Health
How Trump’s Medical Research Cuts Would Hit Colleges and Hospitals in Every State
A proposal by the Trump administration to reduce the size of grants for institutions conducting medical research would have far-reaching effects, and not just for elite universities and the coastal states where many are located.
Also at risk could be grants from the National Institutes of Health to numerous hospitals that conduct clinical research on major diseases, and to state universities across the country. North Carolina, Missouri and Pennsylvania could face disproportionate losses, because of the concentration of medical research in those states.
N.I.H. funding in 2024
Per capita Based on spending in the 2024 fiscal year.
|
Total
In the 2024 fiscal year, the N.I.H. spent at least $32 billion on nearly 60,000 grants, including medical research in areas like cancer, genetics and infectious disease. Of that, $23 billion went to “direct” research costs, such as microscopes and researchers’ salaries, according to an Upshot analysis of N.I.H. grant data.
The other $9 billion went to the institutions’ overhead, or “indirect costs,” which can include laboratory upkeep, utility bills, administrative staff and access to hazardous materials disposal, all of which research institutions say is essential to making research possible.
The N.I.H. proposal, which has been put on hold by a federal court, aims to reduce funding for those indirect costs to a set 15 percent rate that the administration says would save about $4 billion a year. The Upshot analysis estimates that a 15 percent rate would have reduced funding for the grants that received N.I.H. support in 2024 by at least $5 billion. The White House said the savings would be reinvested in more research, but the rate cuts would open up sizable budget holes in most projects at research institutions.
It is not clear whether those organizations can fill the gaps with other funding sources or by shifting how they apply for grants. Instead, many officials at universities and hospitals have said that they may have to pull back on medical or scientific research.
“It’s not an overstatement to say that a slash this drastic in total research funding slows research,” said Heather Pierce, senior director for science policy at the Association of American Medical Colleges, which has sued along with other education and hospital associations to block the policy. And slower scientific progress, she said, would affect anyone who depends on the development of new treatments, medical interventions and diagnostic tools.
We estimate that virtually all universities and hospitals would see fewer funds on similar projects in the future. The 10 institutions that receive the most money from N.I.H. stand to lose more than $100 million per year on average.
To understand how the change would work, let’s look at one grant for about $600,000 sent last year to the University of Alabama at Birmingham to study whether exercise can improve memory for people with epilepsy.
The N.I.H. sent the university this funding in the 2024 fiscal year, as part of a multiyear grant. A majority of the money went to direct costs associated with the study. And an additional 45 percent went to indirect costs supporting the research, like building maintenance and administrative staff. Under the new rules, the university would receive a 15 percent rate on such grants, bringing the total down. That would have been a funding loss of nearly $130,000 on this project alone.
The calculation above, which we have repeated for every grant paid last year, is a bit simplified. In reality, the researchers would lose even more money than we’ve shown, because of the way indirect funding is calculated (see our methodology at the bottom of this article).
Our analysis also makes some other conservative assumptions given the policy’s uncertainty. We assume, for instance, that the new 15 percent rate is a flat rate that all grantees would receive, and not a maximum rate (a distinction left unclear in the N.I.H. guidance). We also assume that the change applies not just to institutions of higher education, but also to all kinds of grantees, including hospitals.
In a statement, the White House indicated it would reserve any savings for additional research grants. “Contrary to the hysteria, redirecting billions of allocated N.I.H. spending away from administrative bloat means there will be more money and resources available for legitimate scientific research, not less,” said Kush Desai, a White House spokesman.
The N.I.H. announcement, however, coincides with the Trump administration’s moves to cut spending across the government, and with the N.I.H.’s withholding of funding for grants — their direct and indirect costs alike — in apparent conflict with separate court orders.
The N.I.H. guidance document includes a number of conflicting statements and statistics the Upshot could not reconcile. The N.I.H. also declined to answer questions about the policy and about its public-facing data tracking grant spending.
The N.I.H. since 1950 has provided these overhead funds in a formulaic way, and since 1965, the government has used a rate individually calculated for each institution. Federal officials review cost summaries, floor plans and other information to determine that rate. That number can be higher for institutions in more expensive parts of the country, or for those that use more energy-intensive equipment. The proposal from the Trump administration would set aside those differences in standardizing the rate at 15 percent for every grantee.
The lists below estimate what would have happened to the 10 universities and hospitals that received the most N.I.H. grant money in the 2024 fiscal year, if the formula change had been in effect then.
University of California, San Francisco San Francisco
Johns Hopkins University
Baltimore
Washington University
St. Louis University of Michigan
Ann Arbor, Mich.
University of Pennsylvania
Philadelphia
University of Pittsburgh Pittsburgh, Pa.
Columbia University Health Sciences
New York
Yale University
New Haven, Conn. Stanford University
Stanford, Calif.
University of Washington
Seattle
Source: National Institutes of Health Based on spending in the 2024 fiscal year.
Massachusetts General Hospital
Boston Vanderbilt University Medical Center
Nashville
Brigham and Women’s Hospital
Boston
Boston Children’s Hospital Boston
University of Texas MD Anderson Cancer Center
Houston
Children’s Hospital of Philadelphia
Philadelphia Dana-Farber Cancer Institute
Boston
Cincinnati Childrens Hospital Medical Center
Cincinnati
Beth Israel Deaconess Medical Center Boston
Cedars-Sinai Medical Center
Los Angeles
Source: National Institutes of Health
Based on spending in the 2024 fiscal year, which extends from Oct. 1 to Sept. 30.Largest N.I.H. grant recipients among colleges, universities and medical schools
Name
Total ’24 Funding
Estimated reduction
$793 mil.
$121 mil.
$788 mil.
$136 mil.
$717 mil.
$108 mil.
$708 mil.
$119 mil.
$652 mil.
$129 mil.
$632 mil.
$115 mil.
$611 mil.
$111 mil.
$602 mil.
$131 mil.
$584 mil.
$107 mil.
$542 mil.
$86 mil.
Largest N.I.H. grant recipients among hospitals
Name
Total ’24 Funding
Estimated reduction
$641 mil.
$98 mil.
$468 mil.
$71 mil.
$364 mil.
$77 mil.
$218 mil.
$54 mil.
$180 mil.
$39 mil.
$162 mil.
$32 mil.
$161 mil.
$35 mil.
$153 mil.
$28 mil.
$117 mil.
$23 mil.
$100 mil.
$23 mil.
If courts allow the change to move forward, some of its consequences are hard to predict.
Advocates for the policy change note that these organizations receive numerous other federal subsidies. Most universities and research hospitals are nonprofits that pay no federal taxes, for example. The N.I.H. announcement also noted that these same institutions often accept grants from charitable foundations that offer much lower overhead rates than the federal government, a signal that universities and hospitals willingly pursue research opportunities with less supplemental funding.
Because the indirect payments are based on broad formulas and not specific line items, critics say institutions may be diverting these federal dollars into unaccountable funds to pay for programs that taxpayers can’t see, such as the kinds of diversity, equity and inclusion programs targeted by the Trump administration.
“That’s how you get things like the ability of administrators to use larger overhead pools of money to build out D.E.I. bureaucracies, or to fund Ph.D. programs in the humanities,” said Jay Greene, a senior research fellow in the Center for Education Policy at the Heritage Foundation, a conservative research group. Mr. Greene was the coauthor of a 2022 article urging the N.I.H. to cut or eliminate indirect grant funding. But he did not have specific examples to cite of research funds being spent in this way.
Researchers say the indirect funds have a branding problem, but are a necessary component of research.
“The term ‘indirect costs’ or the alternative term ‘overhead’ sounds dangerously close to ‘slush fund’ to some people,” said Jeremy Berg, who was the director of the National Institute of General Medical Sciences at the N.I.H. from 2003 to 2011. “There are real costs somebody has to pay for, and heating and cooling university laboratory buildings is a real cost.”
Some grant recipients already receive low overhead payments, but a large majority of them currently receive more than 15 percent, meaning they will need to make budgetary changes to absorb the loss. Among the 2024 grants that we analyzed, institutions that received more than $1 million in N.I.H. support got an average of 40 cents of indirect funding for every dollar of direct funding.
As a share of direct funding
Source: National Institutes of Health
Calculated for 613 institutions that received at least $1 million in funding in fiscal year 2024. Federally negotiated rates are higher than these.
Distribution of overhead funding at N.I.H.-funded institutions in 2024
Universities and hospitals may adjust their overall budgets to keep supporting medical research by cutting back on other things they do. Some might be able to raise money from donors to fill the shortfalls, though most universities are already raising as much philanthropic money as they can.
But many research institutions have said they would adjust by simply doing less medical research, because they would not be able to afford to do as much with less government help.
Universities and hospitals might also shift the kinds of research they do, avoiding areas that require more lab space, regulatory compliance or high-tech equipment, and focusing on types of research that will require them to provide less overhead funding themselves. That may mean disproportionate reductions in complex areas of research like genetics.
Those effects may be spread unevenly across the research landscape, as some organizations find a way to adjust, while others abandon medical research altogether.
We’ve compiled a list of institutions that received at least $1 million in N.I.H. funding in the 2024 fiscal year, along with our estimates of how much less they would have gotten under the new policy. Most of these institutions are universities or hospitals, but there are also some private companies and nonprofit research groups. Our numbers tend to be underestimates of the cuts.
New York
New York New York
New York
New York
Bronx, N.Y.
Rochester, N.Y. Ithaca, N.Y.
Amherst, N.Y.
New York
New York
Stony Brook, N.Y. New York
Buffalo, N.Y.
Manhasset, N.Y.
Cold Spring Harbor, N.Y.
Syracuse, N.Y. New York
Brooklyn, N.Y.
Orangeburg, N.Y.
New York
Albany, N.Y. Binghamton, N.Y.
New York
New York
Albany, N.Y.
New York New York
Syracuse, N.Y.
New York
Troy, N.Y.
New York City, N.Y. New York
New York
Albany, N.Y.
Valhalla, N.Y.
Mineola, N.Y. Rochester, N.Y.
White Plains, N.Y.
Menands, N.Y.
Flushing, N.Y.
New York Upton, N.Y.
New York
Bronx, N.Y.
New York
New York New York
Queens, N.Y.
Potsdam, N.Y.
New York
Buffalo, N.Y. Utica, N.Y.
New York
Niskayuna, N.Y.
New York
New York Jamaica, N.Y.
New York
New York
New York
Old Westbury, N.Y. Clifton Park, N.Y.
Garrison, N.Y.
Other
About our analysis
To estimate changes in funding, we relied on data from RePORT, the N.I.H.’s online registry of grants and projects. We limited our analysis to grants listed within the 50 U.S. states, the District of Columbia or Puerto Rico. We also limited it to grants where the amount of indirect funding was known and where the combined indirect and direct funding was within five percent of the listed total funding. These filters resulted in removing many grants to private organizations such as domestic for-profits. We calculated how much indirect funding each grant would have received under the new guidance by multiplying the listed direct funding amount by 15 percent. We then compared that number to the listed indirect funding amount for each great to estimate the impact of the policy.
There are two reasons our calculations are most likely conservative estimates of true reductions in funding. First, only a portion of the direct funding for each grant is considered to be “eligible” for the purposes of calculating indirect funding. For example, laboratory equipment and graduate student tuition reimbursements are deducted from the direct costs before applying the negotiated overhead rate, whereas our calculations assumed 100 percent of the listed direct costs would be eligible. We performed a more accurate version of our calculations for the 10 universities and 10 hospitals receiving the most N.I.H. funds by inferring their eligible direct costs from their reported negotiated rates. When we did this, we saw an additional increase in losses of about 20 percent.
Second, we applied a 15 percent rate to all grants in the database, including those with an initial indirect rate below 15 percent. An analysis by James Murphy helped inform this approach. According to our analysis, then, some grants would actually receive more money under the new guidance. If the new rate operated more like a cap — and grants with rates currently below 15 percent did not change — the overall reductions in funding would be larger, as the reductions would no longer be offset by some small number of funding increases.
Institution
No. of grants
Total ’24 Funding ▼
Estimated change
1,024
$611 mil.
-$111 mil.
596
$480 mil.
-$63 mil.
714
$453 mil.
-$93 mil.
540
$293 mil.
-$55 mil.
331
$197 mil.
-$54 mil.
311
$184 mil.
-$35 mil.
384
$180 mil.
-$32 mil.
221
$102 mil.
-$21 mil.
204
$83 mil.
-$13 mil.
195
$76 mil.
-$13 mil.
129
$69 mil.
-$17 mil.
176
$64 mil.
-$13 mil.
124
$50 mil.
-$9 mil.
77
$48 mil.
-$9 mil.
61
$39 mil.
-$9 mil.
78
$34 mil.
-$12 mil.
72
$25 mil.
-$5 mil.
49
$24 mil.
-$3 mil.
29
$23 mil.
-$2 mil.
17
$17 mil.
-$3 mil.
20
$14 mil.
-$3 mil.
30
$13 mil.
-$3 mil.
38
$13 mil.
-$2 mil.
28
$12 mil.
-$2 mil.
7
$11 mil.
-$3 mil.
38
$11 mil.
-$2 mil.
13
$11 mil.
-$1 mil.
20
$10 mil.
-$1 mil.
33
$10 mil.
-$2 mil.
25
$10 mil.
-$3 mil.
25
$9 mil.
-$1 mil.
2
$8 mil.
-$1 mil.
2
$8 mil.
+$371k
9
$7 mil.
-$2 mil.
7
$6 mil.
-$1 mil.
17
$6 mil.
-$1 mil.
9
$6 mil.
-$1 mil.
20
$6 mil.
-$759k
10
$5 mil.
-$1 mil.
10
$5 mil.
-$961k
14
$5 mil.
-$540k
9
$5 mil.
-$535k
1
$5 mil.
-$1 mil.
3
$4 mil.
-$1 mil.
10
$3 mil.
-$158k
1
$3 mil.
+$213k
1
$3 mil.
+$144k
9
$3 mil.
-$607k
15
$3 mil.
-$647k
9
$2 mil.
-$270k
13
$2 mil.
-$313k
5
$2 mil.
-$745k
4
$2 mil.
-$738k
4
$2 mil.
-$259k
3
$2 mil.
-$459k
8
$2 mil.
-$142k
6
$1 mil.
-$333k
5
$1 mil.
-$415k
1
$1 mil.
+$113k
3
$1 mil.
-$35k
4
$1 mil.
-$336k
3
$1 mil.
-$199k
3
$1 mil.
-$315k
2
$1 mil.
-$27k
56
$16 mil.
-$1 mil.
Total
5,887
$3.3 bil.
-$618 mil.
Health
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Health
Simple daily habit could help people with type 2 diabetes manage blood sugar
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Sitting next to a window may help people with type 2 diabetes control their insulin levels, according to new research.
The study, published in Cell Metabolism, found that exposure to natural light — even indoors next to a window — changes how the body processes glucose and uses energy.
People in Western societies spend 80% to 90% of their time under artificial lights, which are much dimmer and less dynamic than sunlight, the researchers noted. Natural daylight is a powerful cue for the body’s internal clock, also known as the circadian rhythm.
EXPERTS REVEAL EXACT BEDTIME THAT COULD PREVENT LATE-NIGHT ‘SECOND WIND’ INSOMNIA
The body’s internal clock influences many processes, including digestion, hormone release and metabolism, according to research. When it gets out of sync, it can worsen insulin resistance and blood sugar control, which are two of the main issues caused by type 2 diabetes.
Typical lighting in homes and offices is much dimmer and lacks the biological signals provided by natural daylight. (iStock)
To test the effects of daylight on blood sugar, scientists recruited 13 adults with type 2 diabetes. Each person spent two separate 4.5-day periods in a controlled office setting, according to a press release.
DIABETES PREVENTION LINKED TO SPECIFIC TYPE OF EXERCISE, STUDY SHOWS
In one period, they worked in front of large windows with natural daylight streaming in. In the other period, participants worked in the same room with the windows covered and were exposed only to typical indoor lighting.
Daylight isn’t a replacement for medication or traditional management strategies like diet and exercise, the researchers noted.
Everyone ate similar meals, followed the same schedule and continued their usual diabetes medications in both conditions.
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While average blood sugar levels didn’t differ drastically between the two conditions, people spent more time in the healthy glucose range when they were exposed to natural daylight — their blood sugar fluctuated less and stayed within a desirable range for a greater portion of the day.
Participants who were exposed to daylight burned more fat and fewer carbohydrates, a metabolic pattern linked to better blood sugar regulation. (iStock)
Exposure to natural light also affected metabolism. In daylight, participants burned more fat and fewer carbohydrates for energy.
Muscle biopsies and laboratory tests further showed that the genes responsible for the body’s cellular clocks were more synchronized under natural light conditions, the study revealed.
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Better alignment of these genes can improve nutrient processing and how cells respond to insulin, the researchers concluded.
Sitting near windows or spending more time outdoors could support diabetes management alongside standard treatments, researchers say. (iStock)
However, daylight isn’t a replacement for medication or traditional management strategies like diet and exercise, according to the team.
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The study did have some limitations, including that the group of patients was small. The researchers cautioned that larger studies are needed to confirm these results and determine how much natural light exposure is optimal.
TEST YOURSELF WITH OUR LATEST LIFESTYLE QUIZ
“This study also highlights the often unnoticed impact of the built environment on our health, and raises further concerns about the prevalence of office environments with poor (natural) daylight access,” the researchers noted.
Health
Frequent heartburn may be a warning sign of a more dangerous condition, doctor says
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For most people, heartburn is an occasional annoyance and source of temporary discomfort. But for some, chronic heartburn can lead to more dangerous conditions — potentially even pre-cancerous ones.
About 10% of people with chronic gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer, according to medical experts.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer, but most will not.
POPULAR SLEEP POSITIONS COULD BE DAMAGING YOUR NERVES, ACCORDING TO EXPERTS
When acid reflux becomes dangerous
“Your stomach is designed to handle acid. Your esophagus is not,” Dr. Daryl Gioffre, a Florida-based gut health specialist and certified nutritionist, told Fox News Digital.
About 10% of people with chronic acid reflux will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer. (iStock)
“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”
In most people, the lower esophageal sphincter — which Gioffre refers to as the “acid gate” — keeps acid in the stomach, which is lined with thick mucus and specialized cells designed to protect it.
“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”
“But when the gate gets weak, it relaxes or stays slightly open, and acid slips back up the wrong way,” he said. This “gate” can weaken with magnesium deficiency, high stress, alcohol, poor sleep, dehydration and late-night snacking, all of which can disrupt healthy digestion.
When acid hits the esophagus, it irritates tissue that was never designed to withstand it, according to the doctor.
“Every time acid comes back up the wrong way, it injures the lining like a slow chemical burn,” said Gioffre, who is also the author of “Get Off Your Acid” and “Get Off Your Sugar.” Over time, that irritation erodes the lining, drives inflammation and can change the cells.
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“These new cells are no longer normal esophageal cells — they begin to shift into cells that look more like stomach lining, because those cells can tolerate the acid,” the doctor said. “That change is called metaplasia, or Barrett’s esophagus.”
Once the cells start changing, the risk of further mutation goes up. If that process continues, Gioffre warned, it can progress to dysplasia, which is the stage right before esophageal cancer.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer. (iStock)
“So the real danger is not the heartburn you feel,” he summarized. “It is the repeated acid exposure forcing the esophagus to adapt in ways it was never designed to. Fixing reflux at the root stops this entire cascade before those cellular changes begin.”
Men at higher risk
Men generally have a higher risk because they burn through magnesium faster, tend to carry more visceral fat pushing upward on the stomach, eat heavier meals and snack late at night, Gioffre cautioned. These activities all weaken the acid gate and shut down healthy digestion.
THE BREAD THAT KEEPS THINGS MOVING IN THE BATHROOM — AND DOCTORS SAY IT REALLY WORKS
“Eating within three hours of lying down almost guarantees the stomach does not empty, and that is one of the biggest drivers of nighttime reflux,” he said. “On top of that, men often ignore symptoms, or mask them with PPIs and antacids instead of fixing the root cause.”
All of these factors contribute to a “perfect storm” for chronic inflammation and long-term damage, according to Gioffre.
Warning signs
There are certain red flags that indicate when acid reflux has gone beyond an occasional annoyance and has progressed to constant and chronic.
“If that burn becomes more frequent or more intense, or starts showing up even when you have not eaten, your body is waving a giant warning flag,” Gioffre said.
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach. (iStock)
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach, according to the doctor.
EXPERT WARNS OF ‘SILENT EPIDEMIC’ THAT PUTS MEN’S HEALTH AT SERIOUS RISK
“Ulcers in your throat, or even in your mouth, are another sign that the acid is doing real damage,” he warned.
“Another major warning sign is when reflux goes from something you notice occasionally to something you feel every day or every night, or when PPIs and antacids stop helping,” Gioffre said. “That usually means the lining is irritated and eroded, and may already be changing on a cellular level.”
Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, the doctor said. (iStock)
Unexplained weight loss, vomiting blood and black stools are all serious symptoms that demand immediate attention, the doctor added.
“The bottom line: When reflux becomes consistent, chronic and starts impacting swallowing, your voice, or the tissues in your mouth or throat, it is no longer just a nuisance,” Gioffre told Fox News Digital. “That is the point where the esophagus may be moving toward a precancerous state, and men especially cannot afford to wait on it.”
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3 key ways to prevent reflux
Gioffre shared the following essential steps to preventing acid reflux and improving digestive health.
No. 1: Follow the 3-hour rule
“Stop eating three hours before bed,” the doctor recommends. “When you eat late, the stomach does not empty, pressure builds and the acid gate relaxes, guaranteeing that acid travels upward into your esophagus while you sleep.”
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Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, he warned. “This one rule alone can dramatically lower acid reflux and cancer risk.”
No. 2: Strengthen the acid gate
When stomach acid is low, the lower esophageal sphincter loses its tone, allowing acid to travel upward instead of staying in the stomach, Gioffre said.
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“The fastest way to tighten that gate is to build your mineral reserves, especially magnesium,” he said.
The best way to do this is to load up on magnesium-rich foods like avocado, spinach, pumpkin seeds, chia seeds, quinoa and almonds, and consider adding a clean magnesium supplement.
No. 3: Remove or neutralize daily triggers
The fastest way to protect your esophagus, according to Gioffre, is to eliminate or neutralize the foods and habits that weaken the acid gate and push acid the wrong way.
For people who can’t fully eliminate these triggers, certain habits can help neutralize their impact by reducing acid strength and pressure before it reaches the esophagus.
The doctor recommends cutting back on alcohol and caffeine, both of which relax the acid gate and increase the risk of acid reflux. (iStock)
“Drinking most of your water earlier in the day helps, because pounding water at night stretches the stomach and relaxes the acid gate, making it much easier for acid to flow the wrong way once you lie down,” he said.
He also recommends cutting back on alcohol and caffeine, both of which relax the acid gate instantly.
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Some other major triggers that fuel the reflux cycle include chocolate, spicy foods, garlic, onions, sugar, ultraprocessed foods and heavy nighttime meals, according to the doctor.
“These foods and habits weaken the lower esophageal sphincter, drive up inflammation and push pressure upward,” he said. “That’s exactly how a little heartburn turns into chronic reflux, and slowly causes the kind of damage that puts the esophagus at risk for cancer.”
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