Health
Death Toll in Gaza Likely 40 Percent Higher Than Reported, Researchers Say

Deaths from bombs and other traumatic injuries during the first nine months of the war in Gaza may have been underestimated by more than 40 percent, according to a new analysis published in The Lancet.
The peer-reviewed statistical analysis, led by epidemiologists at the London School of Hygiene and Tropical Medicine, used modeling in an effort to provide an objective third-party estimate of casualties. The United Nations has relied on the figure from the Hamas-led Ministry of Health, which it says has been largely accurate, but which Israel criticizes as inflated.
But the new analysis suggests the Hamas health ministry tally is a significant undercount. The researchers concluded that the death toll from Israel’s aerial bombardment and military ground operation in Gaza between October 2023 and the end of June 2024 was about 64,300, rather than the 37,900 reported by the Palestinian Ministry of Health.
The estimate in the analysis corresponds to 2.9 percent of Gaza’s prewar population having been killed by traumatic injury, or one in 35 inhabitants. The analysis did not account for other war-related casualties such as deaths from malnutrition, water-borne illness or the breakdown of the health system as the conflict progressed.
The study found that 59 percent of the dead were women, children and people over the age of 65. It did not establish what share of the reported dead were combatants.
Mike Spagat, an expert on calculating casualties of war who was not involved in this research, said the new analysis convinced him that Gaza casualties were underestimated.
“This is a good piece of evidence that the real number is higher, probably substantially higher, than the Ministry of Health’s official numbers, higher than I had been thinking over the last few months,” said Dr. Spagat, who is a professor at Royal Holloway College at the University of London.
But the presentation of precise figures, such as a 41 percent underreported mortality, is less useful, he said, since the analysis actually shows the real total could be less than, or substantially more. “Quantitatively, it’s a lot more uncertain than I think comes out in the paper,” Dr. Spagat said.
The researchers said their estimate of 64,260 deaths from traumatic injury has a “confidence interval” between 55,298 and 78,525, which means the actual number of casualties is likely in that range.
If the estimated level of underreporting of deaths through June 2024 is extrapolated out to October 2024, the total Gazan casualty figure in the first year of the war would exceed 70,000.
“There is an importance to war injury deaths, because it speaks to the question of whether the campaign is proportional, whether it is, in fact, the case that sufficient provisions are made to to avoid civilian casualties,” said Francesco Checchi, an epidemiologist with an expertise in conflict and humanitarian crises and a professor at the London School of Hygiene and Tropical Medicine who was an author on the study. “I do think memorializing is important. There is inherent value in just trying to come up with the right number.”
The analysis uses a statistical method called capture-recapture analysis, which has been used to estimate casualties in other conflicts, including civil wars in Colombia and Sudan.
For Gaza, the researchers drew on three lists: The first is a register maintained by the Palestinian Ministry of Health, which mainly comprises the dead in hospital morgues and estimates of the number of unrecovered people buried in rubble. The second is deaths reported by family or community members through an online survey form the ministry established on Jan. 1, 2024, when the prewar death registration system had broken down. It asked Palestinians inside and outside Gaza to provide names, ages, national ID number and location of death for casualties. The third source was obituaries of people who died from injuries that were published on social media, which may not include all of the same biographical details and which the researchers compiled by hand.
The researchers analyzed these sources to look for individuals who appear on multiple lists of those killed. A high level of overlap would have suggested that few deaths were uncounted; the low amount they found suggested the opposite. The researchers used models to calculate the probability of each individual appearing on any of the three lists.
“Models enable us to actually estimate the number of people who have not been listed at all,” Dr. Checchi said. That, combined with the listed number, gave the analysts their total.
Patrick Ball, director of research at the Human Rights Data Analysis Group, and a statistician who has conducted similar estimates of violent deaths in conflicts in other regions, said the study was strong and well reasoned. But he cautioned that the authors may have underestimated the amount of uncertainty caused by the ongoing conflict.
The authors used different variations of mathematical models in their calculations, but Dr. Ball said that rather than presenting a single figure — 64,260 deaths — as the estimate, it may have been more appropriate to present the number of deaths as a range from 47,457 to 88,332 deaths, a span that encompasses all of the estimates produced by modeling the overlap among the three lists.
“It’s really hard to do this kind of thing in the middle of a conflict,” Dr. Ball said. “It takes time, and it takes access. I think you could say the range is larger, and that would be plausible.”
While Gaza had a strong death registration process before the war, it now has only limited function after the destruction of much of the health system. Deaths are uncounted when whole families are killed simultaneously, leaving no one to report, or when an unknown number of people die in the collapse of a large building; Gazans are increasingly buried near their homes without passing through a morgue, Dr. Checchi said.
The authors of the study acknowledged that some of those assumed dead may in fact be missing, most likely taken as prisoners in Israel.
Roni Caryn Rabin and Lauren Leatherby contributed reporting.

Health
Why Older People May Not Need to Watch Blood Sugar So Closely

By now, Ora Larson recognizes what’s happening. “It feels like you’re shaking inside,” she said. “I’m speeded up. I’m anxious.” If someone asks whether she would like a salad for lunch, she doesn’t know how to respond.
She has had several such episodes this year, and they seem to be coming more frequently.
“She stares and gets a gray color and then she gets confused,” her daughter, Susan Larson, 61, said. “It’s really scary.”
Hypoglycemia occurs when levels of blood sugar, or glucose, fall too low; a reading below 70 milligrams per deciliter is an accepted definition. It can afflict anyone using glucose-lowering medications to control the condition.
But it occurs more frequently at advanced ages. “If you’ve been a diabetic for years, it’s likely you’ve experienced an episode,” said Dr. Sei Lee, a geriatrician at the University of California, San Francisco, who researches diabetes in older adults.
The elder Ms. Larson, 85, has had Type 2 diabetes for decades. Now her endocrinologist and her primary care doctor worry that hypoglycemia may cause falls, broken bones, heart arrhythmias and cognitive damage.
Both have advised her to let her hemoglobin A1c, a measure of average blood glucose over several months, rise past 7 percent. “They say, ‘Don’t worry too much about the highs — we want to prevent the lows,’” the younger Ms. Larson said.
But her mother has spent 35 years working to maintain an A1c below 7 percent — a common recommendation, the goal people sing and dance about in pharma commercials.
She faithfully injects her prescribed drug, Victoza, about three times a week and watches her diet. She’s the oldest member of the Aqua for Arthritis class at a local pool in St. Paul, Minn.
So when her doctors recommended a higher A1c, she resisted. “I think it’s a bunch of hooey,” she said. “It didn’t make sense to me.”
“She got a lot of encouragement and recognition from her physicians for controlling her diabetes, staying on top of it,” her daughter explained. “They always praised her ‘tight control.’”
“For someone who’s been so compliant all these years, it’s like they changed the rules.”
In fact, they have.
More than a decade ago, the American Geriatrics Society called for a hemoglobin A1c of 7.5 to 8 for most older adults with diabetes, and 8 to 9 percent for those contending with multiple chronic illnesses and limited life expectancy. (The elder Ms. Larson has multiple sclerosis and hypertension.)
Other medical societies and advocacy groups, including the American Diabetes Association and the Endocrine Society, have also revised their guidelines upward for older patients.
Relaxing aggressive treatment can involve stopping a drug, lowering a dose or switching to another medication — an approach called de-intensification.
The advent of effective new diabetes drugs — GLP-1 receptor agonists (like Ozempic) and SGLT2 inhibitors (like Jardiance) — has further altered the landscape. Some patients can substitute these safer medications for risky older ones.
But the new drugs can also complicate decisions, because not all older patients can switch — and for those who can, insurance companies may balk at the new medications’ high price tags and deny coverage.
So de-intensification is proceeding, but too gradually.
A 2021 study of Medicare beneficiaries with diabetes, for instance, looked at patients who had gone to an emergency room or been hospitalized because of hypoglycemia. Fewer than half had their medication regimens de-intensified within 100 days.
“Nursing-home residents are the ones that get into trouble,” said Dr. Joseph Ouslander, a geriatrician at Florida Atlantic University and the editor in chief of The Journal of the American Geriatrics Society.
Another 2021 study, of Ontario nursing homes, found that over half of residents taking drugs for Type 2 diabetes had A1c levels below 7 percent. Those with the greatest cognitive impairment were being treated most aggressively.
Dr. Ouslander has calculated, based on a national study, that roughly 40,000 emergency room visits annually resulted from overtreatment of diabetes in older adults from 2007 to 2011. He thinks the numbers are likely to be much higher now.
A brief primer: Diabetes can cause such grievous complications — heart attacks, stroke, vision and hearing loss, chronic kidney disease, amputations — that so-called strict glycemic control makes sense in young adulthood and middle age.
But tight control, like every medical treatment, involves a period of time before paying off in improved health. With diabetes, it’s a long time, probably eight to 10 years.
Older people already contending with a variety of health problems may not live long enough to benefit from tight control any longer. “It was really important when you were 50,” said Dr. Lee. “Now, it’s less important.”
Older diabetics don’t always welcome this news. “I thought they’d be happy,” Dr. Lee said, but they push back. “It’s almost like I’m trying to take something away from them,” he added.
The risk that tight control will also set off hypoglycemia increases as patients age.
It can make people sweaty, panicky, fatigued. When hypoglycemia is severe, “people can lose consciousness,” said Dr. Scott Pilla, an internist and diabetes researcher at Johns Hopkins. “They can become confused. If they’re driving, they could have an accident.”
Even milder hypoglycemic events “can become a quality-of-life issue if they’re happening frequently,” causing anxiety in patients and possibly leading them to limit their activities, he added.
Experts point to two kinds of older drugs particularly implicated in hypoglycemia: insulin and sulfonylureas like glyburide, glipizide and glimepiride.
For people with Type 1 diabetes, whose bodies cannot produce insulin, injections of the hormone remain essential. But the medication is “widely recognized as a dangerous drug” because of its hypoglycemia risk and should be carefully monitored, Dr. Lee said.
The sulfonylureas, he added, “are becoming less and less used” because, while less risky than insulin, they also cause hypoglycemia.
The great majority of older adults with diabetes have Type 2, which gives them more options. They can supplement the commonly prescribed drug metformin with the newer GLP-1 and SGLT2 drugs, which also have cardiac and kidney benefits. If necessary, they can add insulin to their regimens.
Among the new drugs’ more popular consequences, however, is weight loss.
“For older people, if they’re frail and not very active, we don’t want them losing weight,” Dr. Pilla pointed out. And both metformin and the GLP-1 and SGLT-2 medications can have gastrointestinal or genitourinary side effects.
For 15 years, Dan Marsh, 69, an accountant in Media, Pa., has treated his Type 2 diabetes by injecting two forms of insulin daily. When he takes too much, he said, he wakes up at night with “the damn lows,” and needs to eat and take glucose tablets.
Yet his A1c remains high, and last year doctors amputated part of a toe. Because he takes many other medications for a variety of conditions, he and his doctor have decided not to try different diabetes drugs.
“I know there’s other stuff, but we haven’t gone that way,” Mr. Marsh said.
With all the new options, including continuous glucose monitors, “figuring out the optimal treatment is becoming more and more difficult,” Dr. Pilla said.
Bottom line, though, “older people overestimate the benefit of blood-sugar lowering and underestimate the risk of their medications,” he said. Often, their doctors haven’t explained how the trade-offs shift with older age and accumulating health problems.
Ora Larson, who carries chewable glucose tablets with her in case of hypoglycemia (fruit juice and candy bars are also popular antidotes), intends to talk over her diabetes treatment with her doctors.
It’s a good idea. “The biggest risk factor for severe hypoglycemia is having had hypoglycemia before,” Dr. Lee said.
“If you have one episode, it should be thought of as a warning signal. It’s incumbent on your doctor to figure out, Why did this happen? What can we do so your blood sugar doesn’t go dangerously low?”
Health
Popular frozen drink linked to children’s illness, study finds

Lara Trump on setting a healthy example for her children
Amid the widespread support for Robert F. Kennedy Jr.’s MAHA movement, Lara Trump — mom, wellness advocate and daughter-in-law of President Donald Trump — shared her beliefs in a healthy America with Fox News Digital.
A popular summertime treat could contain hidden dangers to kids’ health, a new study cautions.
Researchers at University College Dublin conducted a review of 21 children who became ill between 2009 and 2024 after consuming a “slush ice drink.”
A vast majority of the children, none of whom had preexisting medical conditions, became ill within an hour of having the drink.
SCHOOL MEALS RAISE EYEBROWS AS MAHA ADVOCATES URGE ‘DIFFERENT CHOICES IN THE LUNCH LINE’
The patients, who ranged in age from 2 to 6 years old, all received medical treatment in the U.K. and Ireland.
The most prevalent symptoms included acute decrease in consciousness, hypoglycaemia (low blood sugar), metabolic acidosis (lactic acid build up in the bloodstream), pseudohypertriglyceridaemia (falsely elevated triglycerides) and hypokalaemia (low potassium levels), according to the findings, which were published in the journal Archives of Disease in Childhood.
A popular summertime treat could contain hidden dangers to kids’ health, a new study cautions. (iStock)
“The children had very low blood sugar levels, were unconscious (one had a seizure) and had high levels of lactate in their blood,” lead study author Ellen Crushell, a pediatrician at Children’s Health Ireland and a clinical professor at University College Dublin, told Fox News Digital.
EXCESSIVE PHONE AND SCREEN USE TIED TO MANIC SYMPTOMS FOR ONE GROUP, STUDY FINDS
“They had high levels of glycerol in their blood and urine when sick, which disappeared when they recovered. They recovered well, but needed hospitalization and intravenous fluids.”
The researchers concluded that consumption of slush ice drinks containing glycerol may cause a syndrome called glycerol intoxication.
The majority of the children (95%) did not have continued symptoms after avoiding the drinks.
What is glycerol?
“Glycerol is used as a sweetener and to maintain the semi-frozen texture of some (not all) slush ice drinks,” Crushell said.
“It is being used more often in recent years as a sugar substitute,” she noted. “Large doses can be harmful to small children.”

The researchers concluded that the consumption of slush ice drinks containing glycerol may cause a syndrome called glycerol intoxication. (iStock)
The effect of sudden illness after consuming a slush drink had never been reported in the medical literature, Crushell noted.
This study did have some limitations, the researchers acknowledged.
“The numbers are small and include only the sickest children who were brought to emergency departments and who were referred on to specialists in inherited metabolic disorders,” Crushell said.
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“They were referred because their symptoms were similar to those of some rare metabolic diseases. We do not know the extent of children who may develop milder symptoms.”
The other limitation is that the amount of glycerol ingested in the various slush drinks is unknown, she added.
Recommendations for parents
Crushell said slush ice drinks “do not convey health benefits at any age” and are not recommended as part of a healthy, balanced diet.
The UK Food Standards Agency and the Food Safety Authority of Ireland (FSAI) have both issued guidance recommending that children age 4 and under avoid consuming slush ice drinks containing glycerol, and that children 5 and up should only drink them in moderation.

The researcher noted that slush ice drinks “do not convey health benefits at any age” and are not recommended as part of a healthy, balanced diet. (iStock)
“The use of slush ice machines by children in the home should be monitored,” Crushell advised. “Parents and guardians should check the ingredients of syrups used to make slush ices in the home for the presence of glycerol and follow the manufacturer’s instructions for use.”
For more Health articles, visit www.foxnews.com/health
The researchers hope this new study could lead to the development of new policies and guidance related to glycerol ingestion.
Fox News Digital reached out to the U.S. Food and Drug Administration and to a leading manufacturer of slush drinks requesting comment.
Health
When a Couple’s Drinking Habits Diverge

Casey and Mike Davidson always enjoyed drinking together.
The couple, both 49, met after college while working as consultants at the same firm. Romance blossomed over work happy hours, then time spent lingering over a bottle of wine on long dates.
In their mid-20s, the pair moved to Seattle and made a group of friends who were always up for a drink. Afternoons were for hiking, kayaking and sipping beers on Lake Union; evenings were for rollicking, boozy dinner parties.
But by their 30s, their drinking habits diverged. Ms. Davidson drank a bottle of wine by herself most nights, and felt increasingly uneasy about it, while Mr. Davidson settled into life as a self-described “single-beer-a-night drinker.”
“I was really defensive about my drinking,” Ms. Davidson said, adding, “I didn’t want him watching me every time I poured a third glass of wine.”
Like the Davidsons, many couples have had to grapple with the role alcohol plays in their partnership — even if neither party drinks to the point where it causes clear, consistent problems at home, or takes an obvious toll on their health. Their relationship may still receive a shock when one partner decides to cut back or quit altogether.
“It can drive a wedge between people in terms of how they socialize, how they relax and unwind, their bedroom activities,” said Ruby Warrington, the author of “Sober Curious.” “It can be really uncomfortable.”
We asked couples, and experts on substance use, how to navigate changing tolerances for drinking within a relationship.
Finding New Pathways for Connection
Ms. Davidson, who now lives in Redmond, Wash., never hit the kind of dramatic rock bottom people tend to associate with heavy drinking, but at 40 she quit for good, and now works as a sobriety coach.
She slept better and felt less anxious and foggy, but she also worried that her newfound sobriety might hurt her marriage. “It was scary for me to stop drinking, because I wondered how we would connect,” she said.
Research on alcohol and marital happiness suggests that couples who abstain and couples who drink heavily together tend to report comparable levels of relationship satisfaction.
But problems can arise when one partner drinks regularly and the other doesn’t, said Kenneth Leonard, director of the University at Buffalo’s Clinical and Research Institute on Addictions, who has studied the topic for decades. That lopsided dynamic can lead to relationship dissatisfaction and increased chances of divorce.
The reasons for that are likely to be complex, he said, though at a simple level, couples often drink to unwind and connect, and losing that may come with some cost initially. People often do not realize how ingrained alcohol is in their relationships, experts said, even if neither party has a substance use problem.
Julie Kraft, a licensed marriage and family therapist and co-author of “The Mindfulness Workbook for Addiction,” said a major upside of the “sober curious movement” and abstinence challenges like Dry January is that they offer opportunities for self-reflection.
“Am I using alcohol for stress relief?” she said. “Am I using it to feel more connected to my partner? Am I using it to avoid my partner?” One of the first things she discusses with couples looking to make changes is to brainstorm ways they might fill those spaces or needs.
The Davidsons found connection points that didn’t involve alcohol, like going to see live music on Saturday nights at a local cafe, browsing bookstores together and going to the movies.
Arthur Tindsley, 41, from Oxfordshire, England, also feared that sobriety would change his marriage. He grew up steeped in British pub culture, but in recent years, he and his wife have both looked critically at their drinking habits, going through long periods of abstinence.
Sitting down in a nice restaurant together and sharing a bottle of wine used to be one of his most cherished activities. “All of those entrenched, habitual ways that we are partners together have had to change, or are in a process of changing,” he said.
Their go-to date night now? “It’s going to sound really boring,” he said, “but we go on a walk.”
Connecting With Your ‘Why’
When working with couples in which one or both partners wants to moderate or stop drinking, Laura Heck, a licensed marriage and family therapist based in Bend, Ore., emphasizes the importance of each individual understanding their own reasons for making the change.
“Each person has to connect with their own ‘why’” Ms. Heck said, adding, “I never want one person to lean into another person’s goal and just tack it on.” She offered her own relationship as an example: Her husband stopped drinking years ago because of a heart condition. Lately, Ms. Heck has been abstaining as well, but not because of him. She simply wants to better understand the ways in which drinking has become a habit for her — and to improve her marathon times.
Experts also emphasize that partners cannot force each other to change.
“One thing we remind everyone is that their journey is their own,” said Andrea Pain, executive director of Moderation Management, a nonprofit that runs peer support groups for those who want to cut back on their drinking. “You can’t expect anyone to change what they’re doing because you’ve set this new intention for yourself.”
The Davidsons acknowledge that they are lucky. Their marriage was fundamentally sound before Ms. Davidson quit drinking, she said, and Mr. Davidson never felt threatened by her decision, nor did he attempt to derail her efforts, something which she has seen happen among her coaching clients.
The pair have found their rhythm: Mr. Davidson continues to drink in moderation, Ms. Davidson remains sober. “The way I think about it is: If I decided to become a vegetarian, that doesn’t mean Mike has to be a vegetarian too,” she said. “But he certainly wouldn’t take me to a steakhouse.”
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