If You’re Poor, Fertility Treatment Can Be Out of Reach
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Mary Delgado’s first pregnancy went according to plan, but when she tried to get pregnant again seven years later, nothing happened. After 10 months, Delgado, now 34, and her partner, Joaquin Rodriguez, went to see an OB-GYN. Tests showed she had endometriosis, which was interfering with conception. Delgado’s only option, the doctor said, was in vitro fertilization.
“When she told me that, she broke me inside,” Delgado said, “because I knew it was so expensive.”
Delgado, who lives in New York City, is enrolled in Medicaid, the federal-state health program for low-income and disabled people. The roughly $20,000 price tag for a round of IVF would be a financial stretch for lots of people, but for someone on Medicaid — for which the maximum annual income for a two-person household in New York is just over $26,000 — the treatment can be unattainable.
Expansions of work-based insurance plans to cover fertility treatments, including free egg freezing and unlimited IVF cycles, are often touted by large companies as a boon for their employees. But people with lower incomes, often minorities, are more likely to be covered by Medicaid or skimpier commercial plans with no such coverage. That raises the question of whether medical assistance to create a family is only for the well-to-do or people with generous benefit packages.
“In American health care, they don’t want the poor people to reproduce,” Delgado said. She was caring full-time for their son, who was born with a rare genetic disorder that required several surgeries before he was 5. Her partner, who works for a company that maintains the city’s yellow cabs, has an individual plan through the state insurance marketplace, but it does not include fertility coverage.
Some medical experts whose patients have faced these issues say they can understand why people in Delgado’s situation think the system is stacked against them.
“It feels a little like that,” said Elizabeth Ginsburg, a professor of obstetrics and gynecology at Harvard Medical School who is president-elect of the American Society for Reproductive Medicine, a research and advocacy group.
Whether or not it’s intended, many say the inequity reflects poorly on the U.S.
“This is really sort of standing out as a sore thumb in a nation that would like to claim that it cares for the less fortunate and it seeks to do anything it can for them,” said Eli Adashi, a professor of medical science at Brown University and former president of the Society for Reproductive Endocrinologists.
Yet efforts to add coverage for fertility care to Medicaid face a lot of pushback, Ginsburg said.
Over the years, Barbara Collura, president and CEO of the advocacy group Resolve: The National Infertility Association, has heard many explanations for why it doesn’t make sense to cover fertility treatment for Medicaid recipients. Legislators have asked, “If they can’t pay for fertility treatment, do they have any idea how much it costs to raise a child?” she said.
“So right there, as a country we’re making judgments about who gets to have children,” Collura said.
The legacy of the eugenics movement of the early 20th century, when states passed laws that permitted poor, nonwhite, and disabled people to be sterilized against their will, lingers as well.
“As a reproductive justice person, I believe it’s a human right to have a child, and it’s a larger ethical issue to provide support,” said Regina Davis Moss, president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda, an advocacy group.
But such coverage decisions — especially when the health care safety net is involved — sometimes require difficult choices, because resources are limited.
Even if state Medicaid programs wanted to cover fertility treatment, for instance, they would have to weigh the benefit against investing in other types of care, including maternity care, said Kate McEvoy, executive director of the National Association of Medicaid Directors. “There is a recognition about the primacy and urgency of maternity care,” she said.
Medicaid pays for about 40% of births in the United States. And since 2022, 46 states and the District of Columbia have elected to extend Medicaid postpartum coverage to 12 months, up from 60 days.
Fertility problems are relatively common, affecting roughly 10% of women and men of childbearing age, according to the National Institute of Child Health and Human Development.
Traditionally, a couple is considered infertile if they’ve been trying to get pregnant unsuccessfully for 12 months. Last year, the ASRM broadened the definition of infertility to incorporate would-be parents beyond heterosexual couples, including people who can’t get pregnant for medical, sexual, or other reasons, as well as those who need medical interventions such as donor eggs or sperm to get pregnant.
The World Health Organization defined infertility as a disease of the reproductive system characterized by failing to get pregnant after a year of unprotected intercourse. It terms the high cost of fertility treatment a major equity issue and has called for better policies and public financing to improve access.
No matter how the condition is defined, private health plans often decline to cover fertility treatments because they don’t consider them “medically necessary.” Twenty states and Washington, D.C., have laws requiring health plans to provide some fertility coverage, but those laws vary greatly and apply only to companies whose plans are regulated by the state.
In recent years, many companies have begun offering fertility treatment in a bid to recruit and retain top-notch talent. In 2023, 45% of companies with 500 or more workers covered IVF and/or drug therapy, according to the benefits consultant Mercer.
But that doesn’t help people on Medicaid. Only two states’ Medicaid programs provide any fertility treatment: New York covers some oral ovulation-enhancing medications, and Illinois covers costs for fertility preservation, to freeze the eggs or sperm of people who need medical treatment that will likely make them infertile, such as for cancer. Several other states also are considering adding fertility preservation services.
In Delgado’s case, Medicaid covered the tests to diagnose her endometriosis, but nothing more. She was searching the internet for fertility treatment options when she came upon a clinic group called CNY Fertility that seemed significantly less expensive than other clinics, and also offered in-house financing. Based in Syracuse, New York, the company has a handful of clinics in upstate New York cities and four other U.S. locations.
Though Delgado and her partner had to travel more than 300 miles round trip to Albany for the procedures, the savings made it worthwhile. They were able do an entire IVF cycle, including medications, egg retrieval, genetic testing, and transferring the egg to her uterus, for $14,000. To pay for it, they took $7,000 of the cash they’d been saving to buy a home and financed the other half through the fertility clinic.
She got pregnant on the first try, and their daughter, Emiliana, is now almost a year old.
Delgado doesn’t resent people with more resources or better insurance coverage, but she wishes the system were more equitable.
“I have a medical problem,” she said. “It’s not like I did IVF because I wanted to choose the gender.”
One reason CNY is less expensive than other clinics is simply that the privately owned company chooses to charge less, said William Kiltz, its vice president of marketing and business development. Since the company’s beginning in 1997, it has become a large practice with a large volume of IVF cycles, which helps keep prices low.
At this point, more than half its clients come from out of state, and many earn significantly less than a typical patient at another clinic. Twenty percent earn less than $50,000, and “we treat a good number who are on Medicaid,” Kiltz said.
Now that their son, Joaquin, is settled in a good school, Delgado has started working for an agency that provides home health services. After putting in 30 hours a week for 90 days, she’ll be eligible for health insurance.
One of the benefits: fertility coverage.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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A Hospital Kept a Brain-Damaged Patient on Life Support to Boost Statistics. His Sister Is Now Suing for Malpractice.
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ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
In 2018, Darryl Young was hoping for a new lease on life when he received a heart transplant at a New Jersey hospital after years of congestive heart failure. But he suffered brain damage during the procedure and never woke up.
The following year, a ProPublica investigation revealed that Young’s case was part of a pattern of heart transplants that had gone awry at Newark Beth Israel Medical Center in 2018. The spate of bad outcomes had pushed the center’s percentage of patients still alive one year after surgery — a key benchmark — below the national average. Medical staff were under pressure to boost that metric. ProPublica published audio recordings from meetings in which staff discussed the need to keep Young alive for a year, because they feared another hit to the program’s survival rate would attract scrutiny from regulators. On the recordings, the transplant program’s director, Dr. Mark Zucker, cautioned his team against offering Young’s family the option of switching from aggressive care to comfort care, in which no lifesaving efforts would be made. He acknowledged these actions were “very unethical.”
ProPublica’s revelations horrified Young’s sister Andrea Young, who said she was never given the full picture of her brother’s condition, as did the findings of a subsequent federal regulator’s probe that determined that the hospital was putting patients in “immediate jeopardy.” Last month, she filed a medical malpractice lawsuit against the hospital and members of her brother’s medical team.
The lawsuit alleges that Newark Beth Israel staff were “negligent and deviated from accepted standards of practice,” leading to Young’s tragic medical outcome.
Defendants in the lawsuit haven’t yet filed responses to the complaint in court documents. But spokesperson Linda Kamateh said in an email that “Newark Beth Israel Medical Center is one of the top heart transplant programs in the nation and we are committed to serving our patients with the highest quality of care. As this case is in active litigation, we are unable to provide further detail.” Zucker, who is no longer on staff at Newark Beth Israel, didn’t respond to requests for comment. His attorney also didn’t respond to calls and emails requesting comment.
Zucker also didn’t respond to requests for comment from ProPublica in 2018; Newark Beth Israel at the time said in a statement, made on behalf of Zucker and other staff, that “disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations.”
The lawsuit alleges that Young suffered brain damage as a result of severely low blood pressure during the transplant surgery. In 2019, when the federal Centers for Medicare and Medicaid Services scrutinized the heart transplant program following ProPublica’s investigation, the regulators found that the hospital had failed to implement corrective measures even after patients suffered, leading to further harm. For example, one patient’s kidneys failed after a transplant procedure in August 2018, and medical staff made recommendations internally to increase the frequency of blood pressure measurement during the procedure, according to the lawsuit. The lawsuit alleges that the hospital didn’t implement its own recommendations and that one month later, “these failures were repeated” in Young’s surgery, leading to brain damage.
The lawsuit also alleges that Young wasn’t asked whether he had an advance directive, such as a preference for a do-not-resuscitate order, despite a hospital policy stating that patients should be asked at the time of admission. The lawsuit also noted that CMS’ investigation found that Andrea Young was not informed of her brother’s condition.
Andrea Young said she understands that mistakes can happen during medical procedures, “however, it’s their duty and their responsibility to be honest and let the family know exactly what went wrong.” Young said she had to fight to find out what was going on with her brother, at one point going to the library and trying to study medical books so she could ask the right questions. “I remember as clear as if it were yesterday, being so desperate for answers,” she said.
Andrea Young said that she was motivated to file the lawsuit because she wants accountability. “Especially with the doctors never, from the outset, being forthcoming and truthful about the circumstances of my brother’s condition, not only is that wrong and unethical, but it took a lot away from our entire family,” she said. “The most important thing to me is that those responsible be held accountable.”
ProPublica’s revelation of “a facility putting its existence over that of a patient is a scary concept,” said attorney Jonathan Lomurro, who’s representing Andrea Young in this case with co-counsel Christian LoPiano. Besides seeking damages for Darryl Young’s children, “we want to call attention to this so it doesn’t happen again,” Lomurro said.
The lawsuit further alleges that medical staff at Newark Beth Israel invaded Young’s privacy and violated the Health Insurance Portability and Accountability Act, more commonly known as HIPAA, by sharing details of his case with the media without his permission. “We want people to be whistleblowers and want information out,” but that information should be told to patients and their family members directly, Lomurro said.
The 2019 CMS investigation determined that Newark Beth Israel’s program placed patients in “immediate jeopardy,” the most serious level of violation, and required the hospital to implement corrective plans. Newark Beth Israel did not agree with all of the regulator’s findings and in a statement at the time said that the CMS team lacked the “evidence, expertise and experience” to assess and diagnose patient outcomes.
The hospital did carry out the corrective plans and continues to operate a heart transplant program today. The most recent federal data, based on procedures from January 2021 through June 2023, shows that the one year probability of survival for a patient at Newark Beth is lower than the national average. It also shows that the number of graft failures, including deaths, in that time period was higher than the expected number of deaths for the program.
Andrea Young said she’s struggled with a feeling of emptiness in the years after her brother’s surgery. They were close and called each other daily. “There’s nothing in the world that can bring my brother back, so the only solace I will have is for the ones responsible to be held accountable,” she said. Darryl Young died on Sept 12, 2022, having never woken up after the transplant surgery.
A separate medical malpractice lawsuit filed in 2020 by the wife of another Newark Beth Israel heart transplant patient who died after receiving an organ infected with a parasitic disease is ongoing. The hospital has denied the allegations in court filing. The state of New Jersey, employer of the pathologists named in the case, settled for $1.7 million this month, according to the plaintiff’s attorney Christian LoPiano. The rest of the case is ongoing.
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Are You Flourishing? (There’s a Scale)
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What does it mean, to flourish? And how can you do it more?
In 2009, psychologists Diener et al developed the “Flourishing Scale”, or as it was more prosaically called originally, “Subjective Wellness Scale”. The name was changed later, as it was noted that it went beyond what was typically considered mere “wellness”.
This scale was so useful, that colleagues scrambled to see if they could improve on it, such as with PERMA (2012), which looked at:
- Positive emotion
- Engagement
- positive Relationships
- Meaning
- Accomplishment/Achievement
While popular (despite the tenuous acronym, it is a very good list of things to foster in your life), this was studied and measured scientifically and found to not be an improvement on the Flourishing Scale / SWS, so we’re going to stick to the original version for now.
We couldn’t find an interactive online quiz for the scale though (apart from this NY Times one, which is paywalled for NYT subscribers, so enjoy if you’re a NYT subscriber!), so here’s the source material, still hosted on the website of the (now deceased, as of a couple of years ago) author:
Flourishing Scale (FS) ← it’s an eight-question, ranked choice scale
How did you score? And…
What are the keys to flourishing more?
According to Jeffrey Davis M.A., of Tracking Wonder, there are five key attributes that we must develop and/or maintain:
The ability to direct and re-direct your attention
This isn’t just a task-related thing.This is about your mind itself. For example, the ability to recognize what your emotions are telling you, thank them for the message, and then set them aside. Or the ability to cut through negative thought spirals! How often have you worried about future events that didn’t transpire, or twisted yourself in knots over a past event that you can’t change?
Action: check out our previous article “The Off-Button For Your Brain” ← this is a technique for switching off racing thoughts, and it’s really good
Want more? We also did this:
The tendency to shape your time with intention and for impact
Time is an incredibly precious asset. How you use it is a very personal choice. You don’t have to maximize productivity (though you can if you want), but for example there’s a difference between:
- Deciding to spend an hour watching a TV show you really enjoy
- Wondering what’s on TV, browsing aimlessly, watching listlessly, just a distraction
In the former case, you are enjoying your time. Literally: you are experiencing joy during your time.
In the latter case, to borrow from Jim Steinman, “you were only killing time and it’ll kill you right back”!
Action: do a time audit for a week, and see where your time really goes, rather than where you expect or hope for it to go. Use this information to plan your next week more intentionally. Repeat as and when it seems like it might be useful!
The practice of constant improvement
Fun fact: you are good enough already. And you can also improve. You don’t have to, but improving in the areas that are meaningful to you can really add up over time. This could be becoming excellent at something for which already have a passion… It could also be brushing up something that you feel might be holding you back.
Action: do a quick SWOT* self-assessment. Then plan your next step from there!
*Strengths, Weaknesses, Opportunities, Threats. What are yours?
The ability to communicate and listen to others
A lot of this is about feedback. Giving and receiving feedback are often amongst the hardest things we do in the category of communication… Especially if the feedback is negative. How to decide what to disregard as baseless criticism, and what to take on board (and try not to take it personally), or the other way around, how to present negative feedback in a way that won’t trigger defensiveness.
Action: check out our previous article “Save Time With Better Communication” for some tips that really make relationships (of any kind) so much easier.
The commitment to positive experiences
Many things in life are not fun. Often, we know in advance that they will not be fun. The key here is the ability to make the most of a bad situation, and seek out better situations by your actions. Not like a lost person in a desert seeks water, but like a chess player who employs a general strategy to make tactical advantages more likely to appear.
Action: think about something you have to do but don’t want to. How could it be made more fun? Or failing that, how could it be made at least more comfortable?
See also: Working Smarter < Working Brighter!
Want to read more?
Check out: What Is Flourishing in Positive Psychology? (+8 Tips & PDF)
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Tell Yourself a Better Lie – by Marissa Peer
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As humans, we generally lie to ourselves constantly. Or perhaps we really believe some of the things we tell ourselves, even if they’re not objectively necessarily true:
- I’ll always be poor
- I’m destined to be alone
- I don’t deserve good things
- Etc.
Superficially, it’s easy to flip those, and choose to tell oneself the opposite. But it feels hollow and fake, doesn’t it? That’s where Marissa Peer comes in.
Our stories that we tell ourselves don’t start where we are—they’re generally informed by things we learned along the way. Sometimes good lessons, sometimes bad ones. Sometimes things that were absolutely wrong and/or counterproductive.
Peer invites the reader to ask “What if…”, unravel how the unhelpful lessons got wired into our brains in the first place, and then set about untangling them.
“Tell yourself a better lie” does not mean self-deceit. It means that we’re the authors of our own stories, so we might as well make them work for us. Many things in life are genuinely fixed; others are open to interpretation.
Sorting one from the other, and then treating them correctly in a way that’s helpful to us? That’s how we can stop hurting ourselves, and instead bring our own stories around to uplift and fortify us.
Get Your Copy of “Tell Yourself A Better Lie” on Amazon Today!
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Voluntary assisted dying is different to suicide. But federal laws conflate them and restrict access to telehealth
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Voluntary assisted dying is now lawful in every Australian state and will soon begin in the Australian Capital Territory.
However, it’s illegal to discuss it via telehealth. That means people who live in rural and remote areas, or those who can’t physically go to see a doctor, may not be able to access the scheme.
A federal private members bill, introduced to parliament last week, aims to change this. So what’s proposed and why is it needed?
What’s wrong with the current laws?
Voluntary assisted dying doesn’t meet the definition of suicide under state laws.
But the Commonwealth Criminal Code prohibits the discussion or dissemination of suicide-related material electronically.
This opens doctors to the risk of criminal prosecution if they discuss voluntary assisted dying via telehealth.
Successive Commonwealth attorneys-general have failed to address the conflict between federal and state laws, despite persistent calls from state attorneys-general for necessary clarity.
This eventually led to voluntary assistant dying doctor Nicholas Carr calling on the Federal Court of Australia to resolve this conflict. Carr sought a declaration to exclude voluntary assisted dying from the definition of suicide under the Criminal Code.
In November, the court declared voluntary assisted dying was considered suicide for the purpose of the Criminal Code. This meant doctors across Australia were prohibited from using telehealth services for voluntary assisted dying consultations.
Last week, independent federal MP Kate Chaney introduced a private members bill to create an exemption for voluntary assisted dying by excluding it as suicide for the purpose of the Criminal Code. Here’s why it’s needed.
Not all patients can physically see a doctor
Defining voluntary assisted dying as suicide in the Criminal Code disproportionately impacts people living in regional and remote areas. People in the country rely on the use of “carriage services”, such as phone and video consultations, to avoid travelling long distances to consult their doctor.
Other people with terminal illnesses, whether in regional or urban areas, may be suffering intolerably and unable to physically attend appointments with doctors.
The prohibition against telehealth goes against the principles of voluntary assisted dying, which are to minimise suffering, maximise quality of life and promote autonomy.
Some people aren’t able to attend doctors’ appointments in person.
Jeffrey M Levine/ShutterstockDoctors don’t want to be involved in ‘suicide’
Equating voluntary assisted dying with suicide has a direct impact on doctors, who fear criminal prosecution due to the prohibition against using telehealth.
Some doctors may decide not to help patients who choose voluntary assisted dying, leaving patients in a state of limbo.
The number of doctors actively participating in voluntary assisted dying is already low. The majority of doctors are located in metropolitan areas or major regional centres, leaving some locations with very few doctors participating in voluntary assisted dying.
It misclassifies deaths
In state law, people dying under voluntary assisted dying have the cause of their death registered as “the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying”, while the manner of dying is recorded as voluntary assisted dying.
In contrast, only coroners in each state and territory can make a finding of suicide as a cause of death.
In 2017, voluntary assisted dying was defined in the Coroners Act 2008 (Vic) as not a reportable death, and thus not suicide.
The language of suicide is inappropriate for explaining how people make a decision to die with dignity under the lawful practice of voluntary assisted dying.
There is ongoing taboo and stigma attached to suicide. People who opt for and are lawfully eligible to access voluntary assisted dying should not be tainted with the taboo that currently surrounds suicide.
So what is the solution?
The only way to remedy this problem is for the federal government to create an exemption in the Criminal Code to allow telehealth appointments to discuss voluntary assisted dying.
Chaney’s private member’s bill is yet to be debated in federal parliament.
If it’s unsuccessful, the Commonwealth attorney-general should pass regulations to exempt voluntary assisted dying as suicide.
A cooperative approach to resolve this conflict of laws is necessary to ensure doctors don’t risk prosecution for assisting eligible people to access voluntary assisted dying, regional and remote patients have access to voluntary assisted dying, families don’t suffer consequences for the erroneous classification of voluntary assisted dying as suicide, and people accessing voluntary assisted dying are not shrouded with the taboo of suicide when accessing a lawful practice to die with dignity.
Failure to change this will cause unnecessary suffering for patients and doctors alike.
Michaela Estelle Okninski, Lecturer of Law, University of Adelaide; Marc Trabsky, Associate professor, La Trobe University, and Neera Bhatia, Associate Professor in Law, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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10 Ways To Delay Aging
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This is Dr. Colin Rose; he is a Senior Associate of the Royal Society of Medicine. He’s also a main contributor to EduScience, a programme funded by the E.U. which is designed to enhance the teaching and learning of science in schools in Europe.
His most recent work has been about aging—and how to delay it. We also reviewed his latest book, here:
Delay Ageing – by Dr. Colin Rose
So, what does he want us to know? The key lies in his compilation of ten ways in which we age on a cellular level, and what we can to do slow each one of those:
Damage to DNA accumulates
While DNA can get damaged without any external stimulus to cause that, there are a lot of modifiable factors that we can do to reduce DNA damage. The list is easy: if it causes cancer, it causes aging.
Thus, check out: Stop Cancer 20 Years Ago
Cells become senescent
Our cells are replaced all the time; some sooner than others, but all of them at some point. The problem occurs when cells are outliving their usefulness. If a cell becomes completely immortal, that is cancer, but happily most don’t. Nevertheless, having senescent (aging) cells in the body means that those senescent cells are what get copied forwards by mitosis, and our DNA becomes like a photocopy of a tattered old photocopy of a tattered old photocopy. Which, needless to say, is not good for our health. So, the best thing to do is to kill them earlier:
Yes, really: Fisetin: The Anti-Aging Assassin
Mitochondria become dysfunctional
Without properly functional mitochondria, no living human cell can do its job properly.
Options: 7 Ways To Boost Mitochondrial Health To Fight Disease
Beneficial genes are switched off, harmful genes are on
It’s easy to think of our genes as being immutable, but epigenetics means that our environment (amongst other factors) can mean that our gene expression changes.
Imagine it this way: your genes are a set of instructions for your body. However, your body will act or not on those instructions, depending on other factors. Hormones often play a big part in this; for example sex hormones tell the body which set of genetic instructions to read (and thus what kind of body to build/rebuild), and cortisol or oxytocin can tell the body which set of contingency plans to activate or suppress (respectively). A milder example is gray hair; genes have the program for it, but many other factors inform the body when, if, and how to do it.
Of more concern when it comes to aging is what goes on with more critical systems, such as the brain, in which the aforementioned DNA damage can cause unhelpful instructions to get interpreted, resulting in epigenetic changes that in turn facilitate age-related degeneration.
As to what can be done, see : Klotho: Unzipping The Genes Of Aging?
Stem cells become exhausted
Stem cells can become different kinds of cells, and thus they’re very useful for maintaining a healthy body. However, they get depleted with age. We can slow down the rate of loss, though; for example, intermittent fasting can help:
Per Dr. Li’s 5 Ways To Beat Cancer (And Other Diseases)
And for more detail, see:
Doctor’s Tip: Regeneration (stem cells) — one of your body’s five defense systems
(complete with lists of foods to eat or avoid for stem cell health)
Cells fail to communicate properly
Cells need to talk to each other constantly, to continue doing their jobs. We are one big organism, after all, and not a haphazard colony of the countless cells that constitute such. However, cell signalling gets worse with age, which in turn precipitates others age-related problems. Fortunately, there are nutrients that can improve cellular communication.
For example: PS, We Love You ← this is about phosphatidylserine, also called “PS”
Telomeres become shorter
These protective caps on our DNA suffer the wear-and-tear so that our DNA doesn’t have to. However, as they get shorter, the DNA can start suffering damage. For this reason, telomere length is considered one of the most “Gold Standard” markers of cellular aging.
Here’s what can be done for that: The Stress Prescription (Against Aging!)
The body fails to sense nutritional intake properly
This is mostly about insulin signalling (though problems can occur in other systems too, but we only have so much room here), so it’s important to take care of that.
See: Turn Back The Clock On Insulin Resistance
Proteins accumulate errors
This is due to DNA damage, of course, but there are specific things that can reduce protein error accumulation; see for example:
A quick fix – preventing protein errors extends lifespan
See also: Rapamycin Can Slow Aging By 20% (But Watch Out)
The microbiome becomes unbalanced
We at 10almonds often mention that gut health affects pretty much every other kind of health, and it’s true for aging as well. So, take care of that microbiome!
Here’s a primer: Gut Health 101
Want to know more about delaying aging beyond the cellular level?
Check out: Age & Aging: What Can (And Can’t) We Do About It?
Take care!
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Does intermittent fasting increase or decrease our risk of cancer?
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Research over the years has suggested intermittent fasting has the potential to improve our health and reduce the likelihood of developing cancer.
So what should we make of a new study in mice suggesting fasting increases the risk of cancer?
Stock-Asso/Shutterstock What is intermittent fasting?
Intermittent fasting means switching between times of eating and not eating. Unlike traditional diets that focus on what to eat, this approach focuses on when to eat.
There are lots of commonly used intermittent fasting schedules. The 16/8 plan means you only eat within an eight-hour window, then fast for the remaining 16 hours. Another popular option is the 5:2 diet, where you eat normally for five days then restrict calories for two days.
In Australia, poor diet contributes to 7% of all cases of disease, including coronary heart disease, stroke, type 2 diabetes, and cancers of the bowel and lung. Globally, poor diet is linked to 22% of deaths in adults over the age of 25.
Intermittent fasting has gained a lot of attention in recent years for its potential health benefits. Fasting influences metabolism, which is how your body processes food and energy. It can affect how the body absorbs nutrients from food and burns energy from sugar and fat.
What did the new study find?
The new study, published in Nature, found when mice ate again after fasting, their gut stem cells, which help repair the intestine, became more active. The stem cells were better at regenerating compared with those of mice who were either totally fasting or eating normally.
This suggests the body might be better at healing itself when eating after fasting.
However, this could also have a downside. If there are genetic mutations present, the burst of stem cell-driven regeneration after eating again might make it easier for cancer to develop.
Polyamines – small molecules important for cell growth – drive this regeneration after refeeding. These polyamines can be produced by the body, influenced by diet, or come from gut bacteria.
The findings suggest that while fasting and refeeding can improve stem cell function and regeneration, there might be a tradeoff with an increased risk of cancer, especially if fasting and refeeding cycles are repeated over time.
While this has been shown in mice, the link between intermittent fasting and cancer risk in humans is more complicated and not yet fully understood.
What has other research found?
Studies in animals have found intermittent fasting can help with weight loss, improve blood pressure and blood sugar levels, and subsequently reduce the risks of diabetes and heart disease.
Research in humans suggests intermittent fasting can reduce body weight, improve metabolic health, reduce inflammation, and enhance cellular repair processes, which remove damaged cells that could potentially turn cancerous.
However, other studies warn that the benefits of intermittent fasting are the same as what can be achieved through calorie restriction, and that there isn’t enough evidence to confirm it reduces cancer risk in humans.
What about in people with cancer?
In studies of people who have cancer, fasting has been reported to protect against the side effects of chemotherapy and improve the effectiveness of cancer treatments, while decreasing damage to healthy cells.
Prolonged fasting in some patients who have cancer has been shown to be safe and may potentially be able to decrease tumour growth.
On the other hand, some experts advise caution. Studies in mice show intermittent fasting could weaken the immune system and make the body less able to fight infection, potentially leading to worse health outcomes in people who are unwell. However, there is currently no evidence that fasting increases the risk of bacterial infections in humans.
So is it OK to try intermittent fasting?
The current view on intermittent fasting is that it can be beneficial, but experts agree more research is needed. Short-term benefits such as weight loss and better overall health are well supported. But we don’t fully understand the long-term effects, especially when it comes to cancer risk and other immune-related issues.
Since there are many different methods of intermittent fasting and people react to them differently, it’s hard to give advice that works for everyone. And because most people who participated in the studies were overweight, or had diabetes or other health problems, we don’t know how the results apply to the broader population.
For healthy people, intermittent fasting is generally considered safe. But it’s not suitable for everyone, particularly those with certain medical conditions, pregnant or breastfeeding women, and people with a history of eating disorders. So consult your health-care provider before starting any fasting program.
Amali Cooray, PhD Candidate in Genetic Engineering and Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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