Health
As RFK Jr. Champions Chronic Disease Prevention, Key Research Is Cut
Robert F. Kennedy Jr. has spoken of an “existential threat” that he said can destroy the nation.
“We have the highest chronic disease burden of any country in the world,” Mr. Kennedy said at a hearing in January before the Senate confirmed him as the secretary of Health and Human Services.
And on Monday he is starting a tour in the Southwest to promote a program to combat chronic illness, emphasizing nutrition and lifestyle.
But since Mr. Kennedy assumed his post, key grants and contracts that directly address these diseases, including obesity, diabetes and dementia, which experts agree are among the nation’s leading health problems, are being eliminated.
These programs range in scale and expense. Researchers warn that their demise could mean lost opportunities to address an aspect of public health that Mr. Kennedy has said is his priority.
“This is a huge mistake,” said Dr. Ezekiel Emanuel, the co-director of the Healthcare Transformation Institute at the University of Pennsylvania’s Perelman School of Medicine.
Decades of Diabetes Research Discontinued
Ever since its start in 1996, the Diabetes Prevention Program has helped doctors understand this deadly chronic disease. The condition is the nation’s most expensive, affecting 38 million Americans and incurring $306 billion in one recent year in direct costs. With about 400,000 deaths in 2021, it was the eighth leading cause of death.
The program has been terminated, and the reason has little to do with its merits. Instead, it seems to be a matter of a lead researcher’s working in the wrong place at the wrong time.
The program began when doctors at 27 medical centers received funding from the National Institutes of Health for a study asking whether Type 2 diabetes could be prevented. The 3,234 participants had high risk of the disease.
The results were a huge victory. Those assigned to follow a healthy diet and exercise routine regularly reduced their chances of developing diabetes by 58 percent. Those who took metformin, a drug that lowers blood sugar, decreased their risk by 31 percent.
The program entered a new phase, led by Dr. David M. Nathan, a diabetes expert at Harvard Medical School. Researchers followed the participants to see how they fared without the constant attention and support of a clinical trial. The researchers also examined their genetics and metabolism and looked at measures of frailty and cognitive function.
Several years ago, the investigators had an idea. Some studies suggested that people with diabetes had a higher risk of dementia. But scientists didn’t know if it was vascular dementia or Alzheimer’s or what the precise risk factors were. The diabetes program could renew its focus on investigating this with its 1,700 aging participants.
The group added a new principal investigator, the dementia expert Dr. Jose A. Luchsinger. For administrative reasons, including the newfound focus on dementia, the program decided its money should flow through Dr. Luchsinger’s home institution, Columbia University, rather than through Harvard or George Washington University, where a third principal investigator works.
On March 7, the Trump administration cut $400 million in grants and contracts to Columbia, saying Jewish students were not protected from harassment during protests over the war in Gaza. The diabetes grant was among those terminated: $16 million a year that Columbia shared across 30 medical centers. The study ended abruptly.
Asked about the termination, Andrew G. Nixon, director of communications at the Department of Health and Human Services, provided a statement from the agency’s acting general counsel saying that “anti-Semitism is clearly inconsistent with the fundamental values that should inform liberal education” and that “Columbia University’s complacency is unacceptable.”
At the time their grant ended, the researchers had started advanced cognitive testing for evidence of dementia in patients, followed by brain imaging to look for amyloid, the hallmark of Alzheimer’s disease. They planned to complete the tests during the next two years.
Then, Dr. Luchsinger said, the group was going to look at blood biomarkers of amyloid and other signs of dementia, including brain inflammation. For comparison, they planned to perform the same tests on participants’ blood samples from 7 and 15 years ago.
“Very few studies have blood collected and stored going that far back,” Dr. Luchsinger said.
Now much of the work cannot begin, and the part that had started remains incomplete.
Another troubling question the researchers hoped to answer was whether metformin increases, decreases or has no effect on the risk of dementia.
“This is the largest and longest study of metformin ever,” Dr. Luchsinger said. Participants assigned to take the drug in the 1990s took it for more than 20 years.
“We thought we had the potential to put to rest this question about metformin,” Dr. Luchsinger said.
The only ways to save the program, Dr. Nathan said, are for Mr. Kennedy to agree to restore the funding at Columbia or to transfer the grant to a principal investigator at another medical center.
The study investigators are appealing to the diabetes caucus in Congress, hoping it can help make their case to the Health and Human Services.
“We hope the congressmen and senators might prevail and say: ‘This is crazy. This is chronic disease. This is what you wanted to study,’” Dr. Nathan said.
So far, there has been no change.
Include Diversity. Actually, That’s Too Much Diversity.
Compared with the Diabetes Prevention Program, a program to train pediatricians to become scientists is tiny. But pediatric researchers say that the Pediatric Scientist Development Program helps ensure that chronic childhood diseases are included in medical research.
It began 40 years ago when chairs of pediatric departments called for the creation of the program, which has been continually funded ever since by the National Institute of Child Health and Human Development.
Participants are clinicians who were trained in subspecialties like endocrinology and nephrology, practiced as clinicians and were inspired to go into research to help young patients with the diseases they had seen firsthand.
The highly competitive program pays for seven to eight pediatricians to train at university medical centers for a year, pairing them with mentors and giving them time away from the clinic to research conditions including obesity, asthma and chronic kidney disease.
In retrospect, the program’s fate was sealed in 2021 when its leaders applied for a renewal of their grant. It seemed pro forma. This was its eighth renewal.
This time, though, an external committee of grant reviewers told the investigators their proposal’s biggest weakness was a lack of diversity. The program needed to seek pediatricians who represented diverse ethnicities, economic backgrounds, states, types of research and pediatric specialties.
The critique said, for example, that “attention must be given to recruiting applicants from diverse backgrounds, including from groups that have been shown to be nationally underrepresented in the biomedical, behavioral, clinical and social sciences.”
So the program’s leaders sprinkled diversity liberally through a rewritten grant application.
“Diversity, in its broadest sense, was all over the grant,” said Dr. Sallie Permar, professor and chairwoman of pediatrics at Weill Cornell Medical College and director of the program. “It was exactly what the reviewers appreciated when we resubmitted.”
The grant was renewed in 2023. Now it is terminated. The reason? Diversity.
The termination letter, from officials in the National Institute of Child Health and Human Development, said there was no point in trying to rewrite the grant request. The inclusion of diversity made the application so out of line that “no modification of the project could align the project with agency priorities.”
Mr. Nixon, the health department spokesman, did not reply to queries about the pediatric program’s cancellation.
Participants in the program are distraught.
Dr. Sean Michael Cullen had been studying childhood obesity at Weill Cornell in New York. He has investigated why male mice fed a high-fat diet produced offspring that became fat, even when those offspring were fed a standard diet.
He hoped his findings would help predict in humans which children were at risk of obesity so pediatricians could try to intervene.
Now the funds are gone. He may seek private or philanthropic funding, but he doesn’t have any clear prospects.
Dr. Evan Rajadhyaksha is in a similar situation. He’s a childhood kidney disease specialist at Indiana University. When he was a resident, he cared for a little girl who developed kidney disease because of a condition in which some urine washes up from the bladder into the kidneys.
Dr. Rajadhyaksha has a hypothesis that vitamin D supplementation could protect children with this condition.
Now, that work has to stop. Without funding, he expects to leave research and return to clinical work.
Dr. Permar said she hadn’t given up. The program costs only $1.5 million each year, so she and her colleagues are looking for other support.
“We are asking foundations,” she said. “We are starting to ask industry — we haven’t had industry funding before. We are asking department chairs and children’s hospitals, are they willing to fund-raise?”
“We are literally looking under every couch cushion,” Dr. Permar said.
“But,” she said, federal support for the program “has been the foundation and cannot be supplanted.”
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Health
Men may need to work twice as hard as women to prevent potentially deadly disease
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Men may need to exert double the amount of effort as women to fend off heart disease.
That’s according to new research from China that found men need twice as much exercise as women to lower their risk.
The study, published in the journal Nature Cardiovascular Research, analyzed data from more than 85,000 participants in the U.K. Biobank to pinpoint gender differences regarding physical activity and the incidence of coronary heart disease (also known as coronary artery disease).
YOUR HEART MAY BE OLDER THAN YOU THINK — AND THE NUMBER COULD PREDICT DISEASE RISK
Data was pulled from wearable accelerometers, like smartwatches, for a defined period to measure the amount of moderate to vigorous physical activity.
The participants, who did not have coronary heart disease at the start of the study, were monitored for nearly eight years to determine how many developed heart disease and how many died from it.
Men need double the amount of exercise as women to prevent coronary heart disease, research suggests. (iStock)
The average age for the incidence study was about 61 years and 57.3% were women. The mortality study had an average age of about 66 and 30% were women.
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After adjusting for other heart disease risk factors, like BMI (body mass index) and smoking, the researchers found a “notable” difference between men and women.
Specifically, they discovered that women experienced lower risk levels with half the minutes of activity as men.

The association between coronary heart disease risk and physical activity was consistent for both onset of disease and mortality. (iStock)
In terms of developing heart disease, an extra 30 minutes of exercise per week was linked to a 2.9% lower risk in females and a 1.9% lower risk in men.
7 COMMON FITNESS MISTAKES OLDER ADULTS MAKE AND HOW TO AVOID THEM FOR BETTER WORKOUTS
Meeting the standard 150 minutes per week of recommended exercise lowered the women’s incidence risk by 22%, while men’s risk was lowered by 17%.
A further extended workout regimen of 300 minutes, or five hours, per week reduced the risk by 21% for females and only 11% for men.
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For about a 30% reduction in coronary heart disease incidence risk, women need about 250 minutes of exercise per week, while men need about 530 minutes, according to the researchers.

For about a 30% reduction in coronary heart disease incidence risk, women need about 250 minutes of exercise per week, while men need about 530 minutes. (iStock)
When it comes to mortality from heart disease, sticking to 150 minutes of exercise per week reduced women’s risk by a whopping 70%, and only lowered men’s risk by 19%.
To reduce coronary heart disease mortality by 30%, women need about 51 minutes of exercise per week and men need about 85 minutes.
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The researchers commented in the study that these findings “underscore the value of sex-specific tailored coronary heart disease prevention strategies using wearable devices, which may help bridge the ‘gender gap’ by motivating females to engage in physical activity.”
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Fox News senior medical analyst Dr. Marc Siegel spoke about the study on “America’s Newsroom” on Tuesday.
“I can tell you, having been married for almost 30 years, that women are better than men. There’s no question about it,” he said. “Physiologically, spiritually, women are superior.”

To reduce coronary heart disease mortality by 30%, women need about 51 minutes of exercise per week and men need about 85 minutes. (iStock)
Siegel noted that men have higher levels of testosterone, which is “bad for cholesterol,” and tend to build up fat “in the wrong places” in the gut, leading to inflammation.
“We smoke more, we drink more, we don’t exercise as much,” Siegel said about men in general. “All of that puts us at risk for heart disease.”
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According to the doctor, women “start to catch up” with increased risk after menopause, although it “takes a long time.”
“With all these risks, [men] need the exercise way more than women do to make up for it,” Siegel added.
Health
Inside the Poisonous Smoke Killing Wildfire Fighters at Young Ages
Across the country, wildfire fighters work for weeks at a time in poisonous smoke.
The government says they are protected.
We tested the air at one fire to find out why they are still dying.
Across the country, wildfire fighters work for weeks at a time in poisonous smoke.
The government says they are protected.
We tested the air at one fire to find out why they are still dying.
It’s July and the Green fire is tearing through Northern California. An elite federal firefighting crew called the La Grande Hotshots has been sent to help. The 24-person crew has been working for days on the front lines, where invisible toxins hide in the thick haze.
More than 1,000 firefighters are on the fire. Several crews, including the La Grande Hotshots, are trying to contain the flames by building a trench of bare earth that will stretch from a road to a river bank. They’re doing this at night, in hopes that the cooler air will tamp down the smoke.
The crew knows that they’re risking their health.
One longtime member died last year after being diagnosed at 40 with brain cancer. A former crew leader is being treated for both leukemia and lymphoma diagnosed in his 40s. Another colleague was recently told that he has the lungs of a lifelong chainsmoker.
Wildfire fighters nationwide are getting sick and dying at young ages, The New York Times has reported. The federal government acknowledges that the job is linked to lung disease, heart damage and more than a dozen kinds of cancer.
But the U.S. Forest Service, which employs thousands of firefighters, has for decades ignored recommendations from its own scientists to monitor the conditions at the fire line and limit shifts when the air becomes unsafe.
To find out how harmful the air gets on an average-size wildfire, Times reporters brought sensors to the Green fire this summer. We tracked levels of some of the most lethal particles in the air, called PM2.5, which are so tiny that they can enter the bloodstream and cause lasting damage.
Readings above 225.5 micrograms per cubic meter are considered hazardous. On the fire line, levels regularly exceeded 500.
The fire began on July 1 after a lightning storm passed over the Shasta-Trinity National Forest.
By July 16, much of the area was shrouded in smoke.
Around 6 p.m., the La Grande Hotshots started their shift and set off toward the fire line.
Capt. Nick Schramm, a crew leader, assumed the air was reasonably safe. He has done this work for nearly two decades, and like most firefighters, he often has coughing fits after long shifts. But he believes that exposure to hazardous air is unavoidable.
“That’s just the harsh truth,” he said later.
As climate change makes fire seasons worse, several states have tried to shield outdoor workers from wildfire smoke, which can contain poisons like arsenic, benzene and lead. California now requires employers to monitor air quality during fires, and to provide breaks and masks when the air turns unhealthy.
But these rules don’t apply on the wildfires themselves, because state agencies and private companies successfully argued that those constraints would get in the way of fighting fires.
Until recently, federal firefighters weren’t even allowed to wear masks on the job. Masks are now provided, but they are still banned during the most arduous work, closest to the fire. The Forest Service says face coverings could cause heatstroke, though wildland firefighters in other countries regularly use masks without this problem.
As crews descended the ridge toward the fire line, the levels of toxic particles nearly doubled.
Firefighters say that during their shifts they worry more about immediate dangers — falling trees, burns, sharp tools — than about smoke exposure. As the La Grande crew hiked down the steep terrain, Lily Barnes, a squad leader, concentrated on keeping her footing.
Back home in the off-season, she sometimes wonders what the smoke is doing to her body, she said in an interview. “Maybe I’ll realize one day I shouldn’t have been doing this work.”
The handbook issued to Forest Service crews has 10 words of guidance for smoke exposure on the fire line: “If needed, rotate resources in and out of smoky areas.” The agency declined to comment for this story, but in the past has told The Times that while exposure cannot be completely eliminated, rotating crews helps limit risk.
In practice, according to interviews with hundreds of firefighters, workers feel as though they are sent into smoke and then forgotten. Over months of reporting, Times journalists never saw a boss pull a crew back because of exposure.
Even experienced supervisors can’t tell exactly how unhealthy the air is just by looking.
Chuy Elguezabal, the La Grande superintendent, says he pulls his crews out of smoke when it becomes impossible for them to work — when they cannot see or breathe, or they are overcome by headaches and coughing fits.
On the Green fire, he said, the smoke seemed like more of an inconvenience, like the 105-degree daytime heat or the poison oak that had given many of the firefighters weeping sores.
Since the 1990s, Forest Service researchers have suggested giving crews wearable air sensors, but the agency hasn’t done it. Other dangerous workplaces, like coal mines, have long been required to monitor airborne hazards.
On the Green fire, The Times used a device that weighs as much as a deck of cards and costs about $200.
Last year, firefighters wore the same devices during a small federal research project to measure their exposure. For hours, those readings stayed at 1,000 — as high as the monitors go — according to Zach Kiehl, a consultant who worked on the project.
Mr. Kiehl said that ideally, crews would be issued monitors to know when to put on masks or pull back from a smoky area. “You can pay now and prevent future cases, or pay out later when a person is losing a husband or a father,” he said.
The firefighters believe that the decision to work at night has paid off: The smoke occasionally got thick, but didn’t seem bad compared with other fires they have worked. They think the exposure was fleeting.
In fact, the monitors show, the air was never safe.
Methodology
To measure particulate concentrations at the Green fire, The Times followed U.S. Forest Service crews and carried two Atmotube PRO sensors. These portable, inexpensive monitors are the same as those the Forest Service has tested in the field.
We consulted with Dr. Aishah Shittu, an environmental health scientist, and Dr. Jim McQuaid, an atmospheric scientist, both from the University of Leeds. They are co-authors of a study showing that Atmotube Pro sensors demonstrated good performance for measuring fine particulate matter concentrations despite being a fraction of the size of reference-grade models. We also developed our approach in consultation with experts from the Interior Department and the Forest Service.
On the Green fire, the sensors recorded minute-by-minute averages of airborne particles that are 2.5 micrometers in diameter or smaller. The Times then matched these readings with timestamps and locations from a satellite-enabled GPS watch.
Generally, the harm associated with PM2.5 levels is calculated based on a 24-hour average. Here, for near-real-time monitoring on the fire line, we followed the guidance of Drs. Shittu and McQuaid by first averaging the readings from the two sensors and then calculating a 15-minute rolling average.
Using those figures, we categorized the health risks of PM2.5 exposure according to standards set by the U.S. Environmental Protection Agency. We used standards meant for the public because there are no federal occupational standards for wildfire smoke exposure.
After averaging, our data had a correlation coefficient of 0.98 and a mean coefficient of variation between the two sensors of 7.5 percent. The E.P.A. recommends that PM2.5 air measurements have a correlation coefficient of at least 0.7 and a mean coefficient of variation less than 30 percent. Our correlation and variance measures gave us confidence that the sensors were largely in agreement.
The 3-D base map in this article uses Google’s Photorealistic 3D Tiles, which draw from the following sources to create the tiles: Google; Airbus; Landsat / Copernicus; Data SIO, NOAA, U.S. Navy, NGA, GEBCO; IBCAO.
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