Category: 8. Health

The average person makes around 35,000 decisions each day—yes, that many. From the moment you wake until your head hits the pillow, you’re constantly making decisions on daily tasks and events, like what to wear, how to respond to emails and what to eat. All these choices can lead to decision fatigue, leaving you feeling drained. That’s why many of us find ourselves wearing and eating the same things often because it’s one less decision to make. 

When it comes to choosing meals, breakfast tends to be the one we repeat the most. This makes sense, since mornings can be hectic, and having a go-to breakfast option makes busy mornings a little easier. But is it actually healthy to eat the same breakfast every day? Here’s what dietitians say about being a breakfast repeater. 

Pros of Eating the Same Breakfast Every Day

It Reduces Decision Fatigue 

“Sticking to the same breakfast each day can reduce decision fatigue,” says Sapna Peruvemba, M.S., RDN, a registered dietitian. With breakfast already planned, you can conserve the energy you’d normally spend on deciding what to eat for breakfast for more important stuff. Plus, some people actually look forward to having the same daily breakfast. “It offers a sense of routine, which can be comforting—especially for those who enjoy structure in their mornings,” she adds. Another win? Making the same thing for breakfast can simplify your grocery list, cutting down on even more decision-making.

You Stick to Something That Works for You

As the saying goes, “If it’s not broken, don’t fix it.” This can apply to your favorite breakfast too. “When my clients find a breakfast that works for them, I recommend they stick to it as many days a week as possible,” says Melissa Mitri, M.S., RD. “Everyone is different, and so once you find that breakfast that is satisfying, balanced and provides long-lasting energy, it makes sense to stick to it or at least some variation of it.” For some, that might mean whipping up a daily smoothie. For others, a veggie-filled egg scramble is their top breakfast pick. “This takes the guesswork out of your first meal, which can profoundly impact your day in a positive way,” explains Mitri.

Starts Your Day Off Right

Even if you’re having the same thing every day, a well-balanced breakfast can set the tone for making healthier choices the rest of the day. “If it’s a healthy breakfast (e.g., rolled oats and fruit, or eggs with whole-grain toast), you’ve gotten your day off to a good start,” says Lisa Andrews, M.Ed., RD, LD. The key is making sure that your staple breakfast provides an optimal balance of protein, carbohydrates and healthy fats for sustained energy that will power you through the whole morning. Having a balanced breakfast can also give you a head start on meeting the daily recommendations for essential nutrients like folate, vitamin C and calcium. 

Cons of Eating the Same Breakfast Every Day

It Can Get Boring

“While eating the same breakfast every day may work for some people, others may get bored eating in this way,” says Mitri. She adds that this breakfast monotony could potentially derail your health goals: “Boredom may lead to dissatisfaction with your meals or cravings later on because you’re yearning for more variety.” If you find yourself in a breakfast rut, it may be time to switch things up. 

You May Miss Out on Important Nutrients

Missing out on a variety of nutrients is another drawback to being a breakfast repeater. “Eating the same breakfast every day limits the number of nutrients in that meal. Because of this, you may risk missing out on other essential nutrients that you would otherwise get if you had more of a variety of breakfast options in your rotation,” says Mitri. 

Your gut health depends on meal variety too. “Your gut microbiome thrives on dietary diversity, so too much repetition might not be ideal—though this can be balanced out by varying your other meals,” explains Peruvemba. 

The Final Verdict

Good news—dietitians agree that sticking to a go-to breakfast isn’t inherently a bad thing. To make the most of your breakfast, consider these tips: 

• Choose Savory Rather Than Sweet. When deciding on your staple breakfast, Andrews suggests opting for savory options like eggs or frittata versus sweet ones like muffins or waffles. “This may help curb your sweet tooth for the rest of the day and give you more energy in the morning,” she says.
• Add Some Protein. In addition to keeping you full, eating a protein-rich breakfast has other perks. “Protein at breakfast was found to keep blood sugar levels lower at lunch and dinner, according to a small study in healthy adults,” says Andrews. There’s also evidence that eating a protein-rich breakfast may support heart health, such as better blood pressure regulation and HDL (“good”) cholesterol, she adds.
• Don’t Forget About Fiber. Picking a high-fiber breakfast to repeat helps you get closer to the daily fiber goal of 25 grams for women and 38 grams for men—a goal most people fall short of. “Include foods that are high in both protein and fiber to help regulate blood sugar and your appetite. A veggie omelet with whole-grain toast and fresh or frozen fruit is an ‘eggscellent’ way to start your day,” says Andrews.
• Add Variety the Rest of the Day. If you like to eat the same thing in the morning, make sure that you are covering all of your nutrition bases by eating more variety at lunch, dinner and snacks. “Balance out the routine by including a wide variety of nutrient-dense foods in your other meals throughout the day,” says Peruvemba.
• Switch Up Some Ingredients. ”If you like the same breakfast every day, you can still stick to the same general ‘formula,’ while rotating some of the ingredients,” says Mitri. “For example, if [you eat] overnight oats every morning, you can mix the ingredients up every few days, such as the type of fruit you add in, other toppings like nuts or seeds, or rotate different nut butters like almond, peanut or sunflower. Doing this allows you to enjoy the same overall meal while maintaining variety in nutrient content and flavor.”

Our Expert Take

Whether it’s a favorite smoothie, overnight oats or scrambled eggs and toast, many of us have at least one go-to breakfast that we make again and again. Dietitians agree that if it works for you, there’s no need to change things up—especially if it’s a breakfast that offers plenty of filling fiber and protein. The one caveat is that you’ll want to plan a bit of variety in the rest of your meals so that you aren’t missing out on any key nutrients. To prevent boredom, you can also add interest to your staple breakfast by switching out toppings or mix-ins rather than picking something entirely new. If deciding what to eat each morning feels exhausting, make one final decision: stick to the same breakfast.

Every woman deserves to know what her body is trying to tell her – especially if and when those signals could be early signs of some complex disease. Whether it’s heart health, bone health, or even cancer.

Contrary to popular belief, cancer affects women of all ages. Despite its prevalence, many early signs are silent or easily mistaken for everyday issues. From subtle digestive changes to unexplained fatigue or abnormal bleeding, knowing what to look for can save lives.

In fact, experts stress that women should be particularly vigilant about symptoms that linger for more than two to three weeks, especially lumps, unusual discharge, persistent bloating, or unexplained weight loss, because these can signal serious conditions like breast, ovarian, cervical, or endometrial cancer. Recent warnings from oncologists highlight common, often dismissed symptoms: persistent abdominal bloating, irregular bleeding, nipple or breast changes, pelvic or back pain, and chronic fatigue, signs that may point toward cancers such as ovarian, uterine, cervical, or blood cancers.

By trusting these signals and acting early, women can significantly improve their chances of early detection and successful treatment. Because awareness of even very subtle, yet persistent changes can make all the difference. And awareness, paired with timely medical attention and screenings, provides the best defense.

In this carefully curated guide, we’ll break down key symptoms women should not ignore, explain why they matter, and offer guidance on when to see a doctor.

NYU Langone Health’s Perlmutter Cancer Center announces the arrival of acclaimed cancer leaders Anirban Maitra, MD, and Manuel Hidalgo, MD, as co-directors of a new Gastrointestinal (GI) Cancer Center. This marks a milestone in its mission to develop a world-leading GI cancer program with a tightly integrated research and clinical platform focused on translating research into new treatments for GI cancer patients.

Dr. Maitra is a world-renowned physician-scientist whose work has widely influenced the field of pancreatic cancer research, from early detection and biomarker development to tumor microenvironment and early cancer interception strategies. He is also a leading gastrointestinal and pancreatic pathologist, and at NYU Langone, he will be working with the Department of Pathology to develop programs in spatial biology, molecular diagnostics, and tissue-based analytics. At Perlmutter Cancer Center, Dr. Maitra will serve as both co-director of the GI Cancer Center and associate director of translational research, where he will lead efforts to drive discovery from the lab to the clinic across multiple disease areas.

“We are positioned well at Perlmutter Cancer Center to create a truly world-class GI Cancer Center,” said Dr. Maitra. “The integrated nature of this institution gives us so much opportunity to turn what we do at the lab bench into tangible treatments, developing both our understanding of these cancers, and our ability to improve outcomes for our patients.”

Dr. Hidalgo is a highly respected translational researcher and clinical oncologist, having done internationally recognized work in anticancer drug development. He has led early clinical development of more than 50 novel agents that have changed the standard of care for patients with advanced cancers. Having pioneered the use of patient-derived xenografts, which use a sample of a patient’s tumor to develop the best course of treatment, Dr. Hidalgo’s work bridges laboratory discoveries with clinical application. At Perlmutter Cancer Center, he will focus on building robust infrastructure for therapeutic development, investigator-initiated trials, and biomarker-driven studies.

“I am honored to join Perlmutter Cancer Center and help lead the development of this ambitious GI Cancer Center alongside Dr. Maitra,” said Dr. Hidalgo. “The vision behind this initiative is to facilitate collaboration between existing expertise at NYU Langone Health to address the needs of our community of patients.”

Dr. Maitra and Dr. Hidalgo have collaborated with each other in the past to develop a successful pancreatic cancer center earlier in their careers. We are tremendously excited that their reunion at NYU Langone will see them building a GI Cancer Center that partners with our multidisciplinary teams of incredible surgical oncologists, radiation oncologists, medical oncologists, gastroenterologists, and researchers to accelerate scientific discovery into tangible treatments for our patients.”

John P. Leonard, MD, chief of the Division of Hematology and Medical Oncology at NYU Grossman School of Medicine and director of the Center for Blood Cancers at Perlmutter Cancer Center

An ultrasound device that can precisely stimulate areas deep in the brain without surgery has been developed by researchers from UCL and the University of Oxford, opening up new possibilities for neurological research and treatment of disorders such as Parkinson’s disease.

Scientists have long been looking for a way to modulate brain function, which could improve our understanding of how the brain works and help to treat neurological diseases, using non-invasive methods that don’t involve surgery.

One technology that could help is transcranial ultrasound stimulation (TUS), which was recently discovered to be able to modulate the activity of neurons (the brain’s key communication cells) by delivering gentle mechanical pulses that influence how these cells send signals.

But to date current systems have struggled to reach deeper areas of the brain with sufficient precision to target specific brain structures. Conventional TUS systems often affect broader regions than intended, limiting their utility for targeted neuromodulation.

The study, published in Nature Communications, introduces a new ultrasound device capable of influencing deep brain regions without surgery for the first time, targeting areas around 1,000 times smaller than conventional ultrasound devices can pinpoint and 30 times smaller than previous deep brain ultrasound devices.

The new technology features 256 elements configured within a special helmet to send focused beams of ultrasound to specific parts of the brain in order to turn neuronal activity up or down. It also includes a soft plastic face mask which helps to target the ultrasound waves more precisely by keeping the head still.

The research team demonstrated the system’s capabilities on seven human volunteers by targeting a part of the thalamus, a small structure in the centre of the brain that helps to relay sensory and motor information, called the lateral geniculate nucleus (LGN). The LGN is involved in processing visual information.

In the first experiment, participants looked at a flashing checkerboard, which sent signals to the brain through the eyes. During stimulation with the ultrasound device, a functional magnetic resonance imaging (fMRI) scan showed significantly increased activity in the participants’ visual cortex, confirming precise targeting of the LGN.

A second experiment revealed sustained decreases in visual cortex activity for at least 40 minutes after ultrasound stimulation, highlighting the system’s potential for inducing lasting changes in brain function.

Though participants did not consciously perceive any changes in what they were seeing during the experiments, the brain scans revealed significant changes in neural activity. The ultimate goal is to harness these effects to produce clinically beneficial outcomes, such as stopping hand tremors.

This advance opens up opportunities for both neuroscience research and clinical treatment. For the first time, scientists can non-invasively study causal relationships in deep brain circuits that were previously only accessible through surgery.

Clinically, this new technology could transform treatment of neurological and psychiatric disorders like Parkinson’s disease, depression, and essential tremor, offering unprecedented precision in targeting specific brain circuits that play key roles in these conditions.

The ability to precisely modulate deep brain structures without surgery represents a paradigm shift in neuroscience, offering a safe, reversible, and repeatable method for both understanding brain function and developing targeted therapies.”

Professor Bradley Treeby, senior author of the study from UCL Medical Physics and Biomedical Engineering

In addition to its research applications, the system could pave the way for new clinical interventions. Deep brain stimulation (DBS), currently used to treat conditions like Parkinson’s disease, requires invasive surgery and carries associated risks. The new ultrasound system offers a non-invasive alternative with comparable precision, potentially allowing clinicians to test areas of the brain that could be used to treat disease before surgery or even replace surgical approaches altogether.

Recognising this clinical potential, several members of the research team have recently founded NeuroHarmonics, a UCL spinout company developing a portable, wearable version of the system. The company aims to make precise, non-invasive deep brain therapy accessible for both clinical treatment and broader therapeutic applications.

Dr Eleanor Martin, first author of the study from UCL Medical Physics and Biomedical Engineering, said: “We designed the system to be compatible with simultaneous fMRI, enabling us to monitor the effects of stimulation in real time. This opens up exciting possibilities for closed-loop neuromodulation and personalised therapies.”

The researchers emphasise that further studies are needed to fully understand the mechanisms underlying TUS-induced neuromodulation. However, the results mark a significant milestone in the development of safe, effective, and targeted brain stimulation technologies.

Dr Ioana Grigoras, a first author of the study from the Nuffield Department of Clinical Neurosciences, University of Oxford, said: “This novel brain stimulation device represents a breakthrough in our ability to precisely target deep brain structures that were previously impossible to reach non-invasively. We are particularly excited about its potential clinical applications for neurological disorders like Parkinson’s disease, where deep brain regions are especially affected.”

The study was supported by the Engineering and Physical Sciences Research Council (EPSRC), Wellcome, and the NIHR Oxford Health Biomedical Research Centre.

The revelation that over 100 million Pakistanis are overweight ought to ring alarm bells across every policymaking corridor in the country. This is not merely a matter of individual health choices; it is a national crisis unfolding in slow motion. The link between obesity and chronic diseases such as diabetes, cardiovascular illness, and hypertension is well-documented, and these conditions are already stretching our fragile healthcare system to its limits.

We must recognise that this is not an issue to be shrugged off as lifestyle indulgence. The economic consequences are stark: a population plagued with chronic illness cannot be productive, which directly hampers national growth. Rising healthcare costs will only add to the burden, particularly for vulnerable households already struggling to cope with inflation. If the young are unhealthy today, the workforce of tomorrow will be weaker, and less competitive on the global stage. That is not an abstract fear; it is a practical calculation we ignore at our peril.

It is high time the state treated this as a public health emergency. Tackling the crisis requires a two-fold approach: systemic measures and mass awareness. On one hand, we need urban planning that encourages physical activity, regulation of processed food industries, and stronger healthcare interventions for early prevention. On the other hand, awareness campaigns must confront cultural attitudes that normalise sedentary lifestyles and poor diets. Relying solely on individual willpower will achieve little when the environment is stacked against healthier choices.

The urgency of this matter needs to be acknowledged before the crisis deepens further. Pakistan cannot afford to carry the weight—literally—of neglect.

Today, the World Health Organization (WHO) has released updated editions of its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), adding new treatments for various types of cancer and for diabetes with associated comorbidities such as obesity. Medicines for cystic fibrosis, psoriasis, haemophilia and blood-related disorders are among the other additions.

WHO EML and EMLc include medicines for priority health needs of populations. They are adopted in over 150 countries, serving as a basis for public sector procurement, supply of medicines and health insurance, reimbursement schemes. The revisions mark the 24^th edition of WHO EML and 10^th edition of EMLc.

The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact.”

Dr. Yukiko Nakatani, Assistant Director-General for Health Systems, Access and Data

Launched in 1977 largely to promote better access to medicines in developing countries, the WHO Model Lists have become a trusted global policy tool for decisions related to the selection and universal coverage of medicines within all health systems.

The WHO Expert Committee on the Selection and Use of Essential Medicines reviewed 59 applications, including 31 proposals for the addition of new medicines or medicine classes. As a result, 20 new medicines were added to the EML and 15 to the EMLc, along with new use indications for seven already-listed products. The updated lists now include a total of 523 essential medicines for adults and 374 for children, reflecting the most pressing public health needs.

Cancer medicines

Cancer is the second leading cause of death globally, claiming nearly 10 million lives each year and responsible for almost one in three premature deaths from noncommunicable diseases. Cancer treatments have been a major focus of the WHO EML for the past decade. With cancer medicines accounting today for about half of all new drug approvals by regulatory agencies, the Expert Committee applies rigorous criteria to recommend only those therapies that offer the greatest clinical benefit. As a result, few approved cancer medicines are included – only those proven to prolong life by at least 4-6 months.

Seven applications encompassing 25 cancer medicines were evaluated. As part of broader efforts to reduce inequities in cancer care, the Committee recommended increasing access to PD-1/PD-L1 immune checkpoint inhibitors, a class of immunotherapy medicines that help the body’s immune system recognize and attack cancer cells more effectively. Pembrolizumab was added to the EML as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer. For the latter, atezolizumab and cemiplimab are included as therapeutic alternatives.

The Committee also considered several expert-recommended strategies – highlighted in the cancer experts report – aimed at improving access to and affordability of cancer treatments. It endorsed evidence-based clinical and health system strategies, including dose optimisation approaches, to improve access. The Committee emphasized that while health system reforms require time and government action, clinical strategies can be implemented immediately to deliver faster benefits, especially in resource-limited settings.

Medicines for diabetes and obesity

Diabetes and obesity are two of the most urgent health challenges facing the world today. Over 800 million people were living with diabetes in 2022, with half going untreated. At the same time, more than 1 billion people worldwide are affected by obesity, and rates are rising especially fast in low- and middle-income countries. These two conditions are closely linked and can lead to serious health problems, including heart disease and kidney failure.

The WHO Expert Committee reviewed strong scientific evidence showing that a group of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists can help people with type 2 diabetes – especially those who also have heart or kidney disease – by improving blood sugar control, reducing the risk of heart and kidney complications, supporting weight loss, and even lowering the risk of early death.

GLP-1 receptor agonists – semaglutide, dulaglutide and liraglutide – and the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist (tirzepatide) have been added to the EML. They are used as glucose lowering therapy for adults with type 2 diabetes mellitus with established cardiovascular disease or chronic kidney disease and obesity (defined as body mass index (BMI) ≥ 30kg/m²). This provides clear guidance to countries on which patients can benefit most from these therapies.

High prices of medicines like semaglutide and tirzepatide are limiting access to these medicines. Prioritizing those who would benefit most, encouraging generic competition to drive down prices and making these treatments available in primary care – especially in underserved areas – are key to expanding access and improving health outcomes. WHO will continue monitoring developments, support fair pricing strategies, and help countries improve access to these life-changing treatments.

“A large share of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that, in principle, should be financially accessible to everyone,” said Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products. “Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centred programmes that leave no one behind.”

More details of the Expert Committee’s recommendations, describing the additions, changes and removal of medicines and formulations, and decisions not to recommend medicines are available in the Executive Summary here.

Head and neck cancer remains a major global health challenge, ranking among the six most common cancers worldwide and claiming hundreds of thousands of lives each year. A growing body of evidence now points to an intricate connection between energy metabolism and immune regulation as a driving force behind the onset, progression, and treatment resistance of these cancers. The latest comprehensive review on this topic underscores the potential of targeting these intertwined processes to unlock more effective therapies.

Tumor cells in head and neck cancer exhibit profound metabolic reprogramming, altering the way they process glucose, lipids, and amino acids. This reprogramming fuels rapid growth, supports invasion into surrounding tissues, and fortifies tumors against hostile conditions. Changes in glucose transporters and key enzymes accelerate glycolysis, creating a microenvironment rich in lactate that fosters tumor progression and suppresses immune activity. Altered lipid metabolism not only sustains cell membrane production and energy storage but also promotes immune evasion by influencing macrophage polarization and dampening anti-tumor responses. Similarly, restructured amino acid metabolism, particularly in glutamine and arginine pathways, plays a critical role in both tumor growth and the regulation of immune cell activity.

The immune system, a natural line of defense, is often undermined in head and neck cancer. Tumor-driven metabolic shifts deprive CD8⁺ T cells and other immune cells of essential nutrients, weakening their ability to attack malignant cells. At the same time, immune checkpoints such as PD-L1 are upregulated, blocking immune activation. Dysregulation of antigen presentation pathways, altered cytokine signaling, and the recruitment of suppressive immune cells further deepen the immunosuppressive environment.

Importantly, the review highlights that this metabolism–immunity interplay is not just a byproduct of disease-it is a potential therapeutic target. Modulating glucose metabolism through transporter and enzyme inhibitors, interfering with lipid synthesis and cholesterol regulation, or restricting tumor access to key amino acids may tip the balance back in favor of the immune system. Moreover, combining metabolic interventions with immunotherapy could counteract immune suppression and improve patient outcomes, especially in cases resistant to standard treatments.

Pancreatic cancer, which mostly creeps in silently, remains a significant global health challenge with increasing incidence and mortality rates worldwide. It is often considered deadly due to its tendency to be diagnosed at a late stage, its aggressive nature, and the lack of effective treatments for advanced cases.In the middle of this growing concern of pancreatic cancer and a surge in new cases, a new study has uncovered a hidden danger behind a common habit that may put millions at increased risk of this particular type of cancer.What is it, and how is it affecting millions?More often than not, common habits that we’re accustomed to – on a daily basis – put us at great risk, without us even realizing it. Smoking is one such habit.Smoking has long been recognized as a risk factor for pancreatic cancer. Now, new evidence explains how it contributes to tumor growth at a cellular level. Researchers have found that chemicals in cigarette smoke not only spark tumor growth but also suppress the body’s immune defenses, creating fertile ground for cancer to flourish.

Smoking: More than just a risk factor

A recent study from the University of Michigan found that toxins from cigarettes activate specific cells that release a protein called interleukin-22 (IL-22). This protein promotes aggressive tumor growth while simultaneously unleashing a type of immune cell that suppresses the body’s anti-tumor response. The result: a double hit for patients, where tumors grow faster, and the immune system is blindsided.

What is pancreatic cancer?

Pancreatic cancer is a disease in which malignant (cancerous) cells form in the tissues of the pancreas. The pancreas is a gland located behind the stomach that plays a crucial role in digestion and blood sugar regulation by producing enzymes and hormones.While the exact causes are not always clear, risk factors include smoking, family history of pancreatic cancer, long-standing type 2 diabetes, and chronic pancreatitis.Pancreatic cancer is often difficult to diagnose early because symptoms may be subtle or absent in the early stages.

Rising pancreatic cancer cases: A growing concern

Pancreatic cancer is notoriously lethal. It’s often diagnosed late, and five-year survival rates remain under 20% globally. Experts estimate that by 2030, pancreatic cancer may surpass colorectal cancer as the second leading cause of cancer-related deaths in the US, a stark indicator of its growing impact.Unlike many cancers, where early detection has improved outcomes, pancreatic cancer lacks reliable screening methods for the general public. Most patients are diagnosed only after symptoms appear, usually at an advanced stage when treatment options are limited.

When should you consider screening?

Current guidelines make it clear: screening is not recommended for asymptomatic people at average risk. The U.S. Preventive Services Task Force gives it a “D” rating, meaning the potential harms outweigh the benefits.However, there are exceptions. Experts now advise proactive screening for high-risk individuals, including those with:Genetic conditions (e.g., Peutz-Jeghers, familial pancreatic cancer syndromes, BRCA1/2 mutations)A strong family history of pancreatic cancerNew-onset diabetes (especially when accompanied by unexplained weight loss), which may signal early-stage diseaseMajor health centers now recommend annual screening, using MRI or endoscopic ultrasound (EUS), for such high-risk groups, starting at an age tailored to the individual’s genetics and family history.

Why screening high-risk groups matters

For people at elevated risk, surveillance can detect tumors at an earlier, more treatable stage. Though testing comes with potential downsides, like increased anxiety, false positives, and invasive follow-ups, the emotional and clinical benefit of early detection often outweighs the risks for these individuals.Detecting pancreatic cancer in its early stages can significantly improve survival opportunities via surgery and therapy, lifesaving outcomes that are almost impossible when diagnosis comes too late.While the knowledge has been an age-old piece of information, the connection now is clearer than ever: smoking doesn’t just elevate the risk, it actively boosts pancreatic cancer growth by shutting down the immune system’s defenses. With rising incidence and still-poor survival rates, it’s crucial to act now.While mass screening isn’t yet feasible, those at higher risk, either by genetics, family history, or new-onset diabetes, should talk to their doctors about surveillance options like MRI or endoscopic ultrasound. And quitting smoking remains a vital, controllable step everyone can take.

Some of the populations with the highest risk for Alzheimer’s disease remain greatly underrepresented in clinical trials-and a new study helps explain why. Researchers from the Keck School of Medicine of USC found that participants from these high-risk groups are less likely to have elevated amyloid in the brain based on blood levels of p-tau217. Elevated amyloid is a requirement for clinical trials of Alzheimer’s disease treatments, and amyloid is known to accumulate in the brain years before any signs of cognitive decline.

The study, funded in part by the National Institutes of Health (NIH), builds on earlier research with similar findings, but leverages a new and improved blood test, p-tau217, that more accurately detects early signs of Alzheimer’s disease. Rising levels of p-tau217 are strongly linked to the buildup of amyloid, which disrupts brain activity in Alzheimer’s disease, and the p-tau217 test is increasingly used to determine who qualifies for treatment studies. Earlier this year, the U.S. Food and Drug Administration approved a similar test to help diagnose Alzheimer’s disease in the clinic.

Researchers found that cognitively unimpaired individuals from African American, Hispanic and Asian participants were less likely to have levels of p-tau217 in the blood that indicate elevated amyloid in the brain, showing they lacked the early signs of Alzheimer’s disease that would allow them to participate in a trial of lecanemab. The trial is testing whether the treatment can prevent symptoms of dementia related to Alzheimer’s disease in individuals with biological evidence of the disease. These findings suggest that these groups may have a lower prevalence of amyloid and are not at sufficient level of risk to appropriately qualify for amyloid lowering trials. The results were just published in the journal Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM).

Using this new and more accurate marker, we confirmed our earlier finding and affirmed that we may be seeing differences in the prevalence of amyloid across some populations.”

Doris P. Molina-Henry, PhD, assistant professor of research neurology, Alzheimer’s Therapeutic Research Institute (ATRI) , Keck School of Medicine and lead author of the study

In addition to helping explain the lack of diversity in Alzheimer’s disease research, the findings raise questions about whether the disease progresses differently across racial and ethnic groups. To address these and other important questions, some individuals who did not qualify for the AHEAD Study were invited to participate in the Amyloid Plasma Extension Study (APEX). The study will follow the trajectories of these and other blood markers in these individuals over time.

“It is somewhat paradoxical, because the populations showing low levels of amyloid on biomarker assessments are also the groups that face the highest risk of dementia,” Molina-Henry said. “If amyloid is not what drives disease risk in these groups, then we need to do our due diligence to find out what does.”

Eligibility for clinical trials

The study included 6,437 adults, ages 55 to 80, recruited from 75 sites across the country for AHEAD 3-45, a clinical trial designed to test the safety and efficacy of lecanemab, which removes amyloid from the brain. Of those, 4,832 identified as non-Hispanic white, 877 as Hispanic white, 511 as non-Hispanic Black, 155 as non-Hispanic Asian and 62 as Hispanic Black. All participants were cognitively unimpaired.

Using blood tests for p-tau217, the researchers found that non-Hispanic white participants were more likely than other groups to meet the threshold for inclusion in Alzheimer’s disease clinical trials. Those who identified as Hispanic Black, Hispanic white, non-Hispanic Asian and non-Hispanic Black were significantly less likely to qualify to participate.

In addition to blood tests, the researchers collected positron emission tomography (PET) scans from each participant to directly measure amyloid buildup in the brain. Among participants who qualified for the trials based on the p-tau217 test, all racial and ethnic groups were equally likely to meet the PET scan criteria. That suggests that the same blood test cutoff accurately identifies early signs of Alzheimer’s disease pathology across racial and ethnic groups.

What drives dementia risk

As one of the first and largest Alzheimer’s disease trials of cognitively unimpaired individuals to use blood-based biomarkers, the AHEAD study provides a valuable opportunity to better understand risk for future Alzheimer’s disease related dementia across populations. Those insights have important implications for the development of prevention therapies that will be necessary to address the needs of all individuals at risk of dementia.

Blood-based testing also enables much broader data collection than PET scans, which are more costly and burdensome.

“The additional data is helping us paint a clearer picture of why these populations may be underrepresented in research,” Molina-Henry said. “It may not be because of issues in recruitment, access or interest, but simply that the lower frequency of elevated amyloid in some groups makes them less likely to qualify for anti-amyloid trials.”

Further research can help clarify whether the observed differences relate to Alzheimer’s disease development and progression, and whether factors beyond amyloid-such as sociodemographic or genetic characteristics-contribute to dementia risk in these populations.

Next, Molina-Henry and her team will broaden their analysis of Alzheimer’s disease trial eligibility to include more than 20,000 participants screened for the AHEAD 3-45 trials from around the world.

About the study

In addition to Molina-Henry, the study’s other authors are Rema Raman, Andy Liu, Oliver Langford, Robert A. Rissman and Paul Aisen from the Alzheimer’s Therapeutic Research Institute, Keck School of Medicine of USC, University of Southern California; Joel B. Braunstein, Philip B. Verghese and Venky Venkatesh from C2N Diagnostics, LLC, St. Louis, Missouri; Shobha Dhadda and Michael Irrizary from Eisai, Inc., Nutley, New Jersey; Joshua D. Grill from the Institute for Memory Impairments and Neurological Disorders, University of California Irvine; Keith Johnson and Reisa A. Sperling from Mass General Brigham, Harvard Medical School, Boston, Massachusetts; and the AHEAD 3-45 Study Team.

The AHEAD 3-45 Study is conducted as a public–private partnership of the Alzheimer’s Clinical Trial Consortium, funded by the National Institute on Aging, National Institutes of Health, Eisai Inc., the GHR Foundation and other philanthropists.