BOSTON (AP) — Attorneys for Planned Parenthood clinics nationwide argued in federal court Friday that cutting off Medicaid funding to its abortion providers would hurt vulnerable patients who already have limited health care options.

Planned Parenthood Federation of America and its affiliates in Massachusetts and Utah are fighting to block part of President Donald Trump’s tax bill they say is designed to target their clinics. The provision would end Medicaid payments to abortion providers like Planned Parenthood that primarily offer family planning services — things like contraception, abortion and pregnancy tests — and received more than $800,000 from Medicaid in 2023.

Although Planned Parenthood is not specifically named in the statute, which went into effect July 4, the organization’s leaders say it was meant to affect their nearly 600 centers in 48 states. However, a major medical provider in Maine and likely others have also been hit.

“It’s the affiliation provision that makes this rotten to the core,” said Planned Parenthood attorney Alan Schoenfeld during Friday’s hearing in Boston.

The plaintiffs have filed their federal lawsuit against Health and Human Services Secretary Robert F. Kennedy Jr.

So far, the provision has been on hold after U.S. District Judge Indira Talwani in Boston granted a temporary restraining order blocking the cuts for two weeks. That order expires July 21, when Talwani has said she will decide whether to grant a motion for a preliminary injunction against the funding cuts while the lawsuit plays out.

On Friday, Talwani was particularly focused on getting a definition of what constituted an affiliation and what a Planned Parenthood health center would have to do to qualify for Medicaid funding, quizzing the federal government’s attorneys if stopping abortions would be enough or if they would have to completely severe all ties.

Emily Hall, an attorney representing HHS, said Friday that the federal government needs more information about Planned Parenthood’s structure and time to finalize interpretations of the law.

“It depends on the nature of the corporate relationship, which I don’t have,” Hall said.

Fears of pending cuts to Planned Parenthood further escalated this week after a Planned Parenthood office in Ohio announced Tuesday that it was closing two health clinics — in Hamilton and Springfield, north of Cincinnati — due to state and federal cuts.

“Make no mistake: This is not a decision made by Planned Parenthood of Southwest Ohio Region,” President and CEO Nan Whaley, a one-time Democratic gubernatorial nominee, told reporters. “We took every possible step to keep these centers open, but the devastating impact of state and federal political attacks has forced us into this very difficult position.”

The centers provide preventive health care, including testing for sexually transmitted diseases, birth control and wellness exams.

Medicaid is a government health care program that serves millions of low-income and disabled Americans. Nearly half of Planned Parenthood’s patients rely on Medicaid.

On his way to an Ultimate Fighting Championship event, Health and Human Services Secretary Robert F. Kennedy Jr. stopped by the home of podcaster Gary Brecka. The two spent time in a hyperbaric oxygen chamber and tried some intravenous nutrition drips that Brecka, a self-avowed longevity and wellness maven, sells and promotes on his show, “The Ultimate Human.”

Then the podcast taping started, and Kennedy — who was also on the mic — took aim at Big Pharma’s influence on federal health policy.

“We have a sick-care system in our country, and the etiology ultimately of all that disease is corruption,” Kennedy said before the show cut away to an ad for vitamin chips. “And it’s the capture of these agencies by the industries they are supposed to regulate.”

While Kennedy lambastes federal agencies he says are overly influenced by the pharmaceutical industry, he and some other figures of the “Make America Healthy Again,” or MAHA, movement — such as siblings Calley and Casey Means, Robert Malone, and Peter McCullough — have their own financial ties to a vast and largely unregulated $6.3 trillion global wellness industry they also support and promote.

Kennedy and those four advisers — three of whom have been tapped for official government roles — earned at least $3.2 million in fees and salaries from their work opposing Big Pharma and promoting wellness in 2022 and 2023, according to a KFF Health News review of financial disclosure forms filed with the U.S. Office of Government Ethics and the Department of Health and Human Services; published media reports; and tax forms filed with the IRS.

The total doesn’t include revenue from speaking fees, the sale of wellness products, or other income sources for which data isn’t publicly available.

The Means siblings have launched wellness companies that have raised more than $99 million from investors, according to company news releases as well as information from Clay, a customer research data company, and Tracxn, an information technology firm that provides access to a database of companies, funding rounds, and investor information.

“Secretary Kennedy, and all HHS officials, fully comply with all ethics and financial disclosure laws,” agency spokesperson Emily Hilliard said in an email. “Any attempt to suggest impropriety is reckless and politically motivated.”

Some public health leaders and ethicists say the financial ties raise red flags, with the potential for personal profits to shape decision-making at the highest levels of federal health agencies.

“It’s becoming completely corrupted,” said Arthur Caplan, founding head of the medical ethics division at New York University’s Grossman School of Medicine. “You shouldn’t have a vested interest in making recommendations on wellness or supplements or health. It opens the door to all kinds of shenanigans. Big Wellness is no different than Big Pharma. They’re a well-organized political force.”

Unlike any other previous administration, President Donald Trump’s administration has elevated anti-vaccine and wellness leaders to positions at HHS from which they can steer federal policy. Adherents to the MAHA movement say the change is long overdue, arguing that previous administrations haven’t devoted sufficient attention to the potential harms of traditional medical approaches.

Critics including health policy leaders and physicians say they worry the revamped HHS and its agencies are now harming public health. For example, they point to a recent Kennedy decision to remove and replace all the members of a vaccine advisory group, a move the American Medical Association criticized as lacking transparency and proper vetting. Two of Kennedy’s newly named panel members — Malone and Martin Kulldorff — previously earned money as paid experts in vaccine lawsuits against Merck, as first reported by Reuters and the life-sciences news outlet BioSpace.

Calley Means, who has criticized the recommended U.S. vaccine schedule for youths and has no medical training, is a special government employee and a top health adviser to Kennedy. He also co-founded the wellness company Truemed.

The company enables people to spend pretax dollars from Flexible Spending Accounts and Health Savings Accounts to pay for wellness products, health food, and SoulCycle classes.

Truemed’s website says it can provide customers with a “Letter of Medical Necessity” for the items.

The IRS has warned consumers about companies that misrepresent wellness items like food as FSA-eligible when they are not, in fact, permitted medical expenses.

The IRS did not respond to questions about the status of that policy under the Trump administration.

In 2024, when Kennedy was running for president as an independent, he promoted Means’ company on his own podcast. Means also promoted his close connection with Kennedy last year on podcasts and on Instagram while also using social media to advance Truemed. And while working for the public as a special government employee since March, Means has used social and new media to promote podcasters who make money selling wellness products, to criticize specific pharmaceutical drugs, and to tout the wellness book he co-wrote, “Good Energy,” according to a KFF Health News review of social media posts and podcasts.

Means has also used podcasts and social media to rail against new injectable weight loss drugs. The Trump administration in April decided not to finalize a rule that would have allowed Medicaid and Medicare to cover the injectable drugs, putting them out of reach for millions of potential users.

Hilliard, the HHS spokesperson, didn’t respond to questions about whether Means, as a Kennedy adviser, has recused himself from decisions that could affect his business. Neither HHS nor the White House responded to requests to speak with him.

His sister, Casey Means, is Trump’s pick for surgeon general and was also an adviser to Kennedy during his 2024 presidential run. She co-founded Levels, a company valued at $300 million in 2022 that promotes glucose monitoring for nondiabetic, healthy individuals. Consumers pay $199 for a one-month supply of continuous glucose monitors.

She has used social media to call for public policy that would encourage blood sugar monitoring for healthy individuals, saying “tips to stabilize glucose should be on every billboard in America.” Research has found little evidence that such monitoring provides health benefits for people without diabetes.

Her company stands to benefit under the Trump administration. Kennedy said in April that he was considering a regulatory framework for federal health programs’ coverage of injectable weight loss drugs that would first require patients to try glucose monitoring or other options.

“And if they don’t work, then you would be entitled to the drug,” he told CBS News.

Casey Means isn’t a practicing doctor and doesn’t hold an active medical license, according to records from the Oregon Medical Board. And, as an online influencer, she “failed to disclose that she could profit” from sales of products she recommends, according to The Associated Press.

HHS spokesperson Hilliard didn’t answer questions about whether Casey Means would recuse herself from working on anything that would directly benefit her company, or why she didn’t disclose that she could profit from sales of products she recommends. HHS didn’t respond to questions about Means’ ties to Kennedy or agency support for glucose monitoring, nor did the agency respond to a request to speak directly to the Trump surgeon general pick.

Outside Advisers

McCullough, a former cardiac doctor who has financial ties to the wellness industry, has been part of Kennedy’s circle of informal advisers, according to people close to the secretary. He also has enough sway with some GOP lawmakers that they’ve had him testify before Congress. In May, he told a Senate subcommittee that mRNA covid-19 vaccines can lead to deaths that have been underreported. But the FDA says the covid vaccines are safe, with fewer than 1 in 200,000 vaccinated individuals experiencing a severe allergic reaction or heart problems like myocarditis or pericarditis.

He profits from his anti-covid-vaccine message. McCullough devised a protocol he says helps people detox from covid mRNA shots, selling the products through The Wellness Co. McCullough is the company’s chief scientific officer, draws a partial salary, and holds an equity stake.

For $89.99, consumers can purchase Ultimate Spike Detox supplements containing nattokinase, an enzyme from fermented soybeans. A two-month supply of Spike Support supplements sells on Amazon for about $62. More than 900 bottles have sold in the past month.

McCullough didn’t respond to an email seeking comment. HHS also didn’t respond to questions about his relationship with Kennedy.

Some health policy leaders and doctors say the financial connections federal health officials and advisers have to the wellness industry raise concerns.

“It’s exactly the problem RFK has taken up with the FDA, saying it’s too beholden to pharma,” said Pieter Cohen, an associate professor of medicine at Harvard University.

“When you’re in bed with supplement manufacturers, you are creating the same kinds of conflicts of interest, whether or not you directly profit,” he said. “You should be independently advocating for public health, not cheerleading for any particular industry.”

The wellness sector includes personal care, weight loss, health, nutrition, and wellness tourism.

Its lobbying influence is markedly smaller than the lobbying reach of pharmaceutical companies, according to OpenSecrets, a research organization that tracks money in U.S. politics. The nutritional and dietary supplements industry spent about $3.7 million on lobbying in 2024, for example, compared with the $387 million the pharmaceutical industry spent the same year.

It’s also gotten far less scrutiny. The industry is a growing political force with its own lobbyists, celebrities, and industry-backed advocacy groups, and research shows that public interest in wellness has grown since the pandemic. Eighty-four percent of U.S. consumers say wellness is a “top” or “important” priority, according to a survey released this year by McKinsey & Co.

Unlike with Big Pharma, there’s scant regulation of the industry. Companies can sell supplements and other products without notifying the FDA, and there’s little oversight by the Federal Trade Commission of their product claims.

“The wellness industry profiteers by undermining and creating distrust in science and regulated products,” said Andrea Love, an immunologist and microbiologist who founded ImmunoLogic, a science and health education organization. “They are messaging that the government and Big Pharma are hiding information and treatments or cures to keep us weak and vulnerable.”

Ethics and Disclosures

People on both sides of the issue say the industry has found its captain in Kennedy, an anti-vaccine activist with deep ties to the MAHA and wellness movements.

He has profited by referring people to law firms that are suing over alleged vaccine injury. For example, he gets a fee for referring potential clients to a Los Angeles personal injury firm, according to a January ethics statement to HHS and his financial disclosures. One of his adult sons works at the personal injury law firm.

When his nomination to the HHS secretary post was under consideration, Kennedy indicated in his ethics disclosure that he intended to continue profiting from lawsuits over Gardasil, a Merck vaccine that protects against HPV. After Democrats raised concerns with the financial relationship, he told Congress he would divest his interest and sign over the financial stake to one of his adult sons.

Federal ethics rules bar government employees from participating in matters in which they, their spouse, or their minor child has a financial stake. It doesn’t include adult children such as Kennedy’s sons.

“There are a lot of loopholes, and that is one of them,” said Cynthia Brown, senior ethics counsel at the Citizens for Responsibility and Ethics in Washington, a watchdog organization focused on U.S. government ethics and accountability. “It certainly is an appearance problem. Even if it’s not a technical violation, it is an ethical problem in terms of influence.”

Some lawmakers and ethics leaders weren’t mollified by Kennedy’s planned divestiture. Sen. Elizabeth Warren (D-Mass.) called on Kennedy to agree to a four-year, post-employment ban on accepting any compensation from lawsuits involving any entity regulated by HHS.

“It would be insufficient for RFK Jr. to only divest his interest in the Gardasil case while leaving the window open to profit from other anti-vax lawsuits, including future cases he could bring after leaving office,” she said in a statement.

Kennedy also made money on the MAHA name by applying in September to register it as a trademark. He transferred trademark ownership to a limited liability company led by friend and MAHA ally Del Bigtree after making about $100,000 off the phrase, according to his financial disclosure.

HHS’ Hilliard didn’t answer questions about whether Kennedy had signed over his interest in fees from legal referrals to his son, the money he made by registering MAHA as a trademark, or whether he agreed with Warren’s request that upon leaving office he accept a four-year ban on accepting money from lawsuits involving entities regulated by HHS.

Bigtree is executive director of the Informed Consent Action Network, or ICAN, an anti-vaccination group. He was communications director for Kennedy’s failed presidential campaign, and as an informal adviser to the secretary he helped vet candidates for HHS jobs. Bigtree’s salary at the nonprofit was $234,000 for the 2023 fiscal year, according to documents filed with the IRS. ICAN paid $6 million in legal fees to Siri & Glimstad in 2023. The firm’s managing partner, Aaron Siri, focuses on vaccine injury. He has been Kennedy’s personal lawyer and adviser, and also helped vet candidates for the secretary.

Brown, an ethics counselor, said the transfer and ongoing advisory relationship could raise questions about who is influencing Kennedy. Bigtree, at a Politico event in February, called on Kennedy to recruit scientists to HHS who believe vaccines cause autism, for example. One of Kennedy’s early actions at HHS was the launch of a study on the causes of autism.

ICAN didn’t respond to an email seeking comment. HHS also didn’t respond to questions about Kennedy’s transfer of the MAHA trademark to Bigtree.

“This is the type of Washington wheeling and dealing that raises questions about integrity in government,” Brown said. “If it was trademarked before he became a public official, there may be no law broken. But by transferring it to someone he knows, it illustrates the constant trickle of influence among those in power.”

Past administrations have faced similar criticism over health regulators’ ties to Big Pharma. Alex Azar, who led HHS during the previous Trump administration, worked for drugmaker Eli Lilly before entering public office. Robert Califf, FDA commissioner during the Biden administration, was a consultant to drug companies.

Scott Gottlieb, who was FDA commissioner from 2017 to 2019 and an adviser to Trump’s presidential campaign, stepped down to join the board of the drugmaker Pfizer.

“Big Pharma is well off. But, in general, financial conflicts don’t depend on how much the organizations are spending,” said Zeke Emanuel, a bioethicist who served on a covid advisory board under President Joe Biden. “The question is, is there a reasonable concern that financial or other concerns are affecting their judgment?”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

One of the world’s biggest genetic databases comprises DNA data donated over the years by more than a million retired military service members. It’s part of a project run by the Department of Veterans Affairs.

The initiative, dubbed the Million Veteran Program, is a “crown jewel of the country,” said David Shulkin, a physician who served as VA secretary during the first Trump administration. Data from the project has contributed to research on the genetics of anxiety and peripheral artery disease, for instance, and has resulted in hundreds of published papers. Researchers say the repository has the potential to help answer health questions not only specific to veterans — like who is most vulnerable to post-service mental health issues, or why they seem more prone to cancer — but also relevant to the nation as a whole.

“When the VA does research, it helps veterans, but it helps all Americans,” Shulkin said in an interview.

Researchers now say they fear the program is in limbo, jeopardizing the years of work it took to gather the veterans’ genetic data and other information, like surveys and blood samples.

“There’s sort of this cone of silence,” said Amy Justice, a Yale epidemiologist with a VA appointment as a staff physician. “We’ve got to make sure this survives.”

Genetic data is enormously complex, and analyzing it requires vast computing power that VA doesn’t possess. Instead, it has relied on a partnership with the Energy Department, which provides its supercomputers for research purposes.

In late April, VA Secretary Doug Collins disclosed to Sen. Richard Blumenthal, the top Democrat on the Senate Veterans’ Affairs Committee, that agreements authorizing use of the computers for the genomics project remained unsigned, with some expiring in September, according to materials shared with KFF Health News by congressional Democrats.

Spokespeople for the two agencies did not reply to multiple requests for comment. Other current and former employees within the agencies — who asked not to be identified, for fear of reprisal from the Trump administration — said they don’t know whether the critical agreements will be renewed.

One researcher called computing “a key ingredient” to major advances in health research, such as the discovery of new drugs.

The agreement with the Energy Department “should be extended for the next 10 years,” the researcher said.

The uncertainty has caused “incremental” damage, Justice said, pointing to some Million Veteran Program grants that have lapsed. As the year progresses, she predicted, “people are going to be feeling it a lot.”

Because of their military experience, maintaining veterans’ health poses different challenges compared with caring for civilians. The program’s examinations of genetic and clinical data allow researchers to investigate questions that have bedeviled veterans for years. As examples, Shulkin cited “how we might be able to better diagnose earlier and start thinking about effective treatments for these toxic exposures” — such as to burn pits used to dispose of trash at military outposts overseas — as well as predispositions to post-traumatic stress disorder.

“The rest of the research community isn’t likely to focus specifically” on veterans, he said. The VA community, however, has delivered discoveries of importance to the world: Three VA researchers have won Nobel Prizes, and the agency created the first pacemaker. Its efforts also helped ignite the boom in GLP-1 weight loss drugs.

Yet turbulence has been felt throughout VA’s research enterprise. Like other government scientific agencies, it’s been buffeted by layoffs, contract cuts, and canceled research.

“There are planned trials that have not started, there are ongoing trials that have been stopped, and there are trials that have fallen apart due to staff layoffs — yes or no?” said Sen. Patty Murray (D-Wash.), pressing Collins in a May hearing of the Senate Veterans’ Affairs Committee.

The agency, which has a budget of roughly $1 billion for its research arm this fiscal year, has slashed infrastructure that supports scientific inquiry, according to documents shared with KFF Health News by Senate Democrats on the Veterans’ Affairs Committee. It has canceled at least 37 research-related contracts, including for genomic sequencing and for library and biostatistics services. The department has separately canceled four contracts for cancer registries for veterans, creating potential gaps in the nation’s statistics.

Job worries also consume many scientists at the VA.

According to agency estimates in May, about 4,000 of its workers are on term limits, with contracts that expire after certain periods. Many of these individuals worked not only for the VA’s research groups but also with clinical teams or local medical centers.

When the new leaders first entered the agency, they instituted a hiring freeze, current and former VA researchers told KFF Health News. That prevented the agency’s research offices from renewing contracts for their scientists and support staff, which in previous years had frequently been a pro forma step. Some of those individuals who had been around for decades haven’t been rehired, one former researcher told KFF Health News.

The freeze and the uncertainty around it led to people simply departing the agency, a current VA researcher said.

The losses, the individual said, include some people who “had years of experience and expertise that can’t be replaced.”

Preserving jobs — or some jobs — has been a congressional focus. In May, after inquiries from Sen. Jerry Moran, the Republican who chairs the Veterans’ Affairs Committee, about staffing for agency research and the Million Veteran Program, Collins wrote in a letter that he was extending the terms of research employees for 90 days and developing exemptions to the hiring freeze for the genomics project and other research initiatives.

Holding jobs is one thing — doing them is another. In June, at the annual research meeting of AcademyHealth — an organization of researchers, policymakers, and others who study how U.S. health care is delivered — some VA researchers were unable to deliver a presentation touching on psychedelics and mental health disparities and another on discrimination against LGBTQ+ patients, Aaron Carroll, the organization’s president, told KFF Health News.

At that conference, reflecting a trend across the federal government, researchers from the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality also dropped out of presenting. “This drop in federal participation is deeply concerning, not only for our community of researchers and practitioners but for the public, who rely on transparency, collaboration, and evidence-based policy grounded in rigorous science,” Carroll said.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

“The message that we want to give to the general public is, it opens a new field of investigation, something that we didn’t know about,” said Dr. Igor Koralnik, Northwestern’s chief of neuroinfectious diseases and global neurology and lead author of the study.

Parkinson’s disease is a movement disorder caused by the loss of neurons that produce dopamine, a chemical messenger in the brain. Why these neurons break down is unknown, but it’s thought that this breakdown is caused by many factors, both genetic and environmental.

The team used a tool called ViroFind, which is able to test samples for all known viruses that infect humans much quicker than the usual one-at-a-time “brute force” method. The lab found human pegivirus, or HPgV, in 5 of the 10 Parkinson’s-affected brains they tested, and none of the brains without Parkinson’s.

“Fifty percent of any population having this virus would be very, very high,” Barbara Hanson, the lab’s post-doctoral fellow, said. Estimates calculate HPgV as being present in about 5% of blood donors in North America, and people with healthy immune systems generally lose the virus within two years of exposure. It is not known to cause disease in humans, so most who catch the virus will never know they had it.

Before this study, Hanson said, HPgV had not been found in human brain tissue. It was understood to primarily “live” in blood.

“For this virus to be present in the brain, there must be a reason for that,” Koralnik said.

This doesn’t mean that the virus itself is a trigger for Parkinson’s, though. It could be that an as-yet unidentified genetic mutation that makes people susceptible to Parkinson’s, also allows for the virus to spread throughout the body differently than in people without the mutation.

And even if further research shows HPgV as a direct cause of Parkinson’s, both Koralnik and Dr. Danny Bega, medical director of Northwestern’s Parkinson’s Disease and Movement Disorders Center, said people shouldn’t necessarily worry about getting HPgV.

A patient likely has to encounter a couple of different factors before they develop Parkinson’s, Bega said. He puts it in terms of “hits” — a hit could be genetic, or it could be environmental, such as exposure to a virus or pesticide. These “hits” build up over time until there are enough factors to cause the neuron degeneration specific to Parkinson’s.

It’s possible that this is why Parkinson’s risk increases with age, Bega said. The longer you live, the more of these “hits” you take, as you encounter different Parkinson’s risk factors throughout your life.

“I always caution people who try to blame their Parkinson’s on one thing,” he said. “Rest assured, it’s never one thing that you could have done or should have done differently.”

The work to treat and hopefully one day prevent Parkinson’s is being done through finding these factors and eliminating them one by one. “The more targets that we have, the more likely we are to be able to achieve a treatment that actually can slow things down,” Bega said.

On a recent summer afternoon, Randy and Vera Tom prepared a stir-fried lunch in their Redwood City home with their “sous chef,” a 17-year-old Bichon Frise named Munchies, afoot.

Randy, 70, recently overhauled his lifestyle after the couple participated in a Stanford Medicine study tracking their metabolic responses to carbohydrates in real time with a continuous glucose monitoring device.

The recently published research tracked the glucose levels in the blood of 55 study subjects as they consumed precooked meals starring different carbohydrates such as grapes, jasmine rice, potatoes, pasta and bread. It was led by genetic deep data specialist Mike Snyder, metabolic expert Tracey McLaughin and research dietician Dalia Perelman at Stanford.

The results could lead to better prevention, diagnoses and treatment of prediabetes, diabetes and other metabolic diseases that lower quality of life and raise health care costs.

According to the Centers for Disease Control and Prevention, 38.4 million people, or 11.6% of the U.S. population, had diabetes in 2024.

Most common is Type 2 diabetes, which occurs when the body develops resistance to insulin because of diet, lifestyle, weight and family history. Type 1 diabetes is an autoimmune disease attacking cells of the pancreas, disabling the body’s production of insulin, the hormone that orchestrates the body’s food-processing functions. Both types of diabetes are life-threatening without intervention.

According to the CDC, more than a third of the 250 million people 18 or older in the U.S. and almost half of the 60 million who are 65 or older are prediabetic — the vast majority unknowingly.

“How would you know, if you can only know with a test that you get only if there seems to be a problem?” asked Randy, cleaver in hand, chopping neatly organized piles of lean pork and technicolor-green bok choy.

The opportunity to access more personalized health information while contributing to science attracted the Toms to Stanford’s genomics studies about a decade ago. They’ve been in more than five long-term studies since — the latest was the first involving food.

When the research team asked Randy what he ate over Christmas after seeing spikes in his blood sugar data, the culprit was tamales. Now, he enjoys just one of the corn-based treats per sitting.

For Snyder, the advancement of physiologically specific care has been personal. From 2009 to 2011, he and Stanford profiled his own descent from prediabetes into type 2 diabetes — the first time the phenomenon was documented at the molecular level.

Snyder, who is svelte and active, said, “When I first became diabetic, everybody looked at me and said, ‘No way, it’s gonna go away.’”

But the proof was in his integrative Personal “Omics” Profile, or iPOP, an unprecedented analysis of billions of individual bits of molecular genetic data collected by powerful cutting-edge technology.

This level of analysis allows researchers to understand people by metabolic subtype and tailor treatment to match.

Right now, doctors begin to classify metabolic shifts or prediabetes when glucose levels in the blood exceed 5.7%, with no information as to why the abnormality exists.

But there are four different pathways to metabolic disease — two where the body doesn’t produce enough insulin and two where the body doesn’t respond properly to insulin.

In the study, McLaughlin and Snyder looked for soft slopes in blood sugar. Jagged peaks are generally normal responses to food or sugar.

Everyone’s blood sugar spikes in response to grapes and rice. But the scientists found that people with metabolic problems spiked higher and for longer to potato starch than people who lacked problems. The “potato-to-grape” reaction ratio correlated with different underlying metabolic dysfunctions.

These differences call for precision medicine and targeted preventative measures. Some people might need weight loss. Others might need exercise. Yet others may need sleep — something that lowers blood glucose levels across the board.

“If we understand where the problem lies, we can treat it more effectively,” Perelman said.

The researchers are looking for markers in cells that can identify these problems more easily through simple blood tests.

In the meantime, continuous glucose monitoring offers actionable information for people who want to be proactive about their metabolic health.

“You see what spikes you, you see what doesn’t spike you, so you eat what doesn’t spike you,” Snyder said.

After the study wrapped, the Toms obtained their own monitoring devices. Vera, 71, reacted moderately to her data; Randy took things further.

He avoided foods that caused sustained spikes in his blood sugar and joined a master’s swimming team. The retiree and part-time model dropped 25 extra pounds, shed numbers from his high cholesterol count and reversed his prediabetic condition.

“I don’t think people know that you can reverse it,” he said. “It’s just hard to do. You don’t just take a pill.”

Last fall, continuous glucose monitors became available over the counter. A drawback is the $80 monthly cost because insurance only covers the devices for diabetics.

Snyder, who wears multiple devices tracking his body’s functions and removes them only before getting weighed, thinks everyone should try one.

Perelman said the monitors are not a replacement for clinical consultation. McLaughlin added that the devices can yield false metrics in certain situations.

The next phase of the research will test different foods and “mitigators” — proteins or fats that can lower blood sugar fluctuations when consumed with carbohydrates. Toasted bread, for example, is easier on the system for some people when eaten with meat or a fat source like heavy cream. Mitigators don’t work as well for people with metabolic disorders — another crumb for research. Cornflakes and milk? Bad for nearly everyone.

This time, study participants will receive interventions, from medicine to personalized instructions for diet and lifestyle modifications.

Perelman said, “I want people to know that there’s delicious food that’s incredibly healthy.”

The debate over whether Coca-Cola should use high-fructose corn syrup or cane sugar in its signature soda obscures an important fact: Consumers are increasingly looking for Coke with no sugar at all.

Coca-Cola Zero Sugar, which was introduced in 2017, uses both the artificial sweetener aspartame and the natural sweetener stevia in its recipe. It’s one of Coke’s fastest-growing products, with global case volumes up 14% in the first quarter of the year. By comparison, the company’s total case volumes were up 2%.

PepsiCo also noted Thursday that 60% of its sales volumes in major markets in the second quarter came from low- or no-sugar drinks.

“When you look at colas, the percentage of growth coming from zero sugar is significant,” said Duane Stanford, the editor and publisher of Beverage Digest.

Coca-Cola Co. hasn’t confirmed a presidential pronouncement

The scrutiny over Coke’s sweeteners began Wednesday, when President Donald Trump announced that Atlanta-based Coca-Cola Co. had agreed to switch to using cane sugar in the regular version of its beverage manufactured in the U.S.

“I have been speaking to Coca-Cola about using REAL Cane Sugar in Coke in the United States, and they have agreed to do so,” Trump wrote on his social media site. “I’d like to thank all of those in authority at Coca-Cola. This will be a very good move by them — You’ll see. It’s just better!”

Coca-Cola didn’t confirm the change. In a statement, the company said it appreciated Trump’s enthusiasm and would share details on new offerings soon.

Stanford said he doubts Coca-Cola will fully shift away from high fructose corn syrup, which has sweetened Coke in the U.S. since the 1980s. There would be tremendous supply chain and logistics headaches, he said, and the U.S. doesn’t make enough sugar for Coke’s needs.

He expects the Atlanta-based company will offer a cane sugar-sweetened version in the U.S. just like its rival Pepsi has been doing since 2009. He noted that Coke has indulged U.S. fans by importing Mexican Coke, which is made with cane sugar, since 2005. Coke positions Mexican Coke as an upscale alternative and sells it in glass bottles.

A rush to defend high fructose corn syrup

The corn industry wasn’t happy with the speculation. In a statement Wednesday, Corn Refiners Association President and CEO John Bode said replacing high fructose corn syrup with cane sugar makes no sense and would cost thousands of American manufacturing jobs.

Shares in ADM, a maker of high fructose corn syrup, dipped nearly 2% Thursday after Trump’s announcement.

In a message on X, Coca-Cola defended high fructose corn syrup, saying it’s no more likely to contribute to obesity than table sugar or other full-calorie sweeteners.

“It’s safe; it has about the same number of calories per serving as table sugar and is metabolized in a similar way by your body,” the company said. “Please be assured that Coca-Cola brand soft drinks do not contain any harmful substances.”

The Food and Drug Administration also says there is no evidence of any difference in safety among foods sweetened with high fructose corn syrup and those that sugar, honey or other traditional sweeteners.

US consumers are seeking more options

Soft drink preferences are highly subjective, as anyone who has been in a Pepsi vs. Coke or 7-Up vs. Sprite debate knows. But recent trends indicate that Coke and other drink makers need to focus on the kinds of low- and no-sugar drinks that a growing number of consumers are seeking, according to Stanford.

He said his data shows original Coke was the top seller by volume in the U.S. last year, with 19% market share, while Coke Zero Sugar was seventh and had a 4% market share. But Coke Zero Sugar’s share grew 10%, while original Coke’s share was flat.

Paige Leyden, the associate director of food service, flavors and ingredients reports at the market research company Mintel, said drinks with a health halo like Olipop — which has 1 gram of sugars compared to original Coke’s 65 grams — are also pressuring legacy soda makers. Mintel expects full-sugar sodas will see a 3.4% rise in U.S. sales this year, while diet sodas will see 11.8% growth.

Still, nutritionists suggest avoiding added sugars, no matter the form, since they provide empty calories with no nutrients. The 2020 U.S. dietary guidelines advise people to limit foods and beverages higher in added sugars, and say children under 2 should not be fed them at all.

Health Secretary Robert F. Kennedy, whose nutrition views often diverge from mainstream nutrition science, has spoken out against sugar. His agency is expected to release updated nutrition guidelines later this year.

“There’s things we’ll never be able to eliminate, like sugar,” Kennedy said at an April news conference. “And sugar is poison, and Americans need to know that.”

Aspartame and other artificial sweeteners are also named as a concern in a government report Kennedy issued in May.

AP Health and Science Editor Jonathan Poet contributed from Philadelphia.

What is chronic venous insufficiency?

Chronic venous insufficiency, or CVI, happens when veins in the legs can’t properly carry blood back to the heart. That can lead to blood pooling in the lower legs. In addition to swelling, usually around the feet and ankles, symptoms can include legs that are achy, heavy feeling or tingly, and varicose veins. Severe cases could trigger leg sores known as ulcers.

What causes chronic venous insufficiency?

Overcoming gravity to pump blood from the feet all the way up to the heart is a challenge, especially when someone is standing or sitting for long periods. So legs veins are lined with one-way valves that keep blood from sliding backward on that journey. Anything that damages those valves can lead to chronic venous insufficiency. Risk factors can include blood clots, vein inflammation known as phlebitis or being overweight.

How is chronic venous insufficiency diagnosed and treated?

Doctors must rule out serious causes of leg swelling, such as heart problems, kidney disease or blood clots. Ultrasound exams of the leg veins can help confirm chronic venous insufficiency. According to the Cleveland Clinic, treatment can include wearing compression stockings, elevating the legs and achieving a healthy weight. Also exercise, especially walking, is recommended — because strong leg muscles can squeeze veins in a way that helps them pump blood. Medications and medical procedures are available for more advanced cases.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

WASHINGTON (AP) — Two university hospitals are pioneering new ways to expand lifesaving heart transplants for adults and babies — advances that could help recover would-be heart donations that too often go unused.

The new research aims to overcome barriers for using organs from someone who dies when their heart stops. Called DCD, or donation after circulatory death, it involves a controversial recovery technique or the use of expensive machines.

Surgeons at Duke and Vanderbilt universities reported Wednesday that they’ve separately devised simpler approaches to retrieve those hearts. In the New England Journal of Medicine, they described successfully transplanting hearts to a 3-month-old infant at Duke and three men at Vanderbilt.

“These DCD hearts work just as well as hearts from brain-dead donors,” said Vanderbilt lead author Dr. Aaron M. Williams.

How hearts are saved for donation

Most transplanted hearts come from donors who are brain dead. In those situations, the body is left on a ventilator that keeps the heart beating until the organs are removed.

Circulatory death occurs when someone has a nonsurvivable brain injury but because all brain function hasn’t ceased, the family decides to withdraw life support and the heart stops. That means organs can spend a while without oxygen before being recovered, a time lag usually doable for kidneys and other organs but that can raise questions about the quality of hearts.

To counter damage and determine whether DCD organs are usable, surgeons can pump blood and oxygen to the deceased donor’s abdominal and chest organs — after clamping off access to the brain. But it’s ethically controversial to artificially restore circulation even temporarily and some hospitals prohibit that technique, called normothermic regional perfusion, or NRP.

Another option is to “reanimate” DCD organs in a machine that pumps blood and nutrients on the way to the transplant hospital. The machines are expensive and complex, and Duke’s Dr. Joseph Turek said the devices can’t be used for young children’s small hearts — the age group with the most dire need.

New ways of preserving hearts

Turek’s team found a middle ground: Remove the heart and attach some tubes of oxygen and blood to briefly assess its ability to function — not in a machine but on a sterile table in the operating room.

They practiced with piglets. Then came the real test. At another hospital, life support was about to be withdrawn from a 1-month-old whose family wanted to donate — and who would be a good match for a 3-month-old Duke patient in desperate need of a new heart. The other hospital didn’t allow the controversial NRP recovery technique but let Turek’s team test the experimental alternative.

It took just five minutes to tell “the coronary arteries are filling well, it’s pink, it’s beating,” Turek said. The team promptly put the little heart on ice and raced it back to Duke.

Vanderbilt’s system is even simpler: Infuse the heart with a nutrient-rich, cold preservative solution before removing it from the donor’s body, similar to how hearts from brain-dead donors are handled.

That “replenishes the nutrients that are depleted during the dying process and helps protect it for transport,” Williams explained, adding that Vanderbilt has performed about 25 such transplants so far. “Our view is you don’t necessarily need to reanimate the heart.”

More donated hearts are needed

There’s a huge need for more transplantable hearts. Hundreds of thousands of adults suffer from advanced heart failure, yet many are never even offered a transplant because of the organ shortage.

Every year about 700 children in the U.S. are added to the transplant list for a new heart and about 20% die waiting. Turek said infants are at particular risk.

Last year, people whose lives ended via circulatory death made up 43% of the nation’s deceased donors — but just 793 of the 4,572 heart transplants.

That’s why many specialists say finding ways to use more of those hearts is crucial. The new studies are small and early-stage but promising, said Brendan Parent of NYU Langone Health, who directs transplant ethics and policy research.

“Innovation to find ways to recover organs successfully after circulatory death are essential for reducing the organ shortage,” he said.

If alternatives pan out, “I absolutely think that cardiac programs will be thrilled, especially at hospitals that have rejected NRP.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

WASHINGTON (AP) — The Food and Drug Administration is allowing vaping brand Juul to keep its e-cigarettes on the market, providing relief to a company that has struggled for years after being widely blamed for sparking the teen vaping trend.

FDA regulators said Thursday that Juul’s studies show its e-cigarettes are less harmful for adult smokers, who can benefit from switching completely to vaping.

The FDA decision applies to both tobacco- and menthol-flavored versions of the reusable product, which works with nicotine-filled cartridges sold in two different strengths. Juul previously discontinued several fruit and candy flavors that helped drive its popularity but were favored by teens.

Juul will be one of only two U.S. companies authorized to sell menthol-flavored vapes, which many adults prefer to tobacco flavor.

“This is an important milestone for the company and I think we made a scientifically sound case for the role that menthol can play in e-vapor,” Juul CEO K.C. Crosthwaite told The Associated Press.

Parents, politicians and anti-tobacco groups are certain to oppose FDA’s decision. They have argued for years that Juul products should be permanently banned due to their role in triggering a yearslong spike in underage vaping.

“It is a big step in the wrong direction to authorize sales of the product that was responsible for this public health crisis in the first place,” said Yolonda Richardson, CEO of the Campaign for Tobacco-Free Kids in a statement.

Juul was once valued at over $13 billion and its small, sleek e-cigarettes revolutionized the image and technology of the vaping industry. But the company has since been forced to slash hundreds of jobs and pay billions to settle lawsuits over its role in the rise of youth vaping.

The FDA had ordered the company to remove its products from the market in June 2022. But then the agency abruptly reversed course days later and agreed to reopen its scientific review of Juul’s application after the company pushed back in court.

Juul said that regulators had overlooked thousands of pages of scientific data critical to its submission.

Thursday’s announcement is not an approval or endorsement, and the FDA reiterated that people who do not smoke should not use Juul or any other e-cigarettes. The FDA determination indicates that smokers who switch completely to Juul can reduce their exposure to deadly carcinogens and other chemicals found in traditional cigarettes.

The FDA decision applies to Juul’s original system, which is now roughly a decade old. Crosthwaite said the company hopes to win authorization for its next-generation device and is also considering applying to FDA for more flavors.

“It’s critically important that American adults who use tobacco have regulated options,” Crosthwaite said.

In recent years, the FDA has authorized a handful of e-cigarettes to help adult smokers cut back on cigarettes. Juul’s main competitors, Vuse and Njoy, each previously received FDA permission to remain on the market. Njoy sells the only other menthol-flavored e-cigarettes authorized by FDA.

To meet FDA requirements, companies must show that their products benefit public health. In practice, that means proving that adult smokers who use them are likely to quit or reduce their smoking, while teens are unlikely to get hooked on them.

The brainchild of two Stanford University students, Juul launched in 2015 and within two years rocketed to the top of the vaping market.

Juul quickly outpaced older brands with its high-nicotine, fruity-flavored cartridges, sold in mango, mint and creme brulé. The company’s small, discrete devices provided a more potent, user-friendly alternative to older, bulkier devices.

But the company’s rise was fueled by underage use, and e-cigarettes quickly became ubiquitous in U.S. schools. In 2019, the company was pressured into halting all advertising and eliminating most of its flavors, leaving only tobacco and menthol-flavored options.

By then the company was already the target of multiple investigations and lawsuits by federal, state and local officials as well as class action attorneys.

In 2022, the company paid $1.7 billion to settle thousands of lawsuits brought by families of Juul users, school districts, city governments and Native American tribes. The company separately agreed to pay $1.1 billion to settle lawsuits or investigations from most U.S. states.

Juul is no longer the top-selling e-cigarette brand and now trails Vuse, which is sold by tobacco giant Reynolds American, which also makes Camel and Newport cigarettes.

Teens have shifted away from Juul amid a wider drop in vaping, according to the latest federal figures. The FDA reported last year that teen vaping dropped to a 10-year low, after stepped up enforcement against unauthorized brands imported from China, such as Elf Bar.

Unlike Juul, disposable e-cigarettes like Elf Bar still come in fruit and candy flavors, despite efforts by regulators to block their use.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

LONDON (AP) — Eight healthy babies were born in Britain with the help of an experimental technique that uses DNA from three people to help mothers avoid passing devastating rare diseases to their children, researchers reported Wednesday.

Most DNA is found in the nucleus of our cells, and it’s that genetic material — some inherited from mom, some from dad — that makes us who we are. But there’s also some DNA outside of the cell’s nucleus, in structures called mitochondria. Dangerous mutations there can cause a range of diseases in children that can lead to muscle weakness, seizures, developmental delays, major organ failure and death.

Testing during the in vitro fertilization process can usually identify whether these mutations are present. But in rare cases, it’s not clear.

Researchers have been developing a technique that tries to avoid the problem by using the healthy mitochondria from a donor egg. They reported in 2023 that the first babies had been born using this method, where scientists take genetic material from the mother’s egg or embryo, which is then transferred into a donor egg or embryo that has healthy mitochondria but the rest of its key DNA removed.

The latest research “marks an important milestone,” said Dr. Zev Williams, who directs the Columbia University Fertility Center and was not involved in the work. “Expanding the range of reproductive options … will empower more couples to pursue safe and healthy pregnancies.”

Using this method means the embryo has DNA from three people — from the mother’s egg, the father’s sperm and the donor’s mitochondria — and it required a 2016 U.K. law change to approve it. It is also allowed in Australia but not in many other countries, including the U.S.

Experts at Britain’s Newcastle University and Monash University in Australia reported in the New England Journal of Medicine Wednesday that they performed the new technique in fertilized embryos from 22 patients, which resulted in eight babies that appear to be free of mitochondrial diseases. One woman is still pregnant.

One of the eight babies born had slightly higher than expected levels of abnormal mitochondria, said Robin Lovell-Badge, a stem cell and developmental genetics scientist at the Francis Crick Institute who was not involved in the research. He said it was still not considered a high enough level to cause disease, but should be monitored as the baby develops.

Dr. Andy Greenfield, a reproductive health expert at the University of Oxford, called the work “a triumph of scientific innovation,” and said the method of exchanging mitochondria would only be used for a small number of women for whom other ways of avoiding passing on genetic diseases, like testing embryos at an early stage, was not effective.

Lovell-Badge said the amount of DNA from the donor is insignificant, noting that any resulting child would have no traits from the woman who donated the healthy mitochondria. The genetic material from the donated egg makes up less than 1% of the baby born after this technique.

“If you had a bone marrow transplant from a donor … you will have much more DNA from another person,” he said.

In the U.K., every couple seeking a baby born through donated mitochondria must be approved by the country’s fertility regulator. As of this month, 35 patients have been authorized to undergo the technique.

Critics have previously raised concerns, warning that it’s impossible to know the impact these sorts of novel techniques might have on future generations.

“Currently, pronuclear transfer is not permitted for clinical use in the U.S., largely due to regulatory restrictions on techniques that result in heritable changes to the embryo,” Williams, of Columbia, said in an email. ”Whether that will change remains uncertain and will depend on evolving scientific, ethical, and policy discussions.”

For about a decade, Congress has included provisions in annual funding bills banning the Food and Drug Administration from accepting applications for clinical research involving techniques, “in which a human embryo is intentionally created or modified to include a heritable genetic modification.”

But in countries where the technique is allowed, advocates say it could provide a promising alternative for some families.

Liz Curtis, whose daughter Lily died of a mitochondrial disease in 2006, now works with other families affected by them. She said it was devastating to be told there was no treatment for her eight-month-old baby and that death was inevitable.

She said the diagnosis “turned our world upside down, and yet nobody could tell us very much about it, what it was or how it was going to affect Lily.” Curtis later founded the Lily Foundation in her daughter’s name to raise awareness and support research into the disease, including the latest work done at Newcastle University.

“It’s super exciting for families that don’t have much hope in their lives,” Curtis said.

Ungar reported from Erie, Pennsylvania.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.