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.”
Health
Judge rules West Virginia parents can use religious beliefs to opt out of school vaccine requirements
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A West Virginia judge ruled on Wednesday that parents can use religious beliefs to opt out of school vaccine requirements for their children.
Raleigh County Circuit Judge Michael Froble on Wednesday issued a permanent injunction, saying children of families who object to the state’s compulsory vaccination law on religious grounds will be permitted to attend school and participate in extracurricular sports.
Froble found that a state policy prohibiting parents from seeking religious exemptions violates the Equal Protection for Religion Act signed into law in 2023 by then-Gov. Jim Justice.
West Virginia was among just a handful of states to offer only medical exemptions from school vaccinations when Gov. Patrick Morrisey issued an executive order earlier this year allowing religious exemptions.
ALABAMA, KANSAS TOP LIST OF MOST ‘FAITH-FRIENDLY’ STATES; MICHIGAN, WASHINGTON RANK LOWEST: REPORT
West Virginia Gov. Patrick Morrisey said that the ruling “is a win for every family forced from school over their faith.” (Andrew Harnik/Getty Images)
However, the state Board of Education voted in June to instruct public schools to ignore the governor’s order and follow long-standing school vaccine requirements outlined in state law.
The board said following Wednesday’s ruling that it “hereby suspends the policy on compulsory vaccination requirements” pending an appeal before the state Supreme Court.
Morrisey said in a statement that the ruling “is a win for every family forced from school over their faith.”
Two groups had sued to stop Morrisey’s order, arguing that the legislature has the authority to make these decisions instead of the governor.
Legislation that would have allowed the religious exemptions was approved by the state Senate and rejected by the House of Delegates earlier this year.
The judge found that a state policy prohibiting parents from seeking religious exemptions violates the Equal Protection for Religion Act signed into law in 2023. (Julian Stratenschulte/dpa (Photo by Julian Stratenschulte/picture alliance via Getty Images))
The judge ruled that the failure to pass the legislation did not determine the application of the 2023 law. He rejected the defendants’ argument that religious exemptions can only be established by legislative moves.
“Legislative intent is not absolute nor controlling in interpreting a statute or determining its application; at most, it is a factor,” Froble said.
A group of parents had sued the state and local boards of education and the Raleigh County schools superintendent. One parent had obtained a religious exemption to the vaccine mandate from the state health department and enrolled her child in elementary school for the current school year before receiving an email in June from the local school superintendent rescinding the certificate, according to the lawsuit.
In July, Froble issued a preliminary injunction allowing the children of the three plaintiffs’ families in Raleigh County to attend school this year.
FEDERAL JUDGE RULES PUBLIC CHARTER SCHOOL VIOLATED CHURCH’S FIRST AMENDMENT RIGHTS
State law requires children to receive vaccines for chickenpox, hepatitis B, measles, meningitis, mumps, diphtheria, polio, rubella, tetanus and whooping cough before attending school. (iStock)
Last month, Froble certified the case as a class action involving 570 families who had received religious exemptions in other parts of the state. He said the class action also applies to parents who seek religious exemptions in the future.
Froble said the total number of exemptions so far involved a small portion of the statewide student population and “would not meaningfully reduce vaccination rates or increase health risks.”
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State law requires children to receive vaccines for chickenpox, hepatitis B, measles, meningitis, mumps, diphtheria, polio, rubella, tetanus and whooping cough before attending school.
At least 30 states have religious freedom laws. The laws are modeled after the federal Religious Freedom Restoration Act, which was signed into law in 1993 by then-President Bill Clinton, allowing federal regulations that interfere with religious beliefs to be challenged.
The Associated Press contributed to this report.
Health
12 High-Fiber Foods That Burn Belly Fat Fast for Women Over 50
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Health
The deadly cancer hiding in plain sight — and why most patients never get screened
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A new study from Northwestern Medicine suggests that current lung cancer screening guidelines may be missing most Americans who develop the disease — and researchers say it’s time for a major change.
Published in JAMA Network Open, the study analyzed nearly 1,000 lung cancer patients who were treated at Northwestern Medicine between 2018 and 2023.
The goal was to see how many of those patients would have qualified for screening under existing guidance from the U.S. Preventive Services Task Force (USPSTF).
STEALTH BREAST CANCER THAT HIDES FROM SCANS TARGETED IN BREAKTHROUGH TECH
USPSTF currently recommends annual CT scans for adults ages 50 to 80 who have a 20 pack-year smoking history (the equivalent of one pack of cigarettes per day for 20 years) and either still smoke or quit within the last 15 years.
Only about 35% of those diagnosed with lung cancer met the current criteria to undergo screenings.
Current lung cancer screening guidelines may be missing most people who develop the disease, a new study shows. (iStock)
That means roughly two-thirds of patients would not have been flagged for testing before their diagnosis.
“Not only does that approach miss many patients who had quit smoking in the past or did not quite meet the high-risk criteria, it also misses other patients at risk of lung cancer, such as non-smokers,” Luis Herrera, M.D., a thoracic surgeon at Orlando Health, told Fox News Digital.
The study noted that these patients tended to have adenocarcinoma, the most common type of lung cancer among never-smokers.
Missed patients tended to have adenocarcinoma, the most common type of lung cancer among never-smokers. (iStock)
Those missed by the guidelines were more often women, people of Asian descent and individuals who had never smoked, the study found.
The research team also compared survival outcomes. Patients who didn’t meet the screening criteria had better survival, living a median of 9.5 years compared with 4.4 years for those who did qualify.
ERIN ANDREWS HAD ‘NO SYMPTOMS’ BEFORE CANCER DIAGNOSIS, PUSHES FOR EARLY SCREENINGS
While this difference partly reflects tumor biology and earlier detection, it also highlights how current screening rules fail to catch a broad range of cases that could be treated sooner, according to researchers.
“The current participation in lung cancer screening for patients who do qualify based on smoking history is quite low,” said Herrera, who was not involved in the study. This is likely due to the complexity of the risk-based criteria and stigma associated with smoking and lung cancer, he added.
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To test an alternative, the researchers modeled a different approach: screening everyone between the ages of 40 and 85, regardless of smoking history.
Under that universal, age-based model, about 94% of the cancers in their cohort would have been detected.
Universal screening procedures could save lives and hundreds of thousands of dollars, according to the researchers. (iStock)
Such a change could prevent roughly 26,000 U.S. deaths each year, at a cost of about $101,000 per life saved, according to their estimates.
The study emphasized that this would be far more cost-effective than current screening programs for breast or colorectal cancer, which cost between $890,000 and $920,000 per life saved.
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Herrera noted the many challenges in the adoption of lung cancer screening, from lack of awareness to some providers not recommending the screening test.
However, he added, “The cost of screening is covered by most health insurance plans and many institutions also offer discounts for patients who don’t have insurance.”
“The current participation in lung cancer screening for patients who do qualify based on smoking history is quite low.”
Lung cancer remains the deadliest cancer in the country, killing more people each year than colon, prostate and breast cancer combined. But because of the narrow eligibility criteria based on smoking history, millions at risk never get screened.
Northwestern Medicine researchers argue that expanding screening to include all adults within an age range could help close those gaps, especially for groups often underdiagnosed.
Researchers argue that expanding screening to include all adults could help catch the missing cases. (iStock)
The study was conducted at a single academic center, which means the patient population may not represent the wider U.S. population. It also looked back at existing data, so it can’t prove how the new model would perform in real-world screening programs, the researchers acknowledged.
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The cost and mortality projections rely on assumptions that could shift depending on how screening is implemented.
The researchers also didn’t fully account for the potential downsides of broader screening, such as false positives or unnecessary follow-ups, they noted.
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For patients who don’t qualify for lung cancer screening, there are other opportunities for lung evaluations, including “heart calcium scores, CT scans and other imaging modalities that can at least evaluate the lungs for any suspicious nodules,” Herrera added.
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