People don't see the valleys. They don't see the time in between the peaks, it just looks like one continuous thing. It doesn't work like that... You can have a great trainer, a great program, great team none of this matters if you don't have the right person to do it all. Jake did the work . He earned it."

Walsh has good reason to praise Gyllenhaal's workout routine. To properly prepare for the movie, Walsh explained that he took part in mobility drills, isometric exercises, heavy sled work, squats, bag drills, push-ups, and presses. He also worked on sprints, push-pull machines, and various other drills that worked every muscle that Gyllenhaal needed to train. Many of the exercises were designed specifically to mimic the movements that he needed to make in Road House fights.

Gyllenhaal also needed to follow a specialized diet to build muscle. While putting aside sugar, he increased his caloric and protein intake. After discovering an allergy to his protein supplements, Walsh put together a specialized protein blend that Gyllenhaal could safely consume. Gyllenhaal also cooked much of his food for himself and his family and stuck closely with his plan.

Considering Road House was filmed in numerous locations, including the Dominican Republic, Florida, and Las Vegas, Gyllenhaal likely needed to maintain his physique for some time, even in various unfamiliar environments. While Walsh accounts for the "peaks" and "valleys" in Gyllenhaal's figure, it is still an impressive display, especially for a 43-year-old actor. With considerable effort, Gyllenhaal tailored his diet and exercise plan for Road House to make the movie as realistic as possible.

Road House is available for streaming on Prime Video.

Source: Men's Health

Road House is a remake of the original 1989 film, which followed protagonist Dalton, a Ph.D. educated bouncer at the roughest bar in the south known as the Double Deuce. Jake Gyllenhaal stars as Dalton, with two major changes including Dalton being a retired UFC fighter and the bar locale being in the Florida Keys.

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Jake Gyllenhaal's Road House Transformation & Diet Revealed By Actor's Trainer - Screen Rant

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Scientists have discovered a fascinating connection between eating one avocado every day and an overall enhanced diet quality and healthier life.

Spearheaded by Associate Professor Kristina Petersen and the esteemed retired Professor Penny Kris-Etherton from Penn State Universitys Department of Nutritional Sciences, this study delves into how incorporating a single avocado into ones daily diet can lead to significant nutritional benefits.

The investigation, published in the journal Current Developments in Nutrition, embarked on exploring the effects of a straightforward food-based intervention: the daily intake of one avocado. Avocados, known for their nutrient-dense profile, are packed with fiber and other essential nutrients.

Avocados are a powerhouse of nutrition, and our objective was to ascertain if their regular consumption could boost diet quality, explained Petersen. She highlighted prior observational studies indicating that avocado consumers generally maintain a higher diet quality compared to non-consumers.

The research aimed to establish a causative connection between avocado intake and improved diet quality, especially considering the scant 2% of American adults who consume avocados regularly.

Through telephone interviews conducted at various stages of the study, the research team gathered 24-hour dietary intake data from participants. Their diet quality was then assessed using the Healthy Eating Index, which measures adherence to the Dietary Guidelines for Americans.

The study divided 1,008 participants into two groups: one that continued with their usual diet while limiting avocado consumption, and another that included one avocado daily into their diet for 26 weeks.

The findings were compelling. Participants who integrated an avocado into their daily diet showed a marked improvement in their adherence to dietary guidelines.

This improvement suggests that simple strategies like daily avocado consumption can significantly enhance diet quality, Petersen observed.

Interestingly, the study also uncovered that avocados were often used as substitutes for foods rich in refined grains and sodium, indicating a shift towards healthier dietary choices.

Participants not only increased their vegetable intake through avocados (classified as a vegetable in this study) but also replaced less healthy options with this nutritious fruit.

The substitution effect we observed is particularly noteworthy, as it demonstrates avocados potential in replacing higher-calorie, less nutritious foods, Petersen added.

The broader implications of this research cannot be overstated. With poor diet quality being a significant risk factor for a host of preventable diseases, including heart disease, type 2 diabetes, and kidney disease, enhancing dietary adherence to guidelines is critical.

By fostering better compliance with dietary guidelines, we can substantially lower the risk of chronic conditions and improve overall health outcomes, said Petersen.

While the avocado study offers promising insights, Petersen notes that it is part of a larger exploration into food-based interventions to improve diet quality. Previous studies, such as those examining the impact of pistachios on diet quality, have laid the groundwork for this research.

However, Petersen emphasizes the need for further research to identify additional food-based and behavioral strategies to help individuals meet dietary guidelines and combat chronic disease risk.

In summary, this Penn State study compellingly demonstrates that incorporating just one avocado into your daily diet can significantly improve diet quality and adherence to dietary guidelines.

By substituting avocados for less nutritious foods, individuals can enhance their nutrient intake while taking a proactive step towards reducing the risk of chronic diseases.

This research underscores the power of simple, food-based interventions in fostering healthier eating habits and underscores the need for continued exploration into dietary strategies that can support long-term health and wellness.

As discussed previously, avocados, scientifically known as Persea americana, trace back to regions in Mexico and Central America, where the indigenous peoples domesticated this fruit over 10,000 years ago.

The word avocado itself comes from the Nahuatl word ahuacatl, which means testicle, possibly referring to the fruits shape. Spanish explorers in the 16th century introduced avocados to Europe, and from there, their popularity of eating avocados spread across the globe.

Persea americana thrives in subtropical and tropical climates, requiring well-drained soil and moderate to high rainfall to produce fruit. The tree is partially self-pollinating, and growers often plant complementary varieties close to each other to enhance fruit production through cross-pollination.

There are three main varieties of avocados: Mexican, Guatemalan, and West Indian, each with distinctive characteristics. The Hass avocado, a hybrid of Mexican and Guatemalan varieties, is the most popular, known for its pebbly skin and year-round availability.

The monounsaturated fats in avocados can help reduce bad cholesterol levels in your blood, which can lower your risk of heart disease and stroke. Additionally, the high potassium content aids in regulating blood pressure, further protecting the heart.

Despite their high-fat content, avocados can be a weight-loss-friendly food. The fats are satisfying and can help you feel full longer, reducing the urge to overeat. The fiber in avocados also contributes to weight loss by promoting a feeling of fullness and regulating the digestive system.

Avocados are rich in antioxidants, such as Vitamin E and lutein, which protect your skin from the visible signs of aging and maintain eye health. The healthy fats in avocados support skin elasticity and reduce the risk of age-related eye conditions.

As we learned in the Penn State study above, avocados are a treasure trove of nutrients. They are packed with vitamins (such as K, C, E, and B-6), minerals (including potassium and magnesium), fiber, and heart-healthy monounsaturated fats.

Notably, avocados contain more potassium than bananas, a feature that supports heart health by regulating blood pressure levels. The monounsaturated fats found in avocados are primarily oleic acid, which has been linked to reducing inflammation and has beneficial effects on genes linked to cancer.

The high fiber content in avocados also aids in weight loss and metabolic health by promoting a feeling of fullness and reducing blood sugar spikes.

The buttery texture and mild flavor tasted when eating avocados make them a versatile ingredient in the culinary world. They can be used in a wide array of dishes, from the classic guacamole to smoothies, salads, sandwiches, and even desserts.

Avocados texture makes it an excellent substitute for fats in baking, offering a healthier alternative without compromising taste. A simple yet delicious way to enjoy avocados is to prepare avocado toast. This involves spreading ripe avocado on toasted bread and seasoning it with salt, pepper, and other toppings like tomatoes, eggs, or radishes for added flavor and nutrition.

As the demand for avocados has soared, so has concern over their environmental impact. Avocado farming requires significant water resources, and in some regions, this has led to ecological challenges.

Responsible consumption involves choosing avocados from sustainable sources and being mindful of the environmental footprint associated with their production and distribution.

In summary, avocados are a nutritious fruit with deep historical roots and a wide array of health benefits. Their culinary flexibility makes them a beloved addition to meals across different cultures. As we continue to enjoy this green wonder, its crucial to consider sustainable practices that ensure the longevity of avocado farming for future generations.

The full study was published in the journal Current Developments in Nutrition.

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A study published online Dec. 27, 2023, by JAMA Network Open confirms prior research showing that testosterone replacement therapy (TRT) in men with documented low testosterone levels does not increase their risk of prostate cancer compared to men not using TRT.

Researchers recruited 5,246 men with hypogonadism (a condition in which the testes don't produce enough testosterone), no family history of prostate cancer, and prostate-specific antigen (PSA) levels of less than 3 nanograms per milliliter (ng/ml), a number associated with a low risk of prostate cancer. The researchers randomly divided the men into two groups.

For 14 months, the men used either a topical testosterone gel at a dose designed to maintain normal testosterone levels, or an inactive (placebo) gel. Researchers measured PSA levels and conducted digital rectal exams of the prostate at regular intervals over the next three years. By the end of that period, the number of men diagnosed with prostate cancer was equally low in both the testosterone and placebo groups. Those in the TRT group did see their PSA levels rise during the first year of using the gel. However, the increase was small, and PSA levels did not rise again after that, according to the researchers. The testosterone users also reported few symptoms of an enlarged prostate, such as frequent urination, difficulty urinating, and dripping.

The study was limited to men with hypogonadism who had a low risk of prostate cancer, so it's not clear how TRT may affect higher-risk men or those who use testosterone in higher amounts, for longer periods of time, or for treating other conditions.

Image: gorodenkoff /Getty Images

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Appropriate use of testosterone therapy does not appear to raise prostate cancer risk - Harvard Health

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Study area

We carried out our field work in the grassland located within the Experiment Demonstration Base, Grassland Research Institute, Chinese Academy of Agricultural Sciences (40 36 N, 111 45 E). This area has a continental temperate monsoon climate, with an average annual rainfall of ca. 400mm and an annual mean temperature of ca. 6.9C. The dominant plant species are Leymus chinensis, Stipa capillata, Cleistogenes squarrosa and Medicago sativa. Based on our own trapping record, S. dauricus has been the dominant rodent species here in recent years. Other rodents, such as striped hamster (Cricetulus barabensis) and Mongolian gerbil (Meriones Unguiculatus), were also recorded but relatively low in abundance. According to our observation, steppe polecats (Mustela eversmanii), red foxes (Vulpes vulpes) and domestic dogs (Canis lupus familiaris) are the major predators feeding on S. dauricus [32]. Cattle grazing is common here in spring and summer, resulting in an average grass height of ca. 20cm and an average vegetation cover of 45%.

In mid-July, 2023, we conducted the first round of live-trapping in two 1-ha sites located in the study area. In this season, most S. dauricus were reproductively inactive. The two sites were comparable in terms of vegetation, topography and rodent density. To ensure independence in sampling among the sites, there was a distance of 400m between the nearest sites. We placed 100 Sherman live traps (arranged in a 1010 grid, with 10-m intervals between neighboring traps) baited with fresh peanuts in each site. Since S. dauricus were diurnal, the traps were set open between 07:00 and 19:00 (Beijing time). This round of live-trapping lasted for four consecutive days. We checked all the traps every 2h and rebaited the traps if needed. All the S. dauricus captured were immediately put in separate cotton bags and taken back to our laboratory.

A total of 59 S. dauricus (27 males and 32 females) were captured during the first round of live-trapping. We anesthetized each individual by a multi-channel anesthesia machine designed for small animals (R550IE, RWD Life Science Co., Ltd., Shenzhen, China) with isoflurane. To collect the ectoparasites, the body surface of each S. dauricus was carefully scanned using a fine-toothed comb and a tweezer. We also checked the inner side of each cotton bag used to contain the ground squirrels. All the ectoparasites collected from a S. dauricus were immediately placed in ethanol (95%) contained within a separate 5-ml centrifuge tube. All the S. dauricus were weighted to the nearest 0.1g using an electronic balance, toe-clipped for individual identification, and then maintained in separate plastic boxes for 72h with access to ad libitum food (peanuts, alfalfa leaves, and commercial pellets) and water. No S. dauricus showed any abnormal behavior or healthy problem during this period.

We used all the 52 adult individuals (defined as those heavier than 100g, 23 males and 29 females) for our formal experiment. Each ground squirrel was randomly assigned to one of two groups: control group (without testosterone injection, 11 males and 14 females) and treatment group (with testosterone injection, 12 males and 15 females). At 15:0016:00 in the next day after capture, we collected a fresh fecal sample (typically 0.20.3g) from each experimental animal. All the fecal samples were placed in separate 5-ml centrifuge tubes and then immediately stored frozen at 80C. About 72h after capture, each individual was injected intramuscularly with either a dose of tea oil (control group) or a dose of testosteroneoil mixture (10mg of testosterone undecanoate per ml of tea oil). A total of 1h after injection, we released all the individuals at the places where they were captured.

A total of 10days later, we conducted the second round (five consecutive days) of live trapping to recapture the experimental animals. The procedures of live-trapping, anesthesia, ectoparasite collection, fecal sample collection, and animal maintenance were similar to the first round. A total of 28 S. dauricus were recaptured (six males and seven females from the control group, and five males and ten females from the treatment group). An experienced taxonomist (Jian-Jun Wang) later identified all the ectoparasites based on dichotomous keys. The whole experimental procedure adhered to the guidelines approved by the American Society of Mammalogists [34] and the Regulations of the Animal Welfare Committee of Beijing Veterinarians of the Agriculture Ministry of China (Beijing, China).

We typically followed the protocol used by Li etal. [35] to extract testosterone from the fecal samples, with some modifications. A total of 56 fecal samples were used for hormone analyses (i.e., samples collected from the 28 individuals with recaptures, two samples per individual). Since we used wet feces, variations in water content among samples must be accounted for. Therefore, we simultaneously weighed two fecal subsamples (each ca. 0.1g in weight, hereafter subsamples A and B) from each fecal sample. Subsample B was used for measuring water content and was weighed before and after 24-h drying in a drying oven. The water content value was then used to translate the wet sample weight of the relevant subsample A into dry weight.

Subsamples A were used for hormone extraction and placed in separate 10-ml centrifuge tubes. For each tube, we added 4ml of methanol and 1ml of distilled water and then vortexed it for 30min. We then added 2.5ml of petroleum ether to each tube to remove lipid from it. After 10min of vortex, each tube was centrifuged at 1500r/min for 15min. A total of 2ml of liquid was drawn from the methanol layer within each tube and then placed into a 5-ml cryopreservation tube. The methanol was dried off under forced air and the remain was used for hormone assay.

We performed testosterone assays with a commercially available enzyme immunoassay kit (Rat Testosterone Elisa Kit, produced by FanYin Biotechnology Co., Ltd., Shanghai, China). This kit has a sensitivity of 1.0 nanomol/l, and<1% cross-reactivity to other steroids (including progestins, corticoids and estrogens). The testosterone levels were reported as nanogram of fecal testosterone per gram of dry feces.

We performed all the statistical work in R platform 4.2.2 [36]. We first adopted a paired-sample t-test to test whether our experimental treatment affected the fecal testosterone level of S. dauricus. We built a negative-binomial generalized linear mixed-effect model (GLMM) on tick load recorded on the recaptured individuals (hereafter TickLoadafter) using the R package lme4 [37] and lmerTest [38]. The fixed terms included treatment (control or treatment group), sex (male or female), body weight (averaged value of the two measurements), tick load recorded in the first round of ectoparasite check (i.e., tick load before the testosterone manipulation, hereafter TickLoadbefore), flea load in the second round of ectoparasite check (hereafter FleaLoadafter), and an interactive term between treatment and sex. Site ID was used as a random term. Similar models were also built for FleaLoadafter, with fixed factors including treatment, sex, body weight, flea load recorded in the first round of ectoparasite check (hereafter FleaLoadbefore), TickLoadafter, and an interaction between treatment and sex. Variance inflation factors (VIFs) were calculated using the R package car [39] to assess multicollinearity. As the VIFs were all smaller than ten (Table1), we retained all the factors in the models. Model selection was performed based on Alkaike Information Criterion corrected for small sample size (AICc) [40] using the R package MuMIn [41]. Since the performance did not differ significantly between top candidate models (i.e., delta AICc smaller than 2), we used conditional model averaging to get an averaged model based on the full set of candidate models [40]. As we detected a significant interactive effect between treatment and sex on TickLoadafter, we also built two GLMMs on TickLoadafter for male and female squirrels separately (Table2). For these two models, the fixed terms included treatment, body weight, TickLoadbefore, and FleaLoadafter.

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Whether youre a competitive athlete, a fitness enthusiast or just looking for a more chiseled physique, you may be tempted to turn to supplements to give your body a muscle-building boost.

So, when you hear about SARMs (selective androgen receptor modulators), you may think youve found the magic bullet.

After all, you think, theyre not really steroids. So, they must be ... somehow ... better for you, right?

Not so fast, says family medicine physician Ayan Sanyal, MD. SARMs are still in the investigational stages by the FDA (the U.S. Food and Drug Administration), so their safety profile and long-term effects havent been well studied. But from what we do know, SARMs have been associated with very major negative impacts across several vital organs in your body.

What exactly are SARMs and what are the risks? Dr. Sanyal shares what we know so far.

SARM stands for selective androgen receptor modulators. Its a category of compounds that affect the androgen receptors in your body.

Lets break that down.

Androgens like testosterone and dihydrotestosterone (DHT) are the sex hormones associated with things like muscle development, bone density, and sexual desire and function, Dr. Sanyal explains.

Everyone has androgens in their bodies. But men and people assigned male at birth (AMAB) make more androgens than women and people assigned female at birth (AFAB).

In order to do their work, androgens need to bind to certain receptors throughout your body. But those receptors arent always fully activated. Thats normal.

SARMs bypass that system. Think of SARMs as a key that unlocks the androgen receptors in your muscles and bones. They open the doors and allow a rush of testosterone and DHT into those areas.

One effect of that is quicker muscle growth, without you having to put in the work of lifting weights. But there are other effects, too. Potentially dangerous ones. More on those in a bit.

SARMs arent technically illegal in the way that nonmedical drugs, like, say, cocaine, are illegal. But it is illegal for companies to market them as dietary supplements. And they cant be prescribed by doctors.

SARMs also are banned by the U.S. Department of Defense, as well as sports organizations, including the NCAA and the World Anti-Doping Agency (WADA).

More than 120 SARM products are on the WADA Prohibited List, which means these products show up as a positive on a drug screening test, even if you havent taken them for a while or dont take them regularly, Dr. Sanyal notes.

Why are SARMs prohibited in sports?

Its two-pronged, really.

One reason is that SARMs can give you a competitive advantage by increasing muscle mass.

The other is because the known risks of SARMs are enough to cause concern.

Supplement manufacturers try to bypass the rules and regulations regarding selling SARMs in some sneaky ways.

One hint that you may be looking at a product that contains SARMs is on the labels disclaimer. Because SARMs arent allowed to be sold as supplements, youll see language on their package to the effect of For research purposes only. Or Not for human consumption.

Or you can review the ingredients label. But know that SARMs go by a number of different names, making them hard to spot in a laundry list of ingredients.

The U.S. Anti-Doping Agency (USADA) says some of the most popular SARMs include:

See the full list of SARMs and other WADA-prohibited substances here.

But beware that no matter what the package claims, youre likely not getting the full story.

The supplement market is highly unregulated, and theres very little quality control, Dr. Sanyal warns. Companies are trying to make a quick buck, and they know that some people will pay for SARMs. So, some of these products want you to think youre getting SARMs, but they may actually be a very low percentage of those compounds. (Good for your health. Bad for your wallet.)

On the other hand, the lack of regulation means your product could have very high even toxic levels of SARMs.

SARMs work like anabolic steroids in that they can encourage quick muscle growth. But how they go about that work is a little different.

SARMs target the specific androgen receptors in your muscles and bones. Anabolic steroids unlock the androgen receptors across your whole body. Research from the National Institutes of Health says that anabolic steroids also create new androgen receptors.

The risks of misusing anabolic steroids have been well-studied and understood for years. They include issues like:

Some people will tell you that because SARMs are choosy about which receptors they unlock, they dont have negative side effects. Or that because they work differently from anabolic steroids, they arent a risk to your health.

But scientific research says otherwise.

More research needs to be done to know more about SARMs effects and their long-term effects, but the preliminary research has raised a number of concerns, Dr. Sanyal shares.

The FDA warns that research to date has connected SARMs with risks and side effects like:

SARMs have yet to be subjected to the high-quality longitudinal studies that need to happen to fully understand their risks and any benefits, he continues. Future research will also be able to tell us more about how SARMs interact with other medications and supplements.

Researchers are also studying the potential to use SARMs medically for people living with severe muscle loss, such as people with age-related muscle wasting, HIV or people whove lost muscle mass due to chemotherapy treatments.

When SARMs came along in the 1990s, they proliferated the market as a safer alternative to steroids.

That idea is going out of style. Because the more we learn, the less safe they appear.

In 2017, the FDA released a statement warning against SARMS, saying, in part, SARMs, have not been approved by the FDA and are associated with serious safety concerns.

The warning goes on to say that the FDA has and will continue to take legal action against companies selling products that contain SARMs.

You're really rolling the dice by taking SARMs because we dont know everything that they do to the body on the biochemical level, Dr. Sanyal warns. Eating a healthy diet with plenty of lean proteins and alternating cardio exercise with weight training is going to be the safer route to building muscle.

And if you think a supplement is the way to go, talk with a healthcare professional about safe and effective options.

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SARMs Harmful Side Effects and Risks - Health Essentials

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Season 9 of the CNN podcastChasing Life With Dr. Sanjay Guptaexplores the intersection between body weight and health. We delve into a wide range of topics, including the evolutionary reasons behind why losing weight is so hard and how to talk to kids about weight. You can listen here.

(CNN) The internet and social media are rifewith marketing ploys: Its hard to surf the Web or scroll through platforms such as Instagram, Facebook or TikTok without having a slew of ads pop up left, right and center about exactly what you were just viewing. The cookies and algorithms (and other tricks of the trade) follow online users everywhere.

The bombardment seems particularly merciless if you are searching for lose weight or eat healthy or watching any adjacent reel, story or video. Advertisers and influencers are eager to get your eyeballs on a product, protocol or procedure. Sometimes whats promised seems like it could, maybe, work but how can you really tell if its legit? Whose advice should you follow?

Enter Dr. Mikhail Varshavski, who has made it his mission to debunk medical misinformation and educate people. Better known as Dr. Mike, he is a practicing family medicine physician in Chatham, New Jersey, who shares his expertise with millions of YouTube and social media followers. These so-called snake oil sellers and their dubious miracle cures are not new, he said; he calls them I Know All experts, a term he coined in a 2017 TED Talk.

I think its not a new phenomenon. Ponce de Lenwas searching for the fountain of youth many years ago, and yet were still doing that to this day, Dr. Mike recently told CNN Chief Medical Correspondent Dr. Sanjay Gupta on the podcast Chasing Life. I just think that the strategies have changed because we have this new added tool of social media that traditionally doctors, who are evidence-based, have shied away from.

Dr. Mike said the I Know All experts and their too-good-to-be-true products flourish in the gray zone where science does not yet have clear answers and social media and the internet amplify their voices.

It allowed a prime opportunity for these IKA experts to come in and claim that they have all the answers. And thats really just a form of trust hacking through mass confidence, as if they know whats going on with you, he said.

(Thats) in dark contrast to what a physician is trained to do: We come in and we dont claim to know the exact diagnosis. We create one diagnosis along with a differential of other options. It could be, when we recommend the treatment, we hedge and say it works X percentage of the time. But these IKA experts trust-hack and say, I know whats wrong with you. I know this is going to work for you. Take my miracle potion. And that sells very, very well.

To listen to more of Dr. Mikes conversation and learn why certain seemingly cant hurt, might help approaches to weight loss such as tummy teas, fad diets and colon cleanses could actually be dangerous, click on the player below.

With so much misinformation floating around the internet and social media especially around the topic of weight loss what can you do to make sure youre not going down an ill-advised rabbit hole? Dr. Mike has these five tips.

If it seems too good to be true, it probably is.

Dont trust 99% of things you see on social media; be a healthy skeptic. Thats how l like to say it, said Dr. Mike, noting that there are many sources of information both governmental, such as the US Centers for Disease Control and Preventions FoodSafety.gov, and academic, such as the site run by Harvard Medical School that are trustworthy. (Those websites usually end in .gov, .edu and .org.)

There was a funny commercial I forgot what it was for; I believe insurance and there was a woman going on a date with a gentleman, and he completely lied on his profile. And he was, like, Always trust what you see on the internet. And thats a lot (of) how I feel about supplements online and people talking about supplements online: That if it feels too good to be true, allow that inner skeptic in you to further test it, either by doing some more in-depth research on your own if youre comfortable, or bringing it up at your next visit with your primary care doctor.

Speaking of primary care physicians, prioritize building a relationship with a good medical professional.

Thats the biggest tip I would give: to create a long-lasting relationship with a primary care doctor, said Dr. Mike, adding that he sees people in their 20s and 30s using urgent care as their primary care source.

Thats not what urgent care is meant to be, he said. Its not going to give you good outcomes. Youre not going to form a good relationship. Youre not going to get the benefits of having a longitudinal relationship with a single provider. So, those are important.

Dr. Mike said such a relationship is especially important when it comes to weight loss, because how in the world can you help someone sustain weight loss if theres no continuity of care? Its, by definition, mandatory for it.

When it comes to weight and weight loss, there are many important factors involved, so dont fall into the trap of obsessing over one, whether that be the one right diet, the one perfect food or the one must-take supplement.

Zoom out of just thinking about, What I can take or what I can eat? and understand that theres a lot of other things that impact your weight, Dr. Mike said.

So, getting seven to nine hours of sleep as an adult, during the same hours of the night, consistently is going to be important for good weight control. Getting 150 minutes of moderate-intensity physical activity is going to be important.

Dr. Mike also suggests making small adjustments to your daily habits: Skip the elevator and use the stairs instead, and for short distances, leave the car in the garage and do errands on foot. These things are going to add up and actually lead you to have better control of your weight, he said.

When it comes to weight, dont underestimate the role of your mental health.

(Make) sure that you get help when it comes to mental health issues and concerns, Dr. Mike said. Because if youre not in a good mental health place, its very easy to have food become almost a self-treatment for either unhappiness or anxiety. And those conditions both depression and generalized anxiety disorder are treatable conditions, by either getting therapy, perhaps some medication if thats warranted in your condition.

And you might not even connect weight and mental health but it plays an incredibly potent role in helping you not just get to a healthy weight but stay and maintain a healthy weight.

Understand some basic principles about the food you consume, so you dont, for example, vilify or lionize a single food or ingredient.

For example, Dr. Mike said he recently had a guest on his podcast who tried to equate a chocolate kiss to a grape.

We have to put that in perspective. While you may compare them based on their sugar content, thats one way to categorize them, Dr. Mike said. But then if you compare them to how many nutrients that are valuable to us like vitamins, fiber, etc. in grapes versus chocolate, the grapes are clearly healthier.

So avoid trying to oversimplify nutrition with these hard-and-fast rules, and instead just try and give yourself a general understanding of how foods work. Because when youre not as strict and youre not as hard-and-fast in your thinking about food, you actually create a healthier, long-lasting relationship with food that will give you better outcomes in maintaining a healthy weight.

We hope these five tips help you think more clearly about food, weight and what you see or hear about them on the internet. Listen to the full episodehere. And join us next week on theChasing Life podcast when we explore how different diets (keto vs. low fat vs. vegan) and the timing of when we eat can affect our weight and health.

CNN Audios Jennifer Lai contributed to this report.

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At a Glance

Diabetes affects more than 38 million people nationwide. It occurs when levels of blood sugar, or glucose, are too high. Over time, excess bloodglucose can lead to serious health problems, such as heart disease, stroke, nerve damage, and eye disease.

Some people with type 2 diabetesthe most common typekeep blood glucose in check by making lifestyle changes, including diet and exercise. Medications can also help to control blood glucose. Clinical trials over the past few decades have found that bariatric surgery, or weight-control surgery, can also help control type 2 diabetes. But it had been unclear which of these interventions might have better long-term outcomes.

To learn more, NIH-supported researchers at four institutions drew on data collected from four previous clinical trials conducted between May 2007 and August 2013. These trials were single-center studies comparing the effectiveness of bariatric surgeries to medical and lifestyle interventions. The surgeries included sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding. The medical and lifestyle interventions included nutrition counseling, self-monitoring of glucose, and medication to treat diabetes. By pooling data from the four clinical trials, the researchers had a larger, more diverse data set to analyze. Follow-up data was collected 7 to 12 years after the start of the original trials, through July 2022.

In total, 262 study participants agreed to long-term follow-up. All were between ages 18 and 65. Each had overweight or obesity, as measured by body mass index (BMI). Nearly 70% of participants were women, 31% were Black, and 67% were white. More than half (166) were randomized to receive bariatric surgery. The remaining 96 received diabetes medications plus lifestyle interventions known to be effective for weight loss. Results appeared in the Journal of the American Medical Association on February 27, 2024.

The researchers found that, seven years after the original intervention, 54% of those in the surgery group had an A1c measurement less than 7%.A1c is a blood test that measures a persons average blood sugar levels over the previous two or three months.In contrast, only 27% of those in the medical/lifestyle group had similar A1c values.

In addition, 18% of those in the surgery group no longer had signs or symptoms of diabetes by year seven, compared to 6% in the medical/lifestyle group. The surgery group also had an average weight loss of 20%, compared to 8% in the other group. The differences between groups remained significant at 12 years.

No differences in major side effects were detected. The surgery group did have a higher number of fractures, anemia, low iron, and gastrointestinal events. These might have been due to greater weight loss and associated nutritional deficiencies. Sleeve gastrectomy and Roux-en-Y gastric bypass were both better than adjustable gastric banding at reducing A1c levels.

The surgeries appeared to be beneficial even among those with lower BMI scores, between 27 and 34 at study enrollment. That BMI range includes overweight and low-range obesity. Such people had typically been excluded from receiving bariatric surgery for diabetes. But this finding aligns with other recent data that support the use of surgery for some people with a BMI less than 35.

These results show that people with overweight or obesity and type 2 diabetes can make long-termimprovements in their health and change the trajectory of their diabetes through surgery, says Dr. Jean Lawrence of NIHs National Institute of Diabetes andDigestive and Kidney Diseases.

References:Long-Term Outcomes of Medical Management vs Bariatric Surgery in Type 2 Diabetes. Courcoulas AP, Patti ME, Hu B, Arterburn DE, Simonson DC, Gourash WF, Jakicic JM, Vernon AH, Beck GJ, Schauer PR, Kashyap SR, Aminian A, Cummings DE, Kirwan JP. JAMA. 2024 Feb 27;331(8):654-664. doi: 10.1001/jama.2024.0318. PMID: 38411644.

Funding:NIHs National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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Oprah Winfrey will return to the small screen on Monday to debut an hour-long television program entitled An Oprah Special: Shame, Blame and the Weight Loss Revolution. The new special follows Winfreys exit from the board of WeightWatchers, where she served for nearly a decade after acquiring a 10% stake in the company.

I look forward to continuing to advise and collaborate with WeightWatchers and CEO Sima Sistani in elevating the conversation around recognizing obesity as a chronic condition, working to reduce stigma, and advocating for health equity, Winfrey said in a statement.

More from WWD

In December, Winfrey spoke to People about her use of weight-loss drugs, though she didnt specify which ones she used.

The fact that theres a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for, she told the magazine.

Ahead, learn more about Winfreys upcoming special.

Taped in front of a live studio audience, Winfrey will sit down with medical experts to discuss a variety of weight loss medications including Ozempic, Mounjaro and Wegovy.

Winfrey will be joined by Cleveland Clinics Dr. W. Scott Butsch, ABC News chief medical correspondent Dr. Jennifer Ashton, ABC News medical correspondent Dr. Darien Sutton and Cedars-Sinai Medical Centers Dr. Amanda Velazquez. Winfrey will also speak to patients from around the country about their experience using weight loss drugs.

Questions addressed in the special include: Who are the medications really intended for? Who is eligible to receive weight loss drugs? What are the short-term and long-term side effects?

Story continues

We are thrilled to work with Oprah and the voices she has assembled to open a dialogue that destigmatizes and educates viewers on the important and polarizing topic of weight loss, said Craig Erwich, president of Disney Television Group, in a statement. I can think of no one better to lead this meaningful conversation about such a critical issue that touches all of our lives.

It is a very personal topic for me and for the hundreds of millions of people impacted around the globe who have for years struggled with weight and obesity, said Oprah in a statement. This special will bring together medical experts, leaders in the space and people in the day-to-day struggle to talk about health equity and obesity with the intention to ultimately release the shame, judgment and stigma surrounding weight.

An Oprah Special: Shame, Blame and the Weight Loss Revolution airs Monday, March 18 at 8 p.m. ET on ABC.

An Oprah Special: Shame, Blame and the Weight Loss Revolution will be available to stream on Hulu starting March 19.

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Water is essential for your overall health. But retaining too much water can also cause

Water weight typically occurs because your body is trying to balance out hydration levels, so if you're trying to reduce water retention, it's important to do so as safely as possible. That means avoiding risky methods like diuretics (a kind of drug that causes you to pee frequently to shed excess fluids) which can dry out the kidneys and lead to damage, says Ana Maria Kausel, MD, an endocrinologist at Mount Sinai.

Still, experiencing bloating isn't enjoyable, and it's understandable to want relief fast. Here are the potential reasons behind your water weight, plus how to lose it safely, according to experts.

Meet the experts: Ana Maria Kausel, MD is an endocrinologist at Mt. Sinai and the co-founder of Anzara Health. Frances Largeman-Roth, RDN, is a Brooklyn-based nutritionist and co-author of The Carb Lovers Diet cookbook. Jessica Cording, RD, is a dietitian and the author of The Little Book Of Game-Changers: 50 Healthy Habits For Managing Stress and Anxiety.

In most cases, water retention is a result of too much sodium (salt) in the body. Essentially, your body holds onto water to try and keep your hydration levels stable, Dr. Kausel says. "Eating too much sodium pushes water out of the blood vessel into the tissue. The intravascular volume (the blood inside the vessels) depletes, and the kidneys sense theres a lack of fluid, therefore retaining more," Dr. Kausel explains.

Because your brain senses excess salt in the body, it then sends a signal to the kidney to retain water until the balance between water and sodium is established, she says. This can cause extra puffiness and bloat.

Water retention from medicine is fairly common and is typically a side effect of medications for high blood pressure, chemotherapy, antidepressants, and birth control. If you think your puffiness might be a result of medication, speak with your doctor to see if there's another med you can switch to that won't cause fluid accumulation, says Brooklyn-based nutritionist Frances Largeman-Roth, RDN.

You probably hear "PMS" and cringe at its association with cramps, bloating, acne, and mood swings. Period bloating is typically due to changes in estrogen and progesterone levels, and you may retain more water in the days leading up to your period. But once your period starts, the bloating should slowly go away.

"As blood volume increases by 50 percent during pregnancy, you will also experience mild swelling throughout your body, face, hands, and feet," says Largeman-Roth. While this is completely normal, extreme swelling in the face and hands could be a sign of preeclampsia, which is high blood pressure that can occur after 20 weeks of pregnancy, she notes.

If you're set on losing water weight, doing it safely should be your number one priority. Here are 10 tips for shedding excess fluids.

Even a short cardio session can help you de-puff. Exercise helps with digestionand one of the reasons that somebody might have more water weight is because theyre not eliminating efficiently or are a little backed up, says Jessica Cording, RD, author of The Little Book of Game-Changers: 50 Healthy Habits For Managing Stress & Anxiety.

Exercise also boosts endorphins, she says, which can help relieve stress and indirectly help reduce water weight. People who struggle with stress eating may be inclined to reach for highly processed snacks, which tend to be high in sodium. That can lead to water weight, Cording says.

It may seem counterintuitive, but drinking more water will help transport extra sodium out of your body. A lot of people are surprised by that one, Cording says. When were well-hydrated, the balance of sodium and potassium in our cells is at an optimal level. But if youre dehydrated, your body tries to fix the issue by drawing in sodium in a way that leads to more water retention, Cording explains. So, being adequately hydrated actually helps reduce bloating and water retention because the body is able to work more efficiently, Cording says.

The balance of sodium and potassium in our cells is important, Cording says. If the body doesnt have enough potassium, the balance is off with sodium levelsthey get too high. But when you have enough potassium, it helps your body regulate the levels of sodium in your body. (BTW, the recommended daily allowance of potassium is 2,500 to 2,900 milligrams, with amounts changing when youre pregnant and breastfeeding.) Potassium stars include bananas, oranges, celery, spinach, potatoes, peaches, and winter squash.

To reduce bloat, avoid high-sodium foods like frozen meals and fast food and replace with low-sodium snacks instead. The recommended sodium level per day is less than 2,300 milligrams, which sounds like a lot, but can add up quickly. For example, two slices of bread can have over 400 milligrams of sodium without any toppings. You need some sodium, but when you have too much sodiumespecially when you dont have enough potassium, tooyou are going to notice more water retention, Cording adds.

If you tend to feel puffy after drinking, it's because alcohol can also impact water weight. Alcohol tends to cause dehydration, and dehydration contributes to water retention, Cording says. Alcohol can also mess with your sleepand that, too, can raise your risk of retaining water, she says. Alcohol may even raise the odds youll dive into too many salty snacks, which can also cause you to hold extra water, she says. To reduce water retention, cut out alcohol for a while or make sure to alternate alcohol with a glass of water. Remember: The recommended intake for women is no more than one drink per day.

As tasty as they can be, many packaged and processed foods tend to be high in sodium. These foods also dont have much in the way of important minerals, including potassium, Cording says. Because of that high concentration of sodium and lack of other nutrients, its possible it can contribute to water retention.

Its a time investment, but cooking your own foodat least some of your mealsis a great way to moderate your sodium intake. Many restaurant and fast casual meals are packed with sodium, Cording says. When you do meal prep, you can decide what food youre eating. That puts you in a position of being able to include foods that provide the nutrients you need, even when youre in a rush, Cording says. Of course, its fine to eat out and order in sometimes, but youll deal with much less water weight gain by eating fresh foods.

Another low-lift hack? Rinse your food. For example, beans are a fantastic plant-based food rich in protein and fiber, but canned beans can be high in sodium, Cording says. I always tell my clients to rinse their beans to reduce sodium, Cording says.

If youre already working out regularly but youre still feeling puffy, try adding a 10- to 20-minute daily walk to your routine, perhaps after a big meal or whenever you're feeling bloated. Sitting at a desk all day can cause blood to pool in your legs, Cording adds. Walking helps boost circulation and is also a great mental break from stress and your computer screen, she adds.

Diuretics can help reduce the buildup of fluid in the body. These usually come in the form of medication, per Mayo Clinicbut some foods are diuretics, too, like cucumber (thanks to caffeic acid, which helps fight swelling). Other natural diuretics include watercress, artichoke, and asparagus, Cording says. These promote urination, Cording says. That can help with water retentionand theyre much safer than taking a diuretic pill.

The time it takes to lose water weight will mostly depend on the reason why you're retaining water to begin with. If you had a long night out and drank a lot, it should take roughly a day for the puffiness to go away, says Largeman-Roth.

But if your water weight is due to other reasons, it may take longer as you begin to implement changes to your lifestyle and daily habits. The heart, vessels, hormones, and kidneys are also working nonstop to help balance your water and salt levels, Dr. Kausel adds.

That said, trying to lose water weight rapidly can be dangerous and even life-threatening. "Our bodies are designed to be made up by a certain percentage of water and anything less than that will put vital organs in jeopardy," explains Dr. Kausel. "When you lose water quickly, you get very weak and dizzy." So, always consult your provider about the best way to approach your bloat.

Holding onto water is a normal function of the body, but if you find yourself constantly feeling physically uncomfortable because of it, there are a few lifestyle changes you can make to keep it at a manageable level:

But if you notice youre having rapid shifts in fluid, Cording recommends checking in with a healthcare professional to get an evaluation. Its always a good idea to talk to your doctor if something isnt normal for you, she says.

And remember, depending on the reasons why you're retaining water, it may take longer than you expect to get rid of it. So, patience is key.

Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Mens Health, Womens Health, Self, Glamour, and more. She has a masters degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.

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